剖腹產後腰椎間盤突出之母職角色轉變護理經驗

Nursing Experience of the Maternal role, Post-cesarian-section, in a Patient with Lumbar disc Herniation

本文探討一位35歲女性於剖腹產後因腰椎間盤突出導致雙下肢乏力，無法照顧新生兒，進而在母職角色上出現無力感及適應困難的護理經驗。2024年2月2日至2月15日的護理期間，透過會談、傾聽、觀察家庭互動及查閱病歷等方式收集資料，並運用羅氏適應理論進行整體性評估。結果確立個案存在急性疼痛、身體活動功能障礙、無力感及角色功能因應能力失調等主要健康問題。護理過程中，結合護理專業獨特性及跨團隊協助，為個案制定個別化的復健計畫。藉由不斷強調母職的重要性，並指導新生兒照護技巧，成功緩解個案的腰部及雙下肢痠痛，增強其自我照顧能力，使個案逐漸能適應疾病帶來的挑戰，並順利返家享受為人母的喜悅。此次照護經驗顯示，疾病導致的母嬰隔離對母職適應及負向情緒的調整帶來極大挑戰。建議針對類似個案，應提早透過相關量表篩選出高風險者，並根據產後婦女的行為態度及心理調適階段，整合跨團隊資源提供適切照護。期待此經驗能為同仁照顧類似個案提供參考，促進母嬰健康及家庭幸福。

This case report explores the nursing experience of a 35-year-old female who developed bilateral lower limb weakness due to lumbar disc herniation, post-cesarean-section, resulting in an inability to care for her newborn and subsequent difficulties in maternal role adaptation. Data were collected during the nursing period (February 2-15, 2024) through interviews, active listening, observation of family interactions, and review of medical records. Roy’s Adaptation Model was applied to conduct a comprehensive assessment. The primary health issues identified were acute pain, impaired physical mobility, feelings of helplessness, and ineffective role performance. During the nursing process, an individualized rehabilitation plan was developed by integrating nursing expertise with interdisciplinary collaboration. By emphasizing the maternal role and providing guidance in newborn care, the lumbar and lower limb pain reduced and there was improved self-care. These interventions assisted a gradual adaptation to disease-related challenges and enabled the patient to return home to embrace the joys of motherhood. This nursing experience highlights that maternal-newborn separation due to diseases poses substantial challenges to maternal role adaptation and emotional regulation. For similar cases, it is recommended to implement early screening tools to identify individuals at high risk and to provide individualized interdisciplinary care according to the postpartum behavioral and psychological adaptation stages. This experience provides a reference for nurses to manage similar cases, ultimately promoting maternal-newborn health and family well-being.