Walker Rachael, Abel Sally, Meyer Alannah
Renal Department, Hawkes Bay District Health Board, Hastings.
Nurs Prax N Z. 2010 Aug;26(2):26-34.
In New Zealand, and globally, the incidence of patients developing chronic kidney disease and entering the pre-dialysis phase is increasing at approximately 6% per year. The specialist pre-dialysis nurse plays a key role in providing care to this complex group of chronically ill people, but as yet no literature indicates what constitutes effective pre-dialysis nursing care. This paper reports on qualitative research that asked a group of New Zealand specialist renal nurses what they believed comprised effective pre-dialysis nursing care. Semi-structured phone interviews were undertaken with eleven pre-dialysis nurses from throughout the country. Through inductive analysis a number of key themes were identified. These were; a strong nurse patient relationship, a comprehensive holistic nursing assessment and timely and appropriate patient education. Commonly used measurable indicators, timely initiation of dialysis and formation of dialysis access prior to treatment, were also considered important but essentially seen as out of the nurse's control. We argue that to ensure pre-dialysis care is effective it is important to not only measure quantifiable parameters but also consider the qualitative elements identified as being at the heart of effective pre-dialysis nursing practice.
在新西兰乃至全球范围内，患慢性肾病并进入透析前阶段的患者发病率正以每年约6%的速度上升。专科透析前护理护士在为这群复杂的慢性病患者提供护理方面发挥着关键作用，但目前尚无文献表明有效的透析前护理包括哪些内容。本文报告了一项定性研究，该研究询问了一群新西兰专科肾脏护士，他们认为有效的透析前护理包括哪些方面。对来自全国各地的11名透析前护理护士进行了半结构化电话访谈。通过归纳分析，确定了一些关键主题。这些主题是：牢固的护患关系、全面的整体护理评估以及及时且恰当的患者教育。常用的可衡量指标、及时开始透析以及在治疗前建立透析通路，也被认为很重要，但基本上被视为超出护士的控制范围。我们认为，为确保透析前护理有效，不仅要衡量可量化参数，还应考虑那些被确定为有效透析前护理实践核心的定性因素，这一点很重要。
