照顧一位不孕症婦女接受人工生殖療程之護理經驗

中國文化傳統的價值觀及社會結構，認為生兒育女乃天經地義之強制性義務，傳宗接代被視為傳統華人家庭中最重要的生育價值觀，故國內大多數不孕婦女要比西方國家承受更大的角色期望壓力，不啻為一種沉重的負擔。國內近年來生殖醫療蓬勃發展，為不孕婦女帶來一線生機，也提供不孕夫婦圓夢的希望，但接受不孕療程所造成的併發症，及其所衍生龐大的生殖醫療費用負擔，都可能造成不孕婦女生理及心理的不過及家庭壓力。本報告乃探討一位不孕症婦女接受人工生殖療程合併卵巢過度刺激症候群之照護經驗，期間自2017年5月25日至6月23日，筆者藉由溝通技巧、身體評估及理學檢查，評估確認個案有：體液容積過量、身體心像紊亂、焦慮、情境性低自尊等護理問題，積極運用傾聽跟主動關懷技巧，給予專業醫療照護，改善個案因OHSS產生的併發症，協助其克服不孕症壓力，期望透過本篇報告提供護理同仁日後照護類似個案時，能透過心理衛生教育或諮詢並連結家庭支持系統，協助其正向情緒抒發，增進壓力調適技巧。

關鍵字

不孕症；人工生殖；卵巢過度刺激症候群

並列摘要

Producing of children is a heavily emphasized value obligation in traditional Chinese culture. Most infertile Chinese women experienced greater pressure from this role expectation than that of the Western women. The advancement of reproductive medicine in Taiwan inspired dreams that came true for many infertile couples. However, infertility treatment is expensive and may cause medical complications, including physical and psychological discomfort and family stress. This article describes the experience of a woman undergoing artificial reproductive technology complicated with ovarian hyper stimulation syndrome. The care period was from May 25 to June 23, 2017. The author used communication skills, based on physical assessment and examination results, and identified the nursing problems that included fluid volume excess, body image disturbance, anxiety and situational low self-esteem. The healthcare team used active listening and caring skills, provided professional medical care to improve the complications caused by OHSS and helped the family overcome the pressure caused by infertility. This article may provide some insight into the psychological health education, counseling and linking family with support systems to help them develop positive emotions and stress adjustment skills.

並列關鍵字

infertility ； assisted reproductive technology ； ART ； ovarian hyperstimulation syndrome ； OHSS

參考文獻

Al-Inany, H. G., Youssef, M. A., Aboulghar, M., Broekmans, F., Sterrenburg, M., Smit, J., & Abou-Setta, A. M. (2016). Gonadotrophin-releasing hormone antagonists for assisted reproductive technology. Cochrane Database of Systematic Reviews, 4. (CD001750). https://doi.org/10.1002/14651858.CD001750.pub4.

Cui, W. (2010). Mother or nothing: the agony of infertility. Bulletin of the World Health Organization, 88(12), 881-882. https://doi.org/10.2471/BLT.10.011210

Fiedler, K., & Ezcurra, D. (2012). Predicting and preventing ovarian hyperstimulation syndrome (OHSS): the need for individualized not standardized treatment. Reproductive Biology and Endocrinology, 10(1), 32. https://doi.org/10.1186/1477-7827-10-32.

Verkuijlen, J., Verhaak, C., Nelen, W. L., Wilkinson, J., & Farquhar, C. (2014). Psychological and educational interventions for subfertile men and women. Cochrane Database of Systematic Reviews, 3. (CD011034). https://doi.org/10.1002/14651858.CD011034

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照顧一位不孕症婦女接受人工生殖療程之護理經驗

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