早產兒母親之產後壓力、社會支持、憂鬱及其健康狀況

本研究的目的乃在探討早產兒母親之產後壓力、憂鬱、社會支持和其健康狀態，以及預測早產兒母親健康狀況之因子。於南部兩家醫學中心以及四家地區教學醫院，採用立意取樣， 220位早產兒母親於產後六週內填寫洪氏產後壓力量表、社會支持量表、貝克憂鬱量表和中國人健康量表。研究結果顯示，早產兒母親在產後六週期間最主要前五項壓力來源依次排序為擔心「嬰兒突然生病」、擔心「嬰兒體重大小」、擔心「新生兒篩檢的結果」、擔心「乳汁分泌不足」及擔心「嬰兒奶量的攝取」。在社會支持前五項來源依序排次為「我和家人可以共度愉快的時光」、「當我有麻煩和煩惱時，我可以從醫護人員得到滿意的幫助」、「我很滿意醫護人員對我情緒表示關心及愛護」、「我很滿意醫護人員和我討論事情及分擔問題」及「我的周圍會有朋友對我的情緒表示關心及愛護」。憂鬱的前五項困擾症狀依次數排序為「睡眠習慣的改變」、「疲倦或疲累」、「食慾改變」、「失去精力」及「哭泣」。在自覺不健康的前五項狀況依次排序為「覺得睡眠不好」、「覺得許多事情對您是個負擔」、「覺得頭痛或是頭部有壓迫感」、「覺得神經兮兮，緊張不安」及「感到胸前不適或壓迫感」。早產兒母親之健康狀況會因家人支持、產後壓力以及憂鬱程度不同而呈現差異。而早產兒母親之「年齡」、「教育程度」、「產後壓力」與「憂鬱程度」為其健康狀況的重要預測變項。早產兒母親每增加一歲，不健康狀況增加1.11倍；高中或以下教育程度之母親其不健康狀況是專科或以上教育程度的2.11倍；每增加1分的產後壓力，其不健康狀況增加1.02倍；而有輕度或以上憂鬱程度之母親，其不健康狀況是沒有憂鬱之母親的6.23倍。本研究可作為臨床醫護人員提供早產兒母親在產後需求照護計劃以及日後推行產後婦女健康計劃之參考。未來研究可以進一步探討早產兒母親在產後各週之產後壓力、社會支持、憂鬱及其健康狀況以及採用介入性研究探討改善之成效，以提供醫護人員照護早產兒母親時之參考。

關鍵字

早產兒母親；產後壓力；社會支持；憂鬱；健康狀況

並列摘要

The purpose of this study was to explore postpartum stress, social support, depression, and health status of premature infants’ mothers, and to predict their health status. With purposive sampling, a total of 220 premature infant’s mothers were recruited from two medical centers and four community hospitals in southern Taiwan. The Hung Postpartum Stress Scale, Social Support Scale, Beck Depression Inventory, and Chinese Health Questionnaire were used. The top five postpartum stress stressors perceived by the premature infant’s mothers were：”the baby getting sick suddenly,” ” the baby’s body weight,” ” the results of newborn screening tests,” ” insufficient breast milk,” and “the baby’s intake of milk.” The top five social support sources were: ”I am satisfied with the way my family and I share time together,” ”I am satisfied with the help that I receive from for nursing professionals when something is troubling me,” ”I am satisfied with the way for nursing professionals expresses affection and responds to my feelings such as anger, sorrow, and love,” ”I am satisfied with the way for nursing professionals discusses items of common interest and shares problem solving with me,” and ”I am satisfied with the way my friends express affection, and respond to my emotions, such as anger, sorrow, or love.” The top five of depression symptoms which frequency were: ”change in sleeping,” ”tiredness or fatigue,” ”change in appetite,” ”loss of energy,” and ”crying.” The top five self awareness of unhealthy symptoms status were: ”lost much sleep through worry,” ”been taking things hard, “ ”been suffering from headache or pressure in your head,” ”been feeling nervous and strung-up all the time,” and ”had discomfort or a feeling of pressure in your chest.” The mother’s different health status was significantly different with scores of “family support” and “postpartum stress,” and level of “ depression.” The important predictors for premature infants’ mother health status were : age, education level, postpartum stress, and depression level. One more year of a mother’s age will more likely increase 1.11 times to have minor psychiatric morbidity. The mother with senior high diploma will more likely increase 2.11 times to have minor psychiatric morbidity than the mother with junior college diploma. The mother with an increase of one postpartum stress score will more likely increase 1.02 times to have minor psychiatric morbidity. Mothers with mild or severe depression will more likely increase 6.23 times to have minor psychiatric morbidity than mother who didn’t suffer depression. The results of this study could be used as a reference for nursing professionals for caring postpartum premature infant’s mothers and for promoting postpartum women’s health. Future studies could explore those women’s postpartum stress, social support, depression, and health status in each of postpartum week or evaluate the effect of nursing interventions in promoting those women’s well being.