Schäfer Nicole, Karutz Harald, Schenk Olaf
Department Pädagogik, Pflege und Gesundheit, MSH Medical School Hamburg.
Z Geburtshilfe Neonatol. 2017 Oct;221(5):217-225. doi: 10.1055/s-0043-110056. Epub 2017 Jun 7.
Advances in neonatal care have reduced mortality but increased morbidity in babies born pre-maturely or after high-risk pregnancies. However, this often increases the burden on the family and the parents in particular. A systematic review of the literature was conducted that demonstrated the importance of psychosocial support for parents of children in neonatal care. A systematic search of Pubmed, Psyndex, CINAHI and medpilot was conducted. Reference lists of the included articles were also searched for relevant publications. A free-text search found further publications. Together, 78 publications (from 1975-2015) were included in our review. A shift from a biomedical model and child-centred treatment to family-centred care has already taken place in neonatal care. However, there is still a considerable gap between theory and practice. Although there is awareness of the need for psychosocial support of parents, the focus of day-to-day care is still on medical interventions and life-supporting treatment for the child. In particular, while the importance of an assessment of needs as a basis for family-centred psychosocial support appears to be well-known, validated screening instruments are rarely used. In addition, the demand for psychosocial support of parents is not just solely determined by the child's medical risk. The results highlight the challenges of delivering individualised psychosocial support to families within a healthcare system of limited resources, with practitioners having to take into account the developing parent-child relationship as well as health economics. In future, psychosocial support should be based on evidence rather than intuition. Attachment theory and research, and health psychology can contribute to this development.
新生儿护理方面的进展降低了早产或高危妊娠后出生婴儿的死亡率,但增加了其发病率。然而,这往往增加了家庭尤其是父母的负担。我们对文献进行了系统回顾,结果表明心理社会支持对新生儿护理患儿的父母非常重要。我们对PubMed、Psyndex、CINAHI和medpilot进行了系统检索。还对纳入文章的参考文献列表进行了检索,以查找相关出版物。通过自由文本搜索又发现了其他一些出版物。我们的综述共纳入了78篇出版物(发表时间为1975年至2015年)。新生儿护理已从生物医学模式和以儿童为中心的治疗转向以家庭为中心的护理。然而,理论与实践之间仍存在相当大的差距。尽管人们意识到需要为父母提供心理社会支持,但日常护理的重点仍然是针对儿童的医疗干预和维持生命的治疗。特别是,虽然将需求评估作为以家庭为中心的心理社会支持基础的重要性似乎广为人知,但很少使用经过验证的筛查工具。此外,对父母心理社会支持的需求不仅仅取决于儿童的医疗风险。研究结果凸显了在资源有限的医疗保健系统中为家庭提供个性化心理社会支持所面临的挑战,从业者必须考虑到不断发展的亲子关系以及健康经济学因素。未来,心理社会支持应基于证据而非直觉。依恋理论与研究以及健康心理学可以为这一发展做出贡献。