一位糖尿病婦女住院安胎及待產之護理經驗

Nursing Experience of a Hospitalized Woman with Diabetes Mellitus for Tocolysis and Childbirth

懷孕生產對婦女是件最感動又辛苦的過程。而高品質的照護對糖尿病孕婦而言，在產科的照護更為是相當重要的，若未做好相關的準備，對於母體及胎兒健康皆有極大危害，甚至影響生產結果。糖尿病孕婦若因血糖控制差合併早產或早期破水等現象，均需要住院安胎，此一過程對孕婦及其家庭上，亦會造成沉重的壓力及負擔。本文敘述一位罹患第二型糖尿病且曾有胎死腹中生產經驗的孕婦，於懷孕過程中，因子宮早期收縮合併早產現象而住院安胎、生產的護理過程。筆者於2006年8月19日至9月10日，以生理、心理、社會、靈性四個層面做評估，確立其護理問題為：焦慮感、急性疼痛、潛在危險性損傷等三項。針對這些問題，筆者運用關懷、傾聽、同理心之溝通技巧，建立互信的關係，並以個案之家庭為中心、提供適切及完善的護理措施，來達到緩解個案內心的焦慮，並協助其渡過整個住院過程。期能藉此個案報告的護理經驗與臨床護理人員分享，以提升日後照護此類個案的護理品質。

Childbirth to women is an affecting and difficult process. It is important to provide high quality care for women with diabetes mellitus. Poor blood sugar control and the signs of premature delivery or premature rupture of membranes often resulted in hospitalization for tocolysis, causing significant stress to the mother and her family. This article described the nursing experience during the hospitalized tocolysis period of a woman who had type 2 diabetes, preterm labor, and a history of intrauterine fetal death. From August 19 to September 10, 2006, author provided a physiological, psychological, societal, and spiritual assessment to the patient. The nursing problems of the woman included anxiety, acute pain, and risk for injury. The author applied appropriate communication skills, such as caring, listening, and empathy, to establish the mutual confidence relationship. The author also provided individualized, comprehensive, and family-centered care to relieve the woman’s anxiety and give mental support during hospitalized process. This report can share with other clinical nursing staffs and serve as a reference for planning high quality nursing care for similar cases in the future.