協助有外籍母親及聽障幼兒家庭之護理過程

The Nursing Process in Helping a Family with Foreign Mother and Hearing Impaired Child

本文係探討一位重度聽障致語言發展遲緩幼兒的照護過程，於首次訪視時發現個案年齡已二歲六個月，但卻無任何語言行為，僅以視覺、觸覺、肢體動作與他人溝通，對任何聲音刺激無反應。經進一步深入瞭解，個案之母親為越南籍，由於文化差異及養育認知的不足，加上個案合併有重度聽障及發展遲緩，因而收案管理及追蹤。在半年的照護期間，藉由家訪、電訪、會談及專業團隊的諮詢評估等方式收集資料，撰寫成行為過程記錄，將資料加以分析、歸納，呈現以下的問題：（1）聽障導致語言發展遲緩，自我保護能力受限；（2）家屬對發展遲緩認知偏差；（3）社區資源不足；（4）外籍母親對育兒的無力感。除了提供個案及家屬的支持照護、諮詢外，並予轉介、資源整合，更擔起各專業間協調者之角色，以協助個案父母面對發展遲緩兒之心理適應，及獲得較正確的認識與判斷，進而使個案之父母態度轉為正向積極。由於護理及時的介入與處置，期能將障礙的程度減到最低，並協助並發其潛能。

This case report aims to present a nursing experience involving a child with severe hearing impairment and delayed language development. The patient was discovered during a home visit. At the time she was two and a half years old, but still had not developed any language behavior. She only used eye contact, physical touch, and body language to communicate with her family. She also did not responsd to sound stimulation. The results of a Denver Developmental Screening Test (DDST) showed delayed development, especially of language. The child's mother is from Vietnam. The culture, education, language, and environment of Vietnam are totally different from Taiwan. In addition, the mother did not know how to raise her child. So the author tried to follow up on the case. Data were collected by home visits, phone calls, interviews, and communication with members of a professional health care team during the nursing care period (about six months). Data were recored and it was written a processing analyzed. They revealed five health problems, as follows: (1) hearing impairment causing delayed language development; (2) poor family recognition deviation understanding of delayed development; (3) insufficient community resources; (4) low self-protection, limited capacity for caused by hearing impairment; (5) foreign mother's sense of helplessness about raising the child. The author provided supportive care to the patient and her family, counseled them, and transfered the child quickly to a treatment center. She also coordinated resources and the professional care team in assisting the parents in facing and adapting to the childs developmental delay. As a result, the parents gained knowledge and the ability to make judgments about developmental delay. This fostered a positive attitude on their part and acceptance of the child's admission to the treatment center. The child and family could deal with their problems appropriately because the nurse intervened at the appropriate time with the aim of reducing the obstacles to their doing so. This enabled the child's handicap to be minimized and her potential to be developed.