一位先天性膽道閉鎖患孩母親之壓力及因應行為

Stresses and Coping Behaviors of a Mother of a Baby with Congenital Biliary Atresia

本文是描述護理人員協助一位母親，於其先天性膽道閉鎖患孩住院治療時的壓力與因應行為之護理過程。筆者將照護患孩期間至患孩往生前，與個案的互動，以觀察及會談的方式，蒐集相關資料撰寫成六篇行為過程實錄，並以內容分析法整理歸納。結果發現個案的壓力源共有四項，包括：一、患孩之病情變化；二、治療照護過程；三、經濟來源短絀；四、缺乏社會支持。因應行為方面，個案採取情緒性：如焦慮、罪惡感、哀傷；認知性：包括確認、評價及比較醫療行為；解決問題：尋求醫護人員協助及宗教支持等三種因應行為。筆者於護理期間，依個案之需求給予適當照護：透過護病關係的建立，協助個案調整情緒、提供醫療資訊並尋求支持系統，陪伴個案渡過此次壓力過程。期望藉由此個案報告，協助護理人員瞭解膽道閉鎖患孩母親的壓力及其因應行為，提供臨床照護先天缺陷兒母親的參考。

This article described the nursing experience of assisting a mother of a baby with congenital biliary atresia to cope with the stress during the hospitalization period. After six consultation sections with the client, contents of interview and observation were transcribed in a process recording format and analyzed. Results revealed that the case had four sources of stress, including baby’s conditions, intervention of treatment, and lack of financial and social support system. Mother’s coping behaviors included emotional reaction, such as anxious, sorrowful; cognitional reaction such as confirmation, evaluation, and comparing; and problem-solving reaction such as seeking relief from medical staff or religion. The staff provided appropriate nursing care to the mother in nursing processes, including establishing positive nurse-patient relationship, helping her to adjust emotionally, providing treatment information, and seeking for appropriate support systems. The experience emphasized the importance of paying attention to the need of the mother of a baby with congenital deficiencies.