胎兒染色體異常的婦女於第二孕期接受終止妊娠之生活經驗

Lived experience of women with fetal chromosomal abnormally receiving termination at second trimester

徐金梅(Chin-Mei Hsu)

指導教授 ： 蘇燦煮

國立臺灣大學/醫學院/護理學研究所/碩士(2005年)

https://doi.org/10.6342/NTU.2005.01303

摘要

胎兒染色體檢查可以協助婦女在產前篩檢異常的胎兒，並對異常的診斷進行終止妊娠，然而，對於被確立診斷胎兒異常婦女而言，卻在平靜的孕程中突然遭遇重大衝擊。本研究目的為探討胎兒染色體異常之婦女，面對胎兒異常及急需決定接受終止妊娠之生活經驗。
本研究為質性研究設計，採田野研究法，於台北市某醫學中心進行，研究對象為胎兒染色體異常的婦女，共收集5人。研究者以個案主護護理師身份，於個案之胎兒染色體異常報告確認、接受終止妊娠至產後出院期間，約二週，一面提供照護一面進行訪談資料收集，平均每位個案進行4次面對面訪談及3-6次電話訪談，並以敍述體的方式記錄，再以現象學之解釋性研究分析資料，包括三個策略：主題分析、範例分析、典範案例分析。
研究結果由資料歸類出婦女於第二孕期接受終止妊娠之生活經驗，包括三個類目：惡夢的開始、終止妊娠的煎熬、產後的落寞。
婦女面對胎兒異常及接受終止妊娠是一個連續性的歷程，依據本研究結果建議醫療人員重視與提供不同階段性之護理照護。

關鍵字

胎兒染色體異常 ； 終止妊娠 ； 生活經驗

並列摘要

Fetal chromosomal examination can help women to screen fetal chromosomal abnormalities prenatally, and diagnosis of such anomalies allows pregnancy termination if necessary. However, termination of pregnancy will cause sudden tremendous trauma to women with confirmed cases of fetal anomalies during the supposedly calm period of pregnancy.
The aim of this research is to look at lived experience of women who suffer from fetal chromosomal abnormalities and are urgently required to terminate their pregnancy.
This study is a qualitative research and employs field method. Research was conducted at a medical center of a local hospital in Taipei. Subjects include five women with fetal chromosomal abnormally. As the primary nurse, The researcher conducted an average of four face-to-face interviews with each of the respondents, three to six interviews over the phone, while taking care of those patients. The period of care lasted for approximately two weeks, beginning with confirmed diagnosis of fetal chromosomal abnormalities, followed by subjects’ decision on pregnancy termination, and ending with them checking out of the hospital. The study, presented in the form of narrative, analyzes collected data by interpretive research strategies of phenomenology, including thematic analysis, exemplars, and paradigm cases.
This study looks at lived experience of women going through pregnancy termination during their second pregnancy, including three main issues: the onset of nightmares, the suffering of having to decide on pregnancy termination, and frustration and sadness following the operation.
The whole experience beginning with detecting fetal chromosomal abnormalities and ending with final decision for pregnancy termination is a continuous process. Suggestions based on the findings of this paper will be made to draw medical employees’ attention to this issue as well as to help them provide needed care during different phases of this nonstop process.

並列關鍵字

fetal chromosomal abnormalities ； pregnancy termination ； lived experience

參考文獻

行政院衛生署（2002）．中華民國公共衛生年報．台北：行政院衛生署。

謝豐舟（1999）．周產期醫學．台北：橘井。

江千代（1989）．優生保健與產前診斷及妊娠中絶．當代醫學，16（3），176-177。

黃璉華（1999）．優生保健．台北：臺灣省公共衛生研所。

曾英芬（1990）．分娩與生產過程之護理支持－－比較待產婦與護理人員的知覺．護理研究，8（4），470－481。