NICU早产儿母亲疾病不确定感与早产儿延续护理需求的相关性分析
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摘要
目的探讨新生儿重症监护病房(NICU)早产儿母亲疾病不确定感、早产儿延续护理需求现状及其相关性,为临床干预及院外随访提供依据。方法选取2015年9月—2016年2月在宁夏4家三级甲等医院NICU住院的早产儿母亲为研究对象。采用中文版疾病不确定感父母量表(PPUS)、早产儿延续护理需求调查问卷对早产儿母亲进行问卷调查。结果本研究共发放问卷1 000份,有效问卷968份。NICU早产儿母亲PPUS总分为(88. 20±9. 74)分,其中低水平171(17. 67%)例、中等水平504(52. 07%)例、高水平293(30. 27%)例。延续护理需求总分为(114. 30±20. 86)分,不同水平疾病不确定感的NICU早产儿母亲对延续护理需求不同(F=3. 352,P <0. 05),早产儿母亲疾病不确定感水平越高,延续护理需求总分及各维度得分越高(P <0. 05)。除延续护理方式和常见风险防护外,NICU早产儿母亲疾病不确定感总分及各维度得分与早产儿延续护理需求总分及各维度得分呈正相关(P <0. 05)。结论 NICU早产儿母亲疾病不确定感与早产儿延续护理需求具有相关性,医护工作者不仅要为早产儿提供良好的照护,还应注重其母亲的身心健康并给予相应的措施,同时要加强早产儿延续护理服务的建立,提高早产儿的生存质量。
Objective To explore the status of uncertainty in illness of mothers and continuing care needs of premature infants in Neonatal Intensive Care Unit( NICU),as well as their correlation,to provide basis for clinical intervention and follow-up after hospital discharge.Methods Mothers of premature infants who gave births in 4 grade-A tertiary hospitals in Ningxia between September 2015 and February 2016 were selected as research subjects. All mothers with inclusion criteria were investigated with Parents' Perception of Uncertainty Scale( PPUS) and continuing care needs of preterm infants questionnaire. Results Totally 968 valid questionnaireswereobtained.The total score PPUS was( 88. 20 ± 9. 74). The proportion of mothers with low,moderate and high uncertainty in illness was 17. 67%,52. 07% and 30. 27%,respectively. The total score of continuing care needs assessment was( 114. 30 ± 20. 86). Mothers atlevels of uncertainty in illnesshaddifferent levelsofcontinuing care demands( F = 3. 352,P < 0. 05),and the higher score of continuing care needs was associated with higher level of uncertainty in illness( P <0. 05). In addition to nursing measures and common risk protection,the total score of uncertainty in illness of mothers and the scores of each dimension were positively correlated with the total score of continuing care needs of premature infants and the scores of each dimension( P < 0. 05).Conclusion Uncertainty in illness of mothers was closely related to the continuing care needs of premature infants in NICU. Medical staff should not only provide high-quality care for premature infants,but also pay attention to their mother's mental status,and give appropriate measures to reduce uncertainty in illness. At the same time,more efforts should be made to strengthen the establishment of continuing nursing service for premature infants and improve their quality of life.
Objective To explore the status of uncertainty in illness of mothers and continuing care needs of premature infants in Neonatal Intensive Care Unit( NICU),as well as their correlation,to provide basis for clinical intervention and follow-up after hospital discharge.Methods Mothers of premature infants who gave births in 4 grade-A tertiary hospitals in Ningxia between September 2015 and February 2016 were selected as research subjects. All mothers with inclusion criteria were investigated with Parents' Perception of Uncertainty Scale( PPUS) and continuing care needs of preterm infants questionnaire. Results Totally 968 valid questionnaireswereobtained.The total score PPUS was( 88. 20 ± 9. 74). The proportion of mothers with low,moderate and high uncertainty in illness was 17. 67%,52. 07% and 30. 27%,respectively. The total score of continuing care needs assessment was( 114. 30 ± 20. 86). Mothers atlevels of uncertainty in illnesshaddifferent levelsofcontinuing care demands( F = 3. 352,P < 0. 05),and the higher score of continuing care needs was associated with higher level of uncertainty in illness( P <0. 05). In addition to nursing measures and common risk protection,the total score of uncertainty in illness of mothers and the scores of each dimension were positively correlated with the total score of continuing care needs of premature infants and the scores of each dimension( P < 0. 05).Conclusion Uncertainty in illness of mothers was closely related to the continuing care needs of premature infants in NICU. Medical staff should not only provide high-quality care for premature infants,but also pay attention to their mother's mental status,and give appropriate measures to reduce uncertainty in illness. At the same time,more efforts should be made to strengthen the establishment of continuing nursing service for premature infants and improve their quality of life.
