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加纳新生儿重症监护病房以家庭为中心的护理的经验和背景实践:对家庭和临床医生的定性研究。

Experiences and contextual practices of family-centered care in Ghanaian nicus: a qualitative study of families and clinicians.

机构信息

School of Nursing, Wisconsin International University College-Ghana, P.O Box LG, Accra, Ghana.

University of Health and Allied Health Sciences, Ho, Ghana.

出版信息

BMC Health Serv Res. 2022 Aug 17;22(1):1051. doi: 10.1186/s12913-022-08425-0.

Abstract

BACKGROUND

Families, whether at home or at the hospital, should be a vital part of newborn care. However, most families are excluded from hospital care, particularly in neonatal intensive care units (NICUs). This is incompatible with the concepts of Family-Centered Care (FCC) and may compromise care continuity and family satisfaction following discharge from neonatal intensive care facilities. The purpose of this study was to examine FCC practices in Ghanaian neonatal intensive care units and provide the experiences and contextual practices of FCC from the perspectives of families and clinicians.

METHODS

The study qualitatively examined the contextual practices of FCC from the perspectives of families and clinicians in neonatal intensive care units using an exploratory descriptive design. With the help of MAXQDA software, 36 transcripts were generated and their contents were analyzed.

RESULTS

Contextual practices of FCC, family experiences of FCC and clinician experiences of FCC emerged as three main categories from the data. Respect and dignity, culture and religion and a multidisciplinary approach were the contextual practices. Emotional stress, lack of information and coping strategies were all common family experiences. Support, counseling, education and financial problems have all been experienced by clinicians.

CONCLUSIONS

Shared decision-making, counseling and education, as well as respect/dignity amongst clinicians, managers and families using a multidisciplinary approach are the fundamental concepts of FCC approach in Ghana. Acceptance and integration of FCC approach into neonatal intensive care units may reduce the burden of care as well as improve the quality of care. Further studies are needed to map out strategies and interventions for the integration of FCC into intensive care units.

摘要

背景

家庭,无论是在家庭中还是在医院中,都应该成为新生儿护理的重要组成部分。然而,大多数家庭都被排除在医院护理之外,尤其是在新生儿重症监护病房(NICU)。这与以家庭为中心的护理(FCC)的理念相悖,可能会影响新生儿重症监护病房出院后的护理连续性和家庭满意度。本研究旨在考察加纳新生儿重症监护病房的 FCC 实践,并从家庭和临床医生的角度提供 FCC 的经验和背景实践。

方法

本研究采用探索性描述设计,从家庭和临床医生的角度,使用定性方法检查新生儿重症监护病房中 FCC 的背景实践。在 MAXQDA 软件的帮助下,生成了 36 份转录本,并对其内容进行了分析。

结果

从数据中得出了 FCC 的背景实践、家庭对 FCC 的体验以及临床医生对 FCC 的体验三个主要类别。尊重和尊严、文化和宗教以及多学科方法是 FCC 的背景实践。情感压力、缺乏信息和应对策略是家庭常见的体验。支持、咨询、教育和经济问题是临床医生的共同经历。

结论

在多学科方法的基础上,临床医生、管理者和家庭之间的共同决策、咨询和教育以及尊重/尊严是 FCC 方法的基本概念。在新生儿重症监护病房中接受和整合 FCC 方法可以减轻护理负担,提高护理质量。需要进一步研究,制定将 FCC 纳入重症监护病房的策略和干预措施。

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