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多药耐药菌对生命有限条件下儿童社会参与和生活质量的影响。

The effect of multidrug-resistant organisms on social participation and quality of life in children with life-limiting conditions.

机构信息

Paediatric Palliative Care Centre Children's and Adolescents' Hospital, Datteln Witten/Herdecke University Datteln Germany.

出版信息

Int J Palliat Nurs. 2021 Feb 2;27(1):10-19. doi: 10.12968/ijpn.2021.27.1.10.

Abstract

BACKGROUND

Children with life-limiting conditions have a high risk of colonisation with a multidrug-resistant organism (MDRO). To avoid the spread of hospital-aquired infections to other patients, children with a MDRO are moved to an isolated room or ward. However, such isolation prevents social participation, which may reduce the child's quality of life (QoL). To overcome this challenge of conflicting interests on a paediatric palliative care inpatient unit, a hygiene concept for patients colonised with MDRO, called PALLINI, was implemented. PALLINI advises that, instead of isolating the affected children, strict barrier nursing should be used.

AIM

To identify the impact of a complex hygiene concept on children's and parents' QoL and social participation.

METHODS

Cross-sectional mixed-methods research approach, comprising semi-structured interviews with parents and staff members, and a QoL-questionnaire focusing on the child which was completed by parents.

FINDINGS

In paediatric patients with life-limiting conditions who have MDRO colonisation, using a complex hygiene protocol resulted in both benefits and barriers to social participation. However, the child's QoL did not appear to be affected.

CONCLUSION

All staff members and families have to be familiar with the hygiene concept and the concept has to be self-explanatory and easy to apply.

摘要

背景

患有危及生命疾病的儿童有很高的风险被多重耐药菌(MDRO)定植。为了避免医院获得性感染传播给其他患者,MDRO 定植的儿童会被转移到隔离病房或病房。然而,这种隔离会阻碍社交参与,从而可能降低儿童的生活质量(QoL)。为了克服儿科姑息治疗住院病房中这一对立利益的挑战,实施了一种针对 MDRO 定植患者的卫生概念,称为 PALLINI。PALLINI 建议,不应隔离受影响的儿童,而应使用严格的屏障护理。

目的

确定复杂卫生概念对儿童及其父母的生活质量和社交参与的影响。

方法

采用横断面混合方法研究方法,包括对家长和工作人员进行半结构化访谈,以及家长填写的针对儿童的生活质量调查问卷。

结果

在患有危及生命疾病且 MDRO 定植的儿科患者中,使用复杂的卫生方案会对社交参与产生既有获益又有障碍。然而,儿童的生活质量似乎并未受到影响。

结论

所有工作人员和家庭都必须熟悉卫生概念,该概念必须具有自我解释性且易于应用。

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