照護一位高危險妊娠婦女孕育雙胞胎的護理經驗

Caring Experience of a Woman Who is Pregnant with Twins and at High-Risk

本文係描述照護一位曾經妊娠失敗經驗之婦女，妊娠7週因陰道出血住院安胎之護理經驗，個案擔憂妊娠是否能夠延續及胎兒是否健康的巨大壓力。照護期間自2012年8月24日至2012年11月5日，運用Calgary之家庭評估模式，深入探討個案因高危險妊娠入院安胎的問題。結果發現個案護理問題為（一）不確定感（二）照顧者負荷（三）家庭因應能力失調；經由照護過程深入了解個案家庭對於住院安胎期間的困境及需求，提供以家庭為中心的照護，藉此降低住院個案與家庭之衝擊，並適時運用家庭資源的建構，整合家庭成員相互支持的力量，促進家庭正向調適。由於高危險妊娠會嚴重威脅孕婦與胎兒本身的健康，且當今因高危險妊娠而住院的個案日趨增加，顯現出臨床照護的重要性，故藉此分享照護高危險妊娠個案之經驗，有助於臨床護理人員了解住院安胎家庭之護理需求，並可提供適切之護理照顧。

This article describes the nursing experience of caring a pregnant woman with vaginal bleeding who also had a history of intrauterine fetal death. From August 24 to November 5 2012, the author used Calgary Family Assessment Model to assess the pregnant woman’s needs. The nursing problems included uncertainty, caregiver burden, and disable family coping. Throughout the nursing process, the author deeply comprehends the pregnant woman and her family’s needs and the difficulties which they were facing during the hospitalization for tocolysis. In addition, the author provides the pregnant woman with family-centered nursing care so that it can reduce the impact of hospitalization for the pregnant woman and her family. Moreover, by appropriately applying family resources, the family members developed the power to support each other and this encouraged the family to adjust in a number of positive ways. High risk of pregnancy will seriously threaten the pregnant woman’s and her baby’s health. More and more pregnant women are being sent into hospital for high risk of pregnancy, suggesting the importance of clinical care This report should be shared with other clinical nurses and can serve as a reference when planning high quality nursing care for similar cases in the future.