指导无创机械通气早产儿母亲实施袋鼠式护理对其亲职压力和育儿胜任感的影响

doi:10.3761/j.issn.0254-1769.2022.22.002

摘要/Abstract

摘要：

目的指导无创机械通气早产儿母亲实施袋鼠式护理，并探讨该方法对其亲职压力和育儿胜任感的影响。方法便利选取2019年3月—2020年5月在银川市某三级甲等综合医院出生且入住NICU的64例无创机械通气早产儿及其母亲作为研究对象，采用随机数字表法分为试验组和对照组各32例。试验组在常规发育支持护理的基础上，在早产儿住院第7天生命体征稳定后指导其母亲进行袋鼠式护理，每天1次，每次2 h，共干预7 d。对照组给予常规发育支持护理和健康教育。在早产儿住院第7天、第14天及2、4、6月龄时，分别采用亲职压力量表和育儿胜任感量表评估其母亲的亲职压力和育儿胜任感。结果在早产儿住院第7天，两组亲职压力量表和育儿胜任感量表得分比较，差异无统计学意义（P>0.05）。在早产儿住院第14天以及2、4、6月龄时，试验组亲职压力量表总分低于对照组，育儿胜任感量表总分高于对照组，差异具有统计学意义（P<0.05）。结论指导无创机械通气早产儿母亲实施袋鼠式护理能降低其亲职压力，并提高其育儿胜任感。

关键词: 袋鼠式护理, 无创机械通气, 早产儿, 母亲, 亲职压力, 育儿胜任感, 新生儿护理

Abstract:

Objective To explore effects of kangaroo mother care on the parenting pressure and parenting sense of competence of mothers of premature infants with non-invasive mechanical ventilation. Methods The convenience sampling method was adopted to select 64 mothers and preterm infants with non-invasive mechanical ventilation who were born and admitted to the NICU of a tertiary A comprehensive hospital in Yinchuan from March 2019 to May 2020 as the research subjects. They were divided into an experimental group and a control group with 32 cases in each group by random number table method. In addition to routine development supportive care，after the vital signs were stable on the 7th day of hospitalization，the experimental group was treated with kangaroo mother care once a day for 2 hours and it lasted for 7 days. The control group was treated with routine development supportive care. On the 7th and 14th day of hospitalization，and at the age of 2nd，4th and 6th month of premature infants with non-invasive mechanical ventilation，the Parenting Stress Index-Short Form and Parenting Sense of Competence Scale were used to evaluate the parenting stress and parenting sense of competence of mothers of premature infants with non-invasive mechanical ventilation respectively. Results There was no significant difference in scores of the Parenting Stress Index-Short Form and Parenting Sense of Competence Scale between the 2 groups before the intervention（P>0.05）. After the intervention，the total score of the Parenting Stress Index-Short Form of the mothers in the experimental group were lower on the 14th day of hospitalization and at the age of 2nd，4th and 6th month than those in the control group，while the total score of Parenting Sense of Competence Scale were higher，and the differences were statistically significant（P<0.05）. Conclusion Kangaroo mother care can reduce the parenting pressure of mothers of premature infants with non-invasive mechanical ventilation and improve their parenting sense of competence within 6 months after delivery.

Key words: Kangaroo Mother Care, Non-Invasive Mechanical Ventilation, Preterm Infants, Mothers, Parenting Pressure, Parenting Sense of Competence, Neonatal Nursing

刘艳红, 李胜玲, 崔慧敏, 王晓燕, 孙彩霞. 指导无创机械通气早产儿母亲实施袋鼠式护理对其亲职压力和育儿胜任感的影响[J]. 中华护理杂志, 2022, 57(22): 2700-2706.

LIU Yanhong, LI Shengling, CUI Huimin, WANG Xiaoyan, SUN Caixia. Effects of kangaroo mother care on the parenting pressure and parenting sense of competence of mothers of premature infants with non-invasive mechanical ventilation[J]. Chinese Journal of Nursing, 2022, 57(22): 2700-2706.

