摘要
Objectives:Mothers with substance use disorder(SUD)experience a range of emotions such as feeling ostracized,diminished,and distressed while watching their baby experience withdrawal from substances.Being fully present in the now moment is to trust self to do what is best by moving beyond perceived boundaries to care for self and baby.The process of concept building arose from nursing practice encounters in a special care nursery(SCN)for babies who experienced withdrawal from substances.Method:Liehr and Smith’s 10-phase concept building approach was used to guide the development of this concept.Concept building began with a practice story.The emerging concept was named,core qualities identified,and supported through a literature review.The middle range theory of uncertainty in illness was chosen to serve as theoretical support for the concept.A model was created to provide clarity on the relationships within the concept.Result:A mini-saga was gathered from a mother in the SCN whose newborn had experienced withdrawal from substances.The minisaga follows:Due to the baby’s discomfort and judging eyes of the staff,she was unable to mother her baby.As the baby recovered,she asked for help,comforted her baby,and gained confidence to move beyond perceived boundaries to become the mother she envisioned.Overcoming perceived boundaries to attend to self and baby is trusting oneself to do what is best in spite of feeling ostracized,diminished,and distressed while watching baby withdraw from substances.Conclusion:This concept provides the perspective of mothers with SUD through intermodernism from experiences in nursing practice.The Uncertainty in Illness theory further allows practitioners to gain an understanding of the role uncertainty plays in this unique situation.
背景患有物质使用障碍(substance use disorder,SUD)的母亲在看到婴儿遭受物质戒断症状时会经历一系列情绪,如感到被排斥、被贬低和痛苦。基于在物质戒断婴儿特护病房(Special Care Nursery,SCN)护理实践中遇到的情形构建研究概念。方法应用Liehr和Smith的10阶段概念构建法。为构建的概念命名,确定核心要素,并通过文献回顾得到依据。选择疾病不确定性的中层理论作为这一概念的理论基础,并构建模型以明确此概念的构成。结果从SCN采集到一个微型故事:由于患儿的不适症状和工作人员的评判,母亲无法照顾自己的孩子;当患儿康复后,她寻求帮助,安抚患儿,并获得信心,跨越其感知界限,成为自己期待中的母亲。克服感知界限来照顾自己和婴儿,也就是尽管在看到婴儿遭受戒断症状时感受到被排斥、被贬低和痛苦,但作为母亲坚信自己能做到最好。结论这一概念提供了从护理实践经验中了解SUD母亲的视角,有助于让护理实践者进一步理解不确定性理论在这种特殊情况下所起的作用。
