一位高齡孕婦面臨胎死腹中的經驗與調適行為

本篇個案報告藉由田野研究法探討一位高齡產婦經歷其胎兒死產的心路歷程，與個案接觸的時間為民國92年9月28日至92年10月2日止，護理期間，筆者與個案建立互信及良好之護病關係，其經驗透過訪談及觀察者即是參與者的方式收集深入及完整的資料，此行為過程記錄共計八篇，經內容分析法分析資料後，將其經驗歸納為經驗感受及因應行為兩大方面。其經驗感受包括：胎死腹中的震撼、回溯孕期所付出的努力、擔心奶水的分泌無法執行母親角色、坐月子時的空虛。其調適行為包括：尋找胎兒死亡的原因、合理化、認命、與死去胎兒道別、產時的迴避行為、處理奶水及填充坐月子的空虛。在此一護理過程，筆者的主動傾聽、同理心及和個案一同走過此一堅辛歷程，不僅建立一個有效的情緒發洩管道，也真正深入暸解其感受並提供實質的協助。在此過程，筆者也自覺自我的成長，希冀藉由此篇報告，可作為護理人員在照顧類似經驗婦女之關懷照護參照。

關鍵字

高齡孕婦；胎死腹中；經驗；調適行為

並列摘要

The purpose of this study was to explore the experience and coping behavior of advanced maternal age with intrauterine fetal death. Field study was adopted to collect data, and the same time, observe as participant in order to gather more comprehensive information. The results indicated the mother's experience included: in shock after still birth; recalling her efforts during the pregnancy; worrying about the development of postpartum breast milk and feeling of failure in the maternal role; and doing the month without baby. Coping behavior was identified as: probing the causes of fetal death, rationalization; reconciliation; avoidance of touching death baby during delivery; saying goodbye to the dead baby; trying reduction of breast milk; and filling in the time of doing the month. During the nursing care, the author has built up a rapport and good relationship with the case by listening attentively to her, trying to understand her feeling and experience. Moreover, after the case left the hospital, the author proceeded to give her constant care, providing her with physical, mental, social, and spiritual care in order to overcome the grief process. Hopefully, this paper can serve as a useful reference in the field of nursing, and particularly for those who devote themselves to taking care of mothers experiencing fetal death.