運用泛文化理論照護一位胎死腹中印尼籍產婦之護理經驗

Nursing Experience of Caring a Stillborn Indonesian Woman Using Transcultural Theory

本文描述運用泛文化照顧理論照護一位懷孕23+6週印尼籍初產婦，產檢時發現胎死腹中並經歷引產疼痛、周產期失落面臨哀傷調適過程之護理經驗。護理期間為2021年11月13日至11月15日。筆者於住院期間深入瞭解個案文化背景、建立良好關係，藉由觀察、身體評估及會談方式收集資料，評估個案生理、心理、社會、文化與靈性層面，確立有產痛、哀傷、知識缺失的健康問題。於護理過程中，教導個案按摩、熱敷等措施來因應產痛並播放其喜好之印尼音樂轉移注意力；運用傾聽陪伴、心理支持等方式關懷個案，陪伴一同面對哀傷情緒並尊重其宗教信仰共同討論後續葬儀流程；針對不瞭解產後復舊及文化差異造成的知識缺失，提供印尼版衛教單張並利用翻譯工具溝通，瞭解印尼產後習俗後，以不批判的角度與個案討論差異性，實際教導如何按摩子宮並搜尋可利用資源，如：提供本院電話及衛生所資訊以利個案日後有管道可尋求幫助。隨著越來越多的外籍人士來台生活，在臨床照護上除了專業度也需瞭解其文化背景。期望藉由此次護理經驗分享能提供臨床護理人員照護此類個案的參考，以提升照護品質。

This article describes the nursing experience of using transcultural nursing theory to care for an Indonesian primipara who was 23+6 weeks pregnant and suffered fetal death, as discovered during an obstetric examination. She also experienced labor pain during induction and underwent the adjustment process following perinatal loss and grief. The care period was from November 13th to November 15th, 2021. During the hospitalization, the author explored the patient’s cultural background, built a strong rapport, and collected data through observation, physical assessment, and interviews. This comprehensive approach assessed the patient's physical, psychological, social, cultural, and spiritual aspects, identifying issues such as labor pain, grief, and lack of knowledge. In response to the patient's labor pain, the author taught techniques such as massage and hot compresses, and played the patient’s favorite Indonesian music to help divert her attention. Psychological support was also provided through active listening, companionship, and emotional support to help her cope with grief. The author respected the patient's religious beliefs and facilitated discussions about the funeral process. To address the patient's lack of knowledge regarding postpartum care, influenced by cultural differences and unfamiliarity with Taiwanese healthcare practices, the author provided an Indonesian-language health education leaflet and communicated using a translation tool. After learning about Indonesian postpartum customs, the author discussed these cultural differences with the patient in a nonjudgmental manner, teaching techniques such as uterine massage and sharing available resources. The author provided contact information for the hospital and local health bureaus, ensuring that the patient had channels for future support. As more foreigners come to live in Taiwan, it is essential not only to provide proficient clinical care but also to understand the cultural backgrounds of patients. This nursing experience aims to offer valuable insights to clinical nurses, improving the quality of care for patients from diverse cultural backgrounds.