建構兒童及新生兒加護病房傷慟關懷照護模式之專案

Project of Constructing a Bereavement Care Model for Pediatric and Neonatal Intensive Care Units

高藝庭(Yi-Ting Kao) ； 蔡薰儀(Hsun-Yi Tsai) ； 高嘉霙(Chia-Ying Kao) ； 曹庭儀(Ting-Yi Cao) ； 陳佩吟(Pei-Yin Chen)

《領導護理》 21卷3期 (2020/09) Pp. 90-106

https://doi.org/10.29494/LN.202009_21(3).0008

摘要

面臨孩子死亡，對父母來說是痛徹心扉的悲慟，過程中醫療人員感到不捨但又不知如何撫慰家屬。統計單位傷慟關懷認知率為64.9%，查檢病歷皆未呈現詢問家屬需求之紀錄，利用特性要因圖分析原因有：醫療人員教育訓練不足、缺乏傷慟關懷服務，提出解決方案為：（一）舉辦傷慟關懷在職教育課程；（二）建立關懷標準用語；（三）制定傷慟關懷作業程序；（四）建立傷慟關懷服務家屬需求表單；（五）製作傷慟關懷服務手冊；（六）安排合宜的隱私場所；（七）製作傷慟關懷服務相關用物；（八）制訂傷慟關懷標準作業稽核制度，作為採行辦法。結果顯示傷慟關懷服務認知率為100%、傷慟關懷照護完整率為100%，顯示本專案可供日後臨床照護標準，更能提升照護品質。

關鍵字

傷慟關懷 ； 照護模式 ； 兒童及新生兒 ； 加護病房 ； 建構

並列摘要

The death of a child is a heart-wrenching grief for parents. Medical professionals involved in the care process also felt great sadness but may not know how to offer adequate bereavement care to the child's family. Statistics showed that the cognition rate of bereavement care within the unit was 64.9%, and a review of medical histories found no record of inquiries in regards to the family's needs. A cause and effect analysis indicated that the insufficient training of the medical personnel and lack of bereavement care services were the major reasons. This project proposed a solution consisting of the following measures: (1) offer on-the-job training about bereavement care; (2) establish the standard phraseology of care; (3) set up a standardized operating procedure of bereavement care; (4) establish a form for the list of family's needs about bereavement care services; (5) publish a bereavement care services brochure; (6) arrange suitable privacy venues; (7) manufacture objects required in the provision of bereavement care services; and (8) develop a standardized procedure for auditing bereavement care services. After implementation of these measures, the cognition rate reached 100%; the bereavement care completion rate also reached 100%, suggesting that this project provides a referencing model for future clinical care to improve care quality.

並列關鍵字

bereavement care ； care model ； pediatric and neonatal ； intensive care unit ； construct

參考文獻

江巧琴、李絳桃、王昭慧、唐婉如（2007）．母親經歷新生兒死亡的經驗與感受－質性回溯性研究．護理雜誌，54（5），48-55。DOI： 10.6224/JN.54.5.48

孫瑞 瓊 、 黃慧 琪 （ 2012 ） ． 運用Watson關懷理論照護一位產婦面臨子宮內胎兒死亡的護理經驗．領導護理，13（3），49-59。DOI： 10.29494/LN.201209.0006

劉秀美(2007) ．喪失早產兒的父母之悲傷及照護．護理雜誌，54 (5)，88-91。DOI：10.6224/JN.54.5.88

劉珮琪、謝孟真、黃郁容、張敏玉、程姮鳳、林淑慧（2014）．運用傷慟關懷服務提升終止妊娠照護品質之改善專案．助產雜誌，56，68-79。DOI：10.6518/TJOM. 2014.56.7

鄭雅慧、方寶秋、沈青青（2012）．新生兒安寧緩和醫療之推展．遠源護理，6（2），10-14。DOI：10.6530/YYN.2012.6(2).02