應用紐曼系統模式照顧一位有兩次流產經驗安胎孕婦之護理經驗

Applying the Neuman System of Maternal-fetal Assessment to a Primipara on Tocolytic Treatment to Prevent Pre-term Delivery

本文是運用紐曼系統模式（Neuman System Model）照顧一位有兩次流產經驗之初產婦自33週破水安胎直到分娩的護理經驗。護理期間自92年4月10日至92年4月28日，個案因為過去的流產經驗對安胎過程充滿焦慮及不確定感。筆者運用紐曼系統模式之母親－胎兒評估工具評估個案壓力源，統整出家庭因應能力失調：妥協性及焦慮之護理問題，應用紐曼系統模式的三級預防護理措施，協助家庭學習新的因應方式、傾聽並提供個案正確訊息、提供床邊生產教育等護理措施，協助個案度過此次安胎危機順利分娩。

The article describes the process of caring for a primipara who had experienced miscarriages twice before from 33wks for gestation to delivery. Suffering from pre-term labor, she received tocolytic treatment in the hospital from April 10th to 28th, 2003. During her hospitalization, she was anxious and uncertain about tocolysis due to her history of miscarriage. The authors applied the Neuman system model maternal-fetal assessment to identify stressors of the mother, diagnosing the client as follows: ineffective family coping, patient compromised and anxiety. The authors applied primary, secondary and tertiary prevention measures. Interventions consisted of listening and providing appropriate medical information and childbirth education with the aim of helping the family learn new coping strategies and hel[ing the client minimize the risk of pre-term labor. The client later gave birth smoothly.