A Qualitative Study of Psychosocial Factors Affecting Expecting Mothers Who Choose to Continue a Cleft Lip and/or Palate Pregnancy to Term

胎兒唇顎裂之孕婦選擇繼續姙娠的心理社會衝擊之質性研究

謝月慈(Yueh-Tzu Hsieh) ； 余玉眉(Yu-Mei Yu Chao) ； 蕭淑銖(Judith Shu-Chu Shiao)

《The Journal of Nursing Research》 21卷1期 (2013/03) Pp. 1-9

https://doi.org/10.1097/JNR.0b013e3182828dbd

摘要

背景：進步的產前診斷技術，可以早期發現絕大多數的唇顎裂個案，但也導致許多中止懷孕的決定。然而在臺灣針對此間孕婦所承受的社會心理影響經驗的討論卻相當少見。目的：探討孕婦在胎兒被診斷為唇顎裂後，仍決定繼續姙娠的心理社會衝擊。方法：本研究立意取樣六位胎兒被診斷為唇顎裂後仍決定繼續姙娠的孕婦，於被診斷後兩周 內進行深度訪談。資料收集地點為北部某醫學中心產科門診，期間為2000年5月至2002年3月。研究者在訪問開始之前，均先給予充分的口頭與書面說明，再請受訪者簽署研究同意書。結果：研究結果出現五個主題：（一）失去自我價值的母親、（二）被責備的母親、（三）是否終止姙娠的決策衝突、（四）資訊不足引發的焦慮、（五）照護負擔與不利於小孩的情境。結論：懷孕期被診斷出小孩有唇顎裂，對孕婦的社會心理影響是相當大的。令人欣慰的，無論小孩的健康情況為何，所有的受訪者都不後悔當初的決定。

關鍵字

先天缺陷 ； 唇顎裂 ； 進退兩難 ； 社會心理影響 ； 現象學

並列摘要

Background: Prenatal detection of cleft lip and/or palate (CL/P) leads to high rates of induced termination of pregnancy. There has been little research in Taiwan done on the psychosocial factors affecting those who decide to continue their CL/P pregnancy. Purpose: This study identified the principal psychosocial factors that affect expecting mothers who chose to continue their CL/P pregnancy to term. Methods: Purposive sampling recruited expecting mothers with CL/P-diagnosed fetuses. Recruiting took place between May 2000 and March 2002 at a tertiary referral hospital in Taipei, Taiwan. Those who had decided to continue their pregnancy to term were asked to participate. Researchers obtained oral informed consent to be interviewed during the week following CL/P diagnosis. Interviews for each participant were completed within a 2-week period. All information was given to the interviewees in written and verbal forms before providing their written informed consent to participate. Results: The five major themes central to participant experiences included (1) loss of self-value as a mother, (2) blaming the mother, (3) indecision about whether to continue the pregnancy, (4) anxiety triggered by insufficient information, and (5) burden of care and concerns about potential disadvantaged status. Conclusions: Significant psychological distress was identified among participants following their fetus' CL/P diagnosis. It was encouraging to learn that all participants told researchers in postpartum interviews that they did not regret the decision to take their child to term.

並列關鍵字

birth defect ； cleft lip/palate ； dilemma ； psychosocial consequences ； phenomenology

參考文獻

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