早產兒父母的不確定感與因應行為之探討

Exploring the Uncertainty and Coping Strategies of Parents of Preterm Infants

盧瑛琪(Ying‐Chi Lu) ； 顏文娟(Wen‐Jiuan Yen) ； 李選(Sheuan Lee)

《護理暨健康照護研究》 9卷1期 (2013/03) Pp. 23-32

https://doi.org/10.6225/JNHR.09.1.23

摘要

背景：早產兒脆弱的外表且可能合併長期發展的問題，造成父母須面對種種的不確定感及不可預知的未來。目的：探討早產兒父母的不確定感與因應行為。方法：採相關性研究設計法之結構式問卷，於中部某醫學中心，130位早產兒父母為收案對象，研究工具包括Mishel雙親不確定感認知量表及Jalowiec家屬因應策略量表。結果：早產兒父母不確定感前二項為「我不清楚孩子將來會如何」、「我很難確定要用多久的時間，才能學會照顧孩子」，早產兒父母因應行為前二項為「我期望事情會好轉」、「我盡力尋找關於照顧孩子的資料」。男性早產兒、單胞胎、疾病嚴重度越高、出生週數越少、出生體重越低者，其父母之不確定感較高，早產兒父母不確定感較高者，與採情感取向的因應行為呈正相關，折衷家庭較常使用情感取向的因應行為，早產兒父母不確定感較高者，與採問題取向的因應行為呈負相關，父親及教育程度越高者較常使用問題取向的因應行為，經逐步迴歸分析發現出生週數、早產兒性別、情感取向的因應行為、問題取向的因應行為是 父母不確定感重要影響因子，可解釋33%變異量。結論／實務應用：護理人員需主動了解父母不確定感因素，協助父母獲得認知行為策略及相關訊息，以加強家庭和社會生活的適應，提昇護理服務品質。

關鍵字

早產 ； 早產兒父母 ； 不確定感 ； 因應行為

並列摘要

Background: Preterm infants face higher health and developmental risks both immediately following birth and over the long term. Therefore parents of premature infants face significantly higher uncertainty and unpredictability than those who carry their children to term. Purpose: This study explores the relationship between uncertainty and coping strategies in parents of preterm infants. Methods: This study used a cross‐sectional design and structured questionnaires. Participants were recruited at a medical center hospital in Taichung City in Central Taiwan. Questionnaire data were collected from 130 parents of preterm infants. Mishel's Parent Perception of Uncertainty Scale (PPUS) and the Jalowiec Coping Scale (JCS) were used. Results: The top two uncertainty items cited by participants were: ”It is not clear what is going to happen to my child” and ”It is difficult to determine how long it will be before I can care for my child by myself.” The top two coping behavior items were: ”Hope things will get better” and ”Try to find out more about the situation to handle it better.” Uncertainty score correlated positively with male births, singleton births, illness severity and negatively with gestational age and birth weight. Results also identified a positive correlation between uncertainty score and the degree to which participants pursued emotion‐based strategies and a negative correlation between uncertainty score and the degree to which participants pursued problem‐focused strategies. Fathers and parents with higher education levels tended to employ problem‐focused strategies more than their peers. Conclusions / Implications for Practice: Pediatric nursing staffs may apply the findings to help parents of preterm infants use cognitive coping behaviors to handle feelings of uncertainty and enhance the ability of family members to adjust their life and improve infant care quality. Stepwise regression analysis found number of birth weeks, infant gender, emotion‐oriented coping behaviors, and problem‐oriented coping behaviors to be important factors of influence on level of parent uncertainty, explaining 33% of total variance.

並列關鍵字

premature infant ； parents of preterm infants ； uncertainty ； coping strategies