| Summary: | 碩士 === 長榮大學 === 護理學系(所) === 103 === The prevalence of end stage renal disease （ESRD） in Taiwan is the highest in the world; diabetic nephropathy is the primary reason that patients receive hemodialysis. The purpose of this study was to observe the actual physical experiences of middle-aged patients dealing with diabetic nephropathy and receiving hemodialysis. A qualitative phenomenological approach was employed at a teaching hospital in southern Taiwan from November 2014 to May 2015. Targeted sampling was used to recruit participants. The data from 12 middle-aged diabetic nephropathy patients receiving hemodialysis was collected using in-depth interviews. Colaizzi’s phenomenological analysis method was used for data analysis, and the analysis results were categorized into 4 themes and 10 subthemes. The themes of real life experiences included：(a) Mental and physical suffering: refusing hemodialysis and desiring to end their lives; regarding life pessimistically; being disturbed by their diabetic and hemodialysis conditions. (b) Life limitations: obstruction of normal life and leisure activities; the pressure induced from financial hardship. (c) Adaptation: being open-minded and permitting others to assist them; changing their mind to accept hemodialysis; learning to improve their self-health; and (d) End-of-life evaluation: feeling their lives were like a candle flickering in the wind as they awaited death; appreciating their lives and families. The results of this study can clarify the mental and physical suffering, life limitations, adaptation, and end-of-life evaluation among diabetic nephropathy patients receiving hemodialysis. These results can provide useful information to improve nursing care and thereby to improve patient’s lives.
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