照護一位新住民產後乳房膿瘍之護理經驗

新住民因文化背景差異、語言溝通障礙，對於就醫意願，面臨相當大困境，乳房膿瘍是哺乳期婦女最害怕的急性炎症，若無妥善治療可能導致乳房組織受損，甚至演變為敗血症。本文描述一位文化背景差異之越南籍婦女因產後乳房膿瘍需住院接受抗生素治療之護理。護理期間自2019/6/17至2019/6/29，共13日，運用Gordon十一項健康功能型態進行整體護理評估，並藉由觀察、身體評估、互動溝通等方式收集資料及歸納分析，確立個案主要健康問題有急性疼痛、健康尋求行為、母乳哺餵中斷。在護理過程中，因與個案有語言溝通障礙，故透過主動關懷陪伴與個案和案夫建立良好信任關係，依其個別性及獨特性與個案、案夫和醫療團隊成員共同擬定照護計畫，藉由翻譯人員、網絡資源、自製越語圖卡、肢體語言、疼痛量表等溝通照護技巧並提供傷口照護相關資訊，協助個案減輕傷口疼痛及提供國際泌乳顧問維持乳汁分泌，建立自信心，提升自我傷口照護能力。經此照護，讓個案及案夫不僅對醫療照護信任感增加，亦達跨文化融合照護。冀望藉此護理經驗，提供日後護理人員照顧類似個案之參考。建議醫療院所可增加多國國籍母乳哺餵相關資訊及語言人才庫，助於解決語言溝通不良產生的問題，協助個案成功持續哺餵母乳，提供更優質的照護。

關鍵字

乳房膿瘍；語言溝通障礙；新住民

並列摘要

Due to differences in cultural background and language communication barriers, new immigrants face a great dilemma in their willingness to seek medical treatment. Breast abscess is one of the most feared acute inflammatory diseases among lactating women, which may lead to damage of breast tissue and even sepsis if not properly treated. This article describes the care of a Vietnamese woman hospitalized and treated with antibiotic therapy for a postpartum breast abscess. During the care period from 2019/6/17 to 2019/6/29, a total of 13 days, a holistic care assessment was conducted using Gordon's 11 Health Functioning Patterns, and information was collected and summarized through observation, physical assessment, and interactive communication. The main health problems of the patient were identified as acute pain, health seeking behavior, and interruption of breastfeeding. During the caregiving process, due to language barriers, we sought to establish a good relationship of trust with the case patient and her spouse through proactive care and companionship. We developed a nursing care plan with the case patient, her spouse and the medical team members according to the case's individuality and uniqueness. We provided information about wound care through communication and care skills such as interpreters, internet resources, self-made Vietnamese-language picture cards, body language, and pain scales, thereby assisting the case patient to reduce wound pain and provide assistance through IBCLCs to maintain lactation, build self-confidence and enhance self-care ability. Through this care plan, not only did the trust of the case patient and her spouse in the quality of medical care delivery increase, but it also bridged language barriers and achieved the cross-cultural integration of care. It is hoped that this experience will serve as a reference for future caregivers in caring for similar cases. It is suggested that the medical institution can increase the multinational breastfeeding related information and language talent pools to help solve the problems arising from poor language communication, and help patients to continue breastfeeding and provide better quality medical care.

並列關鍵字

Breast Abscess ； language communication barriers ； New Immigrant Postpartum

主題瀏覽