一位糖尿病產婦面臨死胎的哀傷反應及調適行為

The Reaction and Coping Behavior of a Postpartum Diabetic Woman in Bereavement Following Fetal Death

吳昭華(Chao-Hua Wu) ； 郭素珍(Su-Chen Kuo)

《實證護理》 3卷1期 (2007/03) Pp. 64-72

https://doi.org/10.6225/JEBN.3.1.64

摘要

本個案研究旨在探討一位妊娠31週合併有糖尿病性酮酸中毒的初產婦面對突然身體不適，求醫後發現胎死腹中的失落、哀傷與調適過程，以及夫妻相互扶持共同因應的調適行為。研究者在護理過程中，以臨床田野研究法收集語言及非語言行為資料，再寫成七篇行為過程實錄，並經由內容分析法分析、歸納後發現個案在失落哀傷的過程中經歷了震驚與不相信、隔離與退縮、憤怒與罪惡感、痛苦與無助、回憶與接受。個案的調適行為則藉由有效的行為如：壓抑哀傷情緒、將哀傷視為自我成長與為未來設定目標，同時有良好的支持系統與醫護人員的介入，讓她能順利的走出哀傷的過程，迎接另一次懷孕的挑戰。

關鍵字

糖尿病產婦 ； 哀傷反應 ； 調適行為

並列摘要

The purpose of this case study was to explore the coping process of a 31-week primipara with diabetic ketoacidosis who experienced fetal death. The fetus died after she had visited a doctor because she felt uncomfortable. She then experienced grief and the need, together with her spouse, to cope with the situation. We evaluated her verbal and non-verbal behavior, collected data by clinical field method, and made seven process records. The content analysis method was used to analyze the data. Five main issues of loss and grief were inductively identified: (1) shock and disbelief, (2) isolation and withdrawal, (3) anger and guilt, (4) pain and hopelessness, and (5) recall and acceptance. Three main issues of effective coping behavior were identified: (1) suppressing grief, (2) viewing grief as a function of personal growth, and (3) setting goals for the future. Good supporting systems and nursing professionals also helped the patient to recover successfully from her bereavement and accept the challenge of another pregnancy.

並列關鍵字

postpartum woman with diabetes ； bereaved reaction ； coping behavior