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重症监护病房中先天性心脏病婴儿发育护理实践的实施与策略:范围综述

Implementation and Strategy in Developmental Care Practice in Infants with Congenital Heart Disease in Intensive Care Unit: Scoping Review.

作者信息

Rhamelani Putri, Rakhmawati Windy

机构信息

Faculty of Nursing, Padjadjaran University, Sumedang, West Java, Indonesia.

Department of Pediatric Nursing, Faculty of Nursing, Padjadjaran University, Sumedang, West Java, Indonesia.

出版信息

J Multidiscip Healthc. 2025 May 24;18:2901-2919. doi: 10.2147/JMDH.S516216. eCollection 2025.

Abstract

Congenital Heart Disease (CHD) is a common congenital heart defect in infants. This condition has a higher risk of developmental disorders. The majority of infants with CHD require long-term care in intensive care units, but infants only focus on getting medical care so that developmental care is rarely practiced. This review aims to determine the implementation and strategies in the practice of developmental care for infants with CHD in intensive care units. The study design used a scoping review with a literature search using five primary databases including Scopus, PubMed, Sage Journals, ScienceDirect, and Taylor & Francis. The inclusion criteria were English-language articles, articles with experimental research types, and participants of infant patients with CHD that discussed the effectiveness of implementing developmental care interventions and their implementation strategies. Based on the search results, we analyzed 13 relevant articles. There are several developmental care interventions for infants with CHD that we classified into physiological subsystems (massage therapy, Kangaroo Care (KC), exclusive breastfeeding, and nutritional care); cognitive, motor, and sensory subsystems (early physical therapy, tummy time, oral feeding, and physiotherapy); parent-infant interaction subsystems (Skin-to-Skin Contact (SSC), nutritional risk management, and nutritional training and support); and environmental management subsystems (infant accompaniment). The strategies in implementing the intervention include aspects of health workers (experience, training, and licensing); aspects of intervention protocols; and aspects of intervention methods and models (socialization, strict supervision, and the Plan-Do-Study-Act (PDSA) model). The implementation and strategies of developmental care practices have been proven to improve development in infants with CHD.

摘要

先天性心脏病(CHD)是婴儿常见的先天性心脏缺陷。这种疾病有更高的发育障碍风险。大多数患有先天性心脏病的婴儿需要在重症监护病房接受长期护理,但婴儿只专注于接受医疗护理,因此很少实施发育护理。本综述旨在确定重症监护病房中对患有先天性心脏病的婴儿实施发育护理的实践和策略。研究设计采用了范围综述,通过使用五个主要数据库进行文献检索,包括Scopus、PubMed、Sage期刊、ScienceDirect和Taylor & Francis。纳入标准为英文文章、实验研究类型的文章,以及讨论实施发育护理干预措施的有效性及其实施策略的先天性心脏病婴儿患者参与者。基于检索结果,我们分析了13篇相关文章。有几种针对先天性心脏病婴儿的发育护理干预措施,我们将其分为生理子系统(按摩疗法、袋鼠式护理(KC)、纯母乳喂养和营养护理);认知、运动和感觉子系统(早期物理治疗、俯卧时间、经口喂养和物理疗法);母婴互动子系统(皮肤接触(SSC)、营养风险管理以及营养培训和支持);以及环境管理子系统(婴儿陪伴)。实施干预措施的策略包括卫生工作者方面(经验、培训和执照);干预方案方面;以及干预方法和模式方面(社会化、严格监督和计划-执行-研究-行动(PDSA)模式)。发育护理实践的实施和策略已被证明可改善先天性心脏病婴儿的发育情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91dd/12118484/aaf2f06c3427/JMDH-18-2901-g0001.jpg

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