一位因胎兒異常需終止妊娠婦女的護理經驗

Termination of Pregnancy due to Congenital Abnormalities of Her Twin Fetuses

對一位接受生殖技術而懷孕的母親及其家庭而言，胎兒的成長是充滿期待和喜悅的，然而最大的衝擊莫過於在得知胎兒不健康後的驚慌與無所適從。本篇探討一位藉由人工受孕成功懷有雙胞胎的母親，在安胎過程中得知胎兒異常後接受終止妊娠所經歷之壓力及情緒上的改變。藉由Gorden十一項健康護理評估，確立護理問題有高危險性傷害、照顧者角色緊張、抉擇衝突、哀傷及情境性低自尊等。提供以家庭為中心的照護，幫助個案及家庭克服安胎時的焦慮及不適，並能在得知胎兒畸型不適合再繼續懷孕，其心理由強烈沮喪、哀傷和應付能力失調等狀態下，協助其增加決定能力，進而坦然接受醫療的建議，實施終止妊娠，讓個案及家屬能在人性化及完整性的護理照護下，安然度過這段令人悲苦交集的歷程。期能將此護理經驗提供大家分享，作為日後照顧此類病患時的參考。

To a mother and her family, the pregnancy is through embryo implantation, the growth of the baby is filled with hope and expectations. However, it is the biggest shock to find out that the baby has birth deficiency. This article discusses a mother with a successful embryo implantation of twins. From the process of prenatal test, the mother found out the birth defects of the twins and thus faced with the pressures and emotional changes from accepting pregnancy termination. Based on Gorden, the health problem identifications included high risks of injury, caregiver role strain, decisional conflict, grieving and situational low self-esteem. As the family was the center of care, help should be aiven to the person and family to overcome the anxiety and awkwardness. Knowing the embryo deformity did not suit to continue the pregnancy, we assisted the mother to increase the ability to make decision from the intense mourning and sadness. Then she accepted the medical suggestion to terminate pregnancy. We provided the individual and her family with humanly and complete nursing care to deal with the periods of sadness. We hope to share this nursing experience with other nurses as a reference to deal with this kind of situation in the future.