- 期刊
協助一位經歷產後大出血危機婦女及其家庭因應之加護經驗
The Nursing Experience of a Postpartum Hemorrhage Patient and Her Family Coping in the Intensive Care Unit
摘要
本文探討一位產後大出血行子宮切除術後因持續失血二度入手術室病人之加護照護經驗，護理期間於2018年5月24日至31日，以Gordon評估工具確立高危險性傷害、害怕及家庭因應能力改變等健康問題，照護期間結合多專科團隊改善生理問題，另察覺個案歷經死亡威脅等原因導致害怕擔憂以及案夫面對妻子緊急致命病況和家庭照顧問題產生因應失衡，藉提供完整資訊並整合家庭支持系統，幫助建立親子連結，協助共同度過個體和家庭的衝擊與危機。重症護理優先處理急性問題，因產後婦女的角色和荷爾蒙改變有特殊的生心理變化，對於重症護理師而言顯較困難，建議新增產科重症課程增進護理人員臨床照護能力，並期望以視訊進行重症與產、兒單位跨科別共同查房，真正做到以家庭為中心的重症照護。
並列摘要
This study explored the caring experience in the intensive care unit (ICU), where the subject went through hysterectomy due to Postpartum Hemorrhage (PPH) and was sent to the operating room twice for continuous blood loss from May 24 to May 31 in 2018. Gordon's Functional Health Patterns was applied to evaluate and identify health problems, including injury risk, fear, family response, etc. During the care period, ICU team integrated cross-departmental efforts to mitigate the patient's physiological conditions, however the team realized the patient could not address psychological burden due to the horror caused by the death threat, her husband's adaptability to the fatal illness and family care issue. Therefore, complete information and family supportive system was provided to help building parent-child relationship and overcoming difficulties. The critical care is primarily to address emergent issues. Postpartum women usually experience physiological and psychological changes, and thus it is suggested that obstetric critical care program should be introduced to increase nurses' caring ability, with joint ward inspection conducted via video by the departments of Critical Care, Pediatrics and Obstetrics, as to fulfill the family-centered critical care.
參考文獻
延伸閱讀
- 李宜樺、楊佩欣、鄭紅霞（2008）。協助一位新住民母親於早產兒出院前準備之護理經驗。新臺北護理期刊，10(2)，89-96。https://doi.org/10.6540/NTJN.2008.2.009
- 陳玲玲、呂桂雲（2002）。協助一位子宮內膜異位婦女術後面對不孕之護理經驗。護理雜誌，49(2)，85-90。https://doi.org/10.6224/JN.49.2.85
- 黃靖棻（2011）。運用生產支持協助一位枕後位初產婦自然產之護理經驗。助產雜誌，(53)，61-71。https://doi.org/10.6518/TJOM.2011.53.8
- 陳珮芬、林純臻、房怡慧、盧美言（2018）。The Nursing Experience of a Postpartum Woman with Uterine Who was Complicated with Postpartum Hemorrhage。馬偕護理雜誌，12(2)，54-64。https://doi.org/10.29415/JMKN.201807_12(2).0005
- 洪意華、吳淑蓉（2009）。The Nursing Experience of Caring for a Female Patient Undergoing Perinatal Loss after Intrauterine Fetal Death。高雄護理雜誌，26(1)，76-90。https://doi.org/10.6692/KJN-2009-26-1-7