摘要:
目的 探讨以家庭为中心的NICU早产儿出院指导对早产儿家庭护理的影响.方法 选择在NICU住院的极低及超低出生体质量早产儿174例,采用区组随机化法分为研究组和对照组各87例.对照组采用常规出院指导;研究组采用以家庭为中心的出院指导计划.观察2组早产儿出院时、纠正胎龄2、4、6个月时的身高和体质量变化;观察入NICU时和出院时早产儿母亲护理知识、护理技能、焦虑评分(SAS)和抑郁评分(SDS),比较2组早产儿6个月内母乳喂养率、再住院率、患病率和病死率.结果 2组出生时和纠正胎龄40周体质量、身长和头围差异均无统计学意义(P＞0.05);纠正胎龄2个月、4个月、6个月研究组体质量、身长和头围均显著高于对照组(P＜0.05).研究组母乳喂养率显著高于对照组(P＜0.05),患病率和再住院率显著低于对照组(P＜0.05),2组病死率差异无统计学意义(P＞0.05).入NICU时,2组早产儿母亲的护理知识和护理技能差异均无统计学意义(P＞0.05),出院2个月时较入NICU时显著升高(P＜0.05),研究组提高更为显著(P＜0.05).入NICU时,2组早产儿母亲的SAS和SDS评分差异均无统计学意义(P＞0.05),出院2个月时较入NICU时显著下降(P＜0.05),研究组下降更显著(P＜0.05).结论 对NICU早产儿实施以家庭为中心的出院指导,可促进患儿体格发育,降低患病率,改善家属不良情绪,具有重要的临床价值.
Abstract:
Objective To explore effect of family-centered discharge guidance on family care of premature infants in NICU.Methods A total of 174 premature infants with extremely low birth weight in NICU were studied and were randomly divided into study group and control group,with 87 cases per group.Control group received conventional discharge guidance while the study group received family-centered discharge planning.Height and weight changes of neonates at discharge,and at correct gestational age of 2,4,6 months were observed.Nursing knowledge and nursing skills,Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) scores of puerperae were observed in two groups on admission and at discharge.Breastfeeding rate,re-hospitalization rate,morbidity and mortality within 6 months were compared.Results The body weight,body length and head circumference were not statistically significant of two groups at birth and at corrected gestational age of 40 weeks (P ＞ 0.05),and they were heavier,and larger than those of the control group at corrected gestational age of 2,4 and 6 months (P ＜ 0.05).Breastfeeding rate in the study group was higher,morbidity rate and readmission rate were lower than that of the control group (P ＜ 0.05),but there was no significant difference in mortality of two groups (P ＞ 0.05).At discharge of NICU,mothers of premature infants had no statistically significant difference in nursing knowledge and skills (P ＞ 0.05),but they commanded more after 2 monthsof discharge (P ＜ 0.05),and study group improved more significantly (P ＜ 0.05).At discharge of NICU,SAS and SDS scores of infants'mothers were not statistically significant (P ＞ 0.0 5),but it was significantly decreased at 2 months of discharge (P ＜ 0.0 5),and study group decreased more (P ＜ 0.0 5).Conclusion Family-centered discharge guidance can increase the physical development of children,reduce the morbidity rate,and improve the family's bad mood,so it is worthy of clinical promotion.
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