護理人員“自然流產率”及其相關因素之探討

The aim of this research was to investigate the rate of spontaneous abortions of nurses and the related factors by means of a descriptive cross-sectional survey research and retrospective method, taking each abortions as a sample. Nurses who had spontaneous abortion were compared to nurses who had not. This survey gathered samples from medical centers, provincial or municipal hospitals and private regional hospitals, collecting the data of all married nurses between 20 to 45 years of age when pregnant five years before 2000. The average rate of spontaneous abortion of the nurses' was 18.1%, higher than the women in other careers. The trends of nurses having spontaneous abortions increased with the age and frequency of being pregnant. More than half of the nurses with spontaneous abortion occured within the first trimester of pregnancy, with the peak in the second month. Being infected by contagious diseases, exposed to the environment of disinfectant solution, and having direct contact with the secretion of infected wounds were the main factors related to the pregnant nurses having spontaneous abortions. And there were many other factors such as night shifts increasing numbers of times of changing patients’ positions, sitting less than 25% of the daily eight working hours, and the severity of patients' conditions all had significant differences between nurses who had spontaneous abortion and those who had not. There were more instances of spontaneous abortions nurses working in intensive care units, emergency rooms and recovery rooms. Certain life events such as reconciliation with her spouse after an upsetting fight change in style or increasing social activities, or change in personal image or figure were also related to the spontaneous abortion. Considering the stressful load of work in the following four situations coming across a rude physician, failing to reach the physician in an emergency, requesting to change shifts as rejected by the head nurse or senior nurses, and the quality of care being criticized by other nurses were also related to spontaneous abortions. As to the frequency of work stress, the following seven items: extra increase of work load, seeing physicians' being rude or unmindful towards patients, patients' taking off wound cover bandages by themselves, increasing CPR frequency, arranging on duty on holidays, daily activities not adjust able with other people, listening to patients' groaning with pain; and failing to adjust night shifts were all related to the spontaneous abortion of nurses. The suggestions are that relative authoritative units or people in charge should do their best to improve the above mentioned dangerous working factors, to maintain the security of working units, and to lessen as much as possible the work stress of the pregnant nurses, lest the spontaneous abortion leaves would increase the work burden of the unit, and thereby decrease the quality of nursing service. According to the findings of this study the recommendations would be as follows: 1. to decrease the risk factors of causing spontaneous abortion of nurses. 2. to improve the working situation safety of nurses. 3.to decrease the working stress of pregnant nurses.