本文在分享協助一位長期高血壓導致突發性末期腎病個案，面對初次腹膜透析治療之護理經驗，護理期間為2011年4月26日至2011年5月15日，筆者以Gordon十一項功能性健康型態為評估架構，透過身體評估、觀察、會談及病歷查閱方式收集資料，發現個案有體液容積過量、焦慮、身體心像紊亂之健康問題。個案在突然被告知需靠洗腎維生的緊急情況下，決定接受腹膜透析治療，並在透析後面臨生理與身體外觀改變，導致極大的生、心理壓力。筆者藉由傾聽、關懷、陪伴、同理，與個案建立護病夥伴關係，在信任基礎下引導個案訴說焦慮，正向面對壓力，後續運用跨領域團隊合作照護，照會腹膜透析護理師指導透析相關知識與技能，照會營養師提供飲食指導，照會社工師共同提供心理支持與諮商，邀請病友提供經驗分享，並鼓勵家屬主動關懷與心理支持，協助個案學習腹膜透析技巧與正向面對身體心像的改變，再度重回職場，開創與腹膜透析共存的新生活。此典型的成功照護經驗，為選案與執筆分享之理由，建議照顧初次腹膜透析個案需以關懷為起點，協助個案敞開心房、紓解壓力，再以跨領域團隊照護、病友經驗分享，解決個案生心理層面的問題，面對從此不同的新人生。

This paper describes nursing care for an ESRD patient with rapid onset of end stage renal disease (ESRD) from long-term hypertension starting peritoneal dialysis for the first time. During the care period from April 26 to May 15, 2011, we assessed the patient using Gordon’s functional health patterns and gathered information through physical examination, observation, interview, and review of medical records. Problems we identified included fluid overload, anxiety and body image disturbance. The patient’s physical and emotional stress was caused by not being prepared for peritoneal dialysis before deciding to start treatment and difficulties in coping with the physiological and physical changes. Through listening, loving care, companionship, and empathy, we developed trust in the nurse–patient relationship while also helping the patient with reducing anxiety and reacting positively to pressure. Along with the comprehensive care delivered by the multidisciplinary team of physicians and peritoneal dialysis nurses offering detailed information on the treatment and care, dieticians providing nutrition and diet advice, social workers extending psychological support and counseling as well as assistance from the support group and family members’ encouragement, the patient learnt to live with peritoneal dialysis, adapt to the changes with a positive attitude and returned to work successfully. Emotional care and support, a multidisciplinary team approach, and experience sharing from the support group are all critical when caring for patients undergoing peritoneal dialysis for the first time. By sharing this care strategy, we hope to improve the quality of peritoneal dialysis care.