運用紐曼模式於照顧一位行體外受精懷孕婦女之護理經驗

Nursing Experience of in Vitro Fertilization Women Applying the Neuman System Model

張蔚瀅(Wei-Ying Chang) ； 郭碧照(Pi-Chao Kuo)

《中山醫學雜誌》 22卷1期 (2011/03) Pp. 71-82

https://doi.org/10.30096/CSMJ.201103.0008

摘要

本文探討一位體外受精懷孕婦女安胎至生產期之護理經驗，個案於第三孕期時持續性的宮縮，故住院行安胎治療，安胎過程中，個案因擔心早產而導致不確定感，造成在安胎過程焦躁不安及懷疑能否順利產下健康新生兒。筆者於2009年11月6至14日止之護理期間，經由直接照護、會談、觀察及查閱病歷等，收集個案相關資料，運用紐曼系統模式(Neuman System Model)評估個案身心問題，發現個案之健康問題安胎期為「不確定感」及產後期的「急性疼痛」及「低效性母乳哺餵」。於護理過程中應用初級、次級及三級預防之護理措施，降低個案安胎過程中害怕早產的不確定感，減輕術後傷口疼痛、改善母乳哺餵情況，以提高個案孕產期之生活品質及自我效能，期望此兼顧身心需求之護理措施，可提供醫護人員做為照護體外受精懷孕婦女安胎過程及生產之參考。

關鍵字

紐曼系統模式 ； 體外受精 ； 不確定感 ； 疼痛 ； 低效性母乳哺餵

並列摘要

This paper reports our experience providing nursing care to a women with tocolytics receiving In Vitro Fertilization. During the tocolysis period, the patient felt uncertainty with regard to premature birth and anxious about her ability to give birth to a healthy baby. She was provided nursing care from Nov. 6.2009 to Nov. 14.2009. Her nurse, the author, used the Neuman System Model to collect data and discovered that the case had the following problems: ”uncertain feelings,” ”acute surgical pain after cesarean section” and ”ineffective breastfeeding.” Using Neuman system model as a guide, her nurse aimed to decrease her uncertain feelings and acute surgical pain after cesarean section and improve ineffective breastfeeding skills as well as to make her feel comfortable during confinement and puerperium. This study shares that nursing experience.

並列關鍵字

Neuman system model ； in vitro fertilization/embryo transfer ； uncertainty ； pain ； ineffective breastfeeding