周產期死亡事件對護理人員的衝擊及其因應

The Impact of Perinatal Death on Nurses and Their Coping Strategies

護理人員被期待有能力照護遭遇周產期死亡事件的婦女與家庭，但此事件與情境也衝擊著醫療及護理人員本身的情緒，調適不佳者可能會因此種未解決的哀傷轉為複雜性哀傷，因而損及其健康，甚至影響其照護意願及品質。但這些受創經驗及困難感受卻甚少受到關注，本文自內生感受及外在壓力等角度探討護理人員在照護周產期死亡事件時感受到的衝擊及其因應方式，發現護理人員也與此事件之婦女及家庭一樣地經歷哀傷的過程，他們會有悲痛、無能、無力的感覺，也因為擔心損及專業形象而不敢哭泣，他們尚須擔心說錯話、做錯事所引發的法律問題；而他們常以限制自己投入程度，或表現出有意無意地逃避等方式調適，且通常只與同儕傾訴，因此加強同事支持以及由機構提供正式的教育訓練及情緒輔導，甚至發展具實證基礎的照護模式更為重要，本文也針對未來的政策、策略及研究方向給予建議。

Nurses are expected to care for grieving women and families suffering from perinatal loss. However, these losses can also significantly impact upon the emotional state of nurses. Failure to adjust may endanger the affected nurse's health and render him or her unable or unwilling to provide continuous quality care. There has been little prior research addressing the effect of patient perinatal loss on nurses tasked with providing nursing care. This paper focuses on internal perceptions and external stresses to explore the impact of this traumatic experience on nurses and related coping strategies. We found that nurses experience a grieving process similar to those directly suffering from perinatal loss. Nurses feel sadness, incompetence, and helplessness but dare not cry in order to protect their professional image. They may also worry about the potential legal risks of verbalizing or otherwise expressing their feelings. Strategies frequently used to adjust to the emotional strain include limiting his or her commitment to the patient, seeking emotional escape, and talking to colleagues. Therefore, it is important to develop institute- or hospital-based emotional support networks and training programs and evidence-based nursing care standards for this important issue. This paper also suggests future policies, nursing strategies and further research directions.