照顧一位安胎失敗之產婦面臨周產期失落哀傷歷程之護理經驗

The Nursing Experience of Caring for a Female Patient Undergoing Perinatal Loss Grief Journey after Tocolysis Failure

本文是敘述一位安胎失敗之產婦，護理人員協助其渡過周產期失落哀傷歷程之護理經驗，護理期間為西元2011年6月21日至2011年6月24日。筆者運用Gordon十一項健康功能性型態進行整體性評估，以觀察、會談、諮詢及身體評估等方式收集資料，歸納出個案的健康問題有：一、哀傷／與失去期望中的寶寶有關；二、情境性低自尊／與無法達成母性任務有關。產科臨床醫護人員對於遭遇死產之產婦，大部份仍以醫療處置為主，較少關注其接觸死亡孩子的意願，若能熟悉失落胎兒所造成之哀傷護理，提供立即性適切的照護，協助個案藉由實際行動接受失去胎兒的現實感，並從中鼓勵表達發洩失落的情感，將使得哀傷父母能以正向健康的態度度過危機。故筆者在照顧個案之過程中，除給予生理的基本照護，並從心理層面來瞭解個案感受、想法，提供整體性照護，與家屬共同協助個案度過失落哀傷。筆者期望藉此文獻及護理經驗，提供臨床護理人員照護此類個案之參考，以發揮護理的實質功能。

This paper describes the nursing experience of caring for a female patient undergoing perinatal loss grief after tocolysis failure during nursing period June 21-24, 2011. The Gordon 11-item Health Functional Patterns model was used to overall evaluate the patient and collect data. The following health problems were summarized by observation, interview, consultation and physical assessment: 1. Grief, which relates to the loss of baby in expectation 2. Low self-esteem, which relates to unreached maternal tasks. For female patients who undergo stillbirth, most clinical nurses in Obstetrics pay more attention to medical treatment than their wishes in touching the dead child. If nursing staff are familiar with the care of grief relief resulting from the loss of child and provide instant and proper care, assist the patient to accept the fact of child loss and encourage her to express the feelings of child loss, the parents in grief will be able to go through and get over the crisis with a positive and healthy attitude. During nursing care period, the author has tried to mentally take care of the patient and understand her feelings and thoughts in addition to the basic medical treatment so as to provide an overall caring system. Through this paper and the nursing experience, the author hopes to provide clinical nursing staff with a reference in this kind of case in order to give a more practical function in nursing.