照顧一位不孕婦女接受胚胎植入術之手術全期護理經驗

Perioperative Nursing Experience of an Infertile Woman Undergoing Embryo Transfer

10.6386/CGN.202304/SP_34_1.0015

黃瑞珍(Jui-Chen Huang)；陳淑華(Shu-Hwa Chen)

不孕婦女 ； 胚胎移植 ； 術前訪視 ； infertile woman ； embryo transfer ； preoperative nursing consultation

長庚護理

34卷增訂刊1（2023 / 04 / 01）

1 - 12

繁體中文;英文

本篇描述一位34歲婦女因不孕症接受取卵及胚胎植入術之手術全期護理經驗。個案結婚3年未能懷孕生子，背負傳宗接代壓力，並首次面對人工生殖手術，出現焦慮及負向感受，引發筆者動機。照護期間為2019年12月7日與12月11日，以Gordon's 11項功能性健康型態評估為基礎，透過持續地關懷、觀察、訪談、傾聽、身體評估、直接護理、病歷查閱與電訪追蹤等收集資料，發現個案有：術前焦慮、潛在危險性手術情境傷害及特定知識缺失。藉由手術全期護理的介入，和個案在互信的基礎上，主動提供正確手術訊息及個別性護理，增進對手術的瞭解及因應能力；術中個案處於被麻醉下手術，自我控制能力完全喪失，全程參與並運用合適的安全防護措施；術後衛教個案日常生活起居的保健方法或諮詢並連結家庭支持系統等，強化居家自我照顧能力。建議於門診確定手術時，可運用QR Code條碼方式，提供個案先行閱讀相關衛教訊息，以降低術前焦慮。期望藉此能提供臨床照護類似個案之參考。

A 34-year-old woman who had not got pregnant for three years after her marriage. Under the tremendous pressure of carrying on the family line and facing the uncertainty of assisted reproductive treatment, anxiety and negative thinking flooded over her mind. A complete perioperative care is of vital importance to alleviate her anxiety and raise the chance of pregnancy. She was admitted on 7th December 2019 and discharged on 11th December 2019. During this period, based on Gordon's 11 function health patterns, we observed, interviewed, listened to her concerns and evaluated her physical condition. Together with the information collected from her chart and telephone interview, we found that her pressing concerns included preoperative anxiety, existing risk for operative injury and specify knowledge deficit. A mutual trust with the patient had been built up before perioperative care initiated. We then provided surgical informationto enhance patient's understanding of the goal of surgery and side effects and designed an individualized nursing careprogram for her. During the surgery, we accompaniedwith the patient and ensured every precautious measure be executed to avoid any injury in the operating room. In the postoperative period, we provided health information on daily life and inquiry service after discharge. For further outpatient surgery needed, we provided QR Code linkage to obtain pertinent health information in advance for patients in order to lower any anxiety. We would like to share this nursing experience to those who have similar clinical scenario.

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