喪失早產兒的父母之悲傷及照護

Parents' Grief at the Loss of a Premature Infant and Approaches to Their Care

每年約有三千多名極低體重早產兒死亡，表示台灣每年有三千多對父母失去他們的早產兒。對父母而言，最大的傷痛莫過於失去孩子，失去孩子猶如失去未來，尤其早產兒在父母未預期的情況下出生，就結束生命，父母會面臨一些困境，但臨床上卻常被護理人員忽視。本文目的是在探討悲傷輔導相關理論，以提供父母合宜的照護，當護理人員了解父母的悲傷反應，則他們的反應可被理解及接受。文獻整理之悲傷過程分為：休克及麻木期、找尋及渴望期、瓦解混亂期、再組織期；悲傷的反應包括有：感覺、生理感官知覺、認知、行為四部份；悲傷復原的四個任務為：接受失落的事實、經驗悲傷的痛苦、重新適應一個逝者不存在的新環境、將逝者的情感重新投注在未來的生活上。透過悲傷輔導理論提出照護失去早產兒的父母之具體措施及三項建議，以作為臨床工作之參考，期望增進護理人員對此議題的認知，提供更完善的照護，護理品質得以提昇。

The more than 3,000 deaths of premature infants due to low weight in Taiwan cause deep personal grief in their parents, for whom there is no pain greater than losing a child. This loss, nearly always sudden and unexpected, is an issue often ignored by clinic nursing staff. The purpose of this paper was to consider various grief counseling theories in order to help nurses attend to the grief counseling needs of parents who lose a premature infant. Better understanding of parents' grief responses by nursing staffs will help nurses to accept and address such. Grief processes identified include: shock and numbness, searching and yearning, disorientation and reorganization. Grief responses include: feel, physiology and sense organs, cognition and behavior. The four tasks essential to grief recovery include: to accept the reality of the loss, to work through the pain of grief, to adjust to an environment in which the deceased is missing, and to emotionally relocate the deceased and move on with life. Coaching through grief counseling theory puts forward and looks after concrete measures, and provides three suggestions for the parents who lose a premature infant. These can be used as reference by clinical staffs, help promote nursing staff understanding of this topic, help improve care for grieving parents and improve care quality.