图/表 3

表1 两组一般资料比较

Table 1 Comparison of baseline characteristics of 2 groups

表2 两组无创机械通气早产儿母亲不同时间点亲职压力比较（分，$\bar{x}±s$）

Table 2 Comparison of parenting stress of mothers of prematures with non-invasive mechanical ventilation at different time points between 2 groups（score，$\bar{x}±s$）

表3 两组无创机械通气早产儿母亲不同时间点育儿胜任感比较（分，$\bar{x}±s$）

Table 3 Comparison of Parenting Sense of Competence of mothers of prematures with non-invasive mechanical ventilation at different time points between 2 groups（score，$\bar{x}±s$）

参考文献 25

[1]	Murki S, Singh J, Khant C, et al. High-flow nasal cannula versus nasal continuous positive airway pressure for primary respiratory support in preterm infants with respiratory distress:a randomized controlled trial[J]. Neonatology, 2018, 113(3):235-241. DOI URL
[2]	高海霞, 高洪莲, 王燕, 等. 对NICU出院早产儿母亲实施网络支持干预的研究[J]. 护理学杂志, 2017, 32(9):1-4.
	Gao HX, Gao HL, Wang Y, et al. Study of Internet-supported intervention for mothers of premature infants discharged from NICU[J]. J Nurs Sci, 2017, 32(9):1-4.
[3]	叶秀娟, 王小燕, 刘桂华, 等. 抽动障碍儿童主要照顾者家庭坚韧力及影响因素研究[J]. 中华护理教育, 2021, 18(3):279-284.
	Ye XJ, Wang XY, Liu GH, et al. Family hardiness and its influecing factors of caregivers of children with tic disorder[J]. Chin J Nurs Educ, 2021, 18(3):279-284.
[4]	吴晓蕾, 施燕禧, 张月珍. 早产初产妇育儿胜任感与心理弹性对产后抑郁的影响[J]. 护理研究, 2021, 35(11):1997-2000.
	Wu XL, Shi YX, Zhang YZ. Influence of parenting sense of competence and mental resilience on postpartum depression in preterm primipara[J]. Chin Nurs Res, 2021, 35(11):1997-2000.
[5]	王帆, 王晓燕, 李胜玲, 等. 社会支持在银川市NICU早产儿母亲育儿胜任感与焦虑抑郁间的中介作用[J]. 医学与社会, 2021, 34(7):68-71,76.
	Wang F, Wang XY, Li SL, et al. The mediating role of social support on parenting sense of competence,anxiety and depression of mothers of premature infants in NICU in Yinchuan[J]. Med Soc, 2021, 34(7):68-71,76.
[6]	Isayama T, Iwami H, McDonald S, et al. Association of noninvasive ventilation strategies with mortality and bronchopulmonary dysplasia among preterm infants:a systematic review and meta-analysis[J]. JAMA, 2016, 316(6):611-624. DOI URL
[7]	吴陆萍, 胡小黎, 孙慧连. 参与袋鼠式护理的早产儿父亲情感体验的质性研究[J]. 中华护理教育, 2019, 16(3):211-214.
	Wu LP, Hu XL, Sun HL. Qualitative research on emotional experience of fathers involved in kangaroo care of premature infants[J]. Chin J Nurs Educ, 2019, 16(3):211-214.
[8]	Kapoor A, Khan MA, Beohar V. Pain relief in late preterm neonates:a comparative study of kangaroo mother care,oral dextrose 50%,and supine nesting position[J]. Int J Appl Basic Med Res, 2021, 11(3):188-191. DOI PMID
[9]	李玉, 李胜玲, 孙彩霞, 等. 袋鼠式护理对无创机械通气早产儿呼吸功能的影响[J]. 护理学杂志, 2021, 36(6):11-14.
	Li Y, Li SL, Sun CX, et al. The effect of kangaroo mother care on respiratory function of premature infants on noninvasive ventilation[J]. J Nurs Sci, 2021, 36(6):11-14.
[10]	Mu PF, Lee MY, Chen YC, et al. Experiences of parents providing kangaroo care to a premature infant:a qualitative systematic review[J]. Nurs Health Sci, 2020, 22(2):149-161. DOI URL
[11]	孙振球, 徐勇勇. 医学统计学[M]. 4版. 北京: 人民卫生出版社, 2014:735.
	Sun ZQ, Xu YY. Medical statistics[M]. 4th ed. Beijing: People’s Medical Publishing House, 2014:735.
