照護一位懷雙胞胎合併死產與早產的產婦之護理經驗

The Nursing Experience with a Twin Pregnancy Woman Had Intrauterine Fetal Death and Premature

胡蓮珍(Lien-Jen Hwu) ； 郭碧照(Bih-Jaw Kuo) ； 張雅韻(Ya-Yun Chang)

《中山醫學雜誌》 17卷1期 (2006/06) Pp. 119-129

https://doi.org/10.30096/CSMJ.200606.0013

摘要

本個案報告是描述一位懷孕26週雙胞胎的婦女，合併－胎兒子宮內死亡及－胎兒有腦室出血及心包膜積水而早產，於93年12月14日至20日之護理經驗。筆者運用羅氏適應模式評估個案生理功能、自我概念、角色功能及相互依賴，由開始個案表現出堅強的外表，到深入會談後，發現有疼痛、焦慮及哀傷等護理問題，藉由陪伴、傾聽、不斷鼓勵抒發負向的情緒，重新建構自我，進而接受早產與失去胎兒的事實，促使其早日調適其生活。希望藉由此護理經驗，提供護理人員照護類似個案的參考，提高自己的敏感度，發揮同理心，給予個案安全、信任的感覺，進而深入會談，瞭解產婦心理的深層意義，以發揮護理專業的功能。

關鍵字

雙胞胎 ； 子宮內胎兒死亡 ； 早產 ； 哀傷

並列摘要

The purpose of this article is to describe a nursing experience with a woman who was pregnant with twins and with whom, at 26 weeks, one of the fetuses died in the uterus. Due to prematurity, the other twin ventricular hemorrhage and pericardial effusion. Roy's adaptation model was utilized by the attending nurse to assess the woman's physiological capabilities, self- concept, role function and interdependence.
Initially, the patient was found to be relatively stable. Later, however, it was found through a interview that she was experiencing wound-ache, anxiety, and grief. During this session, the attending nurse listened attentively and encouraged the patient to express her negative mood. The patient re-establishes her self-concept, accepted the fact that she had a premature pregnancy and had lost her baby. She soon adjusted back into life and her daily activities.
This nursing experience demonstrates the protective role that a nurse can have with a patient. The nurse allowed herself to become more sensitive, displayed empathy, and gave the patient a feeling of security and trust. From there, a deep discussion was held in which the patient's mental and emotional concerns could be addressed. In this way, nursing care could be enhanced and the patient's needs better served.

並列關鍵字

twin ； intrauterine fetal death ； premature ； grief