Clubbs Brooke Hildebrand, Barnette Alan R, Gray Natallia, Weiner Lauren, Bond April, Harden Jane, Pineda Roberta
Departments of Communication Studies (Ms Clubbs) and Economics (Dr Gray), Southeast Missouri State University, Cape Girardeau; Level III Neonatal Intensive Care Unit, Saint Francis Medical Center, Cape Girardeau, Missouri (Dr Barnette and Mss Bond and Harden); Department of Communication, University of Illinois at Urbana-Champaign (Dr Weiner); and Program in Occupational Therapy, Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri (Dr Pineda).
Adv Neonatal Care. 2019 Aug;19(4):311-320. doi: 10.1097/ANC.0000000000000600.
Volunteers can provide staff-directed sensory inputs to infants hospitalized in the NICU, but research on volunteer programs is limited.
To evaluate the feasibility of a developmental care partner (DCP) program in a level III NICU and determine its relationship with provider burnout and infant infection rates.
DCPs were trained to provide sensory input to infants, based on the behavioral cues observed by the occupational therapists and nursing staff, in medically stable infants. Feasibility was assessed by documenting the process of training and utilizing volunteers, as well as tracking duration and frequency of DCP visits. Staff burnout measures were assessed using the Maslach Burnout Inventory Human Services Survey (MBI-HSS) before and after implementation. Infant infection rates before and after the introduction of volunteers were compared.
Seventy-two volunteers were interested, and 25 (35%) completed the DCP competencies and provided sensory exposures to 54 neonates, who were visited an average of 8 times (range 1-15). Twelve (48%) DCPs did once-per-week visits, and 9 (36%) did at least 50 contact hours. MBI-HSS scores for staff emotional exhaustion (P < .001) and depersonalization (P < .006) were lower after DCP implementation. There were no differences in infant infection rates before and after DCP implementation (Fisher exact P = 1.000).
Volunteer-based DCP programs may be feasible to implement in community hospitals and could help reduce staff emotional exhaustion and depersonalization without increasing the incidence of infant infections.
Future research on NICU volunteer programs with larger sample sizes and different infant populations is warranted.
志愿者可以为入住新生儿重症监护病房（NICU）的婴儿提供由工作人员指导的感官刺激，但关于志愿者项目的研究有限。
评估三级新生儿重症监护病房中发育关怀伙伴（DCP）项目的可行性，并确定其与医护人员职业倦怠及婴儿感染率之间的关系。
根据职业治疗师和护理人员观察到的行为线索，对发育关怀伙伴进行培训，使其为病情稳定的婴儿提供感官刺激。通过记录志愿者的培训和使用过程，以及跟踪发育关怀伙伴探访的时长和频率来评估可行性。在项目实施前后，使用马氏职业倦怠量表-人类服务调查（MBI-HSS）评估工作人员的职业倦怠情况。比较引入志愿者前后婴儿的感染率。
72名志愿者表示感兴趣，25名（35%）完成了发育关怀伙伴能力培训，并为54名新生儿提供了感官刺激，这些新生儿平均接受了8次探访（范围为1 - 15次）。12名（48%）发育关怀伙伴每周探访一次，9名（36%）探访时长至少达到50小时。发育关怀伙伴项目实施后，工作人员的情绪耗竭（P < 0.001）和去个性化（P < 0.006）方面的MBI-HSS评分降低。发育关怀伙伴项目实施前后婴儿感染率无差异（Fisher精确检验P = 1.000）。
基于志愿者的发育关怀伙伴项目在社区医院实施可能是可行的，并且有助于减少工作人员的情绪耗竭和去个性化，同时不增加婴儿感染的发生率。
有必要对样本量更大、婴儿群体不同的新生儿重症监护病房志愿者项目进行未来研究。
