早产儿主要照顾者及NICU护士对家庭参与式预出院病房体验的质性研究

Premature Infants Primary Caregivers’ and NICU Nurses’ Experience of Taking Part in Family Integrated Care in Pre-Discharge Ward: A Qualitative Study

摘要: 目的：探讨NICU早产儿主要照顾者及护士对家庭参与式预出院病房的真实体验，为制定有效的干预措施提供参考和依据。方法：采用目的抽样法，选取2023年7~9月青岛市某三级甲等医院16例进入NICU预出院病房进行家庭参与式护理的早产儿主要照顾者及17例NICU护士作为研究对象，基于信息动机行为技巧模型为理论框架对其进行半结构访谈，运用Colaizzi7步分析法对原始资料进行整理分析，提炼主题。结果：共提炼出5个主题及12个亚主题：1) 家庭参与式预出院病房的信息缺乏；2) 家庭参与式预出院病房带来的益处包括减轻家长焦虑，提高家长的照顾能力，促进早产儿的生长发育；3) 在预出院病房中实施家庭参与式护理遇到的问题包括家庭参与式预出院病房的参与度不够，护士对预出院病房的参与积极性不高，护理人员知识结构系统不够统一规范；4) 期待完善家庭参与式预出院病房的方案包括建立有效沟通，提高家庭参与式预出院病房的参与度，加强心理疏导且增加人文关怀，提供专业的培训体系；5) 建议增加延续性护理的支持系统包括增加随访的频次，开展多元化随访方式，制定规范统一的随访流程。结论：在预出院病房的家庭参与式护理在实践中会遇到多方面的问题，护理人员应提高家长对家庭参与式护理的认知及家长的参与度，从而提高家长的照护能力，为居家照护患儿提供保障。

Abstract: Objective: To explore premature infants primary caregivers’ and NICU nurses’ experience of engagement for taking part in family Integrated Care in Pre-discharge Ward, and to provide bases for formulating targeted interventions. Methods: From July to September in 2023, the purposive sampling was used to select 16 Premature infants primary caregivers and 17 NICU nurses in a tertiary A general hospital in Qingdao. Semi-structured interviews were held based on the Information-Motivation-Behavior Skill Model framework. Colaizzi’s seven-step method was used for data analysis. Results: 5 main themes and 12 sub-themes were identified, including 1) The preparation for family Integrated Care in Pre-discharge Ward is insufficiency, 2) The benefit from family Integrated Care in Pre-discharge Ward (relieve anxiety, improve caregiving ability promote growth and development), 3) The barrier of taking part in family Integrated Care in Pre-discharge Ward (insufficient participation of family Integrated Care in Pre-discharge Ward, low motivation, the knowledge structure is not systematic enough), 4) Looking forward to improving the family Integrated Care’ scheme (establish effective communication, give psychological support to parents, provide professional training system), 5) Suggest to increase continuing care support system (increase follow-up, develop diversified follow-up ways, formulate unified scheme). Conclusion: There are many problems during taking part in family Integrated Care in Pre-discharge Ward. Nurses should improve parents’ cognition, improve parents’ participation in family Integrated Care, so improve caring ability, provide guarantees for home-based care.