經歷重複性妊娠失敗再度懷孕的高齡孕婦於住院安胎期間之行為表現

Behavioral Responses of an Older Woman Receiving Tocolysis after Repeated Failed Pregnancies

本研究是在探討一位經歷兩次妊娠失敗，而再度懷孕的高齡孕婦，在住院安胎期間的行為表現意涵。研究者透過實際護理的過程、運用深度訪談的方式，將孕婦所呈現的行為，包含語言及非語言的部分，寫成行為過程紀錄。經反覆研讀，將資料整理、歸納、分析，發現個案的壓力主要是來自於對妊娠是否能夠延續的不確定，以及擔憂胎兒的健康。為了能夠繼續妊娠、確保胎兒的健康，個案在住院安胎期間所呈現的行為包括：擔憂孕程狀況、採取有效策略以利安胎成功、遵從醫療措施與護理指導、設立妊娠時間標記以自我鼓勵、監控攝入的物質對胎兒的影響等。因此，護理人員主動發現個案的需要，提供以家庭為中心的護理，對安胎的孕婦以及家庭是非常重要的，以降低突如其來的分娩前早期破水，對個案與整個家庭所帶來的衝擊，裨益安胎的成效。

The purpose of this study was to explore the behavioral responses to tocolysis of an older woman who has experienced two failed pregnancies. As a participant observer the primary researcher simultaneously provided care and recorded the woman's verbal and nonverbal behaviors. After repeated data analysis, it was found that the woman's stress mainly resulted from her uncertainty about a safe passage through pregnancy and about the health of her fetus. In her effort to ensure a successful pregnancy and good fetal health, she exhibited the following behaviors: worrying about the status of her pregnancy, adopting effective strategies to ensure the success of the tocolysis, complying with medical procedures and nursing instructions, establishing the time marks of the pregnancy for the purpose of self-encouragement, and attaching importance to oral intake for the sake of good fetal health. The article concludes that medical personnel should actively identify the needs of pregnant women and provide family-centered nursing care to diminish the impact of preterm premature rupture of membrane and maximize the positive results of tocolysis.