胎兒染色體異常的婦女於第二孕期接受終止妊娠之生活經驗

Lived Experience of Women with Fetal Chromosomal Abnormality Receiving Termination at Second Trimester

產前之胎兒染色體檢查，雖可協助婦女在產前篩檢出異常的胎兒，並依診斷行終止妊娠，但卻迫使婦女在平靜的孕程中，突然遭遇重大的衝擊。本研究目的為探討胎兒染色體異常之婦女，面對胎兒異常、急需決定接受與進行終止妊娠期間之一連串劇變的生活經驗。本研究採質性研究設計，以田野研究法，於台北市某醫學中心進行，研究對象為妊娠1-23週胎兒染色體異常的婦女，共收集5位。研究者以個案主護護理師之身份，於研究對象之胎兒染色體異常報告確認、接受終止妊娠至產後出院期間，約二週，一面提供護理照護，一面進行訪談資料收集，平均每位個案進行4次面對面訪談，及3-6次電話訪談，並以敘述體的方式記錄，再以現象學之解釋性研究分析資料。研究結果由資料歸類出婦女於第二孕期接受終止妊娠之生活經驗，包括三個類目：惡夢的開始、進行終止妊娠的煎熬、產後的落寞。結論：婦女面對胎兒異常並接受終止妊娠是一個連續性的歷程，建議醫療人員重視與提供不同階段性之人性化的護理照護。

Fetal chromosomal examination helps screen fetal chromosomal abnormalities prenatally. Diagnosis of such anomalies allows pregnancy termination, but causes tremendous trauma during pregnancy. The purpose of this study was to explore the lived experience of women suffering from fetal chromosomal abnormalities who are urgently required to terminate their pregnancy. The qualitative field study was conducted at a medical center in Taipei. The researcher, a primary nurse, conducted interviews with five women face to face or over the phone to collect the data. The period of care lasted for two weeks, beginning with confirmed diagnosis of fetal chromosomal abnormalities, followed by the subjects' decision on pregnancy termination, and ending up with their discharge from the hospital. The study is presented in narrative form and the data analyzed using interpretive research strategies of phenomenology. Three categories of lived experience emerged from the data: (1) recurring nightmares, (2) the torment from making the decision of pregnancy termination, and (3) frustration or sadness afterwards. The results illustrated that the lived experience of the women suffering from fetal chromosomal abnormalities and receiving termination was a continuous process. We suggest that medical staff concern themselves with the issue and provide humanistic caring for patients during the various different phases.