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題名：母血篩檢唐氏症陽性孕婦面對羊膜穿刺術的決策過程
書刊名：護理研究
作者：周承珍／李從業／施富金
作者(外文)：Chou, Cheng-chen／Lee, Tsorng-yeh／Shih, Fu-jin
出版日期：2001
卷期：9:1
頁次：頁15-27
主題關鍵詞：母血篩檢唐氏症；羊膜穿刺術；決策過程；紮根理論；Maternal serum screening for Down's syndrome；Amniocentesis；Decision-making process；Grounded theory
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  • 被引用次數被引用次數:期刊(1) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:1
  • 共同引用共同引用:15
  • 點閱點閱:25
　　　　　本研究的目的在探討母血篩檢唐氏症結果為陽性的孕婦在面對羊膜穿刺術的決策過程。以半結構式訪談法，訪談17位孕婦，並使用紮根理論研究法來分析資料。結果發現，個案共有四種決策型態，並依其過程進展，可分為三個階段：獲知檢查結果後過渡期、決策過渡期及決策後過渡期。大部分個案有驚訝、害怕、緊張、擔心、難過、及壓力等反應，個案於決策過渡期關心的事項包括：確定胎兒的健康、正常、與安全，害怕羊膜穿刺術會造成流產、釐清羊膜穿刺術與母血篩檢的關係、傾聽醫生或家庭成員的意見、及害怕胎兒不健康而必須做人工流產的手術等。個案於決策後過渡期關心的事項，則有羊膜穿刺術的相關訊息、胎兒檢查結果為異常時的處置、執行羊膜穿刺術地點的選擇、檢查前的準備、及決策時間的不足等。每一階段並有相對應的因應策略。
　　　　　The purpose of this study was to explore the decision-making process of pregnant women with positive reaction to maternal serum screening for Down's syndrome when facing amniocentesis. Seventeen pregnant women consented to participation in this study. The data were collected through semi-structured interviews and analyzed using the grounded theory method. The findings revealed that there were four decision-making patterns. Each pattern could be grouped into three stages: post-acknowledgement transition, decision-making transition, and after-decision transition. Most participants had psychological reactions, which included shock, fear, nervousness, worry, sadness, and stress. Their concerns during the decision-making transition stage were: confirmation of health, normality, and safety of the fetus, fear of abortion due to amniocentesis, clarification of relations between amniocentesis and maternal serum screening, opinions from physicians and family members, and fear of artificial abortion for unhealthy fetus. Concerns during the after-decision transition stage were: information relating to amniocentesis, the management of an abnormal fetus, the place for amniocentesis, preparation before amniocentesis, and inadequate time for making a decision. Coping strategies were deve-loped to deal with their concerns.
期刊論文
1.黎小娟、李從業(19980600)。母血篩檢唐氏症陽性反應的孕婦面對羊膜穿刺之決策經驗。護理雜誌，45(3)，51-64。new window  延伸查詢new window
2.Rubin, R.(19841200)。Maternal identity and the maternal experience。AJN The American Journal of Nursing，84(12)，1480。  new window
3.Sandelowski, Margarete(1986)。The problem of rigor in qualitative research。Advances in Nursing Science，8(3)，27-37。  new window
4.陳淑溫(19950300)。醫師、護理師及病人間意義差距的省思。護理雜誌，42(1)，95-99。new window  延伸查詢new window
5.陳淑齡、余玉眉(20000400)。懷有唐氏症胎兒的初孕婦接受終止妊娠過程的生活處境。護理研究，8(2)，177-189。new window  延伸查詢new window
6.Wald, N. J.、Cuckle, H. S.、Densem, J. W.、Nanchahal, K.、Royston, P.、Chard, T.、Haddow, J. E.、Knight, G. J.、Palomaki, G. E.、Canick, J. A.(1988)。Maternal serum screening for Down's syndrome in early pregnancy。British Medical Journal，297，883-887。  new window
7.Green, J.、Statham, H.(1993)。Serum screening for Down's syndrome: Some women's experience。British Medical Journal，307，174-177。  new window
8.楊玉娥(1995)。高血清胎兒蛋白孕婦接受羊膜穿刺術前後之主觀經驗。慈濟醫學，7(3)，195-202。  延伸查詢new window
9.Chao, A. S.、Chung, C. L.、Wu, C. D.、Chang, S. D.、Cheng, P. J.、Lin, Y. T.、Soong, Y. K.(1999)。Second Trimester Maternal Serum Screening Using Alpha Fetoprotein, Free Beta Human Chorionic Gonadotropin and Maternal Age Specific Risk: Result of Down Syndrome in an Asian Population。Acta Obstetricia et Gynecologica Scandinavica，78(5)，393-397。  new window
10.Cheng, E. Y.、Luthy, D. A.、Zebelman, A. M.、Williams, M. A.、Lieppman, R. E.、Hickok, D. E.(1993)。A prospective evaluation of a second-trimester screening test for fetal down syndrome using maternal serum alpha-fetoprotein, hCG, and unconjugated estriol。Obstetrics and Gynecology，81，72-77。  new window
