Grace Centre for Newborn Care, Children's Hospital at Westmead, Sydney, New South Wales, Australia.
Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
J Paediatr Child Health. 2022 Apr;58(4):687-696. doi: 10.1111/jpc.15819. Epub 2021 Nov 2.
As more infants survive surgery in the newborn period for major congenital anomalies, the focus has shifted to the quality of care for parents as well as infants. In contemporary neonatal intensive care units (NICUs), doctors are encouraged to practice family-centred care and partner with parents in their infant's care. This study explored doctors' perceptions and parents' self-reported needs and stressors in a surgical NICU.
From January 2014 to September 2015, parents of infants admitted for general surgery for a major congenital anomaly who were present in the NICU between 48 and 72 h of admission and doctors caring for their infant at the time of data collection were invited to participate. Matched data were provided using the Neonatal Family Needs Inventory and the Parental Stressor Scale:NICU.
Matched data for 12 doctor-parent dyads showed that doctors (neonatal medical trainees) consistently under-rated the importance of parents' needs and identified fewer of mothers' than fathers' most important needs. Doctors also consistently under-rated parents' stressors. They perceived few of fathers', but all of mothers', greatest stressors. Thematic analysis revealed four themes: infant pain management; parental autonomy; empathy; and communicating reassurance and education to parents.
The findings suggest incongruences between doctors' perceptions and parents' self-reported needs and stressors. While there is hesitation in making recommendations with this sample size, the findings highlight issues that may inform further research and contribute to a dialogue regarding the role of doctors in family-centred relationship-based models of care in the NICU.
随着越来越多的患有重大先天畸形的婴儿在新生儿期接受手术治疗而存活下来，人们的关注点已转移到父母和婴儿的护理质量上。在当代新生儿重症监护病房（NICU）中，鼓励医生实行以家庭为中心的护理，并与父母一起护理婴儿。本研究探讨了外科 NICU 中医生的看法以及父母的自我报告的需求和压力源。
从 2014 年 1 月至 2015 年 9 月，邀请在 NICU 中接受主要先天异常的一般外科手术并在入院后 48 至 72 小时之间出现的婴儿的父母以及在收集数据时照顾其婴儿的医生参加研究。使用新生儿家庭需求清单和父母压力源量表：NICU 提供匹配的数据。
12 对医生-父母的数据显示，医生（新生儿医学实习生）一直低估了父母需求的重要性，并且确定了母亲比父亲更重要的需求。医生还一直低估了父母的压力源。他们认为父亲的压力源很少，但母亲的最大压力源都认为。主题分析揭示了四个主题：婴儿疼痛管理；父母自主权；同理心；向父母传达安慰和教育。
这些发现表明医生的看法与父母自我报告的需求和压力源之间存在差异。尽管在此样本量下提出建议存在犹豫，但这些发现突出了一些问题，这些问题可能为进一步的研究提供信息，并有助于围绕医生在以家庭为中心的关系为基础的 NICU 护理模式中的作用展开对话。
