Validation of the German Glasgow children's benefit inventory

OBJECTIVE: The aim of this study was to validate the German Glasgow Children's Benefit Inventory (GCBI) in children with different surgical interventions. MATERIAL AND METHODS: The GCBI was translated by using accepted forward-backward translation techniques and mailed to 741 parents whose children underwent either an otorhinolaryngological (n = 641) or an urological intervention (n = 100). The assessment was performed in a retrospective manner at the Medical University Innsbruck, Austria between January and March 2006. An exploratory principal component factor analysis with varimax rotation using factor loadings of >or=0.40 to allocate items to a scale was performed. Frequencies, means and standard deviations were used to describe patient, clinical, sociodemographic, and scale characteristics. RESULTS: The questionnaire was completed and returned by 325 patients (43.9%). The GCBI showed a high internal consistency (alpha = 0.84). The four-factor solution, emotional, vitality, learning and physical health explained 55.7% of variance. CONCLUSION: The German version of the GCBI was proven to be valid and reliable. It is suitable for subjective outcome analysis of different paediatric interventions from infants to adolescents.     

早期护理干预对极低出生体重儿存活质量的影响

目的 探讨早期护理干预对极低出生体重儿存活质量的影响.方法 将106例极低出生体重儿随机分为两组,观察组53例,施行早期胃肠内营养,配合采用非营养性吸吮、全身抚触等发育支持护理干预;对照组53例,出生后视病情允许,早期建立胃肠内营养,予常规护理.结果 观察组吸吮吞咽功能建立时间、足量喂养时间显著短于对照组(P＜0.01),体重增长、神经行为评分显著优于对照组(P＜0.01),并发症显著少于对照组(P＜0.01).结论 对极低出生体重儿早期进行护理干预,减少了常见并发症,提高了极低出生体重儿的存活率及生存质量.     

Nurses Leading Safe Infant Sleep Initiatives in the Hospital Setting

Every day, 10 otherwise healthy infants die from sleep-related deaths in the United States. These deaths, termed sudden unexpected infant death, remain the leading cause of post-neonatal death in the United States despite known modifiable risk factors and prevention recommendations. In birthing hospitals, many parents report being given incorrect and sometimes no information about infant sleep safety, which creates immediate and long-term safety concerns. In this article, we provide an overview of sudden unexpected infant death, including sudden unexpected postnatal collapse, and the latest safe sleep recommendations from the American Academy of Pediatrics. We also offer practical guidelines for nurses—those working at the bedside and those in leadership positions—who may be seeking to improve the quality of infant sleep practices in their organizations.     

简易喂养法在早产儿及低出生体重儿的应用研究

目的通过简易喂养法在早产儿及低出生体重儿的应用 ,以期探讨一种新的喂养方法 ,既能避免静脉营养的高昂费用及经鼻、经口胃管喂养的某些弊端 (如影响患儿肺功能等 ) ,又能有利于患儿胃肠功能恢复及生长发育。方法设简易喂养法组为观察组 ,同期应用其它方法组为对照组 ,观察两组患儿肠鸣音正常与否 ,有无腹胀发生 ,胎便排出情况 ,黄疸持续时间及体重增长 (从出生第 7天开始到出院平均每日增长克数 )情况。结果肠鸣音正常、未发生腹胀者观察组 2 6例 ,占 86 7% ,对照组 2 6例 ,占 74 2 % ,两组有显著性差异 (P <0 0 5 ) ;胎便排尽时间观察组平均 7 4 7天 ,对照组平均 7 1 4天 ,黄疸持续时间观察组平均 9 5 3天 ,对照组平均 1 3 91天 ;体重增长观察组平均每天 1 1 78g ,对照组平均每天 9 1 5 g ;平均住院时间观察组 1 4 5天 ,对照组 1 8 2 6天。结论简易喂养法对早产儿及部分低出生体重儿较静脉营养费用低 ,较经鼻、经口胃管喂养经济方便 ,效果好 ,且能促进患儿胃肠功能恢复及生长发育 ,减少胃肠道并发症的发生 ,缩短住院天数     

