ABSTRACT
Resumen La hemodiálisis es una técnica de sustitución de la función renal. Los pacientes sometidos a hemodiálisis reciben tres sesiones semanales (en promedio), de cuatro horas cada una. En estos pacientes emergen emociones negativas que afectan la calidad de vida del paciente. Presentación del caso: Paciente femenina, de 55 años, con insuficiencia renal crónica, secundaria a un proceso glomerular de diabetes, manifiesta que su vida ha cambiado negativamente desde que se le indicó hemodiálisis. La paciente presenta un claro aislamiento social relacionado con el cambio de su imagen corporal y de su baja autoestima, así como una alteración de la integridad cutánea, vinculado con prurito y sequedad de piel. Se elabora e implementa un plan de cuidados siguiendo las normativas NANDA, NOC y NIC. Se evalúan los resultados tras la aplicación de las intervenciones propuestas. En este caso clínico se destaca la importancia de la participación, de aquellos pacientes en la misma situación, en un grupo de apoyo. Las intervenciones de enfermería, para gestionar las emociones del paciente en hemodiálisis, son eficaces. Las mismas se basan en la evidencia científica más actual. En ocasiones, los enfermeros se centran tan solo en el problema físico y la mejor forma de abordarlo, pero resulta fundamental considerar del mismo modo el aspecto emocional de los pacientes, y saber enseñarles, como se ve en el presente caso, a gestionar estas emociones para mejorar su bienestar y su calidad de vida.
Abstract Introduction: Hemodialysis is a renal replacement therapy technique. Patients receiving this treatment have three sessions per week (average) for four hours. This arouses negative feelings in these patients, affecting their life quality. Case presentation: Case presentation: A female subject, aged 55, with chronic kidney failure, secondary to diabetic glomerular disease, states that her life has changed negatively since hemodialysis was prescribed. Assessment: Is clear that the patient is experiencing social isolation due to a change in her body image and low self-esteem, as well as skin damage caused by itching and dry skin. Care plan: A care plan is prepared and implemented following the NANDA, NOC and NIC standards. Results are evaluated after the application of the proposed interventions. In this case, the importance of the participation of patients in the same situation in a support group is highlighted. Conclusion: Nursing interventions to manage hemodialysis patient emotions are effective. They are based on the most current scientific evidence. Sometimes, nurses only focus on the physical problem and the best way of handling it, but it is essential to consider the emotional aspects of patients as well and to teach them, as shown in this case, to manage these emotions in order to improve their wellness and life quality.
ABSTRACT
The landscape of HIV has changed from an incurable disease to be more like a chronic disease as the result of advances in medications; the lifespan of People Living with HIV (PLHIV) has also lengthened, HIV defining diseases are delayed, and many of the complications of HIV prevented with adherence to medications. The stigma and discrimination of HIV remain however. PLHIV need to cope with emotional issues of guilt, shame, and self-blame; social issues of rejection, termination of employment, fear and bad social experiences. The paradigm shift from negative regard of PLHIV to that of empathy, which is a deliberate and conscious attitude to relate to PLHIV as fellow travellers in life, to be able to feel with them rather than against them, has therapeutic effects. Empathy has its processes of active listening, responding with appropriately chosen words to describe feelings of the patients, and reflecting the desire to understand more about the patient’s emotions and social turmoil. The benefit of empathy in counseling are the ability to connect with the patient, to build trust from the patient being counseled, and a more objective perspective of being able to see the patient from his/her perspective rather than from the therapist’s perspective. More importantly empathy is a positive response to emotional and social issues experienced by the patient compared to platitudes like “You will be alright; or “don’t worry”, which negate and minimise the opportunity to have a catharsis.