- 期刊
協助一位初產婦母乳哺餵之護理經驗
The Nursing experience of assisting a primipara breast-feeding
摘要
本篇文章探討一位初產婦運用共享決策確定嬰兒餵養計畫後，經歷母乳哺餵與育嬰技巧學習困難之護理經驗，筆者於2019年6月23日至6月26日照護期間，運用Gordon十一項健康功能性評估工具，以實際照護、觀察、身體評估、會談等方式收集資料，確立個案有一、決策衝突／與餵養寶寶方式不確定性有關；二、低效性母乳哺餵／與嬰兒就乳與含乳不正確、自覺奶水不足有關；三、照顧者角色緊張／與無法勝任育嬰技巧有關等健康問題。照護期間以個案為中心的照護模式，利用決策輔助工具於照護討論中，鼓勵表達內心感受，提供個案嬰兒餵養方式優缺點之完整資訊，以降低焦慮並協助產婦做出合宜的選擇，另外在擔心無法勝任哺乳與育嬰技巧焦慮及負面情緒方面，提供專業知識及因應措施指導，運用多媒體影片搭配護理指導手冊及嬰兒模型實際操作學習，增進母乳哺餵及育嬰照護之技巧，以提升其母乳哺餵及母親角色的自信心。建議於產婦入院護理評估時，應增加評估產婦的餵養計畫，即時了解產婦的意願，並加強醫病共享決策的臨床應用，提供個別性及完整性的產後照護。期盼藉由此護理經驗的分享，能提供護理人員日後照護此類產婦之參考。
並列摘要
This article explores the nursing experience of a primipara who used shared decision making to influence the feeding plan, the breastfeeding experience and the difficulties in nursing a newborn. During the period of June 23 to June 26, 2019, the author used Gordon's 11 Functional Health Patterns Assessment, and data collection through provision of clinical care, observation, physical assessment, and interviews etc., to determine the nursing problems of the patient with primipara. The nursing problems included conflicts in decision making/uncertainty in nursing the baby, inefficient breastfeeding/incorrect latching of the baby and perceived insufficiency in breastmilk, caregiver's feeling of nervousness/skill incompetency in caring for the infant. A case-centered approach was taken, using decision-making tools and aids in discussions the regarding nursing care, encouragement of expressing inner feelings, providing information on advantages and disadvantages of different feeding methods in an attempt to reduce feeling of anxiety and help the mother with primipara making appropriate choices. In addition, professional knowledge and guidance on countermeasures against the perceived incompetence in breastfeeding and nursing skills were provided. Furthermore, with use of multimedia videos along with nursing education pamphlets and baby models for practical learning was offered to improve breastfeeding and nursing skills and build self-confidence in the new role as a mother. In order to provide better individual and comprehensive postpartum care for breastfeeding, we recommend to evaluate the baby's feeding plan during initial admission assessment, to assess the patient's wishes, to improve the clinical application of shared decision making and to provide individual and comprehensive postpartum care. We hope that by sharing this report, relevant information with reference for other health care professionals who might be caring for such individuals in future.
參考文獻
延伸閱讀
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