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研究生:江巧琴
研究生(外文):CHIANG, Chiao-Ching
論文名稱:母親經歷新生兒死亡的經驗與感受:質性回溯性研究
論文名稱(外文):Mother's experiences and perspectives of neonatal death: A qualitative retrospective inquiry
指導教授:唐婉如唐婉如引用關係
指導教授(外文):Tang Woung-Ru
學位類別:碩士
校院名稱:長庚大學
系所名稱:護理學研究所
學門:醫藥衛生學門
學類:護理學類
論文種類:學術論文
論文出版年:2007
畢業學年度:95
語文別:中文
論文頁數:102
中文關鍵詞:新生兒死亡失落哀傷
外文關鍵詞:neonatal deathlossgrief
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本質性研究之目的在探討母親經歷新生兒死亡的經驗與感受。共訪談八位曾經歷新生兒死亡的母親,以回溯方式透過半結構性訪談指引來收集資料,並以Colaizzi(1978)的現象學研究步驟進行分析,歸納出四個主要概念:「瀕死前的困惑」、「失落後的混亂」、「失落後的調適」、及「專業化的引導」。
依據研究結果顯示:1. 母親面對非預期的新生兒死亡,常在困惑中找尋死亡的緣由,面對生與死的兩極反應而陷於救與不救的兩難中。2. 母親在失落後產生生理、心理與行為上的改變,導致母親角色難以認同,而使夫妻之間產生不一致的期待。3. 失落後的母親無論面對他人無效的安慰或透過本身宣洩的方式,都無法不面對所背負的母親角色,因此常以轉變的思緒來調適失落後的哀傷,母親常因文化剝奪的限制無法參與新生兒的善終過程而導致日後的不安與懊悔。4. 母親期望有專業化的引導帶領其接受死亡的事實,特別是在死亡的剎那,提供逝嬰的紀念物有助於哀傷過程中依附關係的延續,多數母親也強調出院後醫護人員電話關懷追蹤的重要性。
本研究建議失落的母親透過適當的管道表達其哀傷,醫療院所應加強母親返家後的專業追蹤,與家屬共同協助經歷新生兒死亡的母親能夠早日重獲身、心、靈的健康。
The purpose of this qualitative study is to understand mothers’ experiences and perspectives concerning neonatal death. In-depth interviews with eight mothers were conducted. Data were collected using retrospective method based on semi-structured interview guide, and analyzed according to Colaizzi’s (1978) phenomenology approach. Four theme concepts were concluded: puzzles on the brink of neonatal death, chaos in the wake of the loss of babies, adjustments in the wake of the loss of babies, and professional guidance.
The findings are: 1) neonatal death, as an unforeseeable or unpredicted event, constitutes a puzzle for mothers; they tend to seek the cause of the mishaps, and in turn, fall into a dilemma of whether to save the newborn; 2) in the wake of the loss, mothers experience physical, mental, and behavioral changes which might stymie their original positive attitude toward the role of being a mother, and further cause disagreement of expectations between the husband and wife; 3) when mothers try to adjust themselves, common approaches, such as good-will pep-talk and emotional utterance/sharing, are not necessarily meaningful or really helpful. Some factors also play a part, either positively or negatively, in the mental adjustment process; that include responsibility for the household, intentional mood-diversion, prohibiting the mother from attending or participate in funerals for the babies; 4) mothers expect to receive professional guidance to help them facing the fact of death, especially in the moment of separation; providing memorabilia and personalized follow-ups for mothers are beneficial.
In conclusion, it is suggested that mothers experiencing neonatal death should be encouraged to express their grief through appropriate emotional channels, and receive professional follow-ups to rebuild physiologically, psychologically, and spiritually, rather than suppressing their mourning.
第一章 緒論
第一節 研究動機與重要性………………………………………1
第二節 研究目的…………………………………………………3
第二章 文獻查證
第一節 母親失去依附關係的失落感受…………………………4
第二節 母親喪失新生兒的哀傷過程……………………………7
第三節 健康照顧者的照護方式…………………………………16
第四節 質性研究…………………………………………………20
第三章 研究設計與方法
第一節 研究方法…………………………………………………22
第二節 研究參與者………………………………………………24
第三節 研究工具…………………………………………………26
第四節 資料收集的過程…………………………………………29
第五節 資料整理與分析…………………………………………31
第六節 研究的嚴謹度……………………………………………33
第七節 論理考量…………………………………………………35
第八節 預期困難與解決方法……………………………………36
第四章 研究結果
第一節 基本資料分析……………………………………………39
第二節 她~經歷誕生死的煉獄 …………………………………43
第五章 討論
第一節 母親失去新生兒返家後的生活經驗與感受……………68
第二節 專業照顧者所扮演角色的重要性………………………72
第六章 結論與建議
第一節 結論………………………………………………………79
第二節 研究長處與限制…………………………………………80
第三節 建議………………………………………………………81
第四節 研究者的反思……………………………………………84
參考資料
中文部分……………………………………………………………86
英文部分……………………………………………………………89
附錄 ………………………………………………………………96
一、中文部份
王純娟(2002)。哀傷歷程「階段論」之批判。輔導季刊,38(3),48-52。

