護理一位非預期剖腹之初產婦母乳哺餵的經驗

The Nursing Experience of a Breast-feeding Primipara with Unexpected Caesarean Section

本文是描述協助一位非預期剖腹產的初產婦其母乳哺餵之護理經驗。護理期間自2007年1月21日至1月26日。以Gordon十一項健康功能評估為指引，運用觀察、會談及身體評估收集資料，發現個案有：傷口疼痛、低效性母乳哺餵、睡眠型態紊亂及育兒相關知識缺乏等健康照護問題。於照護期間筆者扮演著諮商者與照顧者角色，幫助個案面對第一次哺乳及親子關係的互動；並針對上述健康照護問題，運用適當護理措施以滿足其生理需求，如應用背部按摩及放鬆技巧以減輕疼痛促進舒適，提供哺餵母乳相關知識及技能，以及協助運用支持系統，包括醫護人員、家人和成功哺乳產婦等人的協助，並且鼓勵個案執行親子同室之全家照護模式，讓家中其他成員也能學習如何從旁協助個案哺餵母乳與照顧嬰兒。在護理措施介入後，個案傷口疼痛有緩解，並成功持續哺餵母乳行為，也增進了育兒信心與親子關係。

This case study describes nursing care experiences of a breast-feeding primipara with unexpected caesarean section. The duration of nursing care was from January 21st to 26th, 2007. The Gordon 11-item Functional Health Pattern was used as an assessment tool to collect data through observations, interviews, and physical assessments. Health care problems including wound pain, less effective breastfeeding, disturbed sleep pattern, and deficient knowledge to nurse her baby were found. The author played roles as a consulter and a caregiver during this period of time to help the client to face her firsttime-breastfeeding and interactions between her and the baby. Focused at the client health care problems, the author used adequate nursing implications to support client’s physical needs, such as back massage, relaxing skills to release pain and provided knowledge and skills for breastfeeding, and assisted with available operate supporting systems including health care providers, families, and women who had success in breast-feeding. Additionally, the author encouraged the mother and her new born baby to have rooming-in cares. Furthermore, the other families could learn to take care of the baby and assist the mother to do breastfeeding. Through the nursing intervention, the client released her pain, sustained breastfeeding behaviors, and increased her confidence in nursing baby and interaction with her baby.