NICU早产儿父亲出院准备体验的质性研究

doi:10.3761/j.issn.0254-1769.2023.22.003

摘要/Abstract

摘要：

目的深入了解NICU早产儿父亲出院准备的真实体验，为护理人员制订个性化的早产儿出院健康教育计划及延续性护理计划提供依据。方法采用目的抽样法，选取2022年4月—7月浙江省某三级甲等妇产科医院NICU收治的15例早产儿的父亲作为研究对象，分别在早产儿出院当天和出院后第6周进行2次半结构式访谈，运用Colazzi 7步分析法分析访谈资料。结果将NICU早产儿父亲出院准备的体验归纳为4个主题：①早产儿父亲困扰与成长并存，包括出院当天期待见到早产儿并对出院照护有信心、出院后存在多种负性情绪、出院后同理心和责任心增强；②独立照护能力不足，包括缺乏获取专业照护知识的途径、照护技能有待提高、过度依赖早产儿母亲；③家庭-社会角色冲突；④渴望获得支持，包括医护人员的专业指导、更多家庭支持。结论在出院准备过程中，NICU早产儿父亲的负性情绪与成长体验并存，具有降低角色冲突、增强独立照护能力、获得心理及多方支持等需求。护理人员应为其制订个性化的出院健康教育计划及延续性护理计划，以提高其出院准备水平。

关键词: 重症监护病房, 新生儿, 早产儿, 父亲, 出院准备, 质性研究, 新生儿护理

Abstract:

Objective To gain an in-depth understanding of the real experiences，feelings and needs of fathers of premature infants in NICU regarding hospital discharge preparation，and to provide a basis for medical institutions on the development of personalized health education plans and continuous nursing care plans for discharged premature infants. Methods By the purposive sampling method，15 fathers of premature infants in NICU of a tertiary obstetrics and gynecology hospital in Zhejiang Province from April 2022 to July 2022 on the day of discharge and 6 weeks after discharge were selected for semi-structured interviews，and the interview data were analyzed using the Colazzi’s phenomenological 7-step analysis. Results The experiences and needs of NICU premature fathers in discharge preparation are divided into 4 themes. 1. The father’s problems coexist with the growth of premature infants，such as expecting to see premature infants on the day of discharge and having confidence in discharge care，experiencing various negative emotions after discharge，and increasing empathy and sense of responsibility after discharge. 2. Inadequate ability to care for oneself，including a lack of access to professional care knowledge，a need to improve nursing skills，and an overreliance on premature mothers. 3. Social role conflict in the family. 4. Longing for assistance，including professional medical advice and more family support. Conclusion Fathers of premature infants in the NICU coexist with negative emotions and growth experiences as they prepare for discharge，with various needs such as reducing role conflict，enhancing independent care ability，and obtaining psychological and multi-party support. To improve their discharge preparation level，nursing staff should develop a personalized health education plan as well as a continuous nursing plan.

Key words: Intensive Care Units, Neonate, Premature Infant, Fathers, Discharge Preparation, Qualitative Research, Neonatal Nursing

孙潇潇, 陈朔晖, 梅伶俐, 莫凤逸, 刘丹, 俞晓明. NICU早产儿父亲出院准备体验的质性研究[J]. 中华护理杂志, 2023, 58(22): 2710-2715.

SUN Xiaoxiao, CHEN Shuohui, MEI Lingli, MO Fengyi, LIU Dan, YU Xiaoming. A qualitative study on the experience and needs of fathers of NICU premature infants in preparation for discharge[J]. Chinese Journal of Nursing, 2023, 58(22): 2710-2715.

