题名

運用共享決策於一位先天性腎上腺增生症初次懷孕婦女之生產方式決策

并列篇名

Application of Shared Decision Making on Birth Choice in a Primigravida Woman With Congenital Adrenal Hyperplasia

DOI

10.6224/JN.201910_66(5).11

作者

吳雅鈴(Ya-Ling WU)；呂秀春(Hsiu-Chun LU)；陳克仁(Ke-Jen CHEN)；張思儀(Szu-I CHANG)

关键词

先天性腎上腺增生症 ； 決策衝突 ； 共享決策 ； congenital adrenal hyperplasia ； decision conflict ； shared decision making

期刊名称

護理雜誌

卷期/出版年月

66卷5期（2019 / 10 / 01）

页次

80 - 85

内容语文

繁體中文
中文摘要

本文旨在運用共享決策於一位先天性腎上腺增生症初次懷孕婦女之生產決策。護理期間自2018年1月9日至2018年4月3日，依生理、心理、社會與靈性四大層面，進行整體性的護理評估，歸納孕婦主要健康問題有：焦慮和醫療抉擇衝突的健康問題。護理期間運用以個案為中心的照護模式，利用決策輔助工具於醫病討論，鼓勵表達內心感受，提供個案疾病風險與利益的生產方式及抉擇之完整資訊，以降低焦慮，並協助孕婦做出合宜的生產計畫與選擇，讓孕婦獲得更安全且高品質的照護。在臨床實務上，建議護理人員遇到先天性腎上腺增生症懷孕婦女時，可運用輔助決策工具，協助孕婦做最佳的生產選擇決策。
英文摘要

Shared decision making was used by a primipara with congenital adrenal hyperplasia to make decisions related to her delivery plans and process. The four components of the holistic nursing assessment process (physical, mental, social and spiritual) were conducted by the author from January 9th, 2018 to April 8th, 2018. The major concerns of the subject were anxiety and conflicts related to medical decision making for her health problems. The Case-Centered Care Model and Patient Decision Aids were applied in medical discussions conducted during the period of nursing care. The subject was encouraged to express her feelings during the process. The completed information for the delivery process, including the risks and benefits for the disease, was provided to the subject in order to lower her anxiety, assist her to select the most-appropriate plan for delivery, and ensure high quality, secure nursing care. Using Patient Decision Aids in clinical practice to help pregnant women make the best decisions for their delivery plans is recommended in cases where the patient has congenital adrenal hyperplasia.
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. 鄭君婷, C. T.,林秋菊, C. C.(2017)。知情同意於護理臨床實務之運用。護理雜誌，64(1)，98-104。
    連結：
  2. Cuhaci, N.,Aydın, C.,Yesilyurt, A.,Pınarlı, F. A.,Ersoy, R.,Cakir, B.(2015).Nonclassical congenital adrenal hyperplasia and pregnancy.Case Reports in Endocrinology,2015,Article ID 296924.
  3. Dugas, M.,Shorten, A.,Dubé, E.,Wassef, M.,Bujold, E.,Chaillet, N.(2012).Decision aid tools to support women's decision making in pregnancy and birth: A systematic review and meta-analysis.Social Science & Medicine,74(12),1968-1978.
  4. Elwyn, G.,Frosch, D. L.,Kobrin, S.(2016).Implementing shared decision-making: Consider all the consequences.Implement Science,11,114.
  5. Engberg, H.,Möller, A.,Hagenfeldt, K.,Nordenskjöld, A.,Frisén, L.(2016).The experience of women living with congenital adrenal hyperplasia: Impact of the condition and the care given.Clinical Endocrinology,85(1),21-28.
  6. Jain, D.(2013).Fertility and pregnancy outcome in a woman with classic congenital adrenal hyperplasia.BMJ Case Reports,2013,bcr2013201298.
  7. Mnif, M. F.,Kamoun, M.,Kacem, F. H.,Mnif, F.,Charfi, N.,Naceur, B. B.,Abid, M.(2013).Reproductive outcomes of female patients with congenital adrenal hyperplasia due to 21-hydroxylase deficiency.Indian Journal of Endocrinology and Metabolism,17(5),790-793.
  8. Molenaar, J.,Korstjens, I.,Hendrix, M.,de Vries, R.,Nieuwenhuijze, M.(2018).Needs of parents and professionals to improve shared decision-making in interprofessional maternity care practice: A qualitative study.Birth,45(3),245-254.
  9. Moore, J. E.(2016).Women's voices in maternity care: The triad of shared decision making, informed consent, and evidence-based practices.The Journal of Perinatal & Neonatal Nursing,30(3),218-223.
  10. Mun, D. H.,Yun, H. N.,Kim, J. W.,Kim, Y. H.,Song, T. B.(2016).Successful pregnancy and delivery of a patient with congenital adrenal hyperplasia.Obstetrics & Gynecology Science,59(1),50-53.
  11. Parsa, A. A.,New, M. I.(2017).Steroid 21-hydroxylase deficiency in congenital adrenal hyperplasia.The Journal of Steroid Biochemistry and Molecular Biology,165(Pt. A),2-11.
  12. Remde, H.,Zopf, K.,Schwander, J.,Quinkler, M.(2016).Fertility and pregnancy in primary adrenal insufficiency in Germany.Hormone and Metabolic Research,48(5),306-311.
  13. Witchel, S. F.(2017).Congenital adrenal hyperplasia.Journal of Pediatric and Adolescent Gynecology,30(5),520-534.
  14. 孫婉娜, W. N.,許心恬, H. T.(2017)。決策衝突之論述。高雄護理雜誌，34(1)，25-35。
  15. 國民健康署（2018）．新生兒篩檢歷年成果表．取自https://www.hpa.gov.tw/Pages/Detail.aspx?nodeid=499&pid=401 [Health Promotion Administration, Taiwan, ROC. (2018). Newborn screening results. Retrieved from https://www.hpa.gov.tw/Pages/Detail.aspx?nodeid=499&pid=401]
  16. 陳淑溫, S. W(2018)。共享決策在產科臨床上的應用。台灣醫學，22(5)，560-566。
  17. 衛生福利部醫病共享決策平台（2016）．醫病共享決策介紹．取自https://sdm.patientsafety.mohw.gov.tw/Public/Detail?sn=32&id=1035 [Ministry of Health and Welfare, Platform for Shared Decision Making. (2016). Introduction to medical disease sharing decision. Retrieved from https://sdm.patientsafety.mohw.gov.tw/Public/Detail?sn=32&id=1035]
print cancel