照顧一位不孕症孕婦罹患急性闌尾炎抉擇終止妊娠之護理經驗

A Nursing Experience of an Infertile Woman with Appendicitis Terminating Pregnancy

本篇旨在描述一位不孕症婦女接受多次人工生殖後成功懷孕八周，但因急性闌尾炎需面臨抉擇終止妊娠，進而產生哀傷和失落之照護經驗。護理期間自2015年4月18日至4月27日，筆者運用羅氏適應模式進行系統性評估，並採直接觀察、會談及電話訪談等方式，確立個案有體溫過高、急性疼痛、抉擇衝突及哀傷等護理問題；照護期間筆者給予個別性生理照護，也協同醫療團隊召開家庭會議以提供醫療資訊與說明，協助個案面對終止妊娠的決定；亦藉由傾聽、陪伴及心理支持，輔以宗教信仰與心靈撫慰，讓個案能勇敢面對失去胎兒的事實及渡過終止妊娠的哀傷反應。本文盼能提供護理同仁於此類個案照顧之參考，以提升專業照護的品質。

The aim of this article is to describe a nursing process of an infertile woman eight weeks into pregnancy after multiple artificial inseminations facing decision to terminate pregnancy due to acute appendicitis and grief and loss as result of the decision. The Nursing period was from April 18 to 27, 2015. The author conducted systematic evaluation with Roy’s adaptation model via direct care, meetings, and phone interviews, and confirmed that the patient had hyperthermia, acute pain, grief, and decisional conflict. During the nursing period, the author provided individual physiological care, and coordinated with the medical team to hold a family meeting to provide medical information and instructions to assist the patient in facing the decision of pregnancy termination. The author also assisted the patient to accept the fact of her loss and overcome the grief reaction from pregnancy termination through listening, companionship, psychological support, and religion and spiritual solace. This article can serve as a reference for clinical nurses to improve the quality of professional care.