Lee Eunji, Oh Won-Oak
University of Maryland school of Nursing, 655 W. Lombard St., Baltimore, MD 21201, USA.
College of Nursing, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, South Korea.
Nurse Educ Today. 2025 Jul;150:106687. doi: 10.1016/j.nedt.2025.106687. Epub 2025 Mar 14.
High-risk newborns face significant mortality risks and potential for recovery, making neonatal palliative care essential. However, existing neonatal palliative care education for neonatal intensive care unit (NICU) nurses often prioritizes end-of-life care and overlooks family involvement and long-term management needs.
To develop and prioritize neonatal palliative care educational content tailored for NICU nurses, addressing gaps in current curricula and supporting family-centered, evidence-based practice.
A three-round Delphi survey was conducted to identify key educational topics for neonatal palliative care, followed by a cross-sectional online survey to assess NICU nurses' perceived performance and importance for each topic. Participants included 148 NICU nurses from tertiary hospitals in South Korea with over six months of experience, excluding those with administrative roles. Educational needs were analyzed using the Locus for Focus model, Borich needs analysis, and Importance-Performance Analysis.
This study identified 66 educational topics grouped into five domains: "Physiological care," "Family-centered care," "Continuity of care," "Nursing professional development," and "Multidisciplinary team approach." High-priority topics included balancing critical and palliative care, managing stress, and navigating ethical challenges. Family-centered care was emphasized throughout the NICU stay, emphasizing family involvement in care, guidance on growth and development, and addressing social challenges. Continuity of care post-discharge was also highlighted, particularly rehabilitation, bereavement support, and community health resources.
This study offers a robust framework for developing evidence-based neonatal palliative care educational programs. By addressing contemporary issues and emphasizing long-term, holistic approaches, these findings contribute to advancing family-centered care and enhancing nursing competencies globally.
高危新生儿面临着巨大的死亡风险和康复潜力，这使得新生儿姑息治疗至关重要。然而，现有的针对新生儿重症监护病房（NICU）护士的新生儿姑息治疗教育通常将临终关怀作为重点，而忽视了家庭参与和长期管理需求。
开发并确定为NICU护士量身定制的新生儿姑息治疗教育内容的优先级，填补当前课程中的空白，并支持以家庭为中心的循证实践。
进行了三轮德尔菲调查，以确定新生儿姑息治疗的关键教育主题，随后进行横断面在线调查，以评估NICU护士对每个主题的感知表现和重要性。参与者包括来自韩国三级医院的148名有超过六个月工作经验的NICU护士，不包括担任行政职务的护士。使用聚焦点模型、博里奇需求分析和重要性-表现分析来分析教育需求。
本研究确定了66个教育主题，分为五个领域：“生理护理”、“以家庭为中心的护理”、“护理连续性”、“护理专业发展”和“多学科团队方法”。高优先级主题包括平衡重症护理和姑息治疗、管理压力以及应对伦理挑战。在整个NICU住院期间都强调以家庭为中心的护理，强调家庭参与护理、提供成长和发展指导以及应对社会挑战。还强调了出院后的护理连续性，特别是康复、哀伤支持和社区卫生资源。
本研究为制定循证新生儿姑息治疗教育计划提供了一个强大的框架。通过解决当代问题并强调长期、整体的方法，这些发现有助于在全球范围内推进以家庭为中心的护理并提高护理能力。
