家庭参与式护理对早期足月儿高胆红素血症入院率及其母亲照护能力的影响

Effect of family integrated care on admission rate in early term newborns with hyperbilirubinemia and maternal care ability of mothers

目的 探讨家庭参与式护理(family integrated care,FIC)对早期足月儿高胆红素血症入院率及其母亲照护能力的影响,为预防高胆红素血症以及提高其母亲照护能力提供一种有效的方法。方法 采用便利抽样法,选取2020年3月至12月在本院出生的100例早期足月儿及其母亲作为研究对象。以入住楼层为单位分为2组,对照组50例,实验组50例。对照组给予新生儿家庭常规入院宣教、新生儿照护技能操作及出院指导;试验组在对照组的基础上实施FIC。比较两组早期足月儿2w时因高胆红素血症入院率;两组产妇入院时、出院当日焦虑、抑郁情况;两组产妇入院时、出院当日、新生儿出生2w时新生儿照护能力。结果 试验组早期足月儿2w内因高胆红素血症入院率较对照组低,两组比较,差异有统计学意义(P<0.05)。干预前两组产妇焦虑、抑郁得分比较,差异无统计学意义(均P>0.05),干预后两组产妇焦虑、抑郁得分比较,差异有统计学意义(均P<0.01),试验组得分低于对照组。不同时间点两组产妇照护能力评分重复测量方差分析结果显示具有交互效应、组间效应与时间效应(均P<0.001),其中入院时两组产妇评分比较,差异无统计学意义(P>0.05),出院当日、新生儿出生2w时试验组产妇照护能力评分高于对照组,两组比较,差异有统计学意义(均P<0.001)。结论 FIC能降低早期足月儿因高胆红素血症的入院率,对改善产妇负性情绪,提高其新生儿照护能力有一定作用。

Objective To explore the effect of family integrated care(FIC) on the admission rate in early term infants with hyperbilirubinemia and the care ability of mothers, therefore to provide an effective method for prevention of hyperbilirubinemia and improvement of the care ability of mothers. Methods With the convenience sampling methods, 100 early term newborns hospitalised in our hospital together with the mothers, between March and December 2020, were selected and evenly divided into a control groups and an experiment group according to the ward of stay. The control group was given with routine admission education, skill of childcare and discharge guidance,while the experiment group received FIC on top of what offered to the control group. The two groups were compared with the admission rate in early term newborns within 2 weeks after birth, the anxiety and depression of the mothers at admission and on the day of discharge and the mother’s neonatal care ability at admission on the day of discharge and 2 weeks after birth. Results The admission rate in early term infants with hyperbilirubinemia in the experimental group was statistically significantly lower than that in the control group within 2 weeks of birth(P<0.05). Before intervention, there was no significant difference in the scores of anxiety and depression in the mothers(P>0.05). While after intervention, the score of the experimental group was significantly lower than that of the control group( P<0.05). Repeated measures analysis of variance showed that there were interaction effect, between-group effect and time effect at different time points on the scores of mothers’ neonatal care ability(all P<0.001). There was no statistically significant difference in the score of mothers’ care ability between the two groups at admission(P>0.05). While the scores of mothers’ care ability in the experiment group were significantly higher on the day of discharge, 2 weeks after the birth of the newborns and the mothers’ care ability than that in the control group(P<0.001). Conclusions FIC can effectively reduce the admission rate of early term infants with hyperbilirubinemia by strengthening the health education and targeted follow-up for families with early term infants, encouraging family participation and practice, and offering a positive role to the family. There are significant effects in terms of improvement of negative emotions and the nursing ability in mothers who have early term infants.