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父母在新生儿(重症)监护病房与医护人员沟通方面的需求和感知差距:一项定性访谈研究。

Parents' needs and perceived gaps in communication with healthcare professionals in the neonatal (intensive) care unit: A qualitative interview study.

机构信息

Athena Institute, Vrije Universiteit Amsterdam, the Netherlands.

Department of Pediatrics and Neonatology, OLVG Amsterdam, the Netherlands; Amsterdam UMC, University of Amsterdam, Vrije Universiteit, Emma Children's Hospital, Amsterdam, the Netherlands.

出版信息

Patient Educ Couns. 2021 Jul;104(7):1518-1525. doi: 10.1016/j.pec.2020.12.007. Epub 2021 Jan 8.

Abstract

OBJECTIVE

To explore parents' needs and perceived gaps concerning communication with healthcare professionals during their preterm infants' admission to the neonatal (intensive) care unit (NICU) after birth.

METHODS

Semi-structured, retrospective interviews with 20 parents of preterm infants (March 2020), admitted to a Dutch NICU (level 2-4) minimally one week, one to five years prior. The interview guide was developed using Epstein and Street's Framework for Patient-Centered Communication. Online interviews were audio-taped and transcribed verbatim. Deductive and inductive thematic analysis was performed by two independent coders.

RESULTS

Communication needs and gaps emerged across four main functions of NICU communication: Building/maintaining relationships, exchanging information, (sharing) decision-making, and enabling parent self-management. Communication gaps included: lack of supportive physician communication, disregard of parents' views and agreements, missing communication about decisions, and the absence of written (discharge) information.

CONCLUSION

This study improves our understanding and conceptualization of adequate NICU communication by revealing persisting gaps in parent-provider interaction. Also, this study provides a steppingstone for further integration of parents as equal partners in neonatal care and communication.

PRACTICE IMPLICATIONS

The results are relevant to practitioners in the field of neonatal and pediatric care, providing suggestions for tangible improvements in NICU care in the Netherlands and beyond.

摘要

目的

探讨父母在早产儿出生后入住新生儿(重症监护)病房(NICU)期间与医疗保健专业人员沟通的需求和感知差距。

方法

对 20 名早产儿父母(2020 年 3 月)进行半结构化、回顾性访谈,这些父母的孩子至少在一周前、一至五年前被收入荷兰 NICU(2-4 级)。访谈指南是使用 Epstein 和 Street 的以患者为中心的沟通框架制定的。在线访谈进行了录音,并逐字转录。两名独立的编码员进行了演绎和归纳主题分析。

结果

NICU 沟通的四个主要功能(建立/维持关系、交换信息、(共享)决策和促进父母自我管理)中出现了沟通需求和差距。沟通差距包括:缺乏支持性的医生沟通、忽视父母的观点和协议、关于决策的沟通缺失以及缺乏书面(出院)信息。

结论

本研究通过揭示父母与提供者互动中持续存在的差距,增进了我们对适当的 NICU 沟通的理解和概念化。此外,本研究为进一步将父母整合为新生儿护理和沟通的平等伙伴提供了一个起点。

实践意义

研究结果与新生儿和儿科护理领域的从业者相关,为荷兰乃至其他国家的 NICU 护理提供了切实可行的改进建议。

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