一位移民單親媽媽面臨胃癌手術威脅之護理經驗

Nursing Care of an Immigrant Single Mother Following Surgery for Gastric Cancer

本文描述一位55歲移民單親媽媽，因罹患胃癌引發因應能力失調等問題的護理經驗。個案在2008年初開始有胃痛情形，皆在家附近診所求醫，2011年4月6日因食慾下降、解黑色柏油便，至本院求診。自2011年4月10日至4月20日於腸胃科病房之護理期間，筆者以Gordon十一項健康功能評估進行護理評估，藉由觀察、會談、身體評估等方法收集資料，發現個案有：個人因應能力失調、營養少於身體所需、組織完整性受損、疼痛之護理問題。手術後初期改善疼痛與組織完整性受損，藉由藥物及非藥物預防疼痛再發；其次在恢復期針對因應能力失調為重點，因個案為新移民，支持系統薄弱且擔心女兒學業及經濟問題，經醫療小組會議由社工辦理「外籍配偶社會資源網絡」，以及聯繫家扶中心等相關社會資源，協助個案應用社會資源以增進因應能力解決困境。由此顯示護理人員運用團隊及社會資源進行轉介及追蹤，可以改善個案之問題，建議護理人員可加強此方面之能力培訓，並期望藉由此次護理經驗的分享，作為護理人員日後照護相關個案之參考。

This study describes the nursing experience of an immigrant single mother with ineffective individual coping triggered by gastric cancer. The woman had a stomachache in early 2008 and originally saw doctors at the clinics around her house. She came to our hospital on April 6th, 2011 due to poor appetite and tarry stools. During the hospitalization from April 10th to 20th, 2011, a nursing assessment was conducted based on Gordon’s functional health patterns, and data were collected through observation, interviews, and body assessment. The major nursing problems included ineffective individual coping, impaired nutrition that was less than that required by the body, impaired skin integrity and pain. At the initial stage following the operation, we focused on pain relief and the recovery of impaired skin integrity, as well as preventing pain occurrence by medication and nonmedication treatment. At the convalescent stage, the priority is to improve the ineffective individual coping of the patient. The patient is an immigrant with weaker social support and constant worries about her daughter’s financial and studying problems, so we asked for social resources assistance including introducing her to a “Social Resource Network for Foreign Spouses” by social workers and contact with a Family-Support Center to help the patient strengthen her individual coping ability and overcome the difficulties. This approach means nurses can utilize teamwork or social resources to help the patient solve problems. We hope this experience can be used as a reference in future nursing care.