Axelin Anna, Lehtonen Liisa, Pelander Tiina, Salanterä Sanna
Finnish Post-Graduate School in Nursing Science, Department of Nursing Science, University of Turku, Turku, Finland.
J Obstet Gynecol Neonatal Nurs. 2010 Jul-Aug;39(4):415-24. doi: 10.1111/j.1552-6909.2010.01150.x.
To describe and understand how mothers utilize the opportunity to actively participate in their preterm infants' pain care using facilitated tucking by parents (FTP).
Descriptive and exploratory study with postintervention interview.
Finnish level III Neonatal Intensive Care Unit (NICU).
Twenty-three mothers who had preterm infants born at gestational ages of 32 to 34 weeks.
The parents (N=45) of 29 preterm infants were taught to use FTP. In addition, all nurses in the NICU (N=76) received the same education to support the parents' use of FTP. After 2 to 4 weeks of FTP use, the mothers (n=23) were interviewed using the Clinical Interview for Parents of High-Risk Infants with additional questions related to the infants' pain care. The interviews were analyzed inductively with cross-case analysis and deductively with a previously developed coding scheme.
Facilitated tucking by parents was perceived positively and was used by all participating mothers. Three different styles of involvement in preterm infants' pain care with FTP were identified. They formed a continuum from external to random and finally to internalized involvement. In external involvement, the pain care with FTP was triggered by outside factors such as nurses, whereas in random and internalized involvement the motivation emerged from a parent. Mothers with external involvement thought that any person could apply the FTP. In random involvement, mothers were mainly absent during painful procedures, although they saw themselves as the best caregivers. In internalized involvement, the responsibility for infant pain care was shared within the family. Mothers' NICU-related stress and maternal attachment were associated with this variation.
This study showed that mothers' are willing to actively participate in their preterm infants' pain care. However, the participation is unique according to mother and her experiences before and during NICU admission. Nurses need to consider these differences in mothers when involving them in preterm infants' pain care.
描述并了解母亲们如何利用父母辅助包裹法（FTP）这一机会积极参与早产婴儿的疼痛护理。
干预后访谈的描述性和探索性研究。
芬兰三级新生儿重症监护病房（NICU）。
23名母亲及其孕周为32至34周的早产婴儿。
对29名早产婴儿的父母（共45人）进行了使用FTP的培训。此外，NICU的所有护士（共76人）也接受了相同的培训，以支持父母使用FTP。在使用FTP 2至4周后，对23名母亲进行了访谈，采用高危婴儿父母临床访谈，并增加了与婴儿疼痛护理相关的问题。访谈采用跨案例分析进行归纳分析，并采用先前制定的编码方案进行演绎分析。
父母辅助包裹法得到了积极评价，所有参与的母亲都使用了该方法。确定了三种不同的参与早产婴儿疼痛护理的FTP方式。它们形成了一个从外部参与到随机参与，最终到内化参与的连续体。在外部参与中，FTP疼痛护理由护士等外部因素触发，而在随机参与和内化参与中，动机来自父母自身。外部参与的母亲认为任何人都可以应用FTP。在随机参与中，母亲在痛苦的操作过程中大多不在场，尽管她们认为自己是最好的照顾者。在内化参与中，婴儿疼痛护理的责任在家庭内部分担。母亲与NICU相关的压力和母婴依恋与这种差异有关。
本研究表明，母亲们愿意积极参与早产婴儿的疼痛护理。然而，根据母亲及其在NICU入院前和入院期间的经历，参与方式是独特的。护士在让母亲参与早产婴儿的疼痛护理时需要考虑这些差异。
