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早产儿护理中的父母自主权及新生儿团队的经验:前瞻性观察研究

Parental Autonomy in the Care of Premature Newborns and the Experience of a Neonatal Team: Observational Prospective Study.

作者信息

Piris-Borregas Salvador, Bellón-Vaquerizo Beatriz, Velasco-Echeburúa Leticia, Niño-Díaz Lidia, Sánchez-Aparicio Susana, López-Maestro María, Pallás-Alonso Carmen Rosa

机构信息

Department of Neonatology, Instituto de Investigación Biomédica, 12 de Octubre University Hospital, Avenida de Córdoba s/n, Madrid, 28041, Spain, 34 91390195.

出版信息

JMIR Pediatr Parent. 2024 Aug 30;7:e55411. doi: 10.2196/55411.

Abstract

BACKGROUND

The European Foundation for the Care of Newborn Infants (EFCNI) has promoted the importance of parental involvement in the care of children.

OBJECTIVE

The study aimed to examine how the time required by parents to achieve autonomy in the care of their very low-birth weight newborn infants was modified during the implementation of a training program.

METHODS

This was an observational prospective study in the context of a quality improvement initiative. The Cuídame (meaning "Take Care of Me" in English) program was aimed at achieving parental autonomy. It was implemented over 2 periods: period 1, from September 1, 2020, to June 15, 2021; and period 2, from July 15, 2021, to May 31, 2022. The days required by parents to achieve autonomy in several areas of care were collected from the electronic health system.

RESULTS

A total of 54 and 43 families with newborn infants were recruited in periods 1 and 2, respectively. Less time was required to acheive autonomy in period 2 for participation in clinical rounds (median 10.5, IQR 5-20 vs 7, IQR 4-10.5 d; P<.001), feeding (median 53.5, IQR 34-68 vs 44.5, IQR 37-62 d; P=.049), and observation of neurobehavior (median 18, IQR 9-33 vs 11, IQR 7-16 d; P=.049). More time was required to achieve autonomy for kangaroo mother care (median 14, IQR 7-23 vs 21, IQR 10-31 d; P=.02), diaper change (median 9.5, IQR 4-20 vs 14.5, IQR 9-32 d; P=.04), and infection prevention (median 1, IQR 1-2 vs 6, IQR 3-12; P<.001).

CONCLUSIONS

Parents required less time to achieve autonomy for participation in clinical rounds, feeding, and observation of neurobehavior during the implementation of the training program. Nevertheless, they required more time to achieve autonomy for kangaroo mother care, diaper change, and infection prevention.

摘要

背景

欧洲新生儿护理基金会(EFCNI)强调了父母参与儿童护理的重要性。

目的

本研究旨在探讨在实施一项培训计划期间,父母在照顾极低出生体重新生儿时实现自主护理所需的时间是如何变化的。

方法

这是一项在质量改进倡议背景下进行的前瞻性观察研究。Cuídame(英文意为“照顾我”)计划旨在实现父母自主护理。该计划分两个阶段实施:第1阶段,从2020年9月1日至2021年6月15日;第2阶段,从2021年7月15日至2022年5月31日。从电子健康系统收集父母在几个护理领域实现自主护理所需的天数。

结果

第1阶段和第2阶段分别招募了54个和43个有新生儿的家庭。在第2阶段,参与临床查房(中位数10.5,四分位间距5 - 20天 vs 7,四分位间距4 - 10.5天;P <.001)、喂养(中位数53.5,四分位间距34 - 68天 vs 44.5,四分位间距37 - 62天;P =.049)和神经行为观察(中位数18,四分位间距9 - 33天 vs 11,四分位间距7 - 16天;P =.049)方面实现自主护理所需时间减少。袋鼠式护理(中位数14,四分位间距7 - 23天 vs 21,四分位间距10 - 31天;P =.02)、更换尿布(中位数9.5,四分位间距4 - 20天 vs 14.5,四分位间距9 - 32天;P =.04)和预防感染(中位数1,四分位间距1 - 2天 vs 6,四分位间距3 - 12天;P <.001)方面实现自主护理需要更多时间。

结论

在培训计划实施期间,父母在参与临床查房、喂养和神经行为观察方面实现自主护理所需时间减少。然而,在袋鼠式护理、更换尿布和预防感染方面实现自主护理需要更多时间。

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