本文探討一位由腹膜透析轉血液透析病患的照護經驗，照護期間 2014 年 3 月 26 日至 5 月 31 日，筆者藉由觀察、會談、身體評估及查閱病歷收集資料，以 Gordon 十一項健康功能型態為評估架構，確立個案有無望感、營養不均衡：少於身體所需、 皮膚搔癢問題。個案因腹膜纖維化需面臨透析模式及生活習慣的改變，自主照護行為 被剝奪，產生無望感；因口腔潰瘍導致進食量少，產生營養不均衡；錯誤皮膚照護認 知，產生皮膚搔癢。筆者運用同理心，建立良好的護病關係，找出個案喜愛手做物的 興趣，藉由完成手做物達到成就感，讓個案重新自我價值認定，衛教口腔照護的方法 及合宜食物溫度，增加個案進食量，改善營養不均衡，提供正確皮膚照護方式，藉由 清涼型外敷製劑治療搔癢，將個案生、心理及社會層面之衝擊降至最低，提升生活品 質。

This paper describes providing nursing care to a patient that was transferred from CAPD to hemodialysis during the period of March 26 to May 31 of 2014. By means of observations, interviews, physical exams, medical data collections, and evaluations based on Gordon’s 11- item functional health patterns, the author established that the patient had several mental and physical issues, including a sense of hopelessness, imbalanced nutrition (less than body requirements), and pruritus. The patient underwent dialysis due to peritoneal fibrosis and lifestyle changes resulting in loss of self-care autonomy, less food intake because of oral ulcer which led to nutrition imbalance and pruritus from lack of proper skincare knowledge. During the care period, the author employed an empathic approach and was able to establish good caretaker-patient relationship. After finding out that the patient enjoyed making handicrafts, the caretaker encouraged the patient to pursue this hobby which brought him a sense of achievement and improved self-worthiness. The patient was educated on oral care and appropriate food temperature that led to increase of food intake and improved nutrition balance. Appropriate skin care methods were also taught to the patient, including the use of topical cooling agents to treat pruritus. The author was able to improve the patient's quality of life by minimizing the physical, mental, and social impacts suffered by the patient.