Klawetter Susanne, Greenfield Jennifer C, Speer Stephanie Rachel, Brown Kyria, Hwang Sunah S
School of Social Work, Portland State University, Portland, OR, USA.
Graduate School of Social Work, University of Denver, Denver, CO USA.
AIMS Public Health. 2019 May 5;6(2):160-183. doi: 10.3934/publichealth.2019.2.160. eCollection 2019.
Hospitals and perinatal organizations recognize the importance of family engagement in the neonatal intensive care unit (NICU). The Agency for Healthcare Research and Quality (AHRQ) defines family engagement as "A set of behaviors by patients, family members, and health professionals and a set of organizational policies and procedures that foster both the inclusion of patients and family members as active members of the health care team and collaborative partnerships with providers and provider organizations." In-unit barriers and facilitators to enhance family engagement are well studied; however, less is known specifically about maternal engagement's influence in the NICU on the health of infants and mothers, particularly within U.S. social and healthcare contexts. In this integrative review, we examine the relationship between maternal engagement in the NICU and preterm infant and maternal health outcomes within the U.S. Results from the 33 articles that met inclusion criteria indicate that maternal engagement in the NICU is associated with infant outcomes, maternal health-behavior outcomes, maternal mental health outcomes, maternal-child bonding outcomes, and breastfeeding outcomes. Skin-to-skin holding is the most studied maternal engagement activity in the U.S. preterm NICU population. Further research is needed to understand what types of engagement are most salient, how they should be measured, and which immediate outcomes are the best predictors of long-term health and well-being.
医院和围产期组织认识到家庭参与新生儿重症监护病房（NICU）的重要性。医疗保健研究与质量局（AHRQ）将家庭参与定义为“患者、家庭成员和医疗专业人员的一系列行为，以及一系列组织政策和程序，这些行为和程序促进患者和家庭成员作为医疗团队的积极成员被纳入其中，并与提供者及提供者组织建立合作关系”。关于加强家庭参与的病房内障碍和促进因素已有充分研究；然而，在美国社会和医疗背景下，关于产妇参与对新生儿重症监护病房中婴儿和母亲健康的具体影响，我们所知甚少。在这篇综合综述中，我们研究了美国新生儿重症监护病房中产妇参与与早产儿及产妇健康结局之间的关系。符合纳入标准的33篇文章的结果表明，新生儿重症监护病房中产妇的参与与婴儿结局、产妇健康行为结局、产妇心理健康结局、母婴情感联结结局以及母乳喂养结局相关。在美国早产儿重症监护病房人群中，肌肤接触是研究最多的产妇参与活动。需要进一步研究以了解哪些类型的参与最为显著、应如何衡量这些参与，以及哪些直接结局是长期健康和幸福的最佳预测指标。
