早産兒返家照顧初期母親所經歷之家庭壓力經驗

The Family Stress Experience during the Early Stage of Caretaking in Prematurity from Mothers' Perspectives: A Phenomenological Study

陳素瑩(Su-Ying Chen) ； 穆佩芬(Pei-Fan Mu) ； 夏萍絗(Ping-Hui Hsia) ； 黃碧桃(Be-Tau Hwang)

《護理研究》 8卷1期 (2000/02) Pp. 26-36

https://doi.org/10.7081/NR.200002.0026

摘要

本研究應用學研究方法，以母親的主觀描述來探討早産兒出院返家照顧的頭2-3個月期間之家庭壓力經驗的本質結構。基於家庭系統理論（Montgomery & Fewer，1998）與家庭壓力理論（Boss，1998），以Colaizzi（1978）現象學研究法進行研究。研究採立意取樣，個案來源爲北部某醫學教學中心，選案條件爲：（1）懷孕週數不滿37週，（2）出生體重等於或低於2500公克，住過加護單位且無先天性畸型，（3）出院2-3週並與父母同住之早産兒的母親。經分析了12個個案資料並沒有新的主題出現，故停止收集資料。研究者爲資料收集者，資料收集除包括案家庭及早産兒一般資料，並運用半結構式記談指引，經30-60分鍾深度錄音訪談。依Colaizzi（1978）現象學研究步驟分析資料，研究嚴謹度之控制乃採交互資料分析信度，內容效度與結構效度之審核。研究結果顯見，早産兒返家照顧之家庭壓力經驗涵蓋了四個層面：（一）母親角色緊張，（二）擔心受傷之情境性經驗，（三）母性行爲，及（四）家庭衡定。本非軍事化結果除了提供早産兒以家庭爲中心及以生活經驗本質爲導向出院計盡的重要指引外，研究結果亦可應用至其他高危險性新生兒家庭之照顧。未來研究可合併其他研究方法，對家庭壓力現象做全面性的瞭解。

關鍵字

早産兒 ； 母親 ； 家庭 ； 壓力 ； 現象學

並列摘要

Based on the family systems theory (Montgomery & Fewer, 1988) and the contextual model of family stress (Boss, 1988), the purpose of this study was to use Colaizzi’s (1978) phenomenological approach to investigate the essence of family stress experience from mothers’ perspective during the first 2 to 3 months of caring for a premature infant after discharge from the hospital. Twelve subjects were purposely chosen from a medical center in Taipei. The criteria for choosing the mothers were: The premature infant gestational age was less than 37 weeks and the birth weight was equal to or less than 2500 grams, and the premature infant was living with parents. The interview data was collected using a tape-recorder and following a semi-structured interview guideline. Intercoder reliability, content validity and construct validity were examined. The results of this study show that the family stress experience includes four dimensions: Maternal role strain, worries about the child getting hurt, maternal role behaviors and the family equilibrium. These findings not only help to establish family-oriented nursing discharge planning for premature infants, but also the results could be applied to understanding the experience of other families with high-risk newborns. Future studies could use other methodologies to capture a more comprehensive picture of family stress experience in relation to home care of the premature.

並列關鍵字

premature infant ； mothers ； family ； stress ； phenomenology

參考文獻

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Boss, P.(1988).Family stress management.California:Sage.

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Colaizzi, P. F.(1976).Exictential, phenomenological alternalives for psychology.New York:Oxford University Press.

Crnic, K. A.,Ragozin, A. S.,Greenberg, M. T.(1983).Social interaction and developmental competence of preterm and full term infant during the first year of life.Child Development.54,1199-1210.