一位初產婦於分娩期維護身體界面完整性的行為

A Primipara's Behaviors to Maintaining Body Boundary Intactness during Labor

本個案研究的目的是探討一位初產婦於分娩期維護身體界面完整性的行為。第一作者擔任個案的主護護士，透過完全參與者的觀察方式，於護理過程中觀察個案的各項語言和非語言行為，並書寫行為過程記錄收集資料後，予以整理歸納分析。個案藉由護理人員作自我定向力與自我力量的來源，在Richardson提出之正常分娩過程的身體界面控制完整期及身體界面退縮可穿透期，應用語言表達、身體姿勢、手部行為及眼部行為以維護身體界面的完整性。主護護士所採取的護理措施，例如滿足生理需求與身體舒適、減緩內在壓力與疼痛、提供正確的訊息、正向鼓勵與迴饋、持續的關懷與支持及指導配偶參與照顧等，使得個案並未出現Richardson所稱的身體界面受到破壞的身體界面渾沌期之行為反應，成功地協助個案達成維護身體界面完整性。

The purpose of this filed study was to explore the efforts made by a primipara to maintain intactness of body boundary during her labor. As a participant observer the primary researcher simultaneously provided care and recorded the primipara's verbal and nonverbal behaviors. Via the nursing care, the primipara tried to achieve a sense of selforientation and lending of ego strength during the labor process. She used verbal, postural, hand and eye behaviors to maintain her body boundary intactness during the controlled-boundary intact phase and the regressive-boundary permeable phase of labor. The primary nurse provided effective nursing interventions such as attending to physical needs and comfort, reducing internal stress and pain, giving correct information, encouragement and emotional support, and providing uninterrupted care, as well as guiding the husband's involvement in the care system. Finally, the primipara did not enter into the desperate-body boundary diffuse phase. This case gives us an experience that primary nursing care may be helpful to a primipara in maintaining her body boundary intactness during labor.