Allen Kimberly A
University of Washington School of Health Sciences, Seattle.
Adv Neonatal Care. 2014 Oct;14(5):336-42. doi: 10.1097/ANC.0000000000000117.
Abusive head trauma in infants occurs in 24.6 to 39.8 per 100,000 infants in developed countries. Abusive head trauma refers to any type of intentional head trauma an infant sustains, as a result of an injury to the skull or intracranial contents from a blunt force and/or violent shaking. The clinical question was: what evidence-based interventions have been implemented by neonatal nurses to prevent abusive head trauma in infants? PubMed was searched to obtain English language publications from 2005 to May 2014 for interventions focused on preventing abusive head trauma using the key term "shaken baby syndrome." A total of 10 studies were identified that met the inclusion criteria. All of the interventions targeted prevention of abusive head trauma with information about abusive head trauma/shaken baby syndrome and the "normal" infant crying behaviors. Interventions taught parents why infants cried, how to calm the infants, ways to cope with inconsolable infants, and how to develop a plan for what to do if they could not cope anymore. Parents who participated in the interventions were consistently able to explain the information and tell others about the dangers of shaking infants compared to the control parents. Only 2 studies calculated the preintervention abusive head trauma rate and the postintervention frequency of abusive head trauma. Each found significant differences in abusive head trauma.
在发达国家,每10万名婴儿中就有24.6至39.8名婴儿遭受虐待性头部创伤。虐待性头部创伤是指婴儿因钝器暴力和/或剧烈摇晃导致颅骨或颅内内容物受伤而遭受的任何类型的故意头部创伤。临床问题是:新生儿护士实施了哪些循证干预措施来预防婴儿虐待性头部创伤?检索了PubMed以获取2005年至2014年5月期间的英文出版物,这些出版物以“摇晃婴儿综合征”为关键词,重点关注预防虐待性头部创伤的干预措施。共确定了10项符合纳入标准的研究。所有干预措施都通过提供有关虐待性头部创伤/摇晃婴儿综合征以及“正常”婴儿哭闹行为的信息来预防虐待性头部创伤。干预措施向家长传授婴儿哭闹的原因、如何安抚婴儿、应对无法安抚的婴儿的方法,以及如果他们无法应对该怎么办的计划制定方法。与对照组家长相比,参与干预措施的家长始终能够解释这些信息,并向他人讲述摇晃婴儿的危害。只有2项研究计算了干预前虐待性头部创伤的发生率和干预后虐待性头部创伤的发生频率。每项研究都发现虐待性头部创伤存在显著差异。