一位新移民女性罹患直腸癌留置腸造口之護理經驗

Caring for a New Immigrant Female Patient Receiving Colostomy for Rectal Cancer

10.6880/TJON.202106_21(1).07

張簡瑞敏(Jui-Min Chang Chien)；柯幸芳(Hsing-Fang Ko)

Leininger泛文化理論 ； 結直腸癌 ； 身體心像紊亂 ； 知識缺失 ； leininger transcultural theory ； colorectal cancer ； body image disturbance ； knowledge deficit

腫瘤護理雜誌

21卷1期（2021 / 06 / 01）

75 - 86

繁體中文

本文描述一位越南籍女性嫁至台灣，經診斷為直腸癌並接受腸造口留置手術，由於對台灣的醫療環境陌生，擔心語言溝通不良，需要學習腸造口照護技能，面對身體結構上的改變，出現不安、沮喪及對自己身體逃避等行為反應。筆者於2018年4月9日至2018年4月20日護理期間，以Leininger泛文化照護理論對病人進行跨文化及生、心理層面等護理評估，運用會談、傾聽及觀察收集資料，歸納、整理收集相關資料，確立主要健康問題有急性疼痛、身體心像紊亂及知識缺失。護理過程中，生理方面除了使用藥物控制疼痛外，運用文化照護層面之保存與維持原有民俗按摩技巧，配合精油及音樂療法使文化與醫療融合，達到緩解病人的疼痛問題；心理方面運用陪伴與家屬的支持，給予關懷及鼓勵，使病人能接受腸造口為身體的一部分；運用翻譯軟件，將腸造口相關衛教單張翻譯成越南語，指導病人學習腸造口照護，以解決病人對腸造口認知缺乏。建議臨床護理人員，照護此類病人時，需將文化背景列入考量，將文化差異性做為護理措施依據，達到跨文化的融合，期盼藉由本文可作為日後護理人員照護此類病人之參考。

This article describes the clinical nursing experience of a Vietnamese immigrant female patient with rectal cancer receiving colostomy. Faced with the new physical changes and new unfamiliar medical environment in Taiwan, the patient worried about the inability to communicate or to learn the colostomy self-care. She experienced related uneasiness, depression, and refusal to accept changes of her body. The nursing period was from April 9, 2018 to April 20, 2018. The author collected data through conversation, listening, and observation by applying the Leininger's Transcultural Care Theory, and the following health problems were identified: acute pain, body image disturbance, and knowledge deficit. During the nursing period, pain medications, awareness of cross-culture gap, traditional massage as well as aromatherapy and music therapy were provided to add the element of culture-cognizance to healthcare in the hopes to achieve pain relief for patient in the physical aspect; the researcher also provided companionship and support of family members to express care and encouragement so that the patient could accept and consider the colostomy as a part of her body; we used translation software to translate the Chinese version of health education manual on colostomy care into Vietnamese to help the patient to learn colostomy care and gain knowledge on colostomy care. We suggest that the clinical nurses should take cultural background into account and include the cultural differences as the basis of nursing intervention to achieve cross-cultural fusion when caring for such patients. The author hopes the finding of this research can be a reference for similar situations in the future.

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