新生儿重症监护病房家庭适应和儿童发展的生物心理社会模型。
A biopsychosocial model of NICU family adjustment and child development.
机构信息
Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA.
Division of Newborn Medicine, MassGeneral for Children, Boston, MA, USA.
出版信息
J Perinatol. 2023 Apr;43(4):510-517. doi: 10.1038/s41372-022-01585-1. Epub 2022 Dec 22.
BACKGROUND
Although infants in Neonatal Intensive Care Units (NICU) are at risk for developmental impairments and parents are at risk for emotional distress, factors that explain outcomes remain unknown. Here, we developed the first biopsychosocial model to explain family adjustment after NICU discharge.
METHODS
Participants included 101 families at The Children's Hospital of Philadelphia Neonatal Follow-Up Program who had been discharged 1.5-2.5 years prior. We gathered data using validated assessments, standardized assessments, and electronic medical records.
RESULTS
Our structural equation model, informed by the Double ABC-X Model, captured the dynamic relationships among infant, parent, couple, and family factors. Infant medical severity, posttraumatic stress, couple functioning, and family resources (e.g., time, money) were key for family adjustment and child development.
CONCLUSIONS
Interventions that target parental posttraumatic stress, couple dynamics, parental perception of time for themselves, and access to financial support could be key for improving NICU family outcomes.
背景
尽管新生儿重症监护病房（NICU）中的婴儿存在发育障碍的风险，而父母也存在情绪困扰的风险，但仍不清楚哪些因素可以解释这些结果。在这里，我们首次开发了一个包含生物-心理-社会因素的模型，以解释 NICU 出院后的家庭适应情况。
方法
参与者包括费城儿童医院新生儿随访项目的 101 个家庭，他们在 1.5-2.5 年前出院。我们使用经过验证的评估、标准化评估和电子病历收集数据。
结果
我们的结构方程模型受双 ABC-X 模型的启发，捕捉了婴儿、父母、夫妻和家庭因素之间的动态关系。婴儿的医疗严重程度、创伤后应激、夫妻关系和家庭资源（如时间、金钱）是家庭适应和儿童发展的关键因素。
结论
针对父母创伤后应激、夫妻关系动态、父母对自己时间的感知以及获得经济支持的干预措施可能是改善 NICU 家庭结局的关键。
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