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中国循证儿科杂志

中国循证儿科杂志 ›› 2015, Vol. 10 ›› Issue (6): 409-414.

• 论著 • 上一篇    下一篇

新生儿重症监护病房实施家庭参与式综合管理对住院早产儿母亲紧张焦虑情绪影响的自身前后对照研究

何利，谭彦娟，黑明燕   

  1. 中南大学湘雅三医院儿科 长沙，410013
  • 收稿日期:2015-12-24 修回日期:2015-12-24 出版日期:2015-12-05 发布日期:2015-12-04
  • 通讯作者: 黑明燕

Effect of family integrated care in neonatal intensive care unit on maternal stressfulness of hospitalized preterm infants: a self comparison study

HE Li, TAN Yan-juan, HEI Ming-yan   

  1. Department of Pediatrics, the Third Xiangya Hospital of Central South University, Changsha 410013, China
  • Received:2015-12-24 Revised:2015-12-24 Online:2015-12-05 Published:2015-12-04
  • Contact: HEI Ming-yan

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摘要：

目的 了解实施家庭参与式综合管理（FICare）对住院早产儿母亲紧张焦虑情绪的影响，进一步证实在中国NICU中实施FICare的必要性。方法 采用自身前后对照研究设计。应用标准化“新生儿重症监护病房父母紧张焦虑评分量表”（PSS:NICU），采用“入组时初次评分-FICare-出院前再次评分”的策略，由专职护士在早产儿母亲参与FICare之前和完成FICare出院当天进行PSS:NICU评分。结果 2014年4月至2015年10月中南大学湘雅三医院NICU符合本文纳入标准的早产儿560例，符合排除标准464例，符合剔除标准32例，64例参与FICare的早产儿母亲进入本文分析，男婴40例，胎龄（32.8±2.6）周，出生体重（1 795 ± 439）g，出生5 min Apgar评分< 7分3例。早产儿母亲的平均年龄（27.4 ± 5.6）岁，大学文化程度及以上者占51.5%，初中文化程度以下者占3.1%，城市户口者占73.4%，家庭人均月收入>5 000元人民币占57.8%。参与FICare前早产儿母亲在PSS:NICU的2/4部分内容评分>3.5分，完成FICare出院当天早产儿母亲PSS:NICU 4个部分的评分均接近2分。参与FICare之前和完成FICare出院当天PSS:NICU 4个部分：在孩子需要入住NICU是否使您焦虑紧张［（4.0 ±1.08） vs （2.02±0.93）］、NICU声光环境［（3.38±0.53） vs （2.18±0.25）］、患儿的病情和治疗状况［（3.76±0.45） vs （2.42±0.20）］、母子亲情父母责任感［（3.44±0.36） vs （2.20±0.18）］评分差异均有统计学意义（t分别为12.124、12.637、11.471和10.879，P均<0.001）。结论 NICU早产儿的母亲存在较高的紧张焦虑情绪，允许早产儿母亲进入NICU参与FICare对缓解其紧张焦虑情绪有积极的促进作用。

Abstract:

Objective This was a sub-grant of Family Integrated Care (FICare), a study aiming at helping parents of preterm infants become the team members in neonatal intensive care unit (NICU) under the supervision of NICU professionals. The objective was to study the effect of FICare in NICU on maternal stressfulness of hospitalized preterm infants, so as to find further evidence for the necessity of FICare in NICUs in China. Methods This was a self comparison study. The standardized parental stressfulness scoring for NICU (PSS: NICU) was conducted by the strategy of 'ante-FICare PSS:NICU - FICare - post-FICare PSS:NICU' by a well trained research nurse at 2 time points: before joining FICare, and the baby's discharge day after joining FICare. SPSS 20.0 software was used for the statistical analysis. Results Patients were all hospitalized preterm infants in the Third Xiangya Hospital of Central South University from April 2014 to October 2015. Five hundred and sixty infants met the inclusion criteria, 464 infants met the exclusion criteria, 32 infants met the dropping criteria, making the final sample size of this study be 64. Among the 64 infant-mother pairs, 40 were male infants with gestational age of (32.8±2.6) weeks and birth weight of (1 795±439) g. 4.7% infants were born with Apgar score< 7 at 5 min. The average age of mothers was (27.4 ± 5.6) years old. 51.5% of the mothers were above college educational level and less than 3.1% of the mothers were under middle school education. Before FICare, the average score was more than 3.5 in 2 out of 4 dimensions of PSS:NICU. After FICare, by the time of discharge, the average score was close to 2 in all 4 dimensions of PSS:NICU. The before and after FICare comparisons showed significant difference in general score［(4.00±1.08) vs (2.02±0.93)］, NICU sight & sound-related score ［(3.38±0.53) vs (2.18±0.25)］, treatment-related score ［(3.76±0.45) vs (2.42±0.20)］, and relationship & parental role-related score ［(3.44±0.36) vs (2.20±0.18)］ (t values were 12.124, 12.637, 11.471 and 10.879, respectively, and all P vaules were <0.001). Conclusion Maternal stressfulness and anxiety level of preterm infants in NICU is high, and it can be positively released by allowing mothers of preterm infants to do FICare in NICU.