一位生下先天缺陷兒的母親其壓力源及克服行為

Stressors and Coping Behavior of a Mother of a Congenitally Defective Infant

本篇個案報告是藉著照顧一位先天性食道閉鎖的新生兒，於患孩出生後六個月間與患孩母親的互動，以田野研究法寫成行為過程紀錄28篇，並以內容分析法進行資料的歸類分析。結果發現母親必須應付的壓力源，在孩子方面為診斷的衝擊、手術對孩子的威脅、與期望不符合的失落、長期居家照顧患孩的壓力。在母親本身則有傳統觀念的壓力、家人對孩子的不接受、社會標記的壓力、以及自我認同的壓力。而其克服行為則包括（1）處理自己負向的情緒，（2）積極增加與孩子的互動，了解孩子的特殊需要，（3）自社會互動中退縮，（4）努力維持正常的自我形象，給予自己正向的回饋，（5）評價家人的接受度。在母親適應其角色的過程中，可知母親壓力來源很廣泛，必須努力應用自己的潛能和資源來克服。護理人員在提供訊息、維持信心、促進親子關係及協助動員資源方面有很大的功能，並成為母親的主要支持人物之一。

This case study was conducted to explore the stressors and coping behavior on a mother’s experience in raising her congenitally detective infant. The data was collected through participant observations during the first six months after birth. Content analysis was used to analyze behavior records. The results show the stressors related to the care of the child including the impact of the diagnosis, life-threatening surgery, unexpected loss, and the burden of high-tech home care. Stressors related to the perception of the mother, including traditional belief, families’ attitudes, social stigma and alteration in self-identity, influenced the mother’s responses. Mother’s coping behaviors included: (1) handle with her negative emotions, (2) interact with her infant and meet the infant’s special caring needs, (3) limit her social activity, (4) maintain her self-image, (5) evaluate families’ acceptance. During this period, the nurse served as an important agent in helping the mother to gain information, maintain confidence, facilitate attachment and mobilize her resources.