感染愛滋病毒剖腹產婦女之照護經驗

The Nursing Experience of Cesarean Section Surgery Care for an HIV-Infected Pregnant Woman

本篇探討一位懷孕18週診斷愛滋病毒感染的懷孕婦女，於妊娠39週住院行剖腹生產的護理經驗。在94年9月23日至10月5日照護期間依據紐曼系統模式為評估架構，藉由術前訪視、術中照護及術後探視會談，確立個案有焦慮、潛在危險性傷害、疼痛、社交隔離等健康問題。護理人員與個案建立專業性人際關係，並應用愛滋病與高危險妊娠專業知識，協助個案渡過剖腹產手術過程。筆者同時全程參與手術及術後恢復照護，藉由術前防護準備與手術室安全標準流程避免潛在危險性傷害，術後恢復期評估減輕疼痛促進舒適，同時鼓勵家屬共同參與產後新生兒照顧與個案的支持，增進親子依附關係及自尊感。由此個案照護經驗中，深深體會護理人員實為愛滋病周產期婦女重要的支持者與代言者，盼提供臨床產科護理人員參考，日後能對日益增多的愛滋病毒感染懷孕個案更深入了解及關懷，進而提升照護品質。本篇探討一位懷孕18週診斷愛滋病毒感染的懷孕婦女，於妊娠39週住院行剖腹生產的護理經驗。在94年9月23日至10月5日照護期間依據紐曼系統模式為評估架構，藉由術前訪視、術中照護及術後探視會談，確立個案有焦慮、潛在危險性傷害、疼痛、社交隔離等健康問題。護理人員與個案建立專業性人際關係，並應用愛滋病與高危險妊娠專業知識，協助個案渡過剖腹產手術過程。筆者同時全程參與手術及術後恢復照護，藉由術前防護準備與手術室安全標準流程避免潛在危險性傷害，術後恢復期評估減輕疼痛促進舒適，同時鼓勵家屬共同參與產後新生兒照顧與個案的支持，增進親子依附關係及自尊感。由此個案照護經驗中，深深體會護理人員實為愛滋病周產期婦女重要的支持者與代言者，盼提供臨床產科護理人員參考，日後能對日益增多的愛滋病毒感染懷孕個案更深入了解及關懷，進而提升照護品質。

This article describes the nursing experience in caring for a pregnant woman was diagnosed HIV during her prenatal examination in her 18th week and receiving Cesarean section surgery in her 39th week. The procedurewas designed according to the Neuman Systems Model between September 23rd and October 5th in 2005.Datawere collected through interviews, observations, listening and communications. Four nursing diagnoses were identified include ng anxiety, high risk for trauma, pain and social isolation.To improve maternal self-esteemand the attachment with the baby, individual nursing interventions were used including providing knowledge related to high-risk pregnancy, developing a good treatment relationship, encouraging the family members to participate in the newborn care, and supporting the case.The author hopes this case reportwill provide a useful reference to clinical obstetrics nurses assigned to caring for HIV- infected pregnant women.