因流產、死產、新生兒死亡而失去寶寶的父母協會(2003)。誕生死。台北:新苗文化。

余玉眉、蔣欣欣、陳月枝、蘇燦煮、劉玉秀(1999a)。質性研究資料的量化及詮釋—從研究例證探討臨床護理研究方法與認識學,第一部份:質性臨床護理研究之方法學及認識學的探討。護理研究,7(3),276-287。

余玉眉、蔣欣欣、陳月枝、蘇燦煮、劉玉秀(1999b)。質性研究資料的量化及詮釋—從研究例證探討臨床護理研究方法與認識學,第二部份:研究例證之方析與詮釋。護理研究,7(4),377-391。

李幼華、林淑珊、邱致中(2004)。一位胎死腹中婦女引產之護理經驗。長庚護理,15(2),209-217

李佳容(2002)。個人面對親人死亡事件心理復原歷程之研究。彰化縣:師範大學輔導研究所碩士論文。

李從業(2002)。傷慟關懷服務於產科護理的運用。護理雜誌,49(1),28-33。

李碧娥(2003)。一位懷連體胎兒而中止懷孕的哀傷反應。醫護科技學刊,5(3),283-291。

吳秀碧(1999)。創傷性的失落與哀傷。輔導季刊,35(3),1-7。

汪文聖(2001)。現象學方法與理論之反思:一個質性方法之介紹。應用心理研究,12(4),49-76。

杜蕙明(1999)。子宮內胎兒死亡之產婦的生活經驗。台北市:國防醫學院護理研究所碩士論文。

林金定、嚴嘉楓、陳美花(2005)。質性研究方法:訪談模式與實施步驟分析。身心障礙研究,3(2),122-136。

林家瑩(1999)。喪失子女的父母失落與悲傷反應及復原歷程之研究。高雄:師範大學輔導研究所碩士論文。

林雁秋、顏妙芬(2003)。協助一位急性腎衰竭母親面臨新生兒死亡的護理經驗。慈濟護理雜誌,2(2),90-96。

林耀盛(2002)。<質性研究:理論與實作對話>眾弦俱寂,唯一高音?反思質性研究。應用心理研究,13(1),1~7。

胡幼慧(1996)。質性研究:理論方法即本土女性研究實例。台北:巨流。

高淑芬、李明濱(1991)。哀傷與傷慟的身心醫學觀。當代醫學,18(4),89-94。

陳杏佳(1990)。現象學方法論與護理研究應用。新台北護理期刊,2(2),117-123。

陳榮華(1998)。葛達瑪詮譯學與中國哲學的詮譯。台北:明文書局。

張玉珍、朱翠萍(1999)。一位失去早產兒父親其角色及哀傷反應。長庚護理,10(1),51-55。

張淑美、劉玲君(2001)。成年人之失落經驗、失落反應及其因應行為之探討。輔導季刊,37(2),23-29。

張瑋倫(1999)。在急診室面對一位嬰兒猝死其雙親哀傷過程之護理經驗。護理新象,9(2),32-38。

曾英芬、許敏桃、郭玲莉(2001)。關懷照顧的現象學研究—從經歷死產之台灣婦女的經驗談起,9(3),223-231。

黃菊珍(2005)。週產期新生兒死亡父母親悲傷調適歷程之研究。台北市:國立台北護理學院生死教育與輔導研究所碩士論文。

葉月珍、馬素華(2001)。哀傷。榮總護理,18(4),429-434。

葉何賢(2003)。悲傷調適歷程及生命意義展現之研究-以喪子(女)父母為例。嘉義縣:南華大學生死學研究所碩士論文。

楊志偉、陳泰瑞(2004)。哀傷簡介。高雄縣醫師會誌,14,16-20。

熊偉(1994)。現象學與海德格。台北:遠流。

廖珍娟(1998)。喪失嬰兒父母之照顧。護理雜誌,45(4),23-32。

穆佩芬(1996)。現象學研究法。護理研究,4(2),195~202。

潘淑滿(2003)。質性研究理論與應用。台北:心理。

齊力、林本炫(2005)。質性研究方法與資料分析。嘉義:南華教社所。

藍逸梅、李從業、陳嘉琪(2001)。概念分析-親子依附。榮總護理,18(2),125~131。

Moran,D.(2005)。現象學導論(蔡錚雲譯)。台北:桂冠。(原著出版於1999)


