James Cook University College of Medicine and Dentistry, Townsville, Queensland, Australia.
Townsville Hospital and Health Service, Townsville, Queensland, Australia.
BMJ Open. 2019 May 14;9(5):e026344. doi: 10.1136/bmjopen-2018-026344.
A qualitative study informed by grounded theory principles to explore the experiences of parents who had extremely preterm or babies with antenatally diagnosed life-threatening diagnoses who were cared for in a regional tertiary neonatal unit. The study was conducted when the child was old enough to be diagnosed with long-term neurodevelopmental or medical sequelae.
North Queensland is a large area in Eastern Australia of 500 000 km, which is served by one tertiary neonatal unit.
Seventeen families representing 21 extremely preterm babies and one baby with congenital malformations who was not expected to survive prior to delivery (but did) were interviewed using grounded theory principles. Interviews were coded and themes derived.
Parents who recollect their neonatal experiences from 3 to 7 years after the baby was cared for in the neonatal intensive care described negative themes of grief and loss, guilt and disempowerment. Positive enhancers of care included parental strengths, religion and culture, family supports and neonatal unit practices. Novel findings included that prior pregnancy loss and infertility formed part of the narrative for parents, and hope was engendered by religion for parents who did not usually have a religious faith.
An understanding of both the negative aspects of neonatal care and the positive enhancers is necessary to improve the neonatal experience for parents. Parents are able to contextualise their previous neonatal experiences within both the long-term outcome for the child and their own life history.
一项基于扎根理论原则的定性研究,旨在探讨在区域三级新生儿病房接受治疗的患有极早产儿或产前诊断为危及生命疾病的父母的经历。该研究是在孩子有足够大的年龄可以被诊断出长期神经发育或医疗后遗症时进行的。
北昆士兰是澳大利亚东部一个面积为 500000 平方公里的大区,由一个三级新生儿病房提供服务。
17 个家庭代表 21 个极早产儿和 1 个出生前预计无法存活但实际上存活下来的先天性畸形婴儿接受了采访,采访采用了扎根理论原则。对采访进行了编码,并得出了主题。
在新生儿重症监护病房接受治疗 3 至 7 年后回忆起新生儿经历的父母描述了悲伤和失落、内疚和无力感等负面主题。护理的积极增强因素包括父母的优势、宗教和文化、家庭支持和新生儿病房的做法。新发现包括,先前的妊娠丢失和不孕不育是父母叙述的一部分,而宗教为那些通常没有宗教信仰的父母带来了希望。
了解新生儿护理的负面方面和积极增强因素对于改善父母的新生儿体验是必要的。父母能够将他们以前的新生儿经历置于孩子的长期预后和他们自己的生活史中进行理解。