本文探討一位慢性腎衰竭個案初期接受血液透析治療，於治療期間因無望感出 現自殺行為之護理經驗。筆者於 2013 年 1 月 20 日至 3 月 16 日護理期間，應用 Gordon 十一項功能性健康型態評估，藉由身體評估、會談、電訪、查閱病歷等方式 收集資料，加以分析整理，確立個案有：（1）自我殘害；（2）體液容積過量；及 （3）營養少於身體所需之健康問題。護理過程中，透過主動關懷、傾聽及接納內心 的感受與想法，藉由家庭、社會支持及協助個案與腎友互相支持與意見交流，找到自 我價值與自信，減少個案自殺的意念；擬定個別性護理計劃，教導控制水份攝取量、 執行體重自我監測與記錄、飲食衛教及血液透析治療，改善透析期間體液容積過量問 題；利用護理指導方式，同時會診營養師，提供營養諮詢與計劃，建立良好的飲食習 慣，滿足個案之營養需求。個案對長期透析時能正向調適及面對疾病所帶來的衝擊， 進而重建自信並找回對生命的信心與希望，恢復往日生活型態。

This article discusses and posts the experience of caring a chronic kidney disease patient, who after receiving initial hemodialysis therapy, presented suicidal behavior due to sense of hopelessness from the disease and treatment. During patient care period from 2013 January 20 to March 16, the author used Gordon’s eleven functional health patterns assessment techniques to collect data, including physical assessment, interviews, medical records, etc., From analysis, it was determined that the case subject had below health problems: (1) Self-mutilation (2) excess of fluid volume and (3) nutrition less than body requirements. During caring process, apart from providing active care, the author also gave careful attention and accepted the patient’s internal feelings and thoughts. Through assistance from family members, social support and interaction with other dialysis patients the author helped him to regain self-worth and self-confidence, and diminished his suicidal thoughts. Furthermore, individualized caring program was developed that included education on how to manage daily fluid intake, the use of self-monitoring body weight assessment form, suggested diet plan for hemodialysis treatment, to help in controlling/diminishing fluid excess during dialysis. By providing appropriate caring guidance together with dietitian’s advice to meet the nutritional needs, the case subject was able to adjust positively towards hemodialysis treatment and face the impact of disease, eventually rebuild self-confidence, regain hope and resume to a healthy lifestyle.