運用統合發展理論於一位重症早產兒之護理經驗

Using synactive theory of development in nursing process with a critical premature infant

黃媚秋(May-Chiou Huang) ； 謝秋菊(Chiu-Chu Hsieh) ； 蔡蓮花(Lian-Hua Tsai) ； 鄒綉菊(Shiow-Jyu Tzou) ； 黃麗萍(Li-Ping Huang) ； 劉慈慧(Tzu-Hui Liu)

《高雄護理雜誌》 34卷2期 (2017/08) Pp. 84-96

https://doi.org/10.6692/KJN-2017-34-2-8

摘要

本文描述一位33 週出生之早產兒因呼吸窘迫插管住新生兒加護病房治療之護理經驗；案母因缺乏照顧經驗及害怕失去個案，面臨極大衝擊及困難。筆者透過直接照護，系統性身體評估、統合發展理論與家庭評估等方式，確立個案現存問題有：氣體交換障礙、低效性嬰兒哺餵型態及混亂性嬰兒行為；筆者應用呼吸支持及氧合促進來維持個案良好換氣，再則，觀察飢餓暗示行為、提供口腔動作發展訓練、寧握護理以及減少環境刺激，讓個案不僅能夠成功餵食且能提升自我統合行為的發展；另外，藉由促進親子依附關係、教導早產兒照護技巧以及提供個別化居家照護等措施，緩解案母照顧者角色緊張的問題，使得個案返家後可以獲得持續及完整的照護。

關鍵字

重症 ； 早產兒 ； 統合發展理論

並列摘要

This article describes a nursing process of caring for a critical premature infant with respiratory distress in the Neonatal Intensive Care Unit. Systematic physical assessment, synactive theory of development and family assessment were used in the process of nursing. Nursing problems of this 33+-week-old premature infant included impaired gas exchange, ineffective infant feeding pattern, and disorganized infant behaviors. Maintaining ventilation status, increasing oxygenation, providing oral training, inspecting implied behavior of hunger, containment, and reducing stimulators from environment were used to facilitate feeding and integrate development of the premature infant. Caregiver role strain was also noted in the process, so a feeding diary and an individual guidebook of premature breastfeeding care were designed for the caregiver. Through nursing education and telephone tracing, the caregiver resumed her self-confidence, and the premature infant received continuous care successfully.

並列關鍵字

critical ； premature infant ； synactive theory of development

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