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新生儿重症监护病房中婴儿安全教育前后产妇对虐待性头部创伤的认知及应对婴儿哭闹的信心评估

Assessment of Maternal Knowledge and Confidence About Abusive Head Trauma and Coping With Infant Crying Before and After Infant Safety Education in the Neonatal Intensive Care Unit.

作者信息

Rabbitt Angela L, Bretl Deborah, Parker Matthew, Yan Ke, Zhang Liyun

机构信息

Department of Pediatrics, Medical College of Wisconsin, Milwaukee (Drs Rabbitt, Parker, and Yan and Ms Zhang); and Child Advocacy and Protection Services, Children's Hospital of Wisconsin, Milwaukee (Ms Bretl). Dr Parker is now at the Pediatric Residency Training Program at the University of California, Los Angeles.

出版信息

J Perinat Neonatal Nurs. 2018 Oct/Dec;32(4):373-381. doi: 10.1097/JPN.0000000000000362.

Abstract

Infants with a history of perinatal illness are at higher risk for abusive head trauma (AHT). Crying is a common trigger for physical abuse, and education on coping with infant crying is an important component of AHT prevention. This study assesses the effects of education in the neonatal intensive care unit (NICU) on mothers' knowledge about AHT and infant crying, self-efficacy in applying the education to infant cares and providing the education to others, and the quality of AHT and infant crying education after discharge. Mothers received a standardized education program about AHT and infant crying and completed a preeducation survey, posteducation survey, and 4- to 5-month follow-up survey. Overall, there was a sustained increase in knowledge (P < .001) and confidence (P < .001). Mothers who received verbal education reported a higher increase in confidence (P = .03). Few received information from healthcare providers about crying (35%) and AHT (20%) after discharge. At follow-up survey, most felt highly confident in their ability to share information about AHT (97%) and calm their infant (95%). Most had shared the education with others (77%). Education on AHT and crying in the NICU can produce sustained increases in mothers' knowledge and confidence, but the effectiveness may be improved by addressing unique barriers to education in this population.

摘要

有围产期疾病史的婴儿遭受虐待性头部创伤(AHT)的风险更高。哭闹是身体虐待的常见诱因,应对婴儿哭闹的教育是预防AHT的重要组成部分。本研究评估了新生儿重症监护病房(NICU)的教育对母亲关于AHT和婴儿哭闹的知识、将教育应用于婴儿护理及向他人传授教育的自我效能,以及出院后AHT和婴儿哭闹教育质量的影响。母亲们接受了关于AHT和婴儿哭闹的标准化教育项目,并完成了教育前调查、教育后调查以及4至5个月的随访调查。总体而言,知识(P < .001)和信心(P < .001)持续增加。接受口头教育的母亲报告信心提升更高(P = .03)。出院后很少有母亲从医疗保健提供者那里获得关于哭闹(35%)和AHT(20%)的信息。在随访调查中,大多数母亲对分享AHT信息(97%)和安抚婴儿(95%)的能力非常有信心。大多数母亲(77%)已将该教育内容分享给他人。NICU中关于AHT和哭闹的教育可使母亲的知识和信心持续增加,但通过解决该人群教育的独特障碍,效果可能会得到改善。

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