Franck Linda S, Kriz Rebecca M, Bisgaard Robin, Gay Caryl L, Sossaman Sharon, Sossaman Jeramy, Cormier Diana M, Joe Priscilla, Sasinski Juliet K, Kim Jae H, Lin Carol, Sun Yao
Department of Family Health Care Nursing and the California Preterm Birth Initiative, University of California, San Francisco, San Francisco (Drs Franck and Gay and Ms Kriz); Intensive Care Nursery (Mss Bisgaard and S. Sossaman and Mr J. Sossaman) and Division of Neonatology (Dr Sun), UCSF Benioff Children's Hospital, San Francisco, California; Neonatal and Pediatrics, Community Regional Medical Center, Fresno, California (Dr Cormier); Division of Neonatology, UCSF Benioff Children's Hospital, Oakland, California (Dr Joe); Intensive Care Nursery, Santa Monica Medical Center, UCLA Health, Santa Monica, California (Ms Sasinski); Division of Neonatology, Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio (Dr Kim); and Division of Neonatology, Kaiser Permanente, Santa Clara, California (Dr Lin).
J Perinat Neonatal Nurs. 2023;37(1):68-76. doi: 10.1097/JPN.0000000000000612. Epub 2022 Feb 9.
This study aims to examine the influence of hospital experience factors on parental discharge readiness, accounting for key background characteristics. Parents/guardians of infants 33 weeks of gestation or less at birth receiving neonatal intensive care at 6 sites were enrolled from April 2017 to August 2018. Participants completed surveys at enrollment, 3 weeks later, and at discharge. Multiple regression analysis assessed relationships between parental experience, well-being, and perceived readiness for infant discharge, adjusting for socioenvironmental, infant clinical, and parent demographic characteristics. Most (77%) of the 139 parents reported high levels of readiness for their infant's discharge and 92% reported high self-efficacy at discharge. The multiple regression model accounted for 40% of the variance in discharge readiness. Perceptions of family-centered care accounted for 12% of the variance; measures of parent well-being, anxiety, and parenting self-efficacy accounted for an additional 16% of the variance; parent characteristics accounted for an additional 9%; and infant characteristics accounted for less than 3% of the variance. Parental perceptions of the family-centeredness of the hospital experience, anxiety, and parenting self-efficacy accounted for a substantial proportion of the variance in readiness for discharge scores among parents of preterm infant. These influential perceptions are potentially modifiable by nursing-led interventions.
本研究旨在考察医院体验因素对父母出院准备度的影响，并考虑关键背景特征。2017年4月至2018年8月，在6个地点对出生时孕周为33周及以下且接受新生儿重症监护的婴儿的父母/监护人进行了招募。参与者在入组时、3周后及出院时完成了调查。多元回归分析评估了父母体验、幸福感与婴儿出院感知准备度之间的关系，并对社会环境、婴儿临床及父母人口统计学特征进行了调整。139名父母中，大多数（77%）表示对婴儿出院有较高的准备度，92%表示出院时自我效能感较高。多元回归模型解释了出院准备度差异的40%。对以家庭为中心的护理的感知解释了12%的差异；父母幸福感、焦虑及育儿自我效能感的测量指标又解释了16%的差异；父母特征又解释了9%；婴儿特征解释的差异不到3%。父母对医院体验以家庭为中心程度的感知、焦虑及育儿自我效能感在早产儿父母出院准备度得分的差异中占很大比例。这些有影响的感知可能可通过护理主导的干预措施加以改变。
