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心脏手术患儿母亲出院准备度、应激与应对的单中心前瞻性研究

Readiness for Hospital Discharge, Stress, and Coping in Mothers of Children Undergoing Cardiac Surgeries: A Single-Center Prospective Study.

机构信息

Children's Intensive Care Unit, Division of Nursing, KK Women's and Children's Hospital, Singapore.

Children's Intensive Care Unit, Department of Pediatric Subspecialties, KK Women's and Children's Hospital, Medicine, Singapore.

出版信息

Pediatr Crit Care Med. 2020 May;21(5):e301-e310. doi: 10.1097/PCC.0000000000002276.

Abstract

OBJECTIVES

To examine the relationship between stress, coping, and discharge readiness in mothers of children undergoing congenital heart surgeries.

DESIGN

Quantitative descriptive study at three time points: pre surgery (time point I), day of hospital discharge (time point II) and 2 weeks following discharge (time point III).

SETTING

Tertiary care pediatric hospital in Singapore.

PARTICIPANTS

One hundred mothers whose children had undergone congenital heart surgeries.

MEASUREMENTS AND MAIN RESULTS

Data collection included self-reported questionnaires of the Pediatric Inventory for Parents and the Coping Health Inventory for Parents across three time points. Readiness for Hospital Discharge Scale was administered at hospital discharge (time point II). The utilization of health services and support was reported at post discharge (time point III). One-hundred mothers participated in this study between May 2016 and July 2017. Their mean age was 35.8 years (SD = 7.0), and the mean age of their children was 3.7 years (SD = 4.6). There was significant reduction in mean stress difficulty (Pediatric Inventory for Parents) of mothers (F = 4.58; p = 0.013) from time point I to III. No significant changes were found in the overall mean coping score (Coping Health Inventory for Parents) of mothers across time. The mean overall score for the readiness for discharge (Readiness for Hospital Discharge Scale) of mothers at hospital discharge was 207.34 (SD = 29.22). Coping through family integration subscale and communication stress predicted discharge readiness of mothers (adjusted R = 0.11; p = 0.034). Mothers who reported higher overall stress (Pediatric Inventory for Parents) 2 weeks post discharge were more likely to call a friend or family member, visit the emergency department, or have their child readmitted to hospital following hospital discharge.

CONCLUSIONS

We identified coping by family integration and communication-related stress as predictors of readiness for discharge. Strategies targeted at communication and family integration for discharge preparation may improve caregivers' readiness for hospital discharge.

摘要

目的

探讨先天性心脏病患儿母亲的压力、应对方式与出院准备之间的关系。

设计

在三个时间点进行定量描述性研究:术前(时间点 I)、出院当天(时间点 II)和出院后 2 周(时间点 III)。

地点

新加坡一家三级儿童医院。

参与者

100 名接受过先天性心脏病手术的患儿母亲。

测量和主要结果

数据收集包括三个时间点的家长儿科量表和家长应对健康量表的自我报告问卷。出院准备量表在出院时(时间点 II)进行评估。出院后(时间点 III)报告了健康服务和支持的使用情况。2016 年 5 月至 2017 年 7 月期间,100 名母亲参加了这项研究。她们的平均年龄为 35.8 岁(SD=7.0),孩子的平均年龄为 3.7 岁(SD=4.6)。母亲的压力困难(家长儿科量表)的平均得分从时间点 I 到 III 显著降低(F=4.58,p=0.013)。母亲的总体应对得分(家长应对健康量表)在整个时间内没有明显变化。母亲在出院时的出院准备总得分(出院准备量表)平均为 207.34(SD=29.22)。通过家庭融合子量表和沟通压力进行应对预测了母亲的出院准备情况(调整后的 R=0.11,p=0.034)。出院后 2 周报告总体压力较高(家长儿科量表)的母亲更有可能打电话给朋友或家人、去急诊室或让孩子在出院后再次住院。

结论

我们发现,通过家庭融合和沟通相关压力进行应对是出院准备的预测因素。针对沟通和家庭融合制定的出院准备策略可能会提高照顾者的出院准备情况。

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