James M L, Hudson C N, Gebski V J, Browne L H, Andrews G R, Crisp S E, Palmer D, Beresford J L
Westmead Hospital, NSW.
Med J Aust. 1987 Nov 2;147(9):434-5, 437-8.
A community-based programme of planned early postnatal transfer home with the continuity of hospital nursing care was instituted in a defined geographic area of the western suburbs of Sydney in 1983. Mothers were offered the option of discharge in 24-48 hours after delivery, with home visits by a hospital midwife, subject to certain medical and social criteria. An evaluation of the programme in terms of morbidity, psychosocial impact on the family and costs was undertaken. For evaluation, a quasi-experimental study of parallel groups was designed in preference to randomized selection as it was believed that the personal choice would be fundamental to the success of the scheme. A contemporary control group was achieved with volunteer mothers who opted for the traditional five- to seven-day hospital stay. Studies of maternal response and the partner's response and adjustment were undertaken, including the administration of questionnaires that were designed to detect the presence of mild postnatal depression. No increased morbidity occurred in the early discharge group. The early discharge group performed more favourably on the questionnaire that was designed to measure their postpartum adjustment. Continued postnatal domiciliary surveillance reduces the risk that early neonatal pathological changes, especially jaundice, may be overlooked.
1983年，在悉尼西郊一个特定地理区域实施了一项基于社区的计划，即产后早期有计划地转回家中，并提供持续的医院护理服务。根据一定的医疗和社会标准，母亲们可以选择在分娩后24至48小时出院，由医院助产士进行家访。对该计划在发病率、对家庭的社会心理影响和成本方面进行了评估。为了进行评估，设计了一项平行组的准实验研究，而不是随机选择，因为人们认为个人选择对该计划的成功至关重要。通过选择传统的五到七天住院的志愿母亲组成了一个当代对照组。对母亲的反应以及伴侣的反应和适应情况进行了研究，包括发放旨在检测轻度产后抑郁症的问卷。早期出院组的发病率没有增加。早期出院组在旨在衡量其产后适应情况的问卷上表现更优。持续的产后家庭监测降低了早期新生儿病理变化（尤其是黄疸）可能被忽视的风险。