母婴床旁护理联合家庭协同护理模式对初产妇产后心理和生活质量的影响

目的探讨母婴床旁护理联合家庭协同护理模式对初产妇产后心理和生活质量的影响。方法将120例初产妇随机分为对照组与观察组,各60例。对照组给予母婴床旁护理干预,观察组在对照组基础上给予家庭协同护理干预。比较两组的护理效果。结果护理后,两组的SAS、SDS评分均降低,且观察组低于对照组(P<0.05)。护理后,观察组的家属知识掌握度、产妇对新生儿护理掌握度评分均高于对照组(P<0.05)。观察组的产妇生活质量评分、自我护理能力优良率及护理满意度均高于对照组(P<0.05)。结论母婴床旁护理联合家庭协同护理模式能有效缓解初产妇的焦虑、抑郁情绪,改善初产妇的自我护理能力和生活质量,提高护理满意度。     

107例早产儿机械通气的临床分析

目的　探讨早产儿机械通气的临床特点及转归。方法　回顾性分析我院NICU 2 0 0 0年 1月至2 0 0 2年 12月收治的 10 7例机械通气早产儿的临床资料 ,并与同期机械通气足月儿进行比较。结果　新生儿肺透明膜病 (HMD)是早产儿接受机械通气治疗的首要原因 ,16 8%的病例需 2次以上机械通气治疗。与足月儿相比 ,早产儿机械通气持续时间长 ,易并发颅内出血及肺出血 ;病死率较高 (2 9 0 % ) ,死亡的高危因素包括 :多胎、复苏史、出生体重 <2 0 0 0g、孕周 <34周、Apgar 5分钟评分 <5 ,及颅内出血。结论　机械通气早产儿是NICU最危重的一组病例 ,认识这组患儿的临床特征有助于更好地进行早产儿护理 ,提高其存活率和生存质量。     

早产儿滴管喂养的观察分析

目的探讨滴管喂养方式对早产低出生体重儿生长发育及疾病康复的影响。方法将45侧早产低出生体重儿随机分为观察组23例（滴管喂养），对照组22例（胃管喂养）。观察两组喂养时的耐受性、不良反应及并发症。结果两组比较观察组耐受性较好，并发症发生率低，不良反应未增加。结论滴管喂养适用于有吞咽功能的早产低出生体重儿，能增强机体抗病力，减少并发症。     

重力滴注鼻饲法对早产儿喂养并发症的影响

目的探讨重力滴注鼻饲法对早产儿喂养并发症的影响。方法将60例早产儿随机分为对照组和观察组,各30例。分别采用分次推注法和重力滴注早产儿配方奶鼻饲法进行肠内营养支持,同时辅以非营养性吸吮。比较两组并发症发生情况。结果观察组胃潴留、食管返流或呕吐、呼吸暂停、误吸发生例数明显少于对照组（P〈0.05）。结论重力滴注早产儿配方奶,可减少肠内营养并发症的发生。     

母婴分离早产儿母亲母乳喂养体验的质性研究

目的了解新生儿重症监护室出院早产儿母亲的母乳喂养体验,为制订有效的母乳喂养指导方案提供依据。方法采用质性研究法,对18名新生儿重症监护室早产儿母亲在早产儿出院后1周内通过家庭访问进行深度访谈,出院第2周、1个月时进行电话访谈。结果母亲在早产儿出院后的母乳喂养中经历了直接母乳喂养的困难、哺乳不确定性的困惑、母乳不足的烦恼以及哺乳知识的缺乏所带来的困惑。结论母婴分离早产儿母亲在早产儿出院后遭遇了母乳喂养方面的困难与不安,加强母亲对早产儿生理特征、母乳喂养知识、母乳喂养技巧的护理指导是产科和儿科当前面临的重要课题。     

国外早产儿连续护理现状及对我国的启示

文章综述了国外早产儿连续护理社会支持系统、实践形式及内容和测评工具,国外早产儿连续护理实践形式包括多学科团队连续护理模式、医护-家长合作模式、居家护理模式、远程医疗管理模式、高危儿门诊随访模式,并针对我国现状提出了相应建议,包括完善相关制度和法规、完善早产儿连续护理内容与工作模式、组建多学科连续护理团队、构造开放式的NICU环境、完善早产儿连续护理相关测评工具,以期为我国开展早产儿连续护理的实践提供指导和帮助。     

Systematic Review of Quality Improvement Initiatives Related to Cue-Based Feeding in Preterm Infants

Objective

To examine and synthesize the outcomes of quality improvement (QI) initiatives related to cue-based feeding of preterm infants to facilitate implementation of findings to improve nursing practice.

