早產兒照護之倫理觀點及其影響因素之調查研究－－以某醫學中心之極低體重早產兒父母為例

The Study of Parents' prespective of Ethics and Effects in Caring the Very-Low-Birth-Weight Premature Baby

本研究目的在探討極低體重早產兒父母面對照護時之倫理觀點以及其影響的相關因素。採立意取樣方式，在88年1月至88年12月間，以某醫學中心新生兒加護中心之極低體重早產兒父母為研究對象，使用自擬之回溯性問卷調查方式，共收集69份有效問卷。資料分析採描述性分析，以及Mann-WhitneyU、Kruskal-Wallis test等統計方法。結果如下：(1)極低體重早產兒父母認為有關照護事宜決定權應由家人決定；(2)醫護人員所提供的訊息以及對早產兒預後的了解，是影響父母們做決策時之最重要考量因素；(3)父母們對於生命信念最重要的是「當面臨倫理抉擇困境時，考慮的只是對早產兒是否有最大的好處及減少傷害至最低」；(4)父母的宗教信仰、是否有死亡子女、家庭收入，以及極低體重早產兒的出生體重、合併症數量和先天異常等基本屬性項目，與生命信念及價值觀的看法具有統計上的差異。此研究結果有助於醫護人員了解極低體重早產兒父母們在面臨照護決策時的倫理觀點，於臨床照護實務上建議能夠適時的提供充分資訊，適度介入宗教信仰及相關的精神支持策略，以協助父母們釐清思緒，降低面臨照護決策時導致之倫理衝擊。

The purposes of this study was to explore the parents' perspective of ethics in caring the VLBW premature infants, and the related factors. Subjects were selected by purposive sampling from the neonatal intensive care unit of a medical center from Jan-1999 to Dec-1999. The instruments were developed by the researchers conducted the study. Sixty nine questionnaires were retrieved and analyzed by described statistics, Mann-Whitney U and Kruskal-Wallis test. The results of this study revealed:(1)The decision to care for VLBW baby should be taken by parents. (2)Information about VLBW baby's outcome from medical staff are the major decision making factors. (3)Seeking the best welfare and minimizing harm for VLBW babies were there parents' major concerns in their belief of life. (4)Religion child mortality, income of family, infant's birth weight, complications and congenital anomalies were six variables significantly related to the parents; life belief. The results of this research will provide the nurses with more understanding about the parents' ethical perspectives. Applying these in clinical situations will improve care quality and reduce impacts from ethical decision-making.