「尋求受孕」對接受生殖科技治療婦女之生活經驗意義

The Meaning of “Seeking Conception” in Infertile Women’s Life Experience During in Vitro Fertilization Treatment

本研究目的為深入了解不孕婦女在接受生殖科技治療期間，尋求受孕之生活經驗的主要意義為何？及其情境脈絡（context）為何？以現象學探究的研究設計，研究情境為一所二千床之醫學中心，研究對象為完成一個月生殖科技治療之不孕婦女，以立意取樣，共得十五位研究個案。研究者以參與性的觀察，一面直接提供個案護理服務，並一面收集資料，將每位個案在一個月治療中與醫療環境互動過程的語言與非語言行為，以行為過程記錄成文字資料，每位個案各有七至八次之資料收集，每次約一至二小時。此資料經現象學之解釋性研究的三個策略分析；包括主題分析、特例與典範案例，歸類出生活經驗的類目。研究結果發現不孕婦女在治療週期中，其〝尋求受孕〞之生活經驗所具有的意義為：（1）生命歷程的生育完整性－－期待完美的生育功能；（2）生命歷程的自我主宰－－取捨與平衡於全權託付與自我主宰生育功能之間；（3）生命歷程的改變－－衝破與脫離不孕的困境及（4）生命歷程的成長－－認定自己是一位母親，由為人子女增長至為人母之發展任務。由於這四種獨特性之意義，個案們對於〝受孕〞寄予最大的希望，而有勇氣渡過這艱辛的一個治療週期。本研究結果，可協助醫療人員了解並設身處地體諒患者之生活經驗，提供人性化的醫療服務。並激發患者之潛能，使其解除、面對或超脫不孕之困苦，以確實執行二十一世紀所提倡的醫療科技與人文醫學的整合。

The purpose of this study was to explore the meaning of “seeking conception” in the infertile women's experience during in vitro fertilization (IVF) treatment. A phenomenological approach was adopted for the study. With purposive sampling, fifteen subjects were selected for in-depth interview. In accordance with the treatment courses, one month in each cycle, there were seven to eight times for data collection. Data from in-depth interviews were analyzed based on the interpretive research strategies of phenomenology. Four key themes emerged from the data: (1) gestalt of conception: expecting the geslalt of concoption, including pregnancy, delivery, and rearing children; (2) self-mastery: balancing between entrusting and self-mastery, including self arrangement, management, and self control versus entrusting high technology and the medical team; (3) changing self-image: breaking away from the infertile self-image and shifting to the fertile status; and (4) growing self: changing identity from a woman to a mother. The results suggest that the medical team should be aware of the insights of infertile women and foster the transition to fertility with appropriate nursing care.