11.Crossley, J. A.、Aitken, D. A.、Connor, J. M.(1991)。Prenatal screening for chromosome abnormalities: Using maternal serum chorionic gonadotrophin. Alpha-fetoprotein and age。Prenatal Diagnosis，11(2)，83-101。  new window
12.Gekas, J.、Gondry, J.、Mazur, S.、Cesbron, P.、Thepot, F.(1999)。Informed Consent to Serum Screening for Down Syndrome: Are Women Given Adequate Information?。Prenatal Diagnosis，19(1)，1-7。  new window
13.Haddow, J. E.、Palomaki, G. E.、Knight, G. J.、Williams, J.、Pulkkinen, A.、Canick, J. A.、Saller, D. N.、Bower, G. B.(1992)。Prenatal screening for Down's syndrome with the use of maternal serum maker。The New England Journal of Medicine，327(9)，588-593。  new window
14.Hemminki, E.、Santalahti, P.、Toiviainen, H.(1999)。Impact of prenatal screening on maternity services - Finnish physicians' opinions。Acta Obstetricia et Gynecologica Scandinavica，78(2)，93-97。  new window
15.Julian-Reynier, C.、Macquort-Moulin, G.、Moatti, J. P.、Loundou, A.、Aurran, Y.、Chabal, F.、Ayme, S.(1993)。Attitudes of women of childbearing age towards prenatal diagnosis in southeastern France。Prenatal Diagnosis，13(7)，613-627。  new window
16.Kuller, J. A.、Laifer, S. A.(1996)。Issues associated with prenatal testing for fetal abnormalities。American Family Physician，53(8)，2435-2440。  new window
17.Macintosh, M. C. M.、Brambati, B.、Chard, T.、Grudzinskas, J. G.(1993)。First-trimester maternal serum schwangerschafts protein 1 (SP1) in pregnancies associated with chromosomal anomalies。Prenatal Diagnosis，13，563-568。  new window
18.Makoul, G.、Arntson, P.、Schofield, T.(1995)。Health Promotion in Primary Care: Physician-patient Communication and Decision Making About Prescription Medication。Social Science & Medicine，41(9)，1241-1254。  new window
19.Spencer, K.(1992)。Antenatal screening for Down's syndrome。British Medical Journal，305。  new window
20.Marteau, T. M.、Kidd, J.、Cook, R.、Michie, S.、Johnston, M.、Slack, J.、Shaw, R. W.(1991)。Perceived risk not actual risk predicts uptake of amniocentesis。British Journal of Obstetrics and Gynecology，98，282-286。  new window
21.Moatti, J. P.、Le-Gales, C.、Julian, C.、Durbec, J. P.、Mattei, J. F.、Ayme, S.(1990)。Socio-cultural inequities in access to prenatal diagnosis: The role of insurance coverage and regulatory policies。Prenatal Diagnosis，10(5)，313-325。  new window
22.Roelofsen, E. E.、Kamerbeek, L. I.、Tymstra, T. M.、Beekhuis, J. R.、Mantingh, A.(1993)。Women's opinions on the offer and use of maternal serum screening。Prenatal Diagnosis，13(8)，741-747。  new window
23.Saenz, R. B.(1999)。Primary care of infants and young children with Down syndrome。American Family Physician，59(2)，395-396。  new window
24.Sheldon, T. A.、Simpson, J.(1991)。Appraisal of a new scheme for prenatal screening for Down's syndrome。British Medical Journal，302，1133-1136。  new window
25.Sjogren, B.、Uddenberg, N.(1988)。Decision making during the prenatal diagnostic procedure: A questionnaire and interview study of 211 women participating in prenatal diagnosis。Prenatal Diagnosis，8(4)，263-273。  new window
26.Wald, N. J.、Kennard, A.、Densem, J. W.、Cuckle, H. S.、Chard, T.、Butler, L.(1992)。Antenatal maternal serum screening for Down's syndrome: Results of a demonstration project。British Medical Journal，305，391-394。  new window
27.Wenger, A. F.(1995)。Cultural context, health and health care decision making。Journal of Transcultural Nursing，7(1)，3-14。  new window
研究報告
1.黃璉華、柯滄銘、謝豐舟、李鎡堯(1991)。影響孕婦接受羊膜穿刺諸因素及其關注之探討。  延伸查詢new window
圖書
1.Glaser, B. G.、Strauss, A. L.(1967)。Grounded Theory。New York：Aldine。  new window
2.Guba, E. G.、Lincoln, Y. S.(1984)。Naturalistic inquiry。Newbury Park, CA：Sage。  new window
3.Strauss, Anselm L.、Corbin, Juliet M.(1990)。Basics of qualitative research: Grounded theory procedure and techniques。Sage。  new window
4.中華民國周產期醫學會(1995)。母血篩檢唐氏症工作手冊。母血篩檢唐氏症工作手冊。臺北：中華民國周產期醫學會。  延伸查詢new window
 
 
 
 
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