Copy of R Birth Crisis分娩危象課件

BIRTHCRISIS:分娩危象CaringfortheFamilyExperiencingPerinatalDeathortheBirthofaChildwithMedicalComplications對(duì)發(fā)生圍產(chǎn)兒死亡或有內(nèi)科合并癥出生新生兒的家庭的關(guān)注Objectives目的Describepossibleemotionalreactionstobirthcrisis敘述分娩危象時(shí)可能有的情緒反應(yīng)Discussspecificresponsesforuseinbirthcrisissituations討論應(yīng)用于分娩危象時(shí)的特殊反應(yīng)Identifysupportgroupsandagenciestoassistfamiliesexperiencingbirthcrisis了解有哪些組織機(jī)構(gòu)可幫助經(jīng)受分娩危象的家庭Defineongoingmanagementstrategiesforaffectedfamilies為受累的家庭制定明確的處理計(jì)劃

Background背景知識(shí)

Mostpregnantcouplesanticipateahealthybaby大多數(shù)懷孕的夫婦盼望一個(gè)健康的孩子Variationfromahealthybirthoutcometriggersfeelingsofloss從期待健康孩子的變化，激發(fā)失去孩子的感覺Perinatalcrisisisunexpectedandunplanned圍產(chǎn)期危象的發(fā)生往往無預(yù)料或不能預(yù)計(jì)Multiplefactorsaffectbirthcrisismanagement許多因素影響分娩危象的處理

InitialEvaluation初步評(píng)價(jià)

Ensuremotherandinfant(whenviable)aremedicallystable保證母親和孩子（如果還活著）生命體征穩(wěn)定Allowparentstoseetheinfantbeforeleavingbirthingroom在離開產(chǎn)房時(shí)允許患者看孩子Inviteafamilymembertogowiththeresuscitationteam邀請(qǐng)一名家屬與復(fù)蘇人員一起

FamilyMeeting家庭會(huì)議

Meetassoonaspossibleaftercrisis危象發(fā)生后盡快接見家庭人員Initialmeetingsetsstageforfuture初次會(huì)議要安排好日后的事項(xiàng)Informbothparentstogether要把兩個(gè)家長(zhǎng)一起請(qǐng)到：Privacyisimportant保密很重要Encourageattendanceofsupportperson鼓勵(lì)支持人員參與Infantshouldbepresent要把嬰兒抱過來Allowparentstimealonefollowingmeeting會(huì)后要讓家長(zhǎng)獨(dú)處

CommunicatingWithParents

與家長(zhǎng)談話

Sitateyelevel坐下，平視家長(zhǎng)Callinfantbyname以稱乎嬰兒名字Avoidmedicaljargon不要用難懂的醫(yī)學(xué)術(shù)語(yǔ)Don’trushmedicalagenda不要匆忙安排醫(yī)療程序Showrelevantequipmentorpictures讓家長(zhǎng)們看有關(guān)的設(shè)備或圖片Providewrittenmaterials提供書面材料Askparentswhatinformationtheydesire詢問家長(zhǎng)需要那些信息Schedulespecificfollow-up安排特殊的隨訪時(shí)間Avoidprematurediagnosticlabels不要堆加未成熟的診斷

GriefandGuilt悲傷與內(nèi)疚

“Whyme?”isarequestforinformationandanexpressionofcomplexemotions“為什么會(huì)是我呢”是一個(gè)咨詢信息，也是一種復(fù)雜感情的表達(dá)Providerstrategies:當(dāng)事者的策略：Addressparents’fearthattheyhavecausedthetragedy疏導(dǎo)家長(zhǎng)不要把悲劇的起因歸咎于自己Avoidassignmentofblame不要指責(zé)Reviewfacts,butacknowledgetheirlimits回顧事實(shí)，在他們的知識(shí)范圍內(nèi)講解Askaboutpersonal,religiousbeliefs,orsupportsystems了解個(gè)性、宗教信仰或支持系統(tǒng)

HelpingTheOlderSibling(s)

對(duì)家中大孩子的幫助

Provideinformation提供信息Encouragethemtoseeandholdchild鼓勵(lì)他們看一看、抱一抱嬰兒Provideagiftortokenofgoodwill送一件禮物或許一個(gè)好愿Encouragefocusonnormaldevelopmentalaspects誘導(dǎo)他們把注意力集中在發(fā)育正常的方面

TheChildWithDisabilities嬰兒殘疾

ParentalAdaptiveTasks要使家長(zhǎng)能接受患兒Acceptchild’scondition接受孩子的殘疾狀況Managechild’sactivitiesofdailyliving料理孩子的日常生活Meetchild’sdevelopmentalneeds滿足孩子生長(zhǎng)發(fā)育的需要Copewithongoingstress承受起長(zhǎng)久的壓力Establishsupportsystem建立支持體系Monitormagnitudeofgrief監(jiān)護(hù)悲傷的程度

ReactionsOfHealthCareProviders

主要保健人員的反應(yīng)

Grief悲傷Guilt內(nèi)疚Identification尋找過失Responsibilityforoutcome對(duì)結(jié)局負(fù)責(zé)Fearoflitigation擔(dān)心被告Withdrawalfromparents回避家長(zhǎng)

Summary小結(jié)Birthcrisisisunexpectedanddifficultforallinvolved分娩危象往往不期而遇，相關(guān)人員面臨困難Beginopen,honestcommunicationimmediately立即開始開誠(chéng)布公地談話Schedulefoll