引文
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[9]FEDELE D A,RAMSEY R R,RYAN J L,et al.The association of illness uncertainty to parent and youth adjustment in juvenile rheumatic diseases:effect of youth age[J].J Dev Behav Pediatr,2011,32(5):361-367.
[10]吴丽娟,廖少玲,胡利人,等.住院早产儿母亲疾病不确定感现状及影响因素分析[J].重庆医学,2018,47(18):2470-2473.
[11]崔慧敏,孙彩霞,李胜玲.NICU早产儿母亲疾病不确定感与家庭功能的相关性[J].实用医学杂志,2017,33(4):643-645.
[12]翁莉,张爱霞,陈燕,等.极早产儿延续护理服务需求调查分析[J].护理实践与研究,2016,13(12):3-6.
[13]秦秀丽,叶天惠,曾铁英.发育支持护理在早产儿家庭护理中的应用现状[J].护理学杂志,2010,25(5):88-90.
[14]郑华蓉.延续护理服务对出院早产儿生长发育的影响[J].护理学杂志,2011,26(23):29-30.
[15]VAN WALRAVEN C,OAKE N,JENNINGS A,et al.The association between continuity of care and outcomes:a systematic and critical review[J].J Eval Clin Pract,2010,16(5):947-956.
[16]方娇娇,张岚,殷秀,等.延续性护理模式对早产儿母亲育儿认知与心理健康的影响[J].中华护理杂志,2017,52(8):938-943.
[2]MITCHELL M L,COURTNEY M.Reducing family members'anxiety and uncertainty in illness around transfer from intensive care:an intervention study[J].Intensive Crit Care Nurs,2004,20(4):223-231.
[3]GUTIERREZ K M.Experiences and needs of families regarding prognostic communication in an intensive care unit:supporting families at the end of life[J].Crit Care Nurs Q,2012,35(3):299-313.
[4]孔秋菊,郭红英,陈庆文,等.早产儿居家护理延续服务需求状况的调查分析[J].全科护理,2016,14(25):2666-2667.
[5]麦嘉轩,谢婉花,马春花,等.中文版疾病不确定感父母量表的初步修订[J].中国实用护理杂志,2013,29(28):46-50.
[6]蒙婷婷,李亚玲.早产儿父母延续性护理需求状况调查与分析[J].川北医学院学报,2016,31(2):257-260.
[7]崔慧敏,孙彩霞,李胜玲.家庭功能对早产儿延续性护理需求的影响[J].中国妇幼保健,2017,32(13):2997-2999.
[8]吴丽娟,廖少玲,敖当,等.以微信为媒介的信息支持对早产儿母亲疾病不确定感的影响[J].广东医学,2015,36(22):3561-3563.
[9]FEDELE D A,RAMSEY R R,RYAN J L,et al.The association of illness uncertainty to parent and youth adjustment in juvenile rheumatic diseases:effect of youth age[J].J Dev Behav Pediatr,2011,32(5):361-367.
[10]吴丽娟,廖少玲,胡利人,等.住院早产儿母亲疾病不确定感现状及影响因素分析[J].重庆医学,2018,47(18):2470-2473.
[11]崔慧敏,孙彩霞,李胜玲.NICU早产儿母亲疾病不确定感与家庭功能的相关性[J].实用医学杂志,2017,33(4):643-645.
[12]翁莉,张爱霞,陈燕,等.极早产儿延续护理服务需求调查分析[J].护理实践与研究,2016,13(12):3-6.
[13]秦秀丽,叶天惠,曾铁英.发育支持护理在早产儿家庭护理中的应用现状[J].护理学杂志,2010,25(5):88-90.
[14]郑华蓉.延续护理服务对出院早产儿生长发育的影响[J].护理学杂志,2011,26(23):29-30.
[15]VAN WALRAVEN C,OAKE N,JENNINGS A,et al.The association between continuity of care and outcomes:a systematic and critical review[J].J Eval Clin Pract,2010,16(5):947-956.
[16]方娇娇,张岚,殷秀,等.延续性护理模式对早产儿母亲育儿认知与心理健康的影响[J].中华护理杂志,2017,52(8):938-943.