早產兒父母親參與加護病房醫療決策之經驗

Medical decision-making experiences in pediatric intensive care unit among prematures’ parents

李晴玉(Ching-Yu Lee)

指導教授 ： 林俐伶

長榮大學/健康科學學院/護理學系(所)/碩士(2013年)

https://doi.org/10.6833/CJCU.2013.00114

摘要

兒科加護病房中，父母親為孩子的決策代理人，但大多數的父母親缺乏參與決策的經驗。本研究目的為探討兒科加護病房早產兒父母親參與醫療決策之經驗，研究設計採現象學研究法，由研究者以一對一或一對二方式進行深度訪談，並利用實際觀察來進行資料收集。研究收案期間自民國100年12月至101年2月，以立意取樣方式於台南地區某醫學中心兒科加護病房進行收案，直至資料飽和為止，共訪談六位曾參與醫療決策之早產兒父、母親，文本資料經處理與建檔後，開始依照執行譯碼、發展概念類組、引出主題三步驟進行資料分析。研究結果共涵蓋三個主題及九個次主題：一、決策過程的反覆掙扎：（一）訊息不足，不知該如何、（二）一個人做決定好難、（三）為什麼要問我？、（四）擔心決策的結果；二、決策的助力在那裏？：（一）渴望獲得多方助力、（二）可信賴專業嗎？、（三）還是得自己想辦法；三、未來決定於現在：（一）不確定的未來、（二）走一步算一步。
研究結果將有助於醫護團隊瞭解父母親在參與醫療決策過程中可能面臨的困境及其需求，及在決策過程中父母親對醫護團隊所抱持的看法與期待，進而提供護理臨床實務及教育之建議。

關鍵字

兒科加護病房 ； 早產兒父母親 ； 醫療決策 ； 現象學

並列摘要

Parents are usually the legal guardians in making medical decisions for their children. However, most of these parents lack of experiences in decision-making process. The purpose of this study was to explore prematures’ parents’ experiences in making medical decisions while their children were admitted in the pediatric intensive care unit. A phenomenological method was used in this study. A total of 6 participants including 3 mothers and 3 fathers who had been involved in making medical decisions were recruited from a medical center in Tainan through a purposed sampling procedure. The data collection period was from December, 2011 to February, 2012 by using one-to-one or one-to-two in-depth interviews. Three steps were performed in data analysis, namely, perform decoding, categories development, and leading to the theme. Three themes and nine sub-themes were found in the study: first, repeatedly struggling in decision-making process, including 4 sub-themes, 1. lack of information, I don’t know how to do, 2. it is difficult to make decisions by myself, 3. why are you asking me? 4. Worry about the results of making decisions. Second theme was: where I can find assistance for decision-making, including 3 sub-themes, 1. eager for multiple helps, 2. can I rely on professions? 3. you have to find out how to do by yourself. The third theme was: future depends on the present, including 2sub-themes, 1. uncertain future, 2. taking it one day at a time.The results of this study can be helpful for the health professions to understand the parents’ struggles and needs in making medical decisions, and the parents’ expectations to the health professions. Further, suggestions for future nursing practices and education are proposed.

並列關鍵字

pediatric intensive care unit ； prematures’ parents

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