家庭参与式早产儿预出院病房的建立及效果评价
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摘要
目的建立家庭参与式早产儿预出院病房并评价其应用效果。方法选取2016年1月—2018年1月在某三级甲等医院新生儿重症监护室住院的早产儿家庭作为研究对象,实验组在家庭参与理念指导下,护理人员对进入预出院病房的48个早产儿家庭给予综合干预措施,包括多学科团队的组建,提供硬件设施及环境保障,照顾者培训,制订出院计划。选取新生儿重症监护室与预出院病房早产儿病情严重程度等特征相匹配的48个早产儿家庭作为对照组,给予常规护理措施。比较两组早产儿出院时照顾者的照顾能力、焦虑情绪及早产儿的院内感染发生率。结果实验组早产儿出院时照顾者的照顾能力优于对照组,焦虑水平显著低于对照组,差异均具有统计学意义(P<0.05)。实验组早产儿未发生院内感染。结论家庭参与式早产儿预出院病房的建立可以提高照顾者的照护能力,减少焦虑情绪,是基于目前国情和医疗体制下可推行的照顾策略。
Objective To establish the pre-discharge ward for premature infants based on family integrated care(FIC) model and evaluate its effects of application. Methods Families with premature infants admitted to a PICU in a tertiary hospital from January,2016 to January,2018 were recruited. Based on FIC model,48 families were transferred to pre-discharge ward and provided with comprehensive interventions(establishing multi-disciplinary team,providing supports of equipment and environment,professional training of caregivers,and providing discharge plan and support). As the control group,48 families with premature infants matched with the experimental group were enrolled and provided with routine care. Care ability,anxiety,and infection rate were compared between two groups.Results Care ability of caregivers in pre-discharge ward was better than that in the control group,and anxiety was lower as well with significant differences(P<0.05). No infant developed infection during hospitalization in the experimental group. Conclusion Pre-discharge ward based on FIC model can improve care ability and decrease anxiety of the caregivers,which can be promoted considering the present situation in China and health care system.
Objective To establish the pre-discharge ward for premature infants based on family integrated care(FIC) model and evaluate its effects of application. Methods Families with premature infants admitted to a PICU in a tertiary hospital from January,2016 to January,2018 were recruited. Based on FIC model,48 families were transferred to pre-discharge ward and provided with comprehensive interventions(establishing multi-disciplinary team,providing supports of equipment and environment,professional training of caregivers,and providing discharge plan and support). As the control group,48 families with premature infants matched with the experimental group were enrolled and provided with routine care. Care ability,anxiety,and infection rate were compared between two groups.Results Care ability of caregivers in pre-discharge ward was better than that in the control group,and anxiety was lower as well with significant differences(P<0.05). No infant developed infection during hospitalization in the experimental group. Conclusion Pre-discharge ward based on FIC model can improve care ability and decrease anxiety of the caregivers,which can be promoted considering the present situation in China and health care system.
引文
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[13]尹志勤,吴艳华,李一美.新生儿重症监护病房患儿母亲的护理需求调查及影响因素分析[J].护理与康复,2010,9(10):842-844.
[14] Phillips-Pula L,Pickler R,Mcgrath JM,et al. Caring for a preterm infant at home[J]. J Perinat Neonatal Nurs,2013,27(4):335-344.
[15]成磊.早产儿出院后父母照顾体验质性研究的系统评价和Meta整合[J].中国循证医学杂志,2015,15(9):1090-1097.
[16] Li C,Yu XR. Qualitative research on real experience of postpartum depression among the mothers of hospitalized premature infants in NICU[J]. Maternal&Child Health Care of China,2015,8(30):2513-2514.
[17]赵宏,钟春霞,宋霞梅,等.以家庭为中心的护理在NICU支气管肺发育不良早产儿中的应用研究[J].中华护理杂志,2018,53(3):285-289.
[18] Sasidharan CK,Gokul E,Anoop P,et al. Benefits of maternal participation in newborn nurseries[J]. Indian J Pediatr,2005,72(10):829-833.
[19] Voos KC,Ross GR,Ward MJ,et al. Effects of implementing family-centered rounds(FCRs)in a neonatal intensive care unit(NICU)[J]. J Maternal-Fetal Neonatal Med,2011,24(11):1403-1406.
[2]周明芳,藤本荣子,晏玲,等.新生儿重症监护室出院早产儿母亲育儿生活体验的质性研究[J].中华护理杂志,2012,47(8):680-682.
[3] Boykova M,Kenner C. Transition from hospital to home for parents of preterm infants[J]. J Perinat Neonat Nur,2012,26(1):81-87.
[4] Lopez GL,Anderson KH,Feutchinger J. Transition of premature infants from hospital to home life[J].Neonatal Netw,2012,31(4):207-214.
[5] Lee SK,O'Bien K. Patients as primary caregivers in the neonatal intensive care unit[J]. CMAJ,2014,186:845-847.
[6] O'Brien K,Bracht M,Macdonel K,et al. A pilot cohort analytic study of family integrated care in a Canadian neonatal intensive care unit[J]. BMC Pregnancy Childbirth,2013,13(2):1-8.
[7]王洁,锅庆玲,赵珍珍,等.家长参与式护理模式在早产儿护理中的应用效果[J].解放军护理杂志,2013,30(3):20-22.
[8]蒙景雯,陈华,李变,等.以家庭为中心的护理方案对早产儿家庭照顾能力的影响[J].护理学杂志,2017,32(9):5-7.
[9]何筱衍,李春波,钱洁,等.广泛性焦虑量表在综合性医院的信度和效度研究[J].上海精神医学,2010,22(4):200-203.
[10]卫生部办公厅.卫生部关于印发医院感染诊断标准(试行)的通知[EB/OL].(2001-11-07)[2018-10-30]. http://www.moh.gov.cn/yzygj/s3593/200804/e19e4448378643a09913ccf2a055c79d.shtml.
[11] Benzies KM,Magill-Evans JE,Hayden KA,et al. Key components of early intervention programs for preterm infants and their parents:a systematic review and meta-analysis[J]. BMC Pregnancy Childbirth,2013,13(Suppl 1):S10.
[12] Scherf RF,Reid KW. Going home:what NICU nurses need to know about home care[J].Neonatal Netw,2006,25(6):421-425.
[13]尹志勤,吴艳华,李一美.新生儿重症监护病房患儿母亲的护理需求调查及影响因素分析[J].护理与康复,2010,9(10):842-844.
[14] Phillips-Pula L,Pickler R,Mcgrath JM,et al. Caring for a preterm infant at home[J]. J Perinat Neonatal Nurs,2013,27(4):335-344.
[15]成磊.早产儿出院后父母照顾体验质性研究的系统评价和Meta整合[J].中国循证医学杂志,2015,15(9):1090-1097.
[16] Li C,Yu XR. Qualitative research on real experience of postpartum depression among the mothers of hospitalized premature infants in NICU[J]. Maternal&Child Health Care of China,2015,8(30):2513-2514.
[17]赵宏,钟春霞,宋霞梅,等.以家庭为中心的护理在NICU支气管肺发育不良早产儿中的应用研究[J].中华护理杂志,2018,53(3):285-289.
[18] Sasidharan CK,Gokul E,Anoop P,et al. Benefits of maternal participation in newborn nurseries[J]. Indian J Pediatr,2005,72(10):829-833.
[19] Voos KC,Ross GR,Ward MJ,et al. Effects of implementing family-centered rounds(FCRs)in a neonatal intensive care unit(NICU)[J]. J Maternal-Fetal Neonatal Med,2011,24(11):1403-1406.