一位新住民初次罹癌引發因應能力失調之照護經驗

The Nursing Experience of Managing Ineffective Coping in a new Immigrant Diagnosed with Cancer

臺灣新住民人口漸增，現已成為臺灣第五大人口族群，然而在不同的文化、語言及環境適應的改變下，若面臨癌症病程時將承受更大的壓力。本文描述一位初罹患子宮頸癌之新住民女性，因缺乏支持系統以及對於治療計劃茫然無措，進而引發因應能力失調，出現言行激動行為之照護經驗。護理期間自2020年11月11日至12月1日，藉由臨床照護、直接觀察、身體評估、會談等方法進行資料收集，運用Gordon十一項功能性健康評估工具，發現個案有排尿功能障礙、知識缺失、因應能力失調等健康問題。照護期間製作印尼文之健康照護圖本及圖卡進行衛教，增進雙側腎造口引流管路之自我照護，以及提供子宮頸癌、放射線治療副作用照護及資訊；透過探視陪伴、鼓勵和引導、運用靈性技巧與跨領域團隊合作，協助個案紓解情緒及增進支持系統，解決身心靈問題，並協助召開家庭會議，使個案能與其印尼家人共同參與治療決策。期盼能藉此照護經驗分享，給予臨床護理人員照護相關族群之參考，並建議臨床護理人員能增進新住民族群之文化敏感度，以提供適切性護理，達全人護理之目標。

Taiwan's population of new immigrants is increasing, and the demographic has become the fifth largest population group in the country. However, in a dynamic environment comprising different cultures, languages and environmental adaptations, one is likely to be under greater pressure in the face of a cancer diagnosis and treatment. This article describes the nursing experience of a new female immigrant in Taiwan who was newly diagnosed with cervical cancer. The lack of a support system and confusion over her treatment plan led to ineffective coping, and her words and actions were agitated. During the nursing care period between November 11 and December 1, 2020, data were collected through clinical care, direct observation, physical assessment, interviews, etc. Using Gordon's 11 Functional Health Patterns assessment framework, we found that the patient had health problems such as impaired urinary elimination, deficient knowledge, and ineffective coping. During the period of nursing care, pictorial books and charts on healthcare in the Indonesian language were devised for health education to improve self-care of bilateral percutaneous nephrostomy (PCN) drainage tubes, and provide care and information on cervical cancer and radiation therapy side effects. Through visiting companionship, encouragement and guidance, and the use of spiritual techniques and cross-disciplinary teamwork, the patient's emotional burdens were relieved, her support system was enhanced to resolve physical and spiritual problems, and family meetings were facilitated for the patient to actively participate in treatment decision-making with her Indonesian family members. We hope that this nursing experience can provide reference for clinical nurses caring for relevant groups, and suggest that clinical nurses enhance the cultural sensitivity of newly settled ethnic groups in order to provide appropriate care and achieve the goal of holistic health care.