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与家长密切合作干预对 NICU 以家庭为中心护理质量的影响。

Effects of the Close Collaboration With Parents Intervention on the Quality of Family-Centered Care in NICUs.

机构信息

Departments of Nursing Science (Drs Toivonen and Axelin) and Psychology and Speech-Language Pathology (Dr Ahlqvist-Björkroth) and Faculty of Medicine (Dr Lehtonen), University of Turku, Turku, Finland; Turku University of Applied Sciences, Turku, Finland (Dr Toivonen); and Department of Pediatrics, Hospital District of Southwest Finland, Turku University Hospital, Turku, Finland (Dr Lehtonen). Ethical approval was provided by the Ethics Committee, Hospital District of Southwest Finland (16/180/2011). Written informed consent was obtained from the parents.

出版信息

Adv Neonatal Care. 2023 Jun 1;23(3):281-289. doi: 10.1097/ANC.0000000000000953. Epub 2021 Oct 1.

Abstract

BACKGROUND

Systematic training for the neonatal staff to support parents' active involvement is lacking. There is little information about the effectiveness of educational interventions.

PURPOSE

To evaluate the effects of an educational intervention to neonatal staff on the quality of family-centered care from the perspectives of parents and nurses.

METHODS

A quasi-experimental before and after study was carried out in 5 Finnish neonatal units in 2014-2018. Data were collected using the DigiFCC-tools with a 7-point Likert scale. Thirty-one fathers and 53 mothers were recruited before the intervention and 21 fathers and 61 mothers after the intervention. They answered 1 question every evening until their infants' discharge. Each nurse answered 1 corresponding question after every shift, during the same period before and after the intervention. Before the intervention 3239 responses and after the intervention 3092 responses were received from nurses.

RESULTS

The fathers' total score and the score indicating "Shared decision making" were higher after the intervention than before the intervention. The mothers' total score did not differ between the 2 time periods. The nurses' total score was higher after the intervention than before the intervention. Of the individual items, higher scores were found for "Active listening," "Parents' trust in the nurse," and "Emotional support."

IMPLICATIONS FOR PRACTICE

Developing the staff's negotiating and active listening skills facilitates better support for parents during infants' intensive care.

IMPLICATIONS FOR RESEARCH

Family-centered care interventions such as Close Collaboration with Parents should be studied in randomized controlled trials, also including child outcomes.

摘要

背景

系统的培训可以让新生儿医护人员支持父母积极参与,但目前这方面的培训仍很缺乏。关于教育干预的有效性,目前信息较少。

目的

评估对新生儿医护人员的教育干预对以家庭为中心的护理质量的影响,评估视角分别为父母和护士。

方法

2014 年至 2018 年,在芬兰的 5 个新生儿病房进行了一项准实验性的前后对照研究。使用 7 点李克特量表的 DigiFCC 工具收集数据。在干预前招募了 31 位父亲和 53 位母亲,在干预后招募了 21 位父亲和 61 位母亲。他们在婴儿出院前每天晚上回答一个问题。在此期间,每位护士在每次轮班后都会回答一个相应的问题,在干预前后的同一时期。在干预前共收到了 3239 份护士的回答,干预后共收到了 3092 份护士的回答。

结果

与干预前相比,父亲的总分和“共同决策”得分在干预后更高。母亲的总分在两个时间段之间没有差异。护士的总分在干预后高于干预前。在各个项目中,“积极倾听”、“父母对护士的信任”和“情感支持”的得分更高。

实践意义

培养医护人员的谈判和积极倾听技巧可以在婴儿接受重症监护期间为父母提供更好的支持。

研究意义

以家庭为中心的护理干预,如与父母密切合作,应在随机对照试验中进行研究,还应包括儿童的结果。

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