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解决新生儿重症监护病房中的与健康相关的社会需求和心理健康需求:探索挑战和技术的潜力。

Addressing Health-Related Social Needs and Mental Health Needs in the Neonatal Intensive Care Unit: Exploring Challenges and the Potential of Technology.

机构信息

Athena Institute, Faculty of Science, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands.

Center for Policy, Outcomes, and Prevention, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA 94305, USA.

出版信息

Int J Environ Res Public Health. 2023 Dec 9;20(24):7161. doi: 10.3390/ijerph20247161.

Abstract

Unaddressed health-related social needs (HRSNs) and parental mental health needs in an infant's environment can negatively affect their health outcomes. This study examines the challenges and potential technological solutions for addressing these needs in the neonatal intensive care unit (NICU) setting and beyond. In all, 22 semistructured interviews were conducted with members of the NICU care team and other relevant stakeholders, based on an interpretive description approach. The participants were selected from three safety net hospitals in the U.S. with level IV NICUs. The challenges identified include navigating the multitude of burdens families in the NICU experience, resource constraints within and beyond the health system, a lack of streamlined or consistent processes, no closed-loop referrals to track status and outcomes, and gaps in support postdischarge. Opportunities for leveraging technology to facilitate screening and referral include automating screening, initiating risk-based referrals, using remote check-ins, facilitating resource navigation, tracking referrals, and providing language support. However, technological implementations should avoid perpetuating disparities and consider potential privacy or data-sharing concerns. Although advances in technological health tools alone cannot address all the challenges, they have the potential to offer dynamic tools to support the healthcare setting in identifying and addressing the unique needs and circumstances of each family in the NICU.

摘要

未满足的与健康相关的社会需求(HRSNs)和婴儿环境中父母的心理健康需求会对他们的健康结果产生负面影响。本研究探讨了在新生儿重症监护病房(NICU)环境中及其他环境中解决这些需求的挑战和潜在技术解决方案。总共对 NICU 护理团队成员和其他相关利益相关者进行了 22 次半结构化访谈,采用解释性描述方法。参与者是从美国三家安全网医院的四级 NICU 中选择的。确定的挑战包括:了解 NICU 中家庭所经历的众多负担;医疗体系内外的资源限制;缺乏精简或一致的流程;没有闭环转诊来跟踪状态和结果;以及出院后的支持存在差距。利用技术促进筛查和转诊的机会包括:自动化筛查、启动基于风险的转诊、使用远程签到、促进资源导航、跟踪转诊以及提供语言支持。然而,技术实施不应该加剧差异,并考虑潜在的隐私或数据共享问题。尽管技术健康工具的进步本身不能解决所有挑战,但它们有可能提供动态工具,以支持医疗保健环境识别和满足 NICU 中每个家庭的独特需求和情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd08/10742453/5301102280ff/ijerph-20-07161-g001.jpg

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