一位心臟病病嬰及其父母之照護經驗

本文旨在探討照護一位行完全大動脈轉位矯正、心室中膈缺損修補及動脈導管關閉等修補手術的病嬰及其父母之護理經驗。研究者於急性加護病房共十五天的護理期間，以觀察、訪談、評估、記錄等技巧，進行生理、心理、社會及靈性等層面的資料收集，根據資料而確立了護理問題如下：低效性呼吸型態、心輸出量減少、疼痛、照顧者角色緊張、潛在危險性父母╱嬰兒依附關係改變。研究者以無創傷性照護的護理理念，協助父母面對病嬰手術急性期的緊張和焦慮。由此次經驗發現，護理人員可成為個案與其父母的支持者、諮詢者及照護提供者。同時，若能及早觀察並處理個案的護理問題，將可協助其接受並克服急性期的情境；此外，我們亦應授權給家屬以幫助其發現照護先天性缺陷兒的技巧，並提供資源以促進家屬於家庭危機過程的適應。

關鍵字

父母；開心手術；無創傷性照護；先天性心臟病

並列摘要

This case study was to explore the nursing care for an infant with corrective surgery of complete TGA,VSD, and PDA and his parents. The skills of observing, interviewing, assessing and recording were used to collect the data of physiology, psychology, society and spirituality which were related the case and family during fifteen days in acute intensive care unit. According to the data, the researchers concluded the nursing problems as below: ineffective breathing pattern, decreased cardiac output, pain, caregiver role strain, risk for impaired parent/infant attachment. Therefore, researchers used atraumatic care to enable parents to face up the nervous and anxiety about child and his operation in the process. As the result, nurse can be a supporter, consultant and caregiver during this experience. Meanwhile, to observe and to deal with the nursing problem early can support parents to accept and overcome the situation of acute stage. Also, we should empower family to find out the care skills for their congenital defect infant and provides supply resources to promote the adaption in the process of family crisis.