Lived Experiences of Taiwanese Women with Multifetal Pregnancies Who Receive Fetal Reduction

台灣之多胞胎妊娠婦女於接受減胎術之經驗感受

王慧蘭(Hui-Lan Wang) ； 余玉眉(Yu-Mei Yu Chao)

《The Journal of Nursing Research》 14卷2期 (2006/06) Pp. 143-154

摘要

本研究目的在探討多胞胎妊娠婦女接受減胎術之經驗感受，採質性研究，以田野研究法收集資料，研究者採觀察者即參與者及電話訪談方式進行，共收集六位多胞胎妊娠婦女接受減胎術之經驗感受資料，研究期間共8-10週，每位個案接觸約9次，所收集的資料以內容分析法予分析、歸類，形成主題。結果歸納為：(1)難以接受非預期懷有多胞胎；(2)擔心多胞胎妊娠的危險及影響而考慮減胎；(3)為求生產順利及小孩健康而決定減胎；(4)對減胎的技術疑惑而焦慮；(5)對胎兒產生情感連結，因減胎覺罪惡；(6)面臨減胎的過程而致身心難捱；(7)處於孕況不穩及罪惡的恐懼中；和(8)疑雲漸落，回歸一般孕程。研究結果顯示多胞胎妊娠婦女面對減胎術是個困難的決定，於接受減胎術過程亦產生許多情緒反應。研究結果有助於醫護人員深入瞭解多胞胎妊娠婦女接受減胎術的經驗感受，並能敏感及明確的提供合宜的護理措施，以增進其適應。

關鍵字

經驗感受 ； 多胞胎妊娠婦女 ； 減胎術

並列摘要

This study explores lived experiences of Taiwanese women with multifetal pregnancies who receive fetal reduction. This qualitative study adopted a field method with observer-as-participant approach to collect data. Six subjects were recruited from a medical center using purposive sampling. Most of the subjects were contacted nine times. The total time of observation was 8-10 weeks. The collected data was analyzed by content analysis, and forming themes. The findings are as follows: (1) difficulty in accepting unexpected multiple pregnancies; (2) worry over danger/risk of multiple pregnancies and concern about fetal reduction; (3) decision to take fetal reduction for the safe delivery and health of two babies; (4) anxiety about the techniques of fetal reduction; (5) growing emotion of attachment to the fetus and guilty feeling; (6) unbearable physical/mental stress when facing the intrusion of fetal reduction; (7) being enmeshed in fear of unstable pregnancy and guilt; and (8) cloud of uncertainty diminished, return to normal pregnancy. The results indicated that the women with multifetal pregnancies, who received fetal reduction, encountered a difficult decision. They were exposed to tremendous emotional responses. The findings of this study can help nurses to gain a deeper understanding of those women's experiences. More sensitive, precise recognition, as well as suitable nursing intervention can be provided, in order to promote better acceptance of and adjustment to the fetal reduction.

並列關鍵字

lived experience ； women with multifetal pregnancies ； fetal reduction

參考文獻

Antsaklis, A.,Souka, A. P.,Daskalakis, G.,Papantoniou, N.,Koutra, P.,Kavalakis, Y.(2004).Embryo reduc-tion versus expectant management in triplet pegnancies.The Journal of Maternal-Fetal and Neonatal Medicine.16,219-222.

Berkowitz, R. L.,Lynch, L.,Stone, J.,Alvarez, M.(1996).The current status of multifetal pregnancy reduction.American Journal of Obstetrics Gynecology.174(4),1265-1271.

Botkin, B. J.,MacDonald, D. I.,MacFarlane, A. J.(1987).Recent trends in the incidence of multiple births and associated mortality.Archives of Disease and Children.62,941-950.

Chao Yu, Y. M.,Tien, S. F.,Chiang, S. S.(1994).Qualitative research: The application of field method on nursing.Taipei:Giant-Current.

Collpy, K. S.(2004)."I couldn't think that far": Infertile women's decision making about multifetal reduction.Research in Nursing & Health.27(2),75-86.