孕產婦之母嬰連結經驗探討

A Study on the Experi Ences of Mother-Infant Bonding

10.6251/BEP.20110224.1

謝珮玲(Pey-Ling Shieh)；應宗和(Tsung-Ho Ying)；曾英珍(Ying-Chen Tseng)；薛媛云(Yuan-Yun Hsueh)；張孝純(Hsiao-Chun Chang)；許芳綺(Fang-Chi Hsu)；林信佑(Shin-Yo Lin)

母嬰連結 ； 母嬰關係 ； 母職 ； 依附 ； 產後焦慮 ； attachment ； motherhood ； mother-infant bonding ； mother-infant relationships ； postpartum anxiety

教育心理學報

43卷3期（2012 / 03 / 01）

681 - 700

繁體中文

「母嬰連結」是母親對寶寶付出的意圖，國內目前對孕產婦母嬰連結經驗的系統性探索尚屬有限，本研究的目的乃在探索孕產婦母嬰連結經驗的內涵。藉由質性典範之發現取向研法，以支持性的半結構式會談進行資料收集，並對會談紀錄進行內容分析。研究對象包括住院中的產婦與安胎孕婦共77名，其中又以產婦68名為主。結果發現孕產婦的母嬰連結包括有「照顧的承諾」、「對寶寶與親職的想望」、「珍惜憐愛與察覺個體性」、「身心負荷與在焦慮中摸索」等四個主題。研究結果除了具有文獻所描繪的母嬰連結內涵外，還指出母親在照顧嬰兒、被嬰兒所「喚起」時的身心狀態。此外，孕產婦對寶寶的母嬰連結中，同時包著正向與非正向經驗。由研究結果，研究者指出未來研究可繼續探討母嬰連結感的發展、相關因素與影響，並編製適合國人之母嬰連結評估工具，在實務上則應對母親之身心負荷感加以關注與支持。

The phenomenon of ”mother-infant bonding” is defined as ”the mothers' emotion and cognition toward their babies, as well as their commitment for babies' wellbeing”. The exploration of ”mother-infant bonding” is limited in Taiwan. The study aims on initial understanding of its nature. Based on the qualitative paradigm and discovery-oriented approach, the authors collect data by a scheme of semi-structured supportive interview. Content analysis was applied in the data analysis. Seventy-seven women who stay at one obstetric unit for childbirth or tocolysis participated in our study, in which in which the majority of participant consisted of women who gave birth to children (N = 68). Four domains of mother-infant bonding, including ”commitment”, ”representation of the child and motherhood”, ”cherish and the awareness of individuality” and ”burden, and explore with anxiety” were revealed. Not only the similar nature of mother-infant bonding was found in Taiwan mothers, we also delineate their psychological and physical status in thinking of or caring of their babies. Both of sweetness and bitterness were found in mothers' experiences. We suggest further explorations of the development, relevant factors and influences for mother-infant bonding are needed. A valid mother-infant bonding scale would be helpful in the assessment. The practitioners should pay more attention and caring in mothers' physical and psychological distress.

