护士如何协助父母做出关于极早产儿生命支持决策的决定。
How nurses assist parents regarding life support decisions for extremely premature infants.
作者信息
Kavanaugh Karen, Moro Teresa T, Savage Teresa A
机构信息
Department of Women, Children, and Family Health Science, University of Illinois at Chicago, Chicago, Illinois 60612-7350, USA.
出版信息
J Obstet Gynecol Neonatal Nurs. 2010 Mar-Apr;39(2):147-58. doi: 10.1111/j.1552-6909.2010.01105.x.
OBJECTIVE
To describe nurse behaviors that assisted parents to make life-support decisions for an extremely premature infant before and after the infant's birth.
DESIGN
Qualitative, longitudinal, collective case study where interviews were done pre- and postnatally and medical chart data were collected.
SETTING
Interviews were conducted face-to-face in a private room in the hospital, in the mother's home, or over the telephone.
PARTICIPANTS
A sample of 40 cases (40 mothers, 14 fathers, 42 physicians, 17 obstetric nurses, 6 neonatal nurses, and 6 neonatal nurse practitioners) was recruited from three hospitals that provided high-risk perinatal care. Parents were at least 18 years of age, English speaking, and had participated in a prenatal discussion with a physician regarding treatment decisions for their infant due to threatened preterm delivery. Physicians and nurses were those identified by parents who had spoken to them about life-support treatment decisions for the infant.
METHODS
Using a semistructured interview guide, a total of 203 interviews were conducted (137 prenatal, 51 postnatal, and 15 end-of-life). For this analysis, all coded data related to the nurse's role were analyzed and summarized.
RESULTS
Parents and nurses described several nurse behaviors: providing emotional support, giving information, and meeting the physical care needs of mothers, infants, and fathers. Physicians' description of the nurse behaviors focused on the way nurses provided emotional support and gave information.
CONCLUSIONS
Nurses play a critical role in assisting parents surrounding life-support decisions.
目的
描述护士在极早早产儿出生前后协助父母做出生命支持决策的行为。
设计
定性、纵向、集体案例研究，在产前和产后进行访谈并收集病历数据。
地点
访谈在医院的私人房间、母亲家中或通过电话面对面进行。
参与者
从三家提供高危围产期护理的医院招募了40个案例的样本（40名母亲、14名父亲、42名医生、17名产科护士、6名新生儿护士和6名新生儿执业护士）。父母年龄至少18岁，会说英语，并且因先兆早产参与了与医生关于其婴儿治疗决策的产前讨论。医生和护士是那些父母曾与其谈论过婴儿生命支持治疗决策的人员。
方法
使用半结构化访谈指南，共进行了203次访谈（137次产前、51次产后和15次临终访谈）。对于本次分析，对所有与护士角色相关的编码数据进行了分析和总结。
结果
父母和护士描述了几种护士行为：提供情感支持、提供信息以及满足母亲、婴儿和父亲的身体护理需求。医生对护士行为的描述集中在护士提供情感支持和提供信息的方式上。
结论
护士在协助父母做出生命支持决策方面发挥着关键作用。
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