照顧一位罹患抗磷脂質症候群初產婦產下死胎之護理經驗

本文探討一位罹患抗磷脂質症候群之初產婦，在待產過程中因胎兒窘迫行剖腹產而面對胎兒死亡的照護經驗。照護期間為2021年1月12日～1月17日，並於2月17日進行電話追蹤。運用Gordon十一項功能性健康型態評估為指引收集資料，發現個案有急性疼痛、哀傷和情境性低自尊。護理過程運用提供芳香精油搭配按摩穴位、放鬆及轉移注意力等控制疼痛方法，緩解個案不適。也透過陪伴、傾聽，並共同收集胎兒紀念物，做告別及祝福，陪伴個案渡過哀傷。安排跨團隊婦產科、免疫風濕科及小兒科醫師提供正確訊息，強化本身價值。最後個案能以正向的態度重拾信心，並表示待身體調養好後，有機會可將失去的胎兒再生回來。冀望此護理經驗作爲護理人員日後照護罹患抗磷脂質症候群並產下死胎之初產婦個案之參考。

關鍵字

抗磷脂質症候群；初產婦；胎兒死亡

並列摘要

This case study describes the nursing experience of a primiparous woman who had antiphospholipid syndrome and faced stillbirth. The care period was from January 12 to January 17, 2021. After discharge, a follow-up telephone interview was conducted on February 17. Patient was assessed using Gordon's 11 Functional Health Pattern and was diagnosed with health care problems such as acute pain, grief, and situational low self-esteem. During the nursing process, pain control methods such as providing aromatic essential oils with massage acupoints, relaxation and distraction were used to relieve patient's discomfort. Additionally, the nursing team listened to the patient, helped collect monuments, and held a parting ceremony to accompany the patient to cope with the sadness. The nursing team also arranged a cross-department health education to provide patient with correct information and strengthen her self-worth. Finally, the patient successfully regained her confidence and looking forward to getting pregnant when fully-recovered. She said that after the body is well recuperated, there are still chances to have children in the future. The nursing experience can be used as a nursing reference for caring for a stillbirth of the primigravida with antiphospholipid syndrome in the future.

並列關鍵字

Antiphospholipid syndrome ； Primigravida ； Stillbirth

參考文獻

杜昀真（2019）‧抗磷脂症候群與懷孕‧內科學誌，30(4)，264-272。https://doi.org/10.6314/JIMT.201908_30(4).05

林莉莉、蔡玉梅、廖淑敏（2020）‧照顧一位早期破水產婦安胎失敗之護理經驗‧馬偕護理雜誌，14(2)，69-80。https://doi.org/10.29415/JMKN.202007_14(2).0007

洪彩純、林德華（2018）‧一位歷經二次胎死腹中終止妊娠產婦之護理經驗‧助產雜誌，60，71-81。https://doi.org/10.6518/TJOM.201812_(60).0008

陳威宏（2019）‧ERAS 術後多模式疼痛治療‧台灣醫學，23(2)，212-222。https://doi.org/10.6320/FJM.201903_23(2).0009

劉舒倫、鍾玉珠（2017）‧一位妊娠高血壓初產婦剖腹產後出血之護理經驗‧彰化護理，24(2)，48-59。https://doi.org/10.6647/CN.24.02.11

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