1. 陳素瑩、穆佩芬、夏萍絅、黃碧桃(2000)。早產兒返家照顧初期母親所經歷之家庭壓力經驗。護理研究，8(1)，26-35。
   連結：
2. 黃淑滿、周麗端、葉明芬(2008)。依附與其相關因素之後設分析─台灣近二十年文獻的研究。教育心理學報，40(1)，39-62。
   連結：
3. 葉光輝、黃宗堅、邱雅沂(2006)。現代華人的家庭文化特徵：以台灣北部地區若干家庭的探討為例。本土心理學研究，25，141-195。
   連結：
4. 趙梅如(2004)。親子間印象深刻之獎勵與懲罰的情感意涵。應用心理研究，21，219-250。
   連結：
5. 鄭溫暖、廖主民(2001)。以質的研究取向─初探本土優秀運動員的心理特性。體育學報，31，159-170。
   連結：
6. Bor, W.,Brennan, P. A.,Williams, G. M.,Najman, J. M.,O''Callaghan, M.(2003).A mother's attitude towards her infant and child behaviour five years later.Australian and New Zealand Journal of Psychiatry,37(6),748-755.
7. Bowlby, J.(1982).Attachment and Loss: Vol. 1. Attachment.New York, NY:Basic.
8. Brockington, I. F.,Macdonald, E.,Wainscott, G.(2006).Anxiety, obsessions and morbid preoccupations in pregnancy and the puerperium.Archives of Women's Mental Health,9(5),253-263.
9. Brockington, I. F.,Oates, J.,George, S.,Turner, D.,Vostanis, P.,Sullivan, M.,Loh, C.,Murdoch, C.(2001).A screening questionnaire for mother-infant bonding disorders.Archives of Women's Mental Health,3,133-140.
10. Chalmers, B.,Samarskaya, M. E.,Tkatchenko, E.,Wallington, T.(1998).Women's experiences of birth in St. Petersburg, Russian Federation: Following a Maternal and Child Health Intervention Program.Birth,15(2),107-116.
11. Deale, T.(2005).Associations between child development and women's attitudes to pregnancy and motherhood.Journal of Reproductive and Infant Psychology,23(1),63-75.
12. Feldstein, S.,Hane, A. A.,Morrison, B. M.,Huang, K. Y.(2004).Relation of the postnatal attachment questionnaire to the attachment Q-set.Journal of Reproductive and Infant Psychology,22(2),111-121.
13. Figueiredo, B.,Costa, R.,Pacheco, A.,Pais, A.(2007).Mother-to-infant and father-to-infant initial emotional involvement.Early Child Development and Care,177(5),521-532.
14. Figueiredo, B.,Costa, R.,Pacheco, A.,Pais, A.(2008).Mother-to-infant emotional involvement at birth.Maternal and Child Health Journal,13(4),539-549.
15. Fleming, A. S.,Rubble, D.,Krieger, H.,Wong, P. Y.(1997).Hormonal and experiential correlates of maternal responsiveness during pregnancy and the puerperium in human mothers.Hormones and Behavior,31,145-158.
16. Fraiberg, S.,Adelson, E.,Shapiro, V.(1975).Ghosts in the nursery: A psychoanalytic approach to the problems of impaired infant-mother relationships.Journal of the American Academy of Child Psychiatry,14(3),387-421.
17. Glasheen, C.,Richardson, G. A.,Fabio, A.(2009).A systematic review of the effects of postnatal maternal anxiety on children.Archives of Women's Mental Health,13(1),61-74.
18. Goulet, C.,Bell, L.,St-Cyr Tribble, D.,Paul, D.,Lang, A.(1998).A concept analysis of parent-infant attachment.Journal of Advanced Nursing,28(5),1071-1081.
19. Hall, P. L.,Wittkowski, A.(2006).An exploration of negative thoughts as a normal phenomenon after childbirth.Journal of Midwifery and Women's Health,51(5),321-330.
20. Jennings, K. D.,Ross, S.,Popper, S.,Elmore, M.(1999).Thoughts of harming infants in depressed and nondepressed mothers.Journal of Affective Disorders,54(1),21-28.
21. Klaus, M. H.,Kennell, J. H.(1983).Bonding: The beginnings of parent-infant attachment.New York, NY:New American Library.
22. Kumar, R. C.(1997)."Anybody's child": Severe disorders of mother-to-infant bonding.British Journal of Psychiatry,171(2),175-181.
23. Lincoln, Y. S.,Guba, E. G.(1985).Naturalistic Inquiry.Beverly Hills, CA:Sage.
24. McLearn, K. T.,Minkovitz, C. S.,Strobino, D. M.,Marks, E.,Hou, W.(2006).Maternal depressive symptoms at 2 to 4 months postpartum and early parenting practices.Archives of Pediatric and Adolescent Medicine,160,279-284.
25. Miller, L.、Rustin, M.、Rustin, M.、Shuttleworth, J.、樊雪梅譯(2002)。嬰兒觀察。台北:五南。
26. Moehler, E.,Brunner, R.,Wiebel, A.,Reck, C.,Resch, F.(2006).Maternal depressive symptoms in the postnatal period are associated with long-term impairment of mother-child bonding.Archives of Women's Mental Health,9(5),273-278.
27. Patton, M. Q.、吳芝儀譯、李奉儒譯(1995)。質的評鑑與研究。台北:桂冠。
28. Righetti-Veltema, M.,Conne-Perreard, E.,Bousquet, A.,Manzano, J.(2002).Postpartum depression and mother-infant relationship at 3 months old.Journal of Affective Disorders,70(3),291-306.
29. Robson, K. S.,Moss, H. A.(1970).Patterns and determinants of maternal attachment.Journal of Pediatrics,77(6),976-85.
30. Siu, B. W.,Ip, P.,Chow, H. M.,Kwok, S. S.,Li, O. L.,Koo, M. L.,Cheung, E. F.,Yeung, T. M.,Hung, S. F.(2010).Impairment of mother-infant relationship validation of the Chinese version of postpartum bonding questionnaire.The Journal of Nervous and Mental Disease,198(3),174-179.
31. Taylor, A.,Atkins, R.,Kumar, R.,Adams, D.,Glover, V.(2005).A new Mother-to-Infant Bonding Scale: Links with early maternal mood.Archives of Women's Mental Health,8(1),45-51.
32. Troy, N. W.(1995).The time of first holding of the infant and maternal self-esteem related to feelings of maternal attachment.Women Health,22(3),59-72.
33. 戈依莉(2004)。產後疲倦。護理雜誌，51(6)，75-79。
34. 王藝華、郭憲華(2006)。協助一位未婚青少女照顧早產兒之護理經驗。護理雜誌，53(5)，76-83。
35. 林素瑛、高美玲、李佳琳、李絳桃(2008)。陰道生產之產婦首次泌乳時間及其相關因素。實證護理，4(4)，257-266。
36. 胡蓮珍(2001)。一位處於婚姻衝突的高齡初產婦於產後的調適行為及護理。醫護科技學刊，3(3)，279-286。
37. 范惠珍、林盈慧(2007)。一位850公克早產兒之護理經驗。高雄護理雜誌，24(2)，17-29。
38. 張靖梅、林獻鋒(2009)。產婦實施24小時母嬰同室之壓力經驗。長庚護理，20(4)，429-440。
39. 許芳綺、林信佑、薛媛云、張孝純、應宗和、曾英珍、謝珮玲(2009)。產科病房「母嬰心理支持」服務之評估：產婦觀點。第四屆台灣臨床心理學會年會暨學術研討會，台北:
40. 陳昭惠、盧玉贏、潘履嵐、高美玲(2001)。台灣地區嬰兒親善醫院實施現況與未來展望。長庚護理，12(1)，64-70。
41. 陳筱婷、周汎澔(2007)。一位母親與其高危險新生兒依附關係建立過程：母性角色達成─為人母理論之應用。高雄護理雜誌，24(1)，38-49。
42. 穆佩芬、夏萍絅(1997)。早產兒家庭之壓力與調適。護理雜誌，44(4)，57-62。
43. 謝珮玲、應宗和、曾英珍、林信佑、薛媛云、許芳綺、張孝純(2009)。「母嬰心理支持」於產科病房之運作模式初探。第四屆台灣臨床心理學會年會暨學術研討會，台北:
44. 蘇建文、鍾志叢(1985)。母親養育嬰兒方式之調查研究。教育心理學報，18，117-148。

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