二. 英文部份
Abe, N., Catlin, A., & Mihara, D. (2001). End of life in the NICU. A study of ventilator withdrawal. MCN American Journal Maternal Children Nursing, 26(3), 141-147

Beyea, S. C., & Nicoll, L. H. (1997). Qualitative and quantitative approaches to nursing research. The association of perioperative registered nurses, 66(2), 323-325

Brost, L., & Kenney, J. W. (1992). Pregnancy after perinatal loss: parental reactions and nursing interventions. Journal of gynecology and Neonatal Nursing, 21(6), 457-463

Buckalew, P. G., & Esposito, L. M. (1995). The role of the home health nurse in sudden infant death syndrome. Journal of Home Health Care Practice, 7(3), 36-45

Byrne, M.M. (2001). Understanding life experiences through a phenomenological approach to research. The association of perioperative registered nurses Journal, 73(4), 830-832

Caelli, K., Downie, J., & Letendre, A. (2002). Parents’ experience of midwife-managed care following the loss of a baby in a previous pregnancy. Journal of Advanced Nursing, 39(2), 127-136

Calhoun, L. K. (1994). Parents’ perception of nursing support following neonatal loss. Journal Perinatal Neonatal Nursing, 8(2), 57-66

Canadian Paediatric Society Statement. (2001). Guidelines for health care professionals supporting families experiencing a perinatal loss. Paediatric Child Health, 6(7), 469-477

Capitulo, K.L. (2004). Perinatal grief online. MCN, American Journal of Maternal Child Nursing, 29(5), 305-311

Capitulo, K.L. (2005). Evidence for healing interventions with perinatal bereavement. MCN, American Journal of Maternal Child Nursing, 30(6), 389-396

Catlin, A., & Carter, B. (2002). Creation a neonatal end-of-life palliative care protocol. Journal of Perinatology, 22(1), 184-195

Colaizzi, P.F. (1978). Pschological research as the phenomenologist views it. In R. Valle & M. King (Eds.), Existential-phenomenological alternatives for psychology (pp. 48-71). New York: Oxford University Press.

Cote-Arsenault, D. (2003). The influence of perinatal loss on anxiety in multigravidas. Journal of Gynecology and Neonatal Nursing, 32(5), 623-629

Davies , R. (2005). Mothers’ stories of loss: their need to be with their dying child and their child’s body after death. Journal Child Health Care, 9(4), 288-300

Dyer, K.A. (2005a). Identifying, understanding, and working with grieving parents in the NICU, Part I: identifying and understanding loss and the grief response. Neonatal Network, 24(3), 35-46

Dyer, K.A. (2005b). Identifying, understanding, and working with grieving parents in the NICU, Part II: Strategies. Neonatal Network, 24(4), 27-39

Gale, G., & Brooks, A. (2006). Implementing a palliative care program in a newborn intensive care unit. Advances in Neonatal Care: official journal of the National Association of Neonatal Nurses, 6(1), 37-53

Guba, E. G. (1990). The alternative paradigm dialog. In Cuba, E. G. (ED.), The paradigm dialog. London: Sage Publications.

Haas, F. (2003). Bereavement care: seeing the body. Nursing Standard, 17(28), 33-37

Hughes, P., Turton, E., Evans, & C.D.H. (2002). Assessment of guidelines for good practice in psychosocial care of mothers after stillbirth: a cohort study. The Lancet, 360(13), 114-118

Hsu, M. T., Tseng, Y. F., & Kuo, L. L. (2002). Transforming loss: Taiwanese women’s adaptation to stillbirth. Journal of Advanced Nursing, 40(4), 379-386

Hughes, P., & Riches, S. (2003). Psychological aspects of perinatal loss. Current Opinion in Obstetrics and Gynecology, 15(2), 107-111

Hutti M. H. (2005). Social and professional support needs of families after perinatal loss. The Journal of Perinatal and Neonatal Nursing, 34(5), 630-636

