孕婦面臨早產前驅症狀之自我處置經驗

Women's Experience of Self-Management of Early Symptoms of Preterm Labor

本研究目的在瞭解無早產方案介入的情形下，早產孕婦於初次就醫安胎前經歷到主觀早產前驅症狀時，採取哪些自我照顧行為，以作為早產預防衛生教育措施之參考。研究設計採質性研究，以立意取樣法（purposive sampling）取樣，資料之收集在台灣北部一所醫學中心之婦產科病房及產房進行，針對妊娠20週至36週之早產住院安胎孕婦為研究對象，共收案九人。以半結構式訪談指引為資料收集工具，會談內容以錄音帶方式記錄，經轉錄成文字後，再以言辭分析法（narrative analysis）分析資料。共收集九卷錄音帶記錄內容及轉錄之訪談實錄九份。結果呈現孕婦面臨早產前驅症狀之自我處置經驗包含四個主題，四項主題按其時序性依序為（一）症狀常態化，（二）區辨症狀之異常性與威脅性，（三）嘗試監控症狀與確保胎兒安全，以及（四）就醫決策的擺盪。四項主題可提供醫護人員瞭解孕婦在面臨早產前驅症狀之處置過程以及非直接尋求醫療體系協助的經驗歷程。此外，本結果亦可提醒醫護人員在早產預防介入措施上宜考量孕婦自我處置特質，以訂定合宜的早產預防措施計畫。

The purpose of this study was to identify women’s self-management experience in dealing with their symptoms of early preterm labor. A qualitative research methodology was utilized to conduct the research. The researchers selected nine pregnant women with early symptoms of preterm labor by purposive sampling. This research was conducted in the labor delivery observation room and in the postpartum unit of a medical center located in Northern Taiwan. In these two units, selected preterm women were admitted for clinical observation and to receive their preterm medical treatment. Women’s preterm labor self-management experiences were collected by semi-structured interview carried out by the researchers, who also obtained permission from participants to use tape recorders to record all interview content for data analysis. Interview contents were examined using the narrative analysis approach. The researchers were able to identify four central themes related to women’s experience of self-management of preterm labor. These four themes were: normalization of symptoms, identification of abnormality and threat, assuring fetus well-being and relieving symptoms, and difficulty in deciding to seek prompt medical advice. These four themes provide information for health care providers to understand how women deal with their preterm labor discomfort at home and why many women seek medical advice at a late stage of preterm labor. The researchers also suggest that health care providers may provide suitable plans to prevent preterm labor by considering the characteristics of women’s self-management experience when dealing with their symptoms of early preterm labor.