题名

與初生生命的道別-護理人員面對死嬰護理的不安與行動

并列篇名

Saying Goodbye to the Newborn: The Unease and Actions of Nursing Professionals in Handling Stillbirth Care

DOI

10.6224/JN.62.1.29

作者

林千惠(Chien-Hui Lin);鄭凱元(Kai-Yuan Cheng);蔣欣欣(Hsien-Hsien Chiang)

关键词

團體互動 ; 護理感知 ; 逝嬰護理 ; group interactive ; nurse perception ; stillbirth care

期刊名称

護理雜誌

卷期/出版年月

62卷1期(2015 / 02 / 01)

页次

29 - 38

内容语文

繁體中文

中文摘要

背景 產房護理人員必須面對死嬰的情境,是無法逃避的現實,但其深層意涵需要釐清。目的 本研究目的在於探討產房護理人員面對死嬰護理的經驗。方法 採用質性研究法,以自由談的團體分析方式,曾有護理死嬰經驗的產房護理人員彼此對話與互動之過程記錄,成為本研究分析的文本。結果 護理人員從內在不安與護理行動,萃取主要主題有無法救治的不安以及面對生命的道別。無法救治的不安包括不能做什麼的罪惡感及終止生命的情緒糾葛;面對生命的道別包括母親與嬰兒間的道別以及自身與嬰兒間的道別;母親與嬰兒間的道別有關注母親的目光及承擔母嬰最後的相處,自身與嬰兒間的道別有為嬰體祈福及尊重逝去的嬰體。結論/實務應用 產房護理人員的團體對話助於展現其主體經驗,建立死嬰護理的實踐知識。

英文摘要

Background: Facing the death of newborns is an inescapable part of the professional responsibilities of delivery room nurses. The meaning of the inner conflict of these nurses and their nursing experience in handling newborn death is poorly addressed in nursing practice. Purpose: This research explores the stillbirth care experiences of delivery room nurses. Methods: A qualitative approach was used to investigate the stillbirth-care experiences of nurse participants. Results: The results elicited the experiences of participants with inner conflict and their resulting action caring. Main themes extracted from data include: feeling unease about being unable to provide effective treatment and the need to say goodbye to the deceased newborn. The former includes the subthemes of: guilt about doing nothing and feeling conflicted about ending a life. The latter includes: caring about and empathizing with the mother and accompanying the mother as she says goodbye to her baby. Additionally, the theme of saying a personal goodbye to the newborn baby includes praying for the baby and respecting baby's body. Conclusions/Implications for Practice: The findings of this study enhance the nursing practice knowledge of stillbirth nursing in the delivery room.

