Penticuff Joy H, Arheart Kristopher L
University of Texas at Austin School of Nursing, TX 78701, USA.
J Perinat Neonatal Nurs. 2005 Apr-Jun;19(2):187-202. doi: 10.1097/00005237-200504000-00016.
This study tested the effect of an intervention to strengthen parent-professional collaboration by increasing the accuracy of parents' understanding of medically relevant information and providing parent-professional meetings to plan infants' care.
A tri-ethnic sample of mothers of 154 very-low-birth-weight infants participated, with parents of 77 infants in a control group and parents of 77 infants in an intervention group. Comprehension of infant medical condition and satisfaction with collaboration in treatment decisions in the 2 groups were measured 3 times during the first 28 days after admission using 9 collaboration scales. Intervention effects were analyzed with ANOVA and ANCOVA.
Statistically significant change was found in 6 of 9 scales used to measure collaboration and accuracy of parents' understanding. The intervention group had fewer unrealistic concerns (P = .018), and less uncertainty about infant medical conditions (P = .003); less decision conflict (P < or = .001), more satisfaction with the process by which medical decisions were made (P = .012) and with the amount of decision input they had (P = .058), and reported more shared decision making with professionals (P = .010). There were no statistically significant differences between the groups in satisfaction with infants' care, satisfaction with relationships with physicians and nurses, and satisfaction with the decisions made for their infants' treatment. Infant birth weight and gestational age and maternal demographic characteristics were found to influence collaboration results. The intervention was especially effective in improving understanding and collaboration in low-income, young, minority mothers.
本研究通过提高家长对医学相关信息的理解准确性以及组织家长与专业人员会议来规划婴儿护理，测试了一种加强家长与专业人员合作的干预措施的效果。
154名极低出生体重婴儿的母亲组成了一个三族裔样本，77名婴儿的家长作为对照组，77名婴儿的家长作为干预组。在入院后的头28天内，使用9种合作量表对两组家长对婴儿病情的理解以及对治疗决策中合作的满意度进行了3次测量。采用方差分析和协方差分析对干预效果进行分析。
在用于衡量合作以及家长理解准确性的9种量表中，有6种发现了具有统计学意义的变化。干预组不切实际的担忧较少（P = 0.018），对婴儿病情的不确定性较小（P = 0.003）；决策冲突较少（P≤0.001），对医疗决策过程的满意度较高（P = 0.012），对自己参与决策的程度满意度较高（P = 0.058），并且报告与专业人员的共同决策更多（P = 0.010）。两组在对婴儿护理的满意度、对与医生和护士关系的满意度以及对为婴儿治疗所做决策的满意度方面没有统计学显著差异。发现婴儿出生体重、胎龄和母亲人口统计学特征会影响合作结果。该干预措施在改善低收入、年轻、少数族裔母亲的理解和合作方面特别有效。
