- 期刊
運用FOCUS家庭介入措施於腦軟化早產兒及其家庭之照護經驗
Nursing Experience from Caring for Premature Infant with Encephalomalacia and their Family Using FOCUS Family Intervention
摘要
本文描述一位極度早產兒因周腦室白質軟化症臨床已不建議積極搶救，案母感到絕望，更與家庭成員出現衝突造成家庭危機，故引發筆者撰寫之動機。照護期間為2020年10月14日至10月30日，藉由會談及身體評估等進行資料收集，以系統性及家庭功能評估架構，確立個案有顱內調適能力降低、身體活動功能障礙、家庭因應能力失調、照顧者角色緊張等健康問題。因早產兒無法表達，醫療決定權在於父母，故應以家庭照護為中心，筆者運用FOCUS家庭介入措施，鼓勵每位家庭成員參與，減輕其不確定感及無望感，提升壓力因應能力，使其正向面對及接受個案預後不佳的情形，建議臨床重視早產兒撤除維生系統之議題，並非僅有兒科醫師及護理師介入，而是需要更多專業人員介入，共同討論對其家庭最好的醫療決策，讓家庭衝擊降至最低，提供更完整的照護品質。
並列摘要
This article describes an extremely premature infant who was no longer recommended for active treatments due to periventricular leukomalacia. The mother of the case felt hopeless and even had conflicts with family members leading to a family crisis, which inspired the author to write about this case. The nursing period was from October 14 to 30, 2020. Data were collected through interviews and physical assessment, based on a systemic and family function assessment framework to establish the case had diminishing intracranial adjustment ability, physical activity dysfunction, family coping disorder, caregiver role tension and other health problems. Premature infants cannot express themselves, and the right to make medical decisions rests with their parents, so family care should be the center of attention. The researcher used FOCUS family intervention measures to encourage each family member to participate, reduce their sense of uncertainty and hopelessness, improve their ability to cope with stress, and make them face the fact positively and accepting the poor prognosis of the infant. It is recommended that clinical attention should be paid to the issue of removing the life support system for premature infants. It needs the intervention of not merely pediatricians and nurses but also more professionals to discuss the best health care decisions for the families, minimize the impacts on the families and provide a more complete quality of care.