背景:高危險孕婦往往無法預期即將發生的變化，因而比正常孕婦經歷更多的不確定感與壓力，並有不好的生產結果；然而目前臨床上相當缺乏對非住院之高危險妊娠孕婦提供持續性護理及預防早產之措施。目的:運用衛教手冊與四週電話健康諮詢介入措施對非住院高危險妊娠孕婦的不確定感、壓力與生產結果之成效評估。方法:採實驗研究設計法，以結構式問卷收集相關資料，研究工具為結構式問卷包括：基本人口學資料表、「高危險妊娠版不確定感－壓力量表」、社會支持量表及生產結果資料表。於台北某醫學中心選取第二孕期非住院的高危險妊娠孕婦共 2人，透過機分派將個案分至實驗組（n = 1）及控制組（n= 1），其中控制組僅接受一般常規照護，而實驗組除了接受一般常規照護外，又再給予衛教手冊與為期四週電話健康諮詢介入措施。結　果健康諮詢介入措施可降低高危險妊娠孕婦之孕期不確定感（β = - .11, p < .001）與孕期壓力（β =- .11, p < .001）；實驗組的新生兒有較高的新生兒出生體重（β = . , p
< .001）；孕期有較高程度的不確定感（β = - . , p = .01 ）與壓力者（β = - .1 , p = .021）、懷雙胞胎者（β = - 0. , p <.001），其新生兒體重較低。結論／實務應用醫療院所應建立高危險妊娠個案管理師主動地提供電話健康諮詢，這不僅可以有效地降低其孕期不確定感及孕期壓力，進而增進正向之生產結果，而節省醫療成本。

Background: Women with high-risk pregnancies, unable to predict with adequate certainty either maternal or fetal outcomes, may face greater stress and uncertainty as well as adverse birth outcome risks than their low-risk pregnancy peers. Limited research has previously been done on non-hospitalized high-risk pregnancy women with regard to strategies
on effective continuity care and preterm labor prevention.Purpose: This study evaluated the effectiveness of an educational pamphlet and 4-week daily telephone health consultation follow-up regimen (administered by nursing staff) in reducing uncertainty and stress and improving birth
outcomes. The intervention targeted women in high-risk pregnancies during their second trimester.Methods: This study was a randomly-controlled trial that recruited 82 non-hospitalized high-risk pregnancy women
in their second trimester from one medical center in Taipei. Researchers used block randomization to assign subjects into either the experimental (n = 41) or control (n = 41) group. Both groups received the same care except for the health consultant intervention program, which included the distribution of an education pamphlet and daily telephone followups
over a period of four weeks. Researchers collected data using astructured questionnaire that included a demographic datasheet, the Uncertainty Stress Scale-High Risk Pregnancy (Chinese Version), the Social Support Questionnaire,and birth outcome datasheet.Results: The designed health consultant nursing intervention program reduced uncertainty (β = -53 .11, p < .001) and stress (β = -33 .11, p < .001) in the experimental group. The experimental group also achieved a higher average birth weight (β = 494 .89 , p < .001) than the control group. This study found that subjects with higher prenatal uncertainty (β= -3.98 , p = .017), higher stress scores (β = -8.13, p = .021) or twins pregnancies (β = -67 0.99 , p < .001) had higher preterm birth incidences.Conclusions / Implications for practice: Study results suggest the efficacy of creating high-risk pregnancy case manager positions charged to provide proactive telephone health consultation services to women in high-risk pregnancy situations. Such may facilitate reductions in prenatal uncertainty and stress levels amongst high-risk pregnancy clients, which can facilitate positive birth outcomes and reduce medical costs.