Maastrup Ragnhild, Weis Janne, Engsig Anne B, Johannsen Kirsten L, Zoffmann Vibeke
Department of Neonatology and The Research Unit for Women's and Children's Health, The Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Public Health, University of Copenhagen, Copenhagen, Denmark.
Scand J Caring Sci. 2018 Jun;32(2):545-553. doi: 10.1111/scs.12478. Epub 2017 Aug 29.
Based on the Family-Centred Care philosophy, skin-to-skin contact is a key activity in neonatal care, and use of this practice is increasing also with extremely preterm infants. Little is known about parents' immediate experiences of and readiness for skin-to-skin contact, while their fragile infant may still not be 'on safe ground'. Knowledge about parents' experiences might reduce doubt and reluctance among healthcare professionals to use skin-to-skin contact with extremely preterm infants and thus increase its dissemination in practice.
To explore parents' immediate experiences of skin-to-skin contact with extremely preterm infants <28-week postmenstrual age.
A qualitative study using thematic analysis.
Thirteen semi-structured interviews conducted in 2008 with 16 parents after skin-to-skin contact with their extremely preterm infants analysed using inductive thematic analysis.
Parents' experiences were related to the process before, during and after skin-to-skin contact and moved from ambivalence to appreciating skin-to-skin contact as beneficial for both parents and infant. The process comprised three stages: (i) overcoming ambivalence through professional support and personal experience; (ii) proximity creating parental feelings and an inner need to provide care; (iii) feeling useful as a parent and realising the importance of skin-to-skin contact. Having repeatedly gone through stages 2 and 3, parents developed an overall confidence in the value of bonding, independent of the infant's survival.
Parents progressed from ambivalence to a feeling of fundamental mutual needs for skin-to-skin contact. Parents found the bonding facilitated by skin-to-skin contact to be valuable, regardless of the infant's survival.
基于以家庭为中心的护理理念,肌肤接触是新生儿护理中的一项关键活动,这种做法在极早产儿中的应用也在增加。对于父母在其脆弱的婴儿可能仍未“脱离危险”时对肌肤接触的即时体验和准备情况,我们知之甚少。了解父母的经历可能会减少医护人员对与极早产儿进行肌肤接触的疑虑和不情愿,从而增加其在实践中的推广。
探讨月经龄小于28周的极早产儿父母对肌肤接触的即时体验。
一项采用主题分析的定性研究。
2008年对16位父母进行了13次半结构式访谈,这些父母在与极早产儿进行肌肤接触后接受访谈,采用归纳主题分析法进行分析。
父母的经历与肌肤接触前、接触中和接触后的过程有关,从矛盾心理转变为认识到肌肤接触对父母和婴儿都有益。这个过程包括三个阶段:(i)通过专业支持和个人经历克服矛盾心理;(ii)亲密接触产生父母情感和内心的护理需求;(iii)作为父母感到有用并认识到肌肤接触的重要性。父母多次经历阶段2和3后,对建立情感联系的价值产生了总体信心,而不依赖于婴儿的存活情况。
父母从矛盾心理发展到对肌肤接触有基本的相互需求感。父母发现肌肤接触促进的情感联系很有价值,无论婴儿是否存活。