照顧一位二尖瓣術後併心衰竭越南籍住民之加護經驗

A Nursing Experience of a Vietnamese Patient with Heart Failure After Mitral Valve Surgery

羅靜宜(Ching-Yi Lo) ； 康芳瑜(Fang-Yu Kang)

《志為護理-慈濟護理雜誌》 17卷5期 (2018/10) Pp. 113-122

摘要

本文主要探討照護一位越南籍女性因風濕性心臟病導致二尖瓣閉鎖不全，進行瓣膜置換術後之護理過程。肇因於文化背景的差異，以Leininger泛文化照顧理論為基礎，協助病人緩解臨床症狀及對環境不熟悉所產生的焦慮，筆者護理期間為2013年12月31日至2014年1月12日，藉由觀察、與家屬互動以及使用越南文讀字卡，鼓勵病人以語言及非語言表達，收集資料中發現病人在加護病房期間，最主要護理問題為：體液容積過量、營養少於身體所需及焦慮；擬定護理計畫時邀請家屬一起參與，擺脫加護病房門禁限制外，也同時啟動跨團隊照護機制解決病人飲食文化的差異，達到跨文化的融合，過程不僅增加病人對團隊的信任感也降低對環境的焦慮，藉此提供照護相關病人臨床護理人員運用。

關鍵字

泛文化照顧理論 ； 風濕性心臟病 ； 焦慮

並列摘要

The article discusses a nursing experience of a female Vietnamese patient with mitral insufficiency caused by rheumatic heart disease after a mitral valve replacement. Due to the differences in cultural background, Leininger's theory of cultural care diversity and universality was employed as a conceptual framework to assist the patient in relieving clinical symptoms, and anxiety caused by unfamiliarity with the environment. The nursing period lasted from Dec. 31^(st), 2013 to Jan. 12^(th), 2014. Data were collected through observation, interaction with the family members using Vietnamese word cards, and communication with the patient via verbal and non-verbal expressions. The patient's main nursing issues during the nursing period were excessive fluid volume, imbalanced nutrition less than body requirements, and anxiety. The family members were invited to participate in the draft of nursing plans. In addition to removing the limitation of ICU visiting hours, multidisciplinary care mechanism was initiated to solve the cultural dietary differences and to achieve cross-culture integration. During the nursing period, the patient's trust in the team had increased, and the anxiety towards the unfamiliar environment decreased. We would like to offer the nursing experience as a reference for clinical nursing staff when attending patients of different culture.

並列關鍵字

anxiety ； Leininger Culture Care Theory ； rheumatic heart disease