调查家庭探视情况：意大利新生儿重症监护病房的袋鼠式护理和母乳喂养政策。
Surveying family access: kangaroo mother care and breastfeeding policies across NICUs in Italy.
机构信息
Neonatology and Neonatal Intensive Care Unit, Careggi University Hospital, Florence, Italy.
Neonatology and Neonatal Intensive Care Unit, University of Modena and Reggio Emilia Hospital, Via del Pozzo 71, 41125, Modena, Italy.
出版信息
Ital J Pediatr. 2021 Dec 2;47(1):231. doi: 10.1186/s13052-021-01164-8.
BACKGROUND
Studies on the application of developmental care initiatives in Italian NICUs are rather scarce. We aimed to assess parental access to the NICUs and facilities offered to the family members and to test "the state of art" regarding kangaroo mother care (KMC) and breastfeeding policies in level III Italian NICUs.
METHODS
A questionnaire both in paper and in electronic format was sent to all 106 Italian level III NICUs; 86 NICUs (i.e., 80% of NICUs) were completed and returned. The collected data were analysed. In addition, a comparison between the 2017 survey results and those of two previous surveys conducted from 2001 to 2006 was performed.
RESULTS
In total, 53 NICUs (62%) reported 24-h open access for both parents (vs. 35% in 2001 and 32% in 2006). Parents were requested to temporarily leave the unit during shift changes, emergencies and medical rounds in 55 NICUs (64%). Some parental amenities, such as an armchair next to the crib (81 units (94%)), a room for pumping milk and a waiting room, were common, but others, such as family rooms (19 units (22%)) and adjoining accommodation (30 units (35%)), were not. KMC was practised in 81 (94%) units, but in 72 (62%), i.e., the majority of units, KMC was limited to specific times. In 11 (13%) NICUs, KMC was not offered to the father. The average duration of a KMC session, based on unit staff estimation, was longer in 24-h access NICUs than in limited-access NICUs. KMC documentation in medical records was reported in only 59% of questionnaires. Breastfeeding was successful in a small proportion of preterm infants staying in the NICU.
CONCLUSION
The number of 24-h access NICUs doubled over a period of 13 years. Some basic family facilities, such as a dedicated kitchen, rooms with dedicated beds and showers for the parents, remain uncommon. KMC and breastfeeding have become routine practices; however, the frequency and duration of KMC sessions reported by NICU professionals still do not meet the WHO recommendations.
背景
在意大利 NICU 中应用发展护理干预措施的研究相对较少。我们旨在评估父母对 NICU 的访问情况以及为家庭成员提供的设施，并测试三级意大利 NICU 中袋鼠式护理 (KMC) 和母乳喂养政策的“现状”。
方法
我们以纸质和电子格式向所有 106 家意大利三级 NICU 发送了一份问卷；86 家 NICU（即 80%的 NICU）完成并返回。收集的数据进行了分析。此外，还对 2017 年调查结果与 2001 年至 2006 年进行的两项先前调查的结果进行了比较。
结果
共有 53 家 NICU（62%）报告称父母可 24 小时随时进入（2001 年为 35%，2006 年为 32%）。在 55 家 NICU（64%）中，父母在换班、紧急情况和医疗查房期间被要求暂时离开病房。一些父母的便利设施，如婴儿床旁的扶手椅（81 个单位（94%））、挤奶室和等候室很常见，但其他设施，如家庭房（19 个单位（22%））和相邻的住宿（30 个单位（35%））则不然。81 个（94%）单位实施了 KMC，但在 72 个（62%）单位中，即大多数单位，KMC 仅限于特定时间。在 11 个（13%）NICU 中，父亲不能进行 KMC。根据单位工作人员的估计，24 小时开放 NICU 的 KMC 时间比限时开放 NICU 长。仅 59%的调查问卷报告了 KMC 在医疗记录中的记录。在 NICU 中住院的早产儿中，母乳喂养成功的比例很小。
结论
24 小时开放的 NICU 数量在 13 年内翻了一番。一些基本的家庭设施，如专门的厨房、为父母提供的带专用床和淋浴的房间，仍然不常见。KMC 和母乳喂养已成为常规做法；然而，NICU 专业人员报告的 KMC 次数和持续时间仍不符合世卫组织的建议。
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