一位雙胞胎死產婦女失落哀傷之護理經驗

The Loss and Grief of a Mother who Gave Birth to Stillborn Twins

本文描述一位懷胎21+6週時面對雙胞胎早產導致死產之失落哀傷婦女之護理經驗。護理期間為2012年1月23日至1月26日及出院後兩次電訪，筆者運用護理專業溝通技能收集個案生理、心理、社會、靈性、發展等五大層面之資料，確立個案健康問題為「哀傷；情境性低自尊；家庭運作過程增進的準備度」。筆者以無私的關愛，同理、接納個案負向情緒；善用家庭支持系統，引導家人分享失落哀傷之傷痛；鼓勵個案透過書信與逝去孩子對話，維持情感聯結。筆者初次照護死產個案，過程雖嫌生澀，然讓個案與家人不再避諱死產議題，進而懷抱希望地與案夫規劃下一次的懷孕。經由此個案之照護經驗，筆者建議產科護理養成教育及在職教育需納入死產照護，充實護理人員照護死產個案及家庭之專業知能。

Childbirth is a pleasurable experience for infertile couple, but when the premature labor and birth of stillborn twins occurs, this unexpected event has a severe impact on the pregnant woman and her family. This report shared the nursing care experience of a mother who gave birth to stillborn twins. The mother and her family received nursing care from January 23-26, 2012 during her hospital stay, and took part in a telephone survey after she returned home. The following problems were identified: grief, situational low self-esteem, and readiness for enhanced family processes. This study found that the mother had no obvious physical trauma from the delivery, but that she had developed psychosocial problems due to losing her babies. These problems included grief. feelings of guilt, low self-esteem, and thoughts of suicide. In the beginning of the postpartum period, her husband and relatives were afraid to mention the birth, and everyone evaded talking about the babies or the pregnancy. This study encouraged the couple to talk about their perceptions and thoughts with each other, and arranged a meeting for the relatives to discuss how to provide mutual support and face the loss of the babies. This study hoped that this case report could provide a reference for good care methods to improve the care quality when clinical nurses face the birth of stillborn infants.