照顧一位初產婦因胎死腹中引產之護理經驗

懷孕對大多數人而言是喜悅的過程，然而若不幸發生胎死腹中，會造成產婦期望落空、身心受到傷害，甚至影響家庭功能。本篇個案為一位妊娠二十四週之初產婦，來院產檢時突然發現胎兒胎死腹中，由開始震驚、無法接受、哀傷到最後死胎引產生下來等一連串之心路歷程。筆者經由會談、身體評估等方式收集資料，並以羅式適應模式進行評估的護理過程。本文中，個案的護理問題有失去胎兒造成之哀傷反應、對生產過程不了解而感到焦慮、引產子宮收縮引起急性疼痛、面對先生關懷感到罪惡感等四項，住院期間，護理重點為提供支持性的環境、傾聽並鼓勵個案表達內心感受，以同理心、不批判的態度接受其情緒反應，以協助個案度過哀傷過程，並藉此次之護理經驗，期望日後護理同仁照顧相關個案時，亦能順利協助個案調適哀傷過程，逐漸走出失去胎兒的傷痛。

關鍵字

初產婦；胎死腹中；引產；哀傷

並列摘要

For most people, pregnancy is a joyful process. However if intrauterine fetal death occurs, the parents, and particularly the mother, may experience multiple losses. Among others, this may include damage to the mother's self-image, which may be severe enough to affect family functioning. A primipara with a 24-week pregnancy was told of fetal demise during her prenatal check up. Labor was induced to remove the stillbirth. Her grief response included shock, denial, and difficulty in accepting the loss of the fetus. We collected data by interviewing the patient and by physical assessment. The Roy Adaptation was used to analyze the nursing process. The patient presented four nursing problems, including grief for loss of her baby, anxiety during labor, acute pain secondary to induced uterine contractions, and guilt feelings in facing her husband. Nursing care involved providing a supportive environment, listening to and encouraging the patient to express her feelings, empathy, and avoiding a judgmental attitude toward her emotional reaction. This experience illustrates ways of helping patients cope with the grief of fetal loss.

並列關鍵字

primipara ； intrauterine fetal death ； induction ； grief

國際替代計量

照顧一位初產婦因胎死腹中引產之護理經驗

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