Jansen, J. L. (2003). A bereavement model for the intensive care nursery. Neonatal Network-Journal of Neonatal Nursing, 22(3), 17-23

John, A.S., Cooke, M. & Goopy, S. (2006). Shrouds of silence: Three women’s stories of prenatal loss. Australian Journal of Advanced Nursing, 23(3), 8-12

Kathleen, L.M., Celia, S. T., Sherylyn, H.B. (2005). The spiritual needs of parents at the time of their child’s death in the pediatric intensive care unit and during bereavement: A qualitative study. Pediatric Critical Care Medicine, 6(4), 420-427

Kavanaugh, K. (1997). Parents’ experience surrounding the death of a newborn whose birth is at the margin of viability. Journal of Obstetric Gynecologic Neonatal Nursing, 1(26), 43-51

Kavanaugh, K., Trier D., & Korzec, M. (2004). Social support following perinatal loss. Journal of Family Nursing, 10(1), 70-92

Kubler-Ross, E. (1969). On death and dying. New York: Macmillan

Laakso, H., & Marita, P. I. (2001). Mother’s grief following the death of a child. Journal of Advanced Nursing, 36(1), 69-77

Laakso, H., & Marita, P.I. (2002). Mothers’ experience of social support following the death of a child. Journal of Clinical Nursing, 11(2), 176-185

Lang, A., Goulet, C., & Amsel, R. (2004). Explanatory model of health in bereaved parents post-fetal/infant death. Nursing Studies, 41(8), 869-880

Logsdon M. C., & Davis, D. W. (2003). Social and professional support for pregnant and parenting women. MCN, The American Journal of Maternal Child Nursing, 28(6), 371-376

Lundqvist, A., Nilstun, T., & Dykes, A. K. (2002a). Both empowered and powerless: Mothers’ experiences of professional care when their newborn dies. Birth, 29(3), 192-199

Lundqvist, A., Nilstun, T., & Dykes, A. K. (2002b). Experiencing neonatal death: an ambivalent transition into motherhood. Pediatric Nursing, 28(6), 621-625

Lundqvist, A., Nilstun, T., & Dykes, A. K. (2003). Neonatal end-of-life care in Sweden — The views of Muslim women. Journal of Perinatal and Neonatal Nursing , 17(1), 77-86

McHaffie, H. E., Laing, I. A., & Lloyd, D. J. (2001). Follow up care of bereaved parents after treatment withdrawal from newborns. Archives Disease in Childhood Fetal & Neonatal Edition, 84(2), 125-128

Michelle, B. (2001). Hermeneutics as a methodology for textual analysis. The Association of Perioperative Registered Nurses, 73(5), 968-970

Mitchell, M. (2005). Preparing student midwives to care for bereaved parents. Nurse Education in Practice, 5, 78-83

Moore, D. B., & Catlin, A. (2003). Lactation suppression:Forgotten aspect of care for the Mother of a dying child. Pediatric Nursing, 29(5), 383-384

Netranipa, P., Sucheera, P., Dittakarn, B., & Prasert, S. (2004). Maternal grief after abortion and related factors. Journal of Medical Association Thailand, 81(11), 1275-1280

Parkes, C. M. (1972). Bereavement: Studies of grief in adult life. New York: International

Pector, E. A. (2004). Views of bereaved multiple-birth parents on life support decisions, the dying process, and discussions surrounding death. Journal of Perinatology, 24(1), 4-10

Potts, S., & Farrell, M. (1999). Treasure Weekend: supporting bereaved siblings. Palliative Medicine, 13(1), 51-56

Robertson, P. A., & Kavanaugh K. (1998). Supporting parents during and after a pregnancy subsequent to a perinatal loss. The Journal of Perinatal and Neonatal Nursing, 12(2), 63-71

Robinson, M., Baker L., & Nackerud L. (1999). The relationship of attachment theory and perinatal loss. Death Studies, 23(3), 257-270

Romesberg, T. L. (2004). Understanding grief: A component of neonatal palliative care. Journal of Hospice and Palliative Nursing, 6(3), 161-170

Ruden, B. M. (1996). Bereavement follow-up: An opportunity to extend nursing care. Journal of Pediatric Oncology Nursing, 13(4), 219-225

Russo, C., & Wong, A. F. (2005). The bereaved parent. Journal of Clinical Oncology, 23(31), 8109-8112

