協助一位早產兒母親建立親子依附關係之護理經驗

Nursing Experience of Assisting a Mother with a Premature Infant to Establish the Relationships between Child's Attachment and Mother

本文敘述一位母親因早產併胎兒窘迫剖腹產後建立親子依附關係之護理經驗。個案擔心早產兒的病況，感到自責、焦慮、不安、內心承受巨大的壓力，需要更多醫護人員的支持及鼓勵，引發筆者書寫的動機。照護期間2018年2月27日至3月5日，筆者透過直接照顧及觀察會談，以羅式適應模式評估及收集資料，發現護理問題有：焦慮／與哺餵母乳知識缺乏／與擔心早產兒病情有關、潛在危險性父母／嬰兒依附關係改變與早產兒分離及互動受限有關、知識缺失／與缺乏早產兒照訊息有關。於照護期間透過依附關係的發展，運用袋鼠式護理增進個案與早產兒的互動，提供早產兒照顧及母乳哺餵相關資訊，協助個案以正向態度學習，提升照顧能力及順利哺餵早產兒。建議可成立早產兒父母親支持團體臉書群組，提供早產兒父母親表達內心感受，和分享個人照護經驗及吸取他人經驗，增加支持系統的空間，期望藉由此照護經驗可提供護理人員日後臨床照護之參考。

This article describes the nursing experience of a mother who established a parent-child attachment relationship after a caesarean section due to premature delivery and fetal distress. This case worried about the condition of the premature baby, she felt self-blame, anxiety, disturbed, and suffering from heavy pressure . Therefore, it's need more support and encouragement from the medical staff, which triggered the author's motivation to write. From February 27th to March 5th, 2018, by using direct and indirect observations, listening and interviewing to search the information, with Roy's adaptation model to convince of the patient has anxiety / lack of knowledge about breastfeeding / and worry about premature babies. The condition is related to the change of the potentially dangerous parent / infant attachment relationship, which is related to the separation and limited interaction of preterm infants, and the lack of knowledge / related to the lack of prenatal infant photo information. During the care period, through the development of attachment relationships, use kangaroo care to enhance the interaction between the case and the premature baby. The writer successfully solves the problems, so that patient and her family can smoothly face with the disease and surgical procedure together. Therefore, patient can have a great courage to accept the physical defect and learn how to self-care. Furthermore, improving the quality of life and return to daily life as soon as possible. This case is good for the hospitalization experience and can promote their quality of life. By sharing this nursing experience, it will provide treasure reference for the future.