一位單親新住民罹患乳癌併骨轉移之照護經驗

Caring for a Single New-Resident Alien Mother Suffering from Breast Cancer and Bone Metastases

10.6880/TJON.202112_21(2).07

陳玫君(Mei-Jun Chen)；標芸菱(Yun-Ling Biao)；王姮樺(Heng-Hua Wang)；陳繪竹(Hui-Zhu Chen)；李文馨(Wen-Hsin Lee)

乳癌 ； 慢性疼痛症候群 ； 單親新住民 ； 嗜中性白血球低下 ； breast cancer ； chronic pain syndrome ； single-parent new-resident ； neutropenia

腫瘤護理雜誌

21卷2期（2021 / 12 / 01）

79 - 92

繁體中文

本文探討一位越南籍單親母親，罹患乳癌併骨轉移引發生理、心理問題，面對此衝擊還需要擔心經濟匱乏及遺孤照顧。筆者護理期間於2018年7月26日至8月3日，藉由會談、觀察及傾聽等方式，依生理、心理、社會及靈性做資料歸納與收集，確立個案有無效性保護能力、慢性疼痛症候群及持家能力障礙的健康問題。於照護過程中，提供化療後預防感染相關知識及增加免疫能力方法，亦能讓個案返家後獲得持續性的照護；同時教導正確使用止痛藥方式並利用穴道按摩、熱敷、按摩技巧、轉移注意力等措施減輕疼痛，配合物理及職能進行復健運動加強肌肉張力達到自我身體控制；會同心理諮商團隊協助溝通與確認問題，並尋求社會資源以解決經濟上壓力，並強化案子獨立自主生活能力，以消除個案對託孤擔憂的問題。我國單親新住民女性配偶人數日漸增，罹癌後家中子女仍未成年，面臨社會支持系統薄弱且擔心遺孤照顧及經濟問題，經由社會資源整合援助，強化孩子獨立自主的能力及教導學習生活技能，繼而解決託孤的問題，落實以家庭為中心的照護理念，希望藉由此經驗能做為日後護理人員臨床照護上之參考。

This thesis discusses the case of a single Vietnamese mother with breast cancer and bone metastases dealing with physical and mental health issues. She also had to cope with the financial distress and anticipated orphan care. The period of nursing carried out by the author was from July 26 to August 3, 2018. Through interviews, observation, and attentive listening, data induction as well as collection were conducted in the aspect of physiology, psychology, sociology and spirituality; and the health problems of the patient were established as ＂ineffective protection＂, ＂chronic pain syndrome＂ and ＂inability to maintain the family＂. The care process entailed providing knowledge on infection prevention after chemotherapy and immunity boosting methods, which allowed the patient to receive continuous care upon returning home. At the same time a guide to the safe use of painkillers was given. The use of acupressure, warm compression, massage techniques, distracting attention, and other measures were provided to reduce pain. The physical and occupational therapy were incorporated in the rehabilitation exercises to increase muscle tone and attain self-control of the body. Communication and the identification of issues were achieved with the assistance of a mental health counseling team, which also helped seek social resources to overcome financial difficulties, strengthening the patient's ability to live independently and to eliminate worries about her child's future. At present, the number of the new-resident alien single female spouses in our country is gradually climbing. Many of the children in these family have not yet reached adulthood when their mothers are diagnosed with cancer. To address the weak social support system and worries about the orphan care and finances, the integration of social resources can be utilized to strengthen the children's ability to live independently and acquire professional skills, thereby resolving the problem of orphan entrustment. Implementing the family-centered care concepts, we hope that these experiences can serve as a clinical care reference for the nursing staff.

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