一位高齡產婦面臨第三孕期胎死腹中之護理經驗

Experience of Nursing an Aged Woman with Intrauterine Fetal Death at the Third Trimester of Pregnancy

婦女歷經懷孕生產若無法順利得到期望中的新生命，對於本身及家屬是極大的衝擊。本文為照顧一位高齡婦女第三孕期突然胎死腹中，必須接受剖腹生產的護理經驗。護理期間由民國91年4月12至17日，筆者運用羅氏護理適應模式評估，了解個案面臨死產的震驚，且必須接受剖腹生產及失去期望中胎兒的事實，主要的護理問題有哀傷、疼痛、睡眠型態混亂。護理重點在於術後維持身體舒適、運用正向的護理支持及鼓勵，幫助個案與家人度過悲傷及面臨死產的低潮，藉著有效的溝通及同感心知道個案的情緒變化，滿足個案被了解的需求，運用傾聽、陪伴、會談與解決疑惑幫助個案提早走出哀傷的情緒以及鼓起勇氣坦然面對再次懷孕的挑戰，藉此護理經驗做為護理同仁日後照護之參考。

This article described the nursing experience of caring for an aged woman who had suffered from the intrauterine fetal death (IUFD) at the third trimester. Understanding the difficulties in facing the shock of fetal death, the need of cesarean section and the loss a long-expected baby, the author tried to use The Roy Adaptation Model of Nursing to make the patient through the sadness, the pain, and the disturbance in sleeping. In addition to the care of physical sufferings, the author made the use of positive attitude to help the patient and her family to pass through the depression state. Effective communication and sympathy satisfied the need of being understood, which help the author to keep up with the mood swing of the patient. Psychological support and encouragement such as listening, accompanying and communicating effectively helped the patient recover from the low state, and found the strength and courage to face the challenge of getting pregnancy. The experience can be a very good example for nursing staff to a hold positive attitude in caring patients with IUFD.