Davis Leigh, Mohay Heather, Edwards Helen
Centre for Nursing Research, School of Nursing, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Brisbane, Queensland 4059, Australia.
J Adv Nurs. 2003 Jun;42(6):578-86. doi: 10.1046/j.1365-2648.2003.02661.x.
Advances in technology have resulted in increasing survival rates even for extremely premature infants. While sophisticated medical management is vital to infant survival, research has found that social factors and care giving processes are important predictors of infants' later outcome. Consequently, evidence is accumulating to demonstrate the fundamental role of mothers and families to the optimal developmental outcome of premature infants.
The aim of the work reported here was to undertake an historical overview of premature infant care practices to increase neonatal nurse's knowledge of the crucial role of mothers and families in the care of their premature infants. Understanding past practice and current trends can provide neonatal nurses with critical insight which will assist in formulating current and future care.
Research and historical articles focusing on maternal involvement in preterm infant care from the development of the incubator to the present time were examined. A search of the literature between 1960 and 2002 was conducted using the MEDLINE, CINAHL and PSYCLIT databases. The search terms were premature infant, neonatal intensive care, history, and maternal care.
Three major themes were identified which reflect the development of neonatal care. Firstly, over the last century advances in medical and public health practice saw a decline in mortality rates for mothers and infants. Secondly, the application of this new knowledge resulted in the institutionalization and professionalization of obstetric and neonatal care which, in turn, resulted in the isolation of infants from their mothers. Finally, concurrent advances in infant research emphasized the importance of mother-infant relationships to infants' developmental outcome, resulting in greater flexibility in hospital practices regarding parental contact with their infants.
As biomedical advances in technology continue to help smaller, sicker premature infants to survive, neonatal nurses are strategically placed to promote positive outcomes for infants and their families through the integration of social science and behavioural research into nursing practice.
技术的进步使得即使是极度早产的婴儿存活率也在不断提高。虽然精密的医疗管理对婴儿存活至关重要，但研究发现社会因素和护理过程是婴儿后期结局的重要预测因素。因此，越来越多的证据表明母亲和家庭对早产儿的最佳发育结局起着根本性作用。
本文所报告工作的目的是对早产婴儿护理实践进行历史概述，以增加新生儿护士对母亲和家庭在照顾其早产婴儿中关键作用的认识。了解过去的实践和当前的趋势可以为新生儿护士提供关键见解，这将有助于制定当前和未来的护理方案。
研究了从恒温箱发明到现在关注母亲参与早产婴儿护理的研究和历史文章。使用MEDLINE、CINAHL和PSYCLIT数据库对1960年至2002年的文献进行了检索。检索词为早产婴儿、新生儿重症监护、历史和母亲护理。
确定了反映新生儿护理发展的三个主要主题。首先，在过去一个世纪里，医学和公共卫生实践的进步使母婴死亡率下降。其次，这些新知识的应用导致了产科和新生儿护理的制度化和专业化，进而导致婴儿与母亲分离。最后，婴儿研究的同步进展强调了母婴关系对婴儿发育结局的重要性，这使得医院在父母与婴儿接触方面的做法更加灵活。
随着生物医学技术的进步继续帮助更小、病情更重的早产婴儿存活，新生儿护士处于战略地位，可以通过将社会科学和行为研究融入护理实践，促进婴儿及其家庭获得积极的结局。