Ryan, P. F., Cote-Arsenault, D., & Sugarman L. L. (1991). Facilitating care after perinatal loss a comprehensive checklist. Journal of Gynecology and Neonatal Nursing, 20(5), 385-389

Schaap, A. H., Wolf, H., Bruinse, H. W., Barkhof-van de Lande, S., & Treffers, P. E. (1997). Long-term impact of perinatal bereavement comparison of grief reactions after intrauterine versus neonatal death. European Journal of Obstetrics & Gynecology and Reproductive Biology, 75(2), 161-167

Scholmann, P., & Fister, S. (1995). Parental perspectives related to decision—Making and neonatal death. Pediatric Nursing, 21(3), 243-47

Schultz, G.S., & Cobb-Stevens, R. (2004). Husserl’s theory of wholes and parts and the methodology of nursing research. Nursing philosophy, 5(3), 216-223

Shieh, C., Kravitz, M., & Wang, H. H. (2001). What do we know about maternal-fetal attachment? Kachsiung Journal Medical Sciences, 17(9), 448-454

Stinson, K.M., Lasker, J.N., Lohmenn, J., Toedter, L.J. (1992). Parent’s grief following pregnancy loss: a comparison of mothers and fathers. Family Relations, 41(2), 218-223

Stringer, M., Shaw, V. D., & Savani, R. C. (2004). Comfort care of neonates at the end of life. Neonatal Network, 23(5), 41-45

Sumner, L.H., Kavanaugh, K. & Moro, T. (2006). Extending palliative care into pregnancy and the immediate newborn period state of the practice of perinatal palliative care. Journal Perinatal Neonatal Nursing, 20(1), 113-116

Van, P. & Meleis, A. I. (2003). Coping with grief after involuntary pregnancy loss: Perspectives of African American woman. Journal of Gynecology and Neonatal Nursing, 32(1), 28-39

Wallerstedt, C., Lilley, M., & Baldwin, K. (2003). Interconceptional counseling after perinatal and infant loss. Journal of Gynecology and Neonatal Nursing, 32(4), 569-573

Worden, J. W. & Monahan, J. R. (1993). Caring for bereaved parents. In A. Armstrong Dailey, & S. Z. Goltzer (Eds.), Hospice care for children (pp. 122-139). New York: Oxford.

Workman, E. (2001). Guiding parents through the death of their infant. Journal of Gynecology and Neonatal Nursing, 30(6), 569-573

Zachariah, R. (1994). Maternal-fetal attachment: influence of mother-daughter and busband-wife relation-ships. Research in Nursing& Health, 17(1), 37-44
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1. 穆佩芬(1996)。現象學研究法。護理研究,4(2),195~202。
2. 廖珍娟(1998)。喪失嬰兒父母之照顧。護理雜誌,45(4),23-32。
3. 葉月珍、馬素華(2001)。哀傷。榮總護理,18(4),429-434。
4. 張瑋倫(1999)。在急診室面對一位嬰兒猝死其雙親哀傷過程之護理經驗。護理新象,9(2),32-38。
5. 張淑美、劉玲君(2001)。成年人之失落經驗、失落反應及其因應行為之探討。輔導季刊,37(2),23-29。
6. 張玉珍、朱翠萍(1999)。一位失去早產兒父親其角色及哀傷反應。長庚護理,10(1),51-55。
7. 高淑芬、李明濱(1991)。哀傷與傷慟的身心醫學觀。當代醫學,18(4),89-94。
8. 林耀盛(2002)。<質性研究:理論與實作對話>眾弦俱寂,唯一高音?反思質性研究。應用心理研究,13(1),1~7。
9. 林雁秋、顏妙芬(2003)。協助一位急性腎衰竭母親面臨新生兒死亡的護理經驗。慈濟護理雜誌,2(2),90-96。
10. 林金定、嚴嘉楓、陳美花(2005)。質性研究方法:訪談模式與實施步驟分析。身心障礙研究,3(2),122-136。
11. 汪文聖(2001)。現象學方法與理論之反思:一個質性方法之介紹。應用心理研究,12(4),49-76。
12. 吳秀碧(1999)。創傷性的失落與哀傷。輔導季刊,35(3),1-7。
13. 李碧娥(2003)。一位懷連體胎兒而中止懷孕的哀傷反應。醫護科技學刊,5(3),283-291。
14. 李從業(2002)。傷慟關懷服務於產科護理的運用。護理雜誌,49(1),28-33。
15. 李幼華、林淑珊、邱致中(2004)。一位胎死腹中婦女引產之護理經驗。長庚護理,15(2),209-217
 
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