協助一位未婚青少女照顧早產兒之護理經驗

The Nursing Experience in Helping an Unmarried Adolescence Girl to Care for Her Premature Infant

本文主要描述協助一位未婚青少女由拒絕至願意學習照顧其早產兒之過程。筆者擔任案子之主護護士期間，發現個案甚少探視案子，原生家庭亦對個案抱怨連連，故於個案住院及到院探視案子時採觀察、會談及電話訪問方式收集資料，運用羅氏適應理論、家庭結構及APGAR家庭功能評估進行資料分析，察覺個案有家庭運作過程改變、潛在危險性父母／嬰兒依附關係改變及早產兒知識缺失等問題。為協助個案及其家庭適應改變，筆者扮演照顧者、支持者、教育者及家庭協調者之角色，溝通親子想法、安排全家會談及教導早產兒袋鼠護理等，終使全家對案子照護問題達到共識，個案也能獲得父母諒解與支持，並漸漸願意學習至熟練早產兒照顧技巧。對未婚青少女母親照護上，應避免批判，並提供家庭良好的互動管道，實施個別性護理計畫及後續照顧方案，才可達到最佳護理效能。建議青少女一入院，社工能立即介入，以提供各項資訊、由公立醫院落實青少年婦產科專門門診、並結合出院準備服務及社區後續關懷，方能提供一整體與持續性的照護。

This case study describes the author's experience in helping an unmarried adolescent girl learn to take proper care of her premature infant. Primary data were collected by observing interactions as well as from face-to-face and telephone interviews. Roy's model, family structure and the APGAR family function assessment theory were used to analyze data. Major problems identified included: alteration of family function, potential risk of parent/infant attachment and insufficient knowledge on the part of the mother regarding childcare. During the course of this study, the author served in a variety of roles including caregiver, educator and support-giver to the adolescent mother as well as provided training on in-home use of the Kangaroo technique for premature births. Maintaining a non-judgmental attitude and providing encouragement to the adolescent mother were essential to the success of assistance efforts. The establishment of an adolescent obstetrics outpatient service with social work intervention, discharge services and home visits by community nurses may be necessary in order to achieve holistic care goals.