照護一位因胎兒染色體異常接受終止妊娠婦女之護理經驗

Woman with Fetal Chromosomal Abnormally Receiving Termination: A Nursing Experience

產前篩檢雖可早期診斷胎兒染色體異常，讓婦女儘早依意願進行終止妊娠處置，卻也迫其提前切斷與胎兒生命的聯結。如何在短暫的引產住院期間，提供身心照護以協助婦女順利度過哀傷，值得吾人關切。本文即是照護一位因胎兒染色體異常而接受終止妊娠婦女於住院期間的護理經驗，護理日期自2009年11月10日至11日。筆者在個案待產及產後護理期間，除建立良好的護病關係及提供支持，並運用羅氏適應模式為基礎，藉由觀察、會談、身體評估等方式收集資料。確立個案主要護理問題為：疼痛／引產處置、哀傷／因胎兒染色體異常接受終止妊娠，針對個案之護理問題，筆者運用人性化的護理照護概念，藉由同理心、傾聽及陪伴，引導抒發內心感受與情緒，協助接受醫療處置及失去孩子的事實，減輕對產婦及家屬造成的衝擊及壓力，促進個案在生理需要、自我概念、角色功能及相互依賴等方面的調適。期藉此護理經驗的分享，提供婦嬰護理人員日後照護與關懷此類個案之參考。

Prenatal diagnosis could detect fetal chromosomal abnormalities early but also shut-down the mother-fetus attachment by the choice of pregnancy termination. How to help these women to cope with the difficult situation in a short staying at the hospital is challenging and deserves additional attention. This case report shared a nursing experience of a woman who had fetal chromosomal abnormally receiving pregnancy termination. During two days of nursing period (Nov. 10 to Nov. 11, 2009), author provided support and used the Roy掇 Adaptation Model as a tool to assess and collect data. Two main nursing problems had determined: 1) pain from induction process; and 2) grief caused by pregnancy termination. In the nursing process, author provided holistic nursing interventions to reduce the impact on the patient and her family members, including listening and empathy how they feel about this situation, assisting them to receive the medical interventions and accept the fact of losing baby, and improving their adaptations. This nursing experience may as a reference for nurses to deal properly with the misfortunate situation in the future.