主题分类 醫藥衛生 > 預防保健與衛生學
醫藥衛生 > 社會醫學
参考文献
  1. Balaguer, A.,Martín-Ancel, A.,Ortigoza-Escobar, D.,Escribano, J.,Argemi, J.(2012).The model of palliative care in the perinatal setting: A review of the literature.BMC Pediatrics,12(1),25.
  2. Barlem, E. L. D.,Lunardi, V. L.,Lunardi, G. L.,Tomaschewski-Barlem, J. G.,da Silveira, R. S.,de Lima Dalmolin, G.(2013).Moral distress in nursing personnel.Revista Latino-Americana de Enfermagem,21,79-87.
  3. Benner, P. (Ed.)(1994).Interpretive phenomenology: Embodiment, caring, and ethics in health and illness.Thousand Oaks, CA:Sage.
  4. Breeze, A. C. G.,Lees, C. C.,Kumar, A.,Missfelder-Lobos, H. H.,Murdoch, E. M.(2007).Palliative care for prenatally diagnosed lethal fetal abnormality.Archives of Disease in Childhood- Fetal and Neonatal Edition,92(1),F56-F58.
  5. Buber, M.(1957).Guilt and guilt feelings.Psychiatry,20(2),114-129.
  6. Cherin, D.,Enguidanos, S.,Brumley, R.(2001).Reflection in action in caring for the dying: Applying organizational learning theory to improve communications in terminal care.Home Health Care Services Quarterly,19(4),65-78.
  7. Clinton, M.(1998).On reflection in action: Unaddressed issues in refocusing the debate on reflective practice.International Journal of Nursing Practice,4(3),197-202.
  8. Fenwick, J.,Jennings, B.,Downie, J.,Butt, J.,Okanaga, M.(2007).Providing perinatal loss care: Satisfying and dissatisfying aspects for midwives.Women and Birth,20(4),153-160.
  9. Gadamer、 H.,陳榮華(譯), Y. H.(Trans.)(2011).高達美詮釋學.台北市=Taipei City, Taiwan, ROC:三民書局=Sam Min Book.
  10. Gold, K. J.,Kuznia, A. L.,Hayward, R. A.(2008).How physicians cope with stillbirth or neonatal death: A national survey of obstetricians.Obstetrics and Gynecology,112(1),29-34.
  11. Krueger, R. A.,Casey, M. A.(2000).Focus groups: A practical guide for applied research.Thousand Oaks, CA:Sage.
  12. Merleau-Ponty、 M.,羅國祥(譯), G. X.(Trans.)(2008).可見的與不可見的.北京市,中國=Beijing, China:商務印書館=The Commercial Press.
  13. Moustakas, C.(1994).Phenomenological research methods.London, England:Sage.
  14. Nishida, K.,吳文宏(譯)(2013).自覺中的直觀與反省.台北市=Taipei City, Taiwan, ROC:聯經=Linking Book.
  15. Osterman, K. F.,Kottkamp, R. B.(1993).Reflective practice for educators: Improving through professional development.Thousand Oaks, CA:Corwin Press.
  16. Platzer, H.,Blake, D.,Ashford, D.(2000).An evaluation of process and outcomes from learning through reflective practice groups on a post-registration nursing course.Journal of Advanced Nursing,31(3),689-695.
  17. Schon, D. A.(1983).The reflective practitioner: How professionals think in action.New York, NY:Basic Books.
  18. Stockhausen, L.(2006).Metier artistry: Revealing reflection-in-action in everyday practice.Nurse Education Today,26(1),54-62.
  19. Taeusch, H. W.(Ed.),Ballard, R. A.(Ed.),Gleason, C. A.(Ed.)(2005).Avery’s diseases of the newborn.Philadephia, PA:Elsevier Saunders.
  20. Varcoe, C.,Doane, G.,Pauly, B.,Rodney, P.,Storch, J. L.,Mahoney, K.,Starzomski, R.(2004).Ethical practice in nursing: Working the in-betweens.Journal of Advanced Nursing,5(3),316-325.
  21. Wallbank, S.,Robertson, N.(2013).Predictors of staff distress in response to professionally experienced miscarriage, stillbirth and neonatal loss: A questionnaire survey.International Journal of Nursing Studies,50(8),1090-1097.
  22. Wool, C.(2013).State of the science on perinatal palliative care.Journal of Obstetric Gynecologic & Neonatal Nursing,42(3),372-382.
  23. Yalom, I. D.(1995).The theory and practice of group psychotherapy.New York, NY:Basic Books.
  24. 余德慧, D. H.(2001).詮釋現象心理學.台北市=Taipei City, Taiwan, ROC:心靈工坊=PsyGarden.
  25. 陳月枝, Y. C.(2000).質性護理研究方法.台北市=Taipei City, Taiwan, ROC:護望=Hu-Wang.
  26. 陳來, L.(2010).宋明理學.台北市=Taipei City, Taiwan, ROC:允晨文化=Win-Chang.
  27. 蔣欣欣, H. H.(2013).團體心理治療.台北市=Taipei City, Taiwan, ROC:五南=Wu-Nan.
  28. 蔣欣欣, H. H.(2006).護理照顧的倫理實踐.台北市=Taipei City, Taiwan, ROC:心理=Psychology.
  29. 蔡錚雲, C. Y.(2014)。護理倫理的哲學省思。護理與哲學的對話研習會,台北市=Taipei City, Taiwan, ROC:
被引用次数
  1. 曾煥棠、陳怡潓(2017)。加護病房護理人員死亡處理能力之探討。健康科技期刊,4(1),21-43。
  2. 林美慧,林青燕,周瓊慧(2022)。以周產期安寧照護概念協助一位因胎兒異常選擇終止妊娠孕母的護理經驗。長庚護理,33(3),121-131。