腎臟移植手術後病人的生理、心理、社會與靈性議題

　　　　　腎臟移植是目前治療末期腎臟疾病的方法之一。接受腎臟移植手術後，新的器官發揮功能，並不代表脫離與慢性病共存的生活，而是另一種慢性疾病生活的開始。移植手術後不只希望病人能活著，還期望他們能夠執行日常生活活動，擁有心理安適與良好的生活品質，同時能依據個人的發展階段，負起個人在家庭及社會上的角色功能。接受腎臟移植手術後病人不只面臨生理方面的問題，如：感染與排斥的威脅、長期合併症等，也面臨許多心理與社會的壓力，如：憂鬱情緒、低自尊感、家庭互動關係改變、就業問題等。在目前的移植照護，護理人員扮演著極重要的教育指導與諮詢的角色與責任，因此應藉由措施的介入協助病人因應。本文探討了接受腎臟移植手術後病人在生理、心理、社會與靈性層面可能面臨的改變與問題，並提出對未來研究的建議，期使移植照護實務能夠更統整且適於病人。
　　　　　Kidney Transplantation (KT) is one of the best treatments for patients with end-stage renal disease. The "new" organ starts functioning after transplantation, but this doesn't mean that the patient now lives without chronic illness. On the contrary, the patient is actually living with another chronic disease. KT not only keeps patients alive, but also encourages them to live their daily lives well, enjoying better psychological well-being and quality of life, and playing role functions and taking responsibilities based on their development tasks. But, KT patients encounter physical problems (infection, rejection, and long-term complications), psychological problems (social stresses, depression, low self-esteem, and altered family interaction), and unemployment issues. Nurses play an important role in assisting KT patients and should adopt appropriate interventions, education programs, and psychological counseling programs to help them to cope with their stresses. This article discusses the physical, psychological, spiritual, and social issues affecting KT patients and seeks to propose suggestions regarding future studies and KT care.