Serlachius Anna, Hames Jessica, Juth Vanessa, Garton Dale, Rowley Simon, Petrie Keith J
Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
Sue and Bill Gross School of Nursing, University of California Irvine, Irvine, California, United States.
J Paediatr Child Health. 2018 Nov;54(11):1227-1233. doi: 10.1111/jpc.14063. Epub 2018 Jun 6.
It has been increasingly recognised that family-centred care (FCC) is associated with enhanced well-being for both parents and infants in paediatric settings, including the neonatal intensive care unit (NICU). Over the past 4 years, our NICU has increasingly adopted a collaborative philosophy of care. The purpose of the study was to examine parental experiences of FCC during both the admission and discharge time points in order to examine differences in parents' experiences and identify areas for improvement.
We conducted interviews at two time points (admission and discharge) with 83 parents (mothers and fathers) of premature and medically fragile infants and analysed the data using thematic analysis.
Three key themes (and sub-themes) were identified: disempowerment, hierarchy between parents and staff and the father's peripheral role. The themes were equally prevalent across admission and discharge.
The challenges relating to FCC reported by parents at both admission and discharge represent some of the key barriers that parents still face in terms of being truly involved in the care of their infant in the NICU. Similar themes at both time points suggest that parents need equal amounts of support during their stay in NICU, irrespective of the level of care the infant is receiving and whether they are approaching discharge. Implications for improving FCC more generally are discussed.
人们越来越认识到，以家庭为中心的护理（FCC）与儿科环境中父母和婴儿的幸福感提升相关，包括新生儿重症监护病房（NICU）。在过去4年里，我们的新生儿重症监护病房越来越多地采用协作式护理理念。本研究的目的是调查父母在入院和出院这两个时间点对以家庭为中心护理的体验，以检验父母体验的差异并确定改进领域。
我们在两个时间点（入院和出院）对83名早产和患有医学复杂性疾病婴儿的父母（母亲和父亲）进行了访谈，并使用主题分析法对数据进行了分析。
确定了三个关键主题（及子主题）：无权、父母与工作人员之间的等级制度以及父亲的边缘角色。这些主题在入院和出院时同样普遍。
父母在入院和出院时报告的与以家庭为中心护理相关的挑战，是父母在新生儿重症监护病房真正参与婴儿护理方面仍然面临的一些关键障碍。两个时间点出现相似主题表明，父母在新生儿重症监护病房住院期间都需要同等程度的支持，无论婴儿接受的护理水平如何以及他们是否即将出院。本文还讨论了更广泛地改善以家庭为中心护理的意义。
