Karolinska Institutet, Stockholm, Sweden.
Neonatal Intensive Care Unit, Karolinska University Hospital, Stockholm, Sweden.
J Clin Nurs. 2020 Nov;29(21-22):4194-4202. doi: 10.1111/jocn.15448. Epub 2020 Aug 20.
To explore parental experiences of therapeutic hypothermia (TH) in their newborn infant suffering from hypoxic ischaemic encephalopathy following perinatal asphyxia.
Since more than a decade, newborn infants are treated with TH following perinatal asphyxia to reduce mortality and disabilities and to improve neurological outcome. The infants' body temperature is lowered to 33.5°C for 72 hr, and the infant is usually cared for in an open incubator. The parents are not able to hold their infant skin to skin, which risks causing emotional reactions in parents and a loss of normal parent-infant bonding.
A qualitative descriptive design using semi-structured interviews.
Up to 7 months after the event, interviews were conducted with 14 parents of seven infants who had received TH in a neonatal intensive care unit (NICU) in Sweden. The interviews were transcribed and analysed using framework approach. Findings were reported following the Standard for Reporting Qualitative Research (SRQR) checklist.
From the interviews, an overall theme was found: Transition through a life-altering time, and three categories: (a) trepidation about prognosis, (b) transitioning into parenthood supported by the caring philosophy of family-centred care (FCC) and (c) rewarming as a milestone.
Parental experiences of TH are based on the immediate emotions and stress of uncertainty of the infant's prognosis. The values of FCC in the NICU append a natural transitioning into parenthood by parental involvement in nursing care and decisions. The rewarming of the infant is seen as a restart to more or less normal circumstances from the critical period of delivery and TH.
The management of NICUs should update the awareness of and deepen knowledge about FCC. The emphasis ought to be on adequate information about TH and the values of FCC to parents in the NICU context.
探讨围产期窒息后患有缺氧缺血性脑病的新生儿接受治疗性低体温（TH）治疗时，父母的体验。
十多年来，新生儿在围产期窒息后接受 TH 治疗，以降低死亡率和残疾率，并改善神经预后。将婴儿的体温降至 33.5°C 持续 72 小时，婴儿通常在开放式孵化器中接受护理。父母无法将婴儿的皮肤紧贴自己的皮肤，这可能会引起父母的情绪反应，并导致正常的母婴情感联系丧失。
使用半结构式访谈的定性描述设计。
在事件发生后长达 7 个月的时间里，对瑞典新生儿重症监护病房（NICU）中接受 TH 的 7 名婴儿的 14 名父母进行了访谈。访谈内容被转录并使用框架方法进行分析。研究结果按照定性研究报告标准（SRQR）清单进行报告。
从访谈中发现了一个总体主题：通过改变生活的时期，以及三个类别：（a）对预后的担忧，（b）在以家庭为中心的关怀（FCC）护理理念支持下过渡到父母身份，（c）复温作为一个里程碑。
父母对 TH 的体验基于婴儿预后不确定的即时情绪和压力。NICU 中的 FCC 价值观通过父母参与护理和决策，为父母的自然过渡到父母身份提供了支持。婴儿的复温被视为从分娩和 TH 的关键时期重新开始，进入或多或少的正常情况。
NICU 的管理应该提高对 FCC 的认识和深化对其的了解。重点应该是在 NICU 环境中向父母提供有关 TH 和 FCC 价值观的充分信息。
