NICU实施出院准备计划对新生儿主要照护者照护能力的效果分析

Effectiveness of Discharge Preparation Program in the NICU on the Caregiving Capacity of Neonatal Primary Caregivers

目的:评价出院准备计划对照护者居家照护技能的效果,为新生儿重症监护室(Neonatal Intensive Care Unit,NICU)新生儿出院准备计划的全面实施与推广提供理论依据。方法:选取2021年11月-2022年6月新疆乌鲁木齐市某三级甲等医院NICU新生儿及主要照护者为研究对象,对照组和干预组各60对。采用便利抽样法,2021年11月-2022年2月入院的新生儿及照护者设为对照组,给予NICU常规护理,2022年3月-2022年6月入院新生儿及照护者设为干预组,在对照组的基础上实施出院准备计划干预措施。比较两组照护者照护能力情况,新生儿溢奶呛咳及尿布性皮炎发生率。结果:(1)两组新生儿及照护者人口学特征的一般资料差异均无统计学意义(P>0.05)。(2)干预组照护者干预后照护能力得分(73.25±7.01)高于对照组(50.18±4.80)分,干预组得分差值d(29.37±8.21)高于对照组(8.57±3.19)分,差异具有显著统计学意义(P<0.001)。(3)干预组新生儿出院后呛咳率(31.67%)和尿布性皮炎发生率(26.67%)均低于对照组(56.67%,45.00%);干预组新生儿发生溢奶呛咳的次数(2.74±0.56)次低于对照组(5.21±1.77)次,差异均具有统计学意义(P<0.05)。结论:(1)实施出院准备计划干预方案后,照护者的照护能力处于中等偏上水平,且在安全防护、特殊照顾及亲子关系三个方面有明显提高。(2)溢奶呛咳及尿布性皮炎发生率降低约20%。(3)有必要在综合医院全面推广出院准备计划。

Objective:To evaluate the effectiveness of the discharge preparation program on the caregivers'home care skills and to provide a theoretical basis for the full implementation and promotion of the neonatal discharge preparation program in the Neonatal Intensive Care Unit(NICU).Methods:Neonates and main caregivers in a NICU hospital in Wulumqi City,Xinjiang Province from November 2021 to June 2022 were selected as the study objects,with 60 pairs in each control group and intervention group.By convenience sampling method,neonates and caregivers admitted from November 2021 to February 2022 were set as the control group and given NICU routine care;neonates and caregivers admitted from March 2022 to June 2022 were set as the intervention group,and intervention measures of discharge preparation plan were implemented on the basis of the control group.The care ability of the two groups of caregivers was compared,and the incidence of neonatal milk discharge cough and diaper dermatitis was compared.Results:(1)No statistically significant differences were found in the general information on the demographic characteristics of the newborns and caregivers in both groups(P>0.05).(2)The post-intervention caregiving ability score of caregivers in the intervention group(73.25±7.01)was higher than that of the control group(50.18±4.80),and the score difference d in the intervention group(29.37±8.21)was higher than that of the control group(8.57±3.19),with statistically significant differences(<0.001).(3)The choking rate(31.67%)and the incidence of diaper dermatitis(26.67%)after discharge were lower in the intervention group than in the control group(56.67%,45.00%);the number of choking and coughing with milk spillage was lower in the intervention group(2.74±0.56)than in the control group(5.21±1.77),and the differences were The differences were statistically significant(P<0.05).Conclusions:(1)After the implementation of the discharge preparation program intervention,the caregivers'caregiving ability was moderately high,and there was a significant improvement in three areas:safety and security,special care,and parent-child relationship.(2)The incidence of milk spillage and choking and diaper dermatitis was reduced by about 20%.(3)It is necessary to fully promote the discharge preparation program in general hospitals.