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参考文献 18

[1]	张沂洁, 朱燕, 陈超. 早产儿发生率及变化趋势[J]. 中华新生儿科杂志, 2021, 36(4):74-77.
	Zhang YJ, Zhu Y, Chen C. Incidence and trend of premature infants[J]. Chin J Neonatol, 2021, 36(4):74-77.
[2]	周瑞茜, 倪王平, 柯若, 等. 家庭参与式护理模式下支气管肺发育不良早产儿2岁内再入院的影响因素分析[J]. 中华护理杂志, 2022, 57(12):1481-1485. DOI
	Zhou RX, Ni WP, Ke R, et al. Risk analysis of readmission of preterm infants with bronchopulmonary dysplasia within 2 years of age based on the family participatory care model in the NICU[J]. Chin J Nurs, 2022, 57(12):1481-1485. DOI
[3]	Filippa M, Saliba S, Esseily R, et al. Systematic review shows the benefits of involving the fathers of preterm infants in early interventions in neonatal intensive care units[J]. Acta Paediatr, 2021, 110(9):2509-2520. DOI URL
[4]	曾欣, 李丽玲, 胡晓静. 国外早产儿父亲实施袋鼠式护理的研究进展及启示[J]. 中华护理杂志, 2022, 57(15):1898-1903. DOI
	Zeng X, Li LL, Hu XJ. Research progress and enlightenment on kangaroo father care of premature infants abroad[J]. Chin J Nurs, 2022, 57(15):1898-1903. DOI
[5]	Jefferies AL, Canadian Paediatric Society,Fetus and Newborn Committee. Going home:facilitating discharge of the preterm infant[J]. Paediatr Child Health, 2014, 19(1):31-42. DOI URL
[6]	文燕, 黄晓波, 韦琴, 等. 高危新生儿父母出院准备度现状调查及其影响因素分析[J]. 广西医学, 2018, 40(11):1268-1271.
	Wen Y, Huang XB, Wei Q, et al. Investigation on the status quo of discharge readiness of parents of high-risk newborns and analysis of its influencing factors[J]. Guangxi Med J, 2018, 40(11):1268-1271.
[7]	郑乔木, 花文哲, 严洁, 等. 重症监护室早产儿父母出院准备水平及其影响因素分析[J]. 中国实用护理杂志, 2021, 37(25):1979-1984.
	Zheng QM, Hua WZ, Yan J, et al. Analysis of status and influencing factors of parents’ discharge preparation for preterm infants in intensive care unit[J]. Chin J Pract Nurs, 2021, 37(25):1979-1984.
[8]	Buck CO, Tucker R, Vohr B, et al. Predictors of parenting readiness in fathers of high-risk infants in the neonatal intensive care unit[J]. J Pediatr, 2020, 217:192-195. DOI URL
[9]	赖敏华, 温馨, 李文硕, 等. 新生儿父亲产后抑郁发生现状及其影响因素的研究[J]. 中华护理杂志, 2015, 50(5):546-551.
	Lai MH, Wen X, Li WS, et al. Incidence and its influencing factors of paternal postpartum depression[J]. Chin J Nurs, 2015,(5):546-551.
[10]	陈杭健, 陈京立. 住院早产儿父亲情感体验的质性研究[J]. 中华护理杂志, 2015, 50(5):625-628.
	Chen HJ, Chen JL. The experience and feelings of fathers of hospitalized preterm infants:a qualitative research[J]. Chin J Nurs, 2015, 50(5):625-628.
[11]	李新辉, 蒋佩, 陶化青, 等. 基于Teach-back的护理本科生多形式社区健康教育实践教学的开展及效果[J]. 全科护理, 2019, 17(14):1778-1781.
	Li XH, Jiang P, Tao HQ, et al. Development and effect of multi-form community health education practice teaching for nursing undergraduates based on Teach-back[J]. Chin Gen Pract Nurs, 2019, 17(14):1778-1781.
[12]	孙玉娇, 张宁, 张红梅, 等. 智慧云住院健康教育平台的构建及在糖尿病患者中的应用效果[J]. 中华护理教育, 2022, 19(12):1073-1077.
	Sun YJ, Zhang N, Zhang HM, et al. Research on construction and application of intelligent cloud inpatient health education platform in diabetes patients[J]. Chin J Nurs Educ, 2022, 19(12):1073-1077.
[13]	王力, 吴利平, 王平, 等. 1型糖尿病患儿健康教育游戏软件的开发及应用研究[J]. 中华护理杂志, 2020, 55(11):1659-1664. DOI
	Wang L, Wu LP, Wang P, et al. Development and application of game software for health-care education in children with type 1 diabetes[J]. Chin J Nurs, 2020, 55(11):1659-1664. DOI
[14]	滕小芸, 韦琴, 何婷, 等. 住院早产儿母亲应对困难现状及影响因素分析[J]. 中华急危重症护理杂志, 2022, 3(2):121-126.
	Teng XY, Wei Q, He T, et al. Investigation of coping difficulties in the mothers of premature infants in the neonatal intensive care unit and influencing factor analysis[J]. Chin J Emerg Crit Care Nurs, 2022, 3(2):121-126.
[15]	Beck CT, Vo T. Fathers’ stress related to their infants’ NICU hospitalization:a mixed research synthesis[J]. Arch Psychiatr Nurs, 2020, 34(2):75-84. DOI URL
[16]	刘桂华, 钱小芳, 欧萍, 等. 延续护理干预对极低及超低出生体重早产儿生长发育的影响[J]. 中华护理杂志, 2015, 50(6):697-703.
	Liu GH, Qian XF, Ou P, et al. Effect of transitional care on the growth and development in very low and extremely low birth weight premature infants[J]. Chin J Nurs, 2015, 50(6):697-703.
[17]	Weiss ME, Sawin KJ, Gralton K, et al. Discharge teaching,readiness for discharge,and post-discharge outcomes in parents of hospitalized children[J]. J Pediatr Nurs, 2017, 34:58-64. DOI URL
[18]	田雨同, 张艳, 侯小花, 等. “互联网+护理服务”平台的构建及应用研究[J]. 中华护理杂志, 2020, 55(10):1537-1542. DOI
	Tian YT, Zhang Y, Hou XH, et al. Research on the construction and application of Internet Nursing Service Platform[J]. Chin J Nurs, 2020, 55(10):1537-1542.