新生儿护士对婴儿健康的感知和自我报告的困扰。
Perceived Infant Well-Being and Self-Reported Distress in Neonatal Nurses.
机构信息
Christine A. Fortney, PhD, RN, is Assistant Professor and Mercedes Pratt, BSN, RN, is Graduate Student, The Ohio State University College of Nursing, Columbus. At the time this research was completed, Ms. Pratt was an undergraduate honors student at The Ohio State University College of Nursing, Columbus. Zackery D. O. Dunnells, BS, is Graduate Student in the Master of Social Work Program, College of Arts and Sciences, Anne and Henry Zarrow School of Social Work, University of Oklahoma, Norman. At the time this research was completed, he was a research assistant in the Center for Biobehavioral Health, Research Institute at Nationwide Children's Hospital, Columbus, Ohio. Joseph R. Rausch, PhD, is Associate Professor, Center for Biobehavioral Health, Research Institute at Nationwide Children's Hospital and Department of Pediatrics, College of Medicine, The Ohio State University, Columbus. Olivia E. Clark, BS, is Graduate Student in the Clinical Psychology Program, Department of Psychology, Loyola University, Chicago, Illinois. At the time this research was completed, she was a research assistant in the Center for Biobehavioral Health, Research Institute at Nationwide Children's Hospital, Columbus, Ohio. Amy E. Baughcum, PhD, is Associate Professor, Department of Pediatrics, College of Medicine, The Ohio State University, and Department of Psychology and Neuropsychology, Nationwide Children's Hospital, Columbus. Cynthia A. Gerhardt, PhD, is Director, Center for Biobehavioral Health, Research Institute at Nationwide Children's Hospital, and Professor, Department of Pediatrics, College of Medicine, and Department of Psychology, The Ohio State University, Columbus.
出版信息
Nurs Res. 2020 Mar/Apr;69(2):127-132. doi: 10.1097/NNR.0000000000000419.
BACKGROUND
Infants who are admitted to a neonatal intensive care unit (NICU) may experience significant symptom burden. Parents are often distressed by these symptoms, which can affect their long-term coping and distress. There is limited research examining nurse perceptions of infant well-being (symptoms, suffering, and quality of life [QOL]) and associations with nurse distress.
OBJECTIVE
The objective of this descriptive study was to explore associations between nurse perceptions of infant well-being and self-reported distress.
METHODS
Nurses caring for infants with potentially life-threatening/life-limiting conditions were recruited from a Level IV NICU in the Midwestern United States as a part of a study on infant symptom burden. Nurses reported their perceptions of infant well-being and their own distress on a 5-point Likert scale. Surveys were administered at the bedside weekly for up to 12 weeks, depending on length of stay. Infant suffering and QOL were examined in relation to nurse distress. A cross-classified multilevel model was used to account for dependence within nurse and within patient.
RESULTS
A total of 593 surveys were collected from nurses. Using a cross-classified multilevel model with variables entered simultaneously, nurse perceptions of greater infant suffering and lower infant QOL were significantly associated with greater nurse distress.
DISCUSSION
Preliminary evidence shows that greater perceived infant suffering and lower perceived infant QOL may be associated with greater levels of self-reported distress in NICU nurses. Further work is needed to better understand factors related to symptom management in the NICU and the potential role of caregiver distress and compassion fatigue in NICU nurses.
背景
入住新生儿重症监护病房（NICU）的婴儿可能会承受严重的症状负担。父母通常会对这些症状感到痛苦，这可能会影响他们的长期应对和痛苦程度。目前，关于护士对婴儿健康状况（症状、痛苦和生活质量[QOL]）的看法及其与护士痛苦程度的关联的研究有限。
目的
本描述性研究的目的是探讨护士对婴儿健康状况的看法与自我报告的痛苦程度之间的关联。
方法
在美国中西部的一家 4 级 NICU 中，招募了照顾有潜在危及生命/生命有限条件的婴儿的护士，作为婴儿症状负担研究的一部分。护士使用 5 点 Likert 量表报告他们对婴儿健康状况的看法和自己的痛苦程度。根据住院时间，每周在床边进行一次调查，最多进行 12 周。检查了婴儿的痛苦和生活质量与护士的痛苦程度的关系。使用交叉分类多水平模型来解释护士和患者内部的依赖性。
结果
共从护士那里收集了 593 份调查。使用同时输入变量的交叉分类多水平模型，护士对婴儿更大痛苦和更低生活质量的感知与更高的护士痛苦程度显著相关。
讨论
初步证据表明，护士对婴儿更大痛苦和更低生活质量的感知可能与 NICU 护士自我报告的更高程度的痛苦有关。需要进一步的工作来更好地了解与 NICU 中症状管理相关的因素以及 NICU 护士的照顾者痛苦和同情心疲劳的潜在作用。
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