Gonya J, Martin E, McClead R, Nelin L, Shepherd E
Center for Perinatal Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.
Acta Paediatr. 2014 Jul;103(7):727-31. doi: 10.1111/apa.12669.
Extremely premature infants experience long hospitalisation and high readmission rates within 30 days of discharge. This quality control investigation retrospectively explored the impact of the Creating Opportunities for Parent Empowerment (COPE©) programme on these rates in an all referral, Level-IV small baby intensive care unit setting.
The parents of 303 extremely premature infants participated in the study. Of those, 135 were admitted before the implementation of COPE© and served as baseline historical controls, and the remaining 168 neonates received the intervention. Length of stay and readmission rates were analysed using parametric and nonparametric tests. Additional analyses were used to compare the two groups in terms of gestational age, birthweight and other acuity measures.
Neonates who received COPE© required significantly reduced lengths of stay than the control neonates (COPE© 127.1 ± 55.8 days vs. control 139.6 ± 61.9 days, p < 0.05) and significantly lower readmission rates (COPE© 23.9% vs. control 13.2%, p = 0.05).
The COPE© programme promoted active parental engagement in the unit and significantly reduced hospital stays and readmission rates. Future interventions should identify the specific components of the programme that support the parents of extremely premature infants during the various phases of hospitalisation.
极早产儿住院时间长，出院后30天内再入院率高。本质量控制调查回顾性探讨了“为父母赋权创造机会”（COPE©）项目对一家全转诊的四级小型婴儿重症监护病房中这些比率的影响。
303名极早产儿的父母参与了该研究。其中，135名在COPE©实施前入院，作为基线历史对照，其余168名新生儿接受了干预。使用参数检验和非参数检验分析住院时间和再入院率。还进行了额外分析，以比较两组在胎龄、出生体重和其他病情严重程度指标方面的情况。
接受COPE©的新生儿住院时间明显短于对照新生儿（COPE©组为127.1±55.8天，对照组为139.6±61.9天，p<0.05），再入院率也显著较低（COPE©组为23.9%，对照组为13.2%，p = 0.05）。
COPE©项目促进了父母在病房中的积极参与，并显著缩短了住院时间和降低了再入院率。未来的干预措施应确定该项目在住院各阶段支持极早产儿父母的具体组成部分。
