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公共卫生环境下医护提供者与接受者对以家庭为中心的新生儿护理模式的接受度:来自印度的一项定性研究

Acceptability of a family-centered newborn care model among providers and receivers of care in a Public Health Setting: a qualitative study from India.

作者信息

Sarin Enisha, Maria Arti

机构信息

, Gurgaon, India.

Department of Neonatology, PGIMER & assoc. Dr. RML Hospital, New Delhi, India.

出版信息

BMC Health Serv Res. 2019 Mar 21;19(1):184. doi: 10.1186/s12913-019-4017-1.

Abstract

BACKGROUND

Family-centered care (FCC), based on collaborative participation of the family along with a team of health care providers, is found to increase the well-being of sick infants in neonatal critical care units. Over the last 4 years, the neonatal unit of Dr. Ram Manohar Lohia Hospital in Delhi has innovated and developed an implementation framework for FCC. This qualitative study assessed the acceptability of family-centered care among providers and family members of neonates to identify gaps and challenges in implementation.

METHODS

In-depth interviews were conducted among a purposive sample of twelve family members of admitted neonates and six providers to examine their perceptions and experiences regarding FCC.

RESULTS

Family members and providers expressed a positive perception and acceptance of FCC based on the competencies and knowledge acquired by parents and other caregivers of essential newborn care. Family members reported being satisfied with the overall health care experience due to the transparency of care and allowing them to be by their baby's bedside. Limitations in the infrastructure or lack of facilities at the public hospital did not seem to dilute these positive perceptions. Providers also perceived FCC as a good practice to be continued in spite of concerns around sharing of nursery space with parents, the need for constant vigilance of parents' practices in handling of their newborns, and the need for separate, designated nursing staff for FCC.

CONCLUSION

Both providers and receivers of neonatal care found FCC to be an acceptable form of care. Providers identified challenges and suggested possible solutions, such as need of periodic provider sensitization on FCC, improved staff organization, and provision of mother-friendly facilities to enable her to provide around-the-clock care by her baby's bedside. Overcoming these challenges would allow for better integration of FCC within general clinical care in neonatal care units.

摘要

背景

以家庭为中心的护理(FCC)基于家庭与医疗保健团队的协作参与,被发现可提高新生儿重症监护病房患病婴儿的幸福感。在过去4年里,德里的拉姆·马诺哈尔·洛希亚博士医院的新生儿科创新并制定了FCC的实施框架。这项定性研究评估了新生儿医护人员和家庭成员对以家庭为中心护理的接受程度,以确定实施过程中的差距和挑战。

方法

对12名住院新生儿的家庭成员和6名医护人员进行了针对性抽样的深入访谈,以考察他们对FCC的看法和经历。

结果

家庭成员和医护人员基于新生儿基本护理的家长和其他护理人员所获得的能力和知识,对FCC表达了积极看法和接受态度。家庭成员报告称,由于护理的透明度以及允许他们陪伴在婴儿床边,他们对整体医疗体验感到满意。公立医院基础设施的限制或设施的缺乏似乎并未削弱这些积极看法。尽管存在与家长共享保育室空间的担忧、需要持续监督家长照顾新生儿的做法以及需要为FCC配备单独的指定护理人员等问题,但医护人员也认为FCC是一种值得继续推行的良好做法。

结论

新生儿护理的提供者和接受者都认为FCC是一种可接受的护理形式。医护人员指出了挑战并提出了可能的解决方案,例如需要定期对医护人员进行FCC培训、改善人员组织安排以及提供方便母亲的设施,使她能够在婴儿床边提供全天候护理。克服这些挑战将有助于FCC更好地融入新生儿护理病房的一般临床护理中。

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