一位已結紮婦女經由生殖科技再次懷孕後於第二次孕期接受終止妊娠的行為反應

Behavioral Responses of a Ligated Woman Who Had Become Pregnant after Assisted Reproductive Technology to Receiving Termination in the Second Trimester of Pregnancy

本個案研究是以田野研究法（field method）探討一位曾經接受結紮行的婦女，在藉由生殖科技終於懷孕後，於第二孕期因胎兒異常而接受終止妊娠產生的行為反應。研究者是於個案住院期間以觀察者即參與者的方式收集資料，再將個安當時呈現的語言與非語言行為書寫成行為過程記錄，共計5篇，資料並以內容分析法予分析、整理、歸類。結果發現此個案呈現的行為反應有：一、關注身體變化；二、母性任務的報行；及三、對終止妊娠產生的行為反應與調適行為：（一）個案於終止妊娠呈現的行為反應，包括：1.憤怒、不滿；2.期望的失落；3.哀傷；4.內疚、自責；5.失去探制力；及6.自我評值。（二）個案對終止妊娠的調適行為有：1.合理化；2.推測及歸因；3.迴避行為；及4.準備行為。生殖科技給予不孕症患者一線生機，即便曾經結紮的婦女都因此受惠，但若孕況生變，必須終止妊娠時，孕婦可謂功虧一簣，處境極為艱困，因此極需我們提供一個支持性的環境，予以接受、陪伴及分享她所有的感受，滿足其身心需求，以協助個案順利渡過此一哀傷過程，逐步的地出創痛。

The purpose of this case study was to explore the behavioral responses of a ligated woman who had become pregnant after assisted reproductive technology, to receiving termination in the second trimester of pregnancy. The field method was used and data were collected through nursing process recording and analyzed with content analysis. Three main areas of her behavior were inductively identified: (1) Concern about her physical changes; (2) Mothering tasks; (3) Behavioral responses and adaptation to termination. Assisted reproductive technology had given her hope, but the failure of her pregnancy made her very sad. She needed support and understanding, and to share her experience with others. The findings of this case study can provide useful information for nurses when caring for such women.