[12]	鲍秀兰. 婴幼儿亲体训练课程视频[EB/OL]. [2020-04-05]. https://mp.weixin.qq.com/s/ljiL6jTA507pRUojMD9ICg.
	Bao XL. Infant parent body training course video[EB/OL]. [2020-04-05]. https://mp.weixin.qq.com/s/ljiL6jTA507pRUojMD9ICg.
[13]	王丹华. 早产/低出生体重儿出院后喂养建议解读[J]. 北京医学, 2016, 38(8):756-758.
	Wang DH. Feeding suggestions for premature/low birth weight infants after discharge[J]. Beijing Med J, 2016, 38(8):756-758.
[14]	Abidin R. Parenting Stress Index Short Form:test manual[M]. Charlottesville. VA: Pediatric Psychological Press, 1990:297-328.
[15]	任文香. 幼儿母亲亲职压力,因应策略与亲子关系满意之关系研究[D]. 中国台湾: 台湾师范大学,1995.
	Ren WX. A study on the relationship between parental stress,coping strategies and parent-child relationship satisfaction among preschool mother[D]. China-Taiwan: National Taiwan Nor-mal University,1995.
[16]	Gibaud J. Sell-esteem and situational stress:factors related to sense of competence in new parents[D]. Michigan: Uiversity of Michigan Ann Arbor,1977.
[17]	杨晓, 高玲玲, 张振香, 等. 中文版育儿胜任感量表在产妇中应用的信效度检验[J]. 中华护理杂志, 2014, 49(7):881-885.
	Yang X, Gao LL, Zhang ZX, et al. The reliability and validity of the Chinese version of Parenting Sense of Competence Scale[J]. Chin J Nurs, 2014, 49(7):881-885.
[18]	Palma EI, Von WKF, Morales BI, et al. Stress in parents of newborns hospitalized in a neonatal intensive care unit[J]. Revista Chilena De Pediatria-Chile, 2017, 88(3):332-339.
[19]	王帆, 李玉, 李胜玲, 等. 袋鼠式护理对早产儿母亲紧张焦虑及亲职压力的影响[J]. 中华行为医学与脑科学杂志, 2020, 29(1):74-78.
	Wang F, Li Y, Li SL, et al. Effects of kangaroo care on stress,anxiety and parental pressure in premature mothers[J]. Chin J Behav Med & Brain Sci, 2020, 29(1):74-78.
[20]	段旭锋, 雷萍, 陈会. 极低出生体重儿母亲亲职压力与共同养育感知的随访研究[J]. 护理研究, 2019, 33(21):3681-3684.
	Duan XF, Lei P, Chen H. A follow-up study on spouse coparenting perceptions and parenting stress among mothers of very low birth weight infants[J]. Nurs Res China, 2019, 33(21):3681-3684.
[21]	Aya-Ramos L, Contreras-Vargas C, Rico JL, et al. Early maternal separation induces preference for sucrose and aspartame associated with increased blood glucose and hyperactivity[J]. Food Funct, 2017, 8(7):2592-2600. DOI PMID
[22]	华玲玲, 周敏, 薛艳, 等. 母乳喂养家庭病房的建立及其在NICU低出生体重儿中的应用研究[J]. 中华护理杂志, 2018, 53(10): 1163-1167.
	Hua LL, Zhou M, Xue Y, et al. Evaluation of effects of mothers breastfeeding in NICU low birth weight infants[J]. Chin J Nurs, 2018, 53(10):1163-1167.
[23]	翟聪利, 孙慧娜, 毛竹香, 等. 母婴皮肤接触持续时间对新生儿影响的研究[J]. 中华护理杂志, 2018, 53(12):1419-1423.
	Zhai CL, Sun HN, Mao ZX, et al. Effects of 90 Min skin-to-skin contact between newborn infants and their mothers on infants’ body temperature,sense of safety and breastfeeding[J]. Chin J Nurs, 2018, 53(12):1419-1423.
[24]	钟娜, 胡琼燕, 梁旭霞, 等. 医院-社区母乳喂养链式管理模式的应用及效果评价[J]. 中华护理杂志, 2022, 57(14):1669-1675. DOI
	Zhong N, Hu QY, Liang XX, et al. Application and effect evaluation of a hospital-community breastfeeding chain management model[J]. Chin J Nurs, 2022, 57(14):1669-1675. DOI
[25]	杨漂羽, 张玉侠, 胡晓静, 等. 极低出生体重儿母乳喂养的循证实践[J]. 中华护理杂志, 2018, 53(6):656-661.
	Yang PY, Zhang YX, Hu XJ, et al. Effect of evidence-based practice for breastfeeding of very low birth weight infants[J]. Chin J Nurs, 2018, 53(6):656-661.