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母亲对晚期早产儿实施间歇性袋鼠式护理的体验:中国四家产后病房的混合方法研究。

Maternal experience of intermittent kangaroo mother care for late preterm infants: a mixed-methods study in four postnatal wards in China.

机构信息

Peking University First Hospital, Beijing, China.

Nuffield Department of Medicine, University of Oxford, Oxford, UK.

出版信息

BMJ Open. 2021 Sep 7;11(9):e050221. doi: 10.1136/bmjopen-2021-050221.

Abstract

OBJECTIVE

To describe how mothers of late preterm infants experienced the provision of intermittent kangaroo mother care (KMC) in four postnatal wards in different hospitals in China, under a pilot KMC project.

DESIGN

A concurrent mixed-methods approach incorporating quantitative maternal questionnaires and qualitative semistructured interviews.

SETTING

Four postnatal wards in level-III hospitals based in different provinces of Southeast and Northwest China.

PARTICIPANTS

All 752 mothers who provided intermittent KMC to their late preterm newborns in the four participating postnatal wards consented to participate in the study (quantitative component), as well as six nurses, two obstetricians and two mothers from two of the participating postnatal wards (qualitative component).

OUTCOME MEASURES

Maternal KMC experiences during a hospital stay, patients' perceptions of KMC initiation, processes, benefits and challenges.

RESULTS

Most mothers had not heard of KMC before being introduced to it in the postnatal ward. On average, mothers and newborns stayed in postnatal wards for 3.6 days; during their stay, mothers provided an average of 3.5 KMC sessions, which is an average of 1.1 sessions a day. Each KMC session lasted an average of 68 min, though there was much variation in the length of a session. Common reasons given for discontinuing a KMC session included restroom use, infant crying and perceived time limitations. Some mothers would have preferred to provide KMC for longer periods of time and nurses encouraged this. Most mothers experienced no difficulty providing KMC, received support from family and medical staff and intended to continue with KMC postdischarge.

CONCLUSION

In order to improve the maternal experience of KMC, it is recommended that raising awareness of KMC should be included in antenatal care and after birth. Longer periods of KMC provision should be encouraged, greater privacy should be provided for mothers providing KMC in postnatal wards and family members should be encouraged to support KMC.

摘要

目的

描述在中国东南和西北地区的 4 家不同医院的 4 个产后病房中,在试点袋鼠式护理(KMC)项目下,晚期早产儿的母亲如何体验间歇性 KMC。

设计

采用定量母亲问卷和定性半结构式访谈相结合的同期混合方法。

设置

中国东南和西北地区的 4 家三级医院的 4 个产后病房。

参与者

在参与的 4 个产后病房中,所有同意为其晚期早产儿提供间歇性 KMC 的 752 位母亲(定量部分)以及来自 2 个参与病房的 6 名护士、2 名产科医生和 2 位母亲(定性部分)都参与了研究。

结局指标

产妇在住院期间的 KMC 体验、患者对 KMC 启动、过程、益处和挑战的看法。

结果

大多数母亲在产后病房中被介绍 KMC 之前从未听说过它。平均而言,母亲和新生儿在产后病房中停留 3.6 天;在他们住院期间,母亲平均进行了 3.5 次 KMC 疗程,平均每天 1.1 次。每次 KMC 疗程平均持续 68 分钟,但疗程长度差异很大。中断 KMC 疗程的常见原因包括上厕所、婴儿哭闹和感知时间限制。一些母亲宁愿长时间提供 KMC,护士也鼓励这样做。大多数母亲在提供 KMC 时没有遇到困难,得到了家人和医务人员的支持,并打算在出院后继续 KMC。

结论

为了改善 KMC 的产妇体验,建议在产前护理和产后将提高对 KMC 的认识纳入其中。应鼓励提供更长时间的 KMC,为在产后病房提供 KMC 的母亲提供更大的隐私,并鼓励家属支持 KMC。

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