運用紐曼護理模式協助一位未婚少女照護極低體重早產兒的護理經驗

Nursing Experience of Using Newman System Model to Assist an Unmarried Teenage Girl to Take Care of a Premature Baby of the Extremely Low Body Weight

本文是在照護一位16歲少女未婚懷孕並早產娩出一名體重l,109公克的早產兒之護理經驗，護理期間自2007年11月20日至2008年3月23日，筆者在護理期間發現個案因未婚生子而茫然無助、獨自面對父母的生氣與失望以及家庭運作出現危機，故筆者於會客時間與家屬會談並以電話進行訪問，運用紐曼護理模式收集資料，確立個案有家庭運作功能改變、潛在性父母／嬰兒依附關係改變、早產兒照護知識缺失等護理問題，同時聯絡社工以建立整體照護網絡，並安排個案執行袋鼠式護理以增進親子依附關係。個案由剛開始因未婚產子面對家人的指責，到取得諒解進而全家共同參與案子的照顧，從不確定親子危機關係至建構親子依附關係。筆者藉由以家庭為中心的整體性護理，協助個案成功化解危機並重整混亂失序的家庭運作，建立日後照護早產兒的責任與能力，同時亦期望藉此報告提供護理人員在照護類似個案時的參考，給予專業性的護理照護，並以家庭為中心提供持續性及整體性之護理。

This article described the nursing experience of looking after an unmarried pregnant 16 years old young girl who delivered an extremely low body weight l109gm premature baby. The nursing period was from November 20, 2007 to March 23, 2008. The patient was very ignorant and helpless. Her parents felt angry and disappointed with her. Her family’s support system developed an urgent crisis. I started talking with her family in visiting time and with the telephone, and using Newman System Model to collect the materials. This patient had problems of changing family operation function and lacking the knowledge of taking care of a premature baby. According to the questions, I got in touch with social workers in order to set up a medical network. We arranged the performance of kangaroo care. We looked after the whole family and helped the patient to rebuild the family operation and solved the crisis. We taught her the skill of taking care of a prematurity and helped her to love the baby and assume her responsibility to the baby.