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以家庭为中心的康复治疗与养育早产22周婴儿的育儿复原力:一项案例研究

Family-Centered Rehabilitation and Parenting Resilience in the Care of an Infant Born at 22 Weeks: A Case Study.

作者信息

Aoyama Yusuke, Mori Tomohiro, Nagata Masako, Sato Yoshiaki

机构信息

Department of Rehabilitation, Nagoya University Hospital, Nagoya, JPN.

Department of Rehabilitation, Nagoya University Graduate School of Medicine, Nagoya, JPN.

出版信息

Cureus. 2025 Aug 7;17(8):e89567. doi: 10.7759/cureus.89567. eCollection 2025 Aug.

DOI:10.7759/cureus.89567
PMID:40918822
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12413936/
Abstract

This case report describes the implementation of Family-Centered Care (FCC) and developmental occupational therapy (OT) for an extremely preterm infant born at 22 weeks and one day of gestation, weighing 448 g. The infant experienced multiple complications, including necrotizing enterocolitis, sepsis, intraventricular hemorrhage, and respiratory distress, requiring prolonged intensive care. Due to physiological fragility and immature neurobehavior, a structured rehabilitation approach was introduced, integrating OT and caregiver participation based on FCC principles. The intervention aimed to enhance the infant's self-regulation and support parenting resilience. Self-regulation was evaluated using the Brazelton Neonatal Behavioral Assessment Scale (NBAS), and parental resilience was assessed with the Parenting Resilience Elements Questionnaire (PREQ). The program was divided into three phases aligned with developmental stages and caregiver involvement. NBAS self-regulation scores improved from a median of 1 (low level) to 6 (ordinary level). PREQ scores for both parents also increased, reflecting stronger emotional bonding, better understanding of the infant's cues, and improved confidence in caregiving. Caregivers were gradually engaged in routines such as suckling, bathing, and developmental play. Collaborative role-sharing among occupational therapists, physical therapists, and nursing staff further supported the intervention. This case highlights how early FCC and developmental OT may promote neurodevelopment and psychological adaptation in families of extremely preterm infants.

摘要

本病例报告描述了对一名孕22周零1天出生、体重448克的极早产儿实施以家庭为中心的护理(FCC)和发育性职业治疗(OT)的情况。该婴儿经历了多种并发症,包括坏死性小肠结肠炎、败血症、脑室内出血和呼吸窘迫,需要长期重症监护。由于生理脆弱和神经行为不成熟,引入了一种结构化康复方法,基于FCC原则整合职业治疗和照顾者参与。干预旨在增强婴儿的自我调节能力并支持养育韧性。使用布雷泽尔顿新生儿行为评估量表(NBAS)评估自我调节能力,并用养育韧性要素问卷(PREQ)评估父母的韧性。该项目分为三个阶段,与发育阶段和照顾者参与度相匹配。NBAS自我调节得分从中位数1(低水平)提高到6(普通水平)。父母双方的PREQ得分也有所提高,反映出更强的情感联结、对婴儿线索的更好理解以及照顾婴儿的信心增强。照顾者逐渐参与到诸如哺乳、洗澡和发育性游戏等日常活动中。职业治疗师、物理治疗师和护理人员之间的协作角色分担进一步支持了干预。本病例突出了早期FCC和发育性OT如何促进极早产儿家庭中的神经发育和心理适应。

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本文引用的文献

1
Infant and Family Outcomes and Experiences Related to Family-Centered Care Interventions in the NICU: A Systematic Review.新生儿重症监护病房中与以家庭为中心的护理干预措施相关的婴儿及家庭结局和经历:一项系统综述
Children (Basel). 2025 Feb 26;12(3):290. doi: 10.3390/children12030290.
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Maternal mental health after infant discharge: a quasi-experimental clinical trial of family integrated care versus family-centered care for preterm infants in U.S. NICUs.母婴出院后心理健康:美国新生儿重症监护病房实施家庭综合护理与以家庭为中心护理对比的准实验性临床试验
BMC Pediatr. 2023 Aug 10;23(1):396. doi: 10.1186/s12887-023-04211-x.
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Effect of family integrated care on breastfeeding of preterm infants: A scoping review.
家庭一体化护理对早产儿母乳喂养的影响:系统评价。
Nurs Open. 2023 Sep;10(9):5950-5960. doi: 10.1002/nop2.1888. Epub 2023 Jun 12.
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Changes of Infant- and Family-Centered Care Practices Administered to Extremely Preterm Infants During Implementation of the NIDCAP Program.在实施新生儿个体化发育护理与评估计划(NIDCAP)期间,给予极早产儿的以婴儿和家庭为中心的护理实践的变化。
Front Pediatr. 2021 Sep 3;9:718813. doi: 10.3389/fped.2021.718813. eCollection 2021.
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Do NICU developmental care improve cognitive and motor outcomes for preterm infants? A systematic review and meta-analysis.NICU 发育护理是否能改善早产儿的认知和运动发育结局?系统评价和荟萃分析。
BMC Pediatr. 2020 Feb 13;20(1):67. doi: 10.1186/s12887-020-1953-1.
7
Effects of family-centred care interventions on preterm infants and parents in neonatal intensive care units: A systematic review and meta-analysis of randomised controlled trials.家庭为中心的护理干预对新生儿重症监护病房早产儿及其父母的影响:系统评价和随机对照试验的荟萃分析。
Aust Crit Care. 2019 Jan;32(1):63-75. doi: 10.1016/j.aucc.2018.10.007. Epub 2018 Dec 13.
8
Effectiveness of Family Integrated Care in neonatal intensive care units on infant and parent outcomes: a multicentre, multinational, cluster-randomised controlled trial.家庭综合护理在新生儿重症监护病房对婴儿和家长结局的有效性:一项多中心、多国、集群随机对照试验。
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Motor Development Interventions for Preterm Infants: A Systematic Review and Meta-analysis.早产儿运动发育干预:系统评价与荟萃分析
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Neonatal Outcomes of Very Low Birth Weight and Very Preterm Neonates: An International Comparison.极低出生体重和极早产儿的新生儿结局:一项国际比较。
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