協助一位護理人員產下高危險性新生兒後之調適歷程

Nursing Experience in the Adaptive Process of a Nurse Delivering a Baby at High Risk

本個案報告係探討一位護理人員產下高危險性新生兒後之調適過程，以非結構式會談及觀察法搜集資料共整理出9篇行為過程記錄，隨後以穆(1997)之病孩病情發展之家庭系統動態特質分期為架構作資料整理。結果發現母親的調適依著患孩疾病發展之階段性而發展。在患孩病情處危機期時母親的調適反應包括：初獲新生兒狀況危急時的負向情緒表現、自責及罪惡感、擔心失去新生兒；於病情轉變期母親的調適反應包括：接受新生兒的病況、對醫療行為之關切、雙向親子互動、擔心新生兒之預後情形；於慢性期母親的調適反應包括：自護理人員手中承接照顧新生兒的工作、投入新生兒之復健工作。相較於一般未接受過護理專業訓練之母親，護理人員產下高危險性新生兒後之調適過程並無太大差異，護理人員雖有專業的訓練背景，在角色轉變為母親時仍掩飾不了擔心孩子病況，自然的反應出壓力調適行為。本報告記載協助一位護理人員在產下高危險性新生兒後，渡過各時期之壓力並正向適應後執行母親角色職責。期能藉由本文作為協助與關懷護理人員面對多重角色轉換壓力適應的參考。The case report concerned the adaptive process of a nurse who delivered a baby at high risk. Nine pages of behavior process recording were gathered by way of non-structure interview and observation. After coding the behavior process recordings, we integrated the data into stages of the family development system with ill children (Mu, 1997).The development of the nurse's adaptive reactions, including the series of crisis stage, transition stage and acceptance stage depended on the seriousness of the baby's condition. Comparing the non-nursing trained mother with the nursing trained mother the adapting process in a highly risky baby, no significant difference was found. For a nurse in a mother role, the stress coping behaviors would present itself naturally and not be related to her professional nurse’s training. The outcomes included a nurse who adapted to the stress of a highly risky newborn baby to carry out her responsibility as a mather. This report provides a reference for caring nurses confronting the stresses of multi-role transformation in their careers.