背景：經歷周產期失落的父母，需同時面對孩子誕生與死亡並存的哀慟，常伴隨死亡不被社會或法律承認的失落感與內疚，這些情緒可能對父母的身心健康及未來生活產生負面影響。在周產期喪親的適應歷程中，父母因性別角色的差異與感知社會支持程度不同，可能導致其在因應策略與適應結果上呈現差異。然而，現有研究對周產期失落父母的因應方式、喪親適應歷程及其影響因素的探討仍屬不足。相關知識可協助醫療專業人員辨識喪親適應困難的高風險父母，及早介入或提供心理支持，以減少周產期失落對父母造成的長期傷害。
研究目的：本研究旨在探討周產期失落早期階段，父母之喪親因應導向（即失落因應導向與復原因應導向）與喪親適應（即哀傷反應與生活品質）間的關係，以及性別和社會支持於此關係間是否存在調節作用。
研究方法：本研究採前瞻性、相關性研究設計，運用方便取樣法，招募過去一個月內曾經歷周產期失落的父母作為研究對象。招募方式包含於台灣南部婦產科醫療院所張貼文宣及現場邀請，亦透過網路平台進行宣傳，共計招募60位（母親50位、父親10位）周產期失落的父母。研究資料透過線上匿名問卷，於周產期失落事件發生後第一個月與第四個月進行收集。問卷內容包括：因應導向量表、周產期失落哀傷量表、生活品質量表、社會支持量表與社會人口學基本資料。以配對樣本 t 檢定與 Wilcoxon 符號等級檢定分析各變項在兩個時間點的變化；以相關分析呈現各變項間的相關性；以多元迴歸分析檢視因應導向與喪親適應的關係，並檢驗性別和社會支持在此關係中是否具有調節效果。
研究結果：於周產期失落後第一個月內，失落（B = 5.71, SE = .75, p < .001）和復原因應導向（B = -2.60, SE = .58, p < .001）皆與哀傷反應有顯著關係，唯有復原因應導向與生活品質各層面呈現顯著關係（B = .26~.39, p < .001）。性別（B = .34, SE = .16, p = .033）及社會支持（B = .25, SE = .10, p = .016）的調節效果僅在生活品質之社會關係層面顯現：母親在復原因應導向提升後，其社會關係層面之生活品質改善程度高於父親；而在社會支持程度偏低（分數低於第25百分位）的情況下，失落因應導向增加對父母社會關係層的生活品質造成更顯著的負向影響。而從周產期失落後第一個月至第四個月間，父母之失落因應導向逐漸下降低（Z = -5.11, p < .001），復原因應導向則逐漸上升（t(53) = 3.68, p = .001），並伴隨哀傷反應減緩（t(53) = -5.52, p < .001），以及生活品質之心理層面的提升（t(53) = 2.59, p = .012）。此外，失落（B = 2.82, SE = .81, p = .001）和復原因應導向的變化（B = -1.85, SE = .55, p = .001）皆與哀傷反應的變化有顯著關係，然僅復原因應導向的變化與生活品質中生理（B = .21, SE = .08, p = .008）和心理層面的變化（B = .22, SE = .07, p = .003）有顯著關係。性別及社會支持於此變化過程中並未展現顯著的調節效果。
研究結論：喪親因應導向與周產期失落父母之哀傷反應和生活品質有關，且在周產期失落後四個月，因應導向、哀傷反應及生活品質皆呈現動態變化，惟生活品質的提升相對不明顯。建議臨床可早期運用喪親因應導向量表進行評估，辨識潛在適應不良的高風險周產期失落父母，並提供及時的介入措施。此外，後續臨床照護可考慮發展針對周產期失落父母的哀傷撫慰服務，以增強父母之復原因應導向，降低失落因應導向，進而促進其喪親適應。

This study examined the relationship between coping orientations—loss-oriented and restoration-oriented—and bereavement adjustment among parents in the early months after perinatal loss. It also explored whether gender and social support moderated these relationships. A prospective correlational design was used, recruiting 60 bereaved parents (50 mothers, 10 fathers) within one month of loss in southern Taiwan through clinics and online platforms. Data were collected at one and four months after perinatal loss. At one month, loss-oriented coping was associated with higher grief reactions, while restoration-oriented coping was linked to lower grief and higher scores across all QOL domains. Moderation analyses revealed that gender and social support influenced the “social relationships” QOL domain: mothers showed greater benefits from restoration-oriented coping than fathers, and parents with low social support experienced stronger negative effects from loss-oriented coping. Over the four-month period, parents demonstrated decreased loss-oriented coping, increased restoration-oriented coping, reduced grief, and improved psychological QOL. Changes in coping orientations were significantly related to changes in bereavement outcomes: reductions in loss-oriented coping and increases in restoration-oriented coping were associated with lower grief, while restoration-oriented coping also predicted improvements in physical and psychological QOL. The findings highlight that coping orientations and bereavement adjustment are dynamic in the early months following perinatal loss. Early assessment of coping orientations and tailored interventions to foster restoration-oriented coping may promote healthier adaptation and enhance QOL.

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