一位雙胞胎孕婦安胎之護理經驗

The Nursing Experience for a Patient with Twins Primipara for Tocolysis

本報告是描述一位具護理背景懷有雙胞胎之初孕婦，在妊娠21週因早期子宮收縮至本院住院安胎之護理過程。筆者於96年4月1日至96年5月29日護理期間，以會談及觀察法收集資料，並運用Gordon十一項功能性健康型態評估個案，確立有情境性低自尊、焦慮、排便型態改變及睡眠型態紊亂等四項護理問題，運用關懷、傾聽與同理心建立信任關係，鼓勵個案表達內心感受、讚美與強調個人價值以增強自尊心；確保母體與胎兒安全與健康、提供正確訊息、增強家庭支持系統與分享成功個案經驗、詳細說明母兒狀況與小兒科醫療團隊介入以減輕焦慮；安排獨立隱密病室如廁，以改善排便問題；推持並促進環境與身體舒適以改善睡眠問題。由此次之護理經驗，體認護理人量不僅是個案的照護者，更是重要的支持者及諮詢者，以同理心、接納、及真誠的態度，持續關懷及陪伴個案，有助於增加封安胎成功的期待與信心的提高。

This report described the nursing process of a twins primipara woman with preterm uterine contraction during the twenty-first week of pregnancy. With the Gordon's 11-item functional health pattern assessment tool, data was collected through case interview and observation from April 1 to May 29, 2007. Four nursing problems were identified: situational low confidence, anxiety, elimination change, and sleep disturbance. The author established a trusting relationship with the patient, encouraged the patient's emotional expression, and enhanced the patient's confidence by respecting personal values. In order to ensure the mother and babies' safety and health, the pediatric team provided information, strengthened the support system by introducing a successful case, and explained the patient's condition to relieve her anxiety. Moreover, the author arranged a private environment for patient's bowel movement, and kept a comfortable and quiet room for patient's sleep. From this nursing experience, the author realized that nurses are not only caregivers but also important supporters and consultants. With empathy, acceptance, and sincerity, the nurses can provide continuous caring for and support to the patient with tocolysis.