[[alternative]]Establishing Abortion Decision Tree Model for Married Adult Women with Unplanned Pregnancy

[[abstract]]長久以來，有關「性」與「死」的議題，總讓人覺得難以啟齒，且牽涉範圍既廣也雜。而人工流產，則是綜合兩性與死亡，不論是因為醫學優生保健之理由；或是因影響心理健康或家庭生活者等因素而決定人工流產，皆帶給當事者婦女許多的壓力，各種情緒，以及在身、心、靈、社各方面有不少的衝擊與改變。 本研究以非預期懷孕之成年已婚婦女為對象，考慮是否繼續懷孕或人工流產二擇一之決定與行動。本研究以Glodwin (1989)提出的「民族誌式決策樹模式」建構方法，包含三大步驟：嘗試研究、模式建立，與模式檢驗，來建立成年已婚婦女面臨非意願懷孕時的決策準則、決策特徵，以及決策樹模式。經過三階段共面對面訪談34位成年已婚婦女，共有43人次分預期懷孕時所做的各項決策與決定，整理出十二項影響成年已婚婦女考慮人工流產的決策特徵，包括：計畫懷孕與否、婚姻伴侶之感情因素、生命觀、考量婆婆/媽媽/先生對性別觀的影響、子女的意義-人數、性別、長相、經濟的負擔；工作、生涯與時間的安排、過往孕產史的印象與影響、養育子女的狀態；懷孕、生育時父母與胎兒的身體健康狀態、居住環境的影響、與社會文化眼光。 整理出來28項決策準則所構成的各項決策路徑，可區分為四項決策型態，包括：主動積極接受人工流產；既然懷孕，就自然而然生下來；再三考慮，峰迴路轉；他人強迫做生育與否的決定。 經由研究發現之決策模式，發現與整理出成年已婚婦女面臨非預期懷孕時可能考慮的各項決策，以及可預估不同決策型態與行動結果的預測機率。除了讓專業醫護人員能夠在面臨此族群婦女時，能更了解其心路歷程，也期盼在臨床實務上施行懷孕及人工流產諮商時，更能關心成年已婚婦女在身、心、靈、社會全方位的照顧與關懷。[[abstract]]Since long time ago, it’s so hard to talk about these issues on “Death” and “Sex”, because they involve in different and various fields. However, no matter the reasons are the medical problems, physical health or the life of family; induced abortion, it combines “Death” and “Sex” and brings lots of stress, emotions, impact and change on these women’s body or mind, soul or society. The study is on the adult and married women those who got the unplanned pregnancy and considered how to make the decision on keeping pregnant or abortion. In order to understand the process and decision criteria, the study uses the method – “Ethnographic Decision Tree Modeling” by Gladwin (1989). The setting of decision tree model concludes three steps: “Pilot Study”,” Building of the Model”, and “Testing of the Model.” After interviewing 34 married adult women with 43 unplanned pregnancies, to find out 12 items of decision character, including planning to get pregnant or not, the relationship an affection of the couple, the points of view on life, was affected by mother, mother-in-law, an husband’s emphasis on male, the meanings of children, the financial burden, the plan an assignment of career and time, the past pregnant experiences, the status of raising children, the health of parents and fetus, the effect of living environment, and social and cultural vision. . Finally, 28 decision criteria compose four decision patterns of married adult women with unplanned pregnancy: receiving abortion positively; second, giving birth as long as getting pregnancy naturally; the minds and thoughts on decision are changeable an uncertain being forced by important othersBy setting the decision model tree, researcher found various decisions, decision characters, decision patterns and probability of choice in order to help medical staff will see the married adult women’s decision-making and to take care of women’s health in physician, psychology, mental and society