母親經歷新生兒死亡的經驗與感受－－質性回溯性研究

Mothers' Experiences and Perspectives of Neonatal Death: A Qualitative Retrospective Inquiry

本研究之目的在探討母親經歷新生兒死亡的經驗與感受。採質性研究，以回溯方式透過半結構性訪談指引收集資料，研究對象為曾經歷新生兒死亡的八位母親，訪談資料以Colaizzi（1978）的現象學研究步驟進行分析。研究結果歸納出四個主要概念：(1)瀕死前的困惑：母親面臨非預期的新生兒死亡，常在疼惜脆弱的生命中找尋死亡的緣由，並陷於救與不救的兩難中。(2)失落後的混亂：母親面臨失落後會產生生理、心理與行為上的混亂，及難以認同的母親角色，使夫妻間產生不一致的期待。(3)失落後的調適：由於傳統的限制，使母親無法參與死亡儀式，產生不安與遺憾，面臨無助的安慰或宣洩，都無法不面對所背負的職責，必須以轉變的思緒來調適。(4)期待專業引導：母親期望有專業化的引導面對死亡的事實，能提供逝嬰紀念物與出院後關懷追蹤的必要性。本研究建議失落的母親透過適當的管道表達其哀傷，醫療院所應加強母親返家後的專業追蹤，協助經歷新生兒死亡的母親能夠早日重獲身、心、靈的健康。

The purpose of this qualitative study is to understand mothers' experiences and perspectives concerning neonatal death. In-depth interviews with eight mothers were conducted. Data were collected using a retrospective method based on semi-structured interview guidance, and analyzed according to Colaizzi's (1978) phenomenology approach. Four themes evolved: (1) Puzzlement on the brink of neonatal death: neonatal death, as an unpredicted event, constitutes a puzzle for mothers; they tend to seek the cause of the mishap, and in turn, fall into a dilemma about whether to try to save the newborn. (2) Chaos in the wake of the loss of babies: mothers' experience of physical, mental, and behavioral changes which might stymie their original positive attitude toward the role of being a mother, and further cause a divergence of expectations between the husband and wife. (3) Adjustments in the wake of the loss: when mothers try to adjust themselves, common approaches, such as good-will pep-talk and emotional utterance/sharing, are not really helpful. Certain factors also play a part, ether positively or negatively, in the mental adjustment process; they include responsibility for the household, intentional mood-diversion, prohibiting the mother from participating in funerals for the babies. (4) Professional guidance: mothers expect to receive professional guidance to help them to face the fact of death, especially in the moment of separation; providing memorabilia and personalized follow-ups for mothers are beneficial. In conclusion, it is suggested that mothers experiencing neonatal death should be encouraged to express their grief through appropriate emotional channels, and receive professional follow-up to rebuild physiologically, psychologically, and spiritually, rather than suppressing their mourning.