早期微量喂养在体重小于1500g早产儿中的应用

【目的】探讨极低及超低出生体重早产儿早期微量低磅奶（早产儿配方奶）喂养的可行性和疗效。【方法】将95例极低及超低出生体重早产儿随机分为早期微量低磅奶喂养（治疗组）52例和早期全静脉营养（TPN对照组）43例两组。观察两组各项指标变化。【结果】两组胃肠道功能紊乱、坏死性小肠结肠炎（NEC）、吸入性肺炎发生率及继发感染发生率比较差异无显著性（P〉0．05）,但治疗组达全量胃肠道营养时间、胆红素水平、继发感染率、体重恢复时间,住院时间等均明显低于对照组（P〈0．05）。【结论】早期微量低磅奶喂养可促进胃肠道发育成熟,不增加胃肠功能紊乱的发生率,并可缩短达足量喂养的时间及住院天数,减轻胆红素水平、减少继发感染的发生率。     

Proposal of indicators to evaluate complementary feeding based on World Health Organization indicators

This study compares complementary feeding World Health Organization (WHO) indicators with those built in accordance with Brazilian recommendations (Ten Steps to Healthy Feeding). A cross‐sectional study was carried out during the National Immunization Campaign against Poliomyelitis in Guarapuava‐Paraná, Brazil, in 2012. Feeding data from 1,355 children aged 6–23 months were obtained through the 24 h diet recall. Based on five indicators, the proportion of adequacy was evaluated: introduction of solid, semi‐solid, or soft foods; minimum dietary diversity; meal frequency; acceptable diet; and consumption of iron‐rich foods. Complementary feeding showed adequacy higher than 85% in most WHO indicators, while review by the Ten Steps assessment method showed a less favorable circumstance and a high intake of unhealthy foods. WHO indicators may not reflect the complementary feeding conditions of children in countries with low malnutrition rates and an increased prevalence of overweight/obesity. The use of indicators according to the Ten Steps can be useful to identify problems and redirect actions aimed at promoting complementary feeding.     

The Effects of Infant Feeding Decisions on Infant Growth

ISSUES AND PURPOSE. To determine the effects of feeding decisions on infant growth in the first 6 months of life.
DESIGN AND METHODS. Growth measurements were collected twice during the first 6 months of infancy as part of a larger investigation of infant feeding practices (N = 52).
RESULTS. Infants who received solid foods before the age of 4 to 6 months weighed less than those who received solid foods after 4 to 6 months. There were no differences in growth measurements between formula-fed and breastfed infants, although breast-fed infants weighed more at birth.
PRACTICE IMPLICATIONS. Emphasize the importance of feeding breast milk (preferably) or formula only for the first 6 months. Advise parents to withhold fruit juices until the infant is at least 6 months old.     

Effects of infant and caregiving conditions on an infant's focused exploration of toys

An infant's exploration of toys, in the context of the mother's regulating actions, is a setting for cognitive and social development. The aim of this study was to examine the contribution of infant and caregiving conditions to the quantity of focused exploration of toys for 8-month-old infants. Infant biological conditions were gender and birth weight, including a range of both prematurely and term-born infants. The infant behavioural condition was responsiveness to care. Caregiving conditions included mother's education, the supportive, stimulating and sustaining quality of the home environment, and the attention-directing and -supporting behaviour of the mother during play. The direct and indirect effects of these conditions on focused toy exploration were modelled using multiple regression. The sample of 79 mother-infant dyads included 43 full-term infants and 36 premature infants. The mother's attention-directing behaviour was a significant negative predictor of focused toy exploration. Infant birth weight did not have a significant direct effect on focused toy exploration. Birth weight did not interact significantly with responsiveness to care or with any of the caregiving environment conditions to affect focused toy exploration. Further study of infant responses to the mother's attention-regulating and emotion-regulating behaviour during play is recommended to better understand how the caregiving environment supports or thwarts focused toy exploration.     

"袋鼠式护理"的现状及研究进展

综述了"袋鼠式护理"产生背景、有效性、安全性、应用现状及发展前景。