J Obstet Gynecol Neonatal Nurs. 2020 Sep;49(5):464-474. doi: 10.1016/j.jogn.2020.07.001. Epub 2020 Jul 26.
To understand the opinions of clinicians about the risks, benefits, barriers, and facilitators to the practice of parent sleep during skin-to-skin care in hospital settings.
Cross-sectional survey.
Online survey.
Clinicians who self-identified as infant care providers, that is, neonatal clinicians (N = 158).
We sent an online survey invitation to neonatal clinicians through neonatal websites, conferences, and social media sites in the United States and used snowball recruitment. We used a risk management framework to analyze qualitative data. We used descriptive statistics and the chi-square and Fisher's exact tests to determine if opinions differed based on clinician and organizational characteristics.
Respondents' support of parent sleep during skin-to-skin care (yes/no) did not differ on the basis of whether the clinician had taken a formal course on skin-to-skin care, facilitated skin-to-skin care more than 100 times, or frequently promoted skin-to-skin care in current practice. Respondents who supported parent sleep (n = 93, 59% of respondents) reported greater implementation of risk control strategies than nonsupporters (n = 53 [57%] vs. n = 3 [5%]; p < .001), such as frequent monitoring of vital signs (n = 33 [35%] vs. n = 2 [3%]; p < .001), use of devices to support skin-to-skin care (n = 49 [53%] vs. n = 19 [29%]; p = .003), and proper positioning (n = 20 [22%] vs. n = 0 [0%]; p < .001). Nonsupporters more frequently reported that parent sleep during skin-to-skin care violates safe sleep recommendations, is habit forming for home, poses a fall risk, and jeopardizes the infant's airway.
Most respondents supported parent sleep during skin-to-skin care, but concerns regarding safety for the infant remained a barrier. The use of a risk management framework may help facilitate a systematic approach to improve the implementation of safe skin-to-skin practices.
了解临床医生对在医院环境中进行皮肤接触时让父母陪睡的风险、益处、障碍和促进因素的看法。
横断面调查。
在线调查。
自我认同为婴儿护理提供者的临床医生，即新生儿临床医生（N=158）。
我们通过美国的新生儿网站、会议和社交媒体向新生儿临床医生发送了在线调查邀请，并使用滚雪球招募。我们使用风险管理框架来分析定性数据。我们使用描述性统计以及卡方检验和 Fisher 精确检验来确定意见是否基于临床医生和组织特征而有所不同。
根据临床医生是否参加过正式的皮肤接触课程、是否促成了 100 多次以上的皮肤接触、还是经常在当前实践中推广皮肤接触，他们对皮肤接触时让父母陪睡的支持（是/否）没有差异。支持父母陪睡的受访者（n=93，占受访者的 59%）比不支持者（n=53[57%] vs. n=3[5%]；p<.001）报告了更多的风险控制策略的实施情况，例如频繁监测生命体征（n=33[35%] vs. n=2[3%]；p<.001）、使用支持皮肤接触的设备（n=49[53%] vs. n=19[29%]；p=.003）和正确定位（n=20[22%] vs. n=0[0%]；p<.001）。不支持者更频繁地报告说，皮肤接触时让父母陪睡违反了安全睡眠建议、会在家中形成习惯、存在跌倒风险、并危及婴儿的气道。
大多数受访者支持皮肤接触时让父母陪睡，但对婴儿安全的担忧仍然是一个障碍。使用风险管理框架可能有助于促进采用系统方法来改善安全皮肤接触实践的实施。
