高危新生儿家属心理需求的调查研究

不论是否早产或体重如何 ,如果一个新生儿比一般的新生儿疾病的发生率及死亡率高便是高危新生儿[1] 。据统计 ,约有5 %新生儿由于产前、产中及产后的多种原因而成为高危新生儿 ,高危新生儿需要重症监护管理才能度过高危期。高危新生儿家属因觉察到患儿生命处于危急状况 ,常出现不同程度的焦虑、心理紊乱和情绪变化。由于在高危新生儿的抢救过程中 ,家属常被隔离在高危病室以外 ,故高危新生儿家属的心理需求常被忽视或忽略。现对 185例高危新生儿家属的心理需求进行调查 ,以了解高危新生儿家属的心理需求及焦虑因素 ,帮助其正确面对现实 ,并…     

基于微信支持的同伴教育在新生儿黄疸患儿家属护理中的应用

目的探讨基于微信支持的同伴教育在日间光疗病房新生儿黄疸患儿家属护理中的应用效果。方法选择2020年5月—2021年4月在本院日间光疗病房治疗的126名新生儿黄疸患儿家属作为研究对象,采用随机数字表法将其分为观察组与对照组,每组各63例。对照组患儿家属采用常规健康宣教方法,观察组采用基于微信支持的同伴教育方案,比较两组家属干预前后的疾病知识知晓率及心理弹性水平。结果经微信支持的同伴教育方案干预后,观察组患儿家属的心理弹性总得分高于对照组,疾病知识知晓率高于对照组,差异均具有统计学意义(P<0.05)。结论基于微信支持的同伴教育方案能够有效改善新生儿黄疸患儿家属的心理弹性水平,提高其疾病知识知晓水平,最终促进新生儿早日康复。     

NICU 患儿家属压力源及干预措施

目的：了解和识别新生儿监护室患儿家属的压力源,为患儿家属心理护理提供科学依据,实施护理干预措施,和谐医患关系。方法选取包括早产儿、新生儿黄疸、新生儿肺炎、新生儿窒息及病情危重的患儿家属为研究对象,采用焦虑自评量表（SAS）及抑郁自评量表（SDS）,对NICU患儿家属进行问卷调查评估分析并实施干预措施。结果 NICU患儿家属文化程度越高抑郁、焦虑指数越高（ P＜0.05）;对照组焦虑、抑郁情绪指数高于心理干预组（ P＜0.01）。结论 NICU危重患儿高度集中,多存在抑郁、焦虑、恐惧情绪、易激动,甚至不配合治疗,通过科学、系统、正规的心理干预,可帮助缓解甚至解除患儿家属抑郁、焦虑、易激动、恐惧心理,有效地减少了医疗纠纷,和谐了医患关系,优化服务,取得了较好的社会效益。     

影响新生儿缺氧缺血性脑病患儿家属心理状态的相关因素调查

目的探讨影响新生儿缺氧缺血性脑病患儿家属心理状态的相关因素,并提出相应对策。方法采用自行设计的调查问卷,对100名新生儿缺氧缺血性脑病患儿家属进行问卷调查,分析影响其心理状态的相关因素。结果影响患儿家属心理状态的相关因素依次为疾病知识缺乏、护理知识缺乏、对疾病预后担心、经济负担、担心药物影响和医院环境。结论建立良好的护患关系,做好疾病知识的健康教育和减轻患儿家属对疾病愈后的担心,对提高患儿家属的心理健康水平具有重要的作用。     

基于风险因素控制的无缝护理模式在新生儿输注高危药物管理中的应用价值分析

目的研究基于风险因素控制的无缝护理模式在新生儿输注高危药物管理中的应用价值。方法采用随机数表法将2019年1月至2021年12月我院收治的且均行高危药物注射治疗的86例新生儿分为对照组和观察组各43例。对照组行常规护理管理,观察组行基于风险因素控制的无缝护理模式。比较两组高危药物使用情况、临床护理质量、不良事件发生情况及家属满意度。结果观察组患儿高危药物总合理使用率为95.35%,明显高于对照组的79.07%,差异有统计学意义(P<0.05);观察组新生儿体征监护、药物输注管理、血管评估及皮肤护理评分均高于对照组,差异有统计学意义(P<0.05);观察组不良事件总发生率明显低于对照组,差异有统计学意义(P<0.05);观察组患儿家属总满意度为93.02%,明显高于对照组的76.74%,差异有统计学意义(P<0.05)。结论基于风险因素控制的无缝护理模式能有效管理新生儿输注高危药物,提高临床护理治疗和患儿家属满意度,减少不良事件发生。     

蓝光照射治疗新生儿高胆红素血症

目的 探讨新生儿黄疸的治疗方法.方法 根据新生儿的特点和对患儿家属的心理分析,采取光照疗法和精心的护理.结果 本组38例患儿,35例好转出院,3例转上级医院继续治疗.结论 蓝光照射治疗和相应的护理措施,能有效治疗新生儿高胆红素血症,促进患儿早日康复.     

蓝光治疗新生儿黄疸的护理

目的探讨蓝光治疗新生儿黄疸的护理经验,提高护理质量,改善护患关系。方法根据新生儿的特点和对患儿家属的心理分析,采取光照疗法和精心的护理,使患儿早日康复。结果 86例患儿全部治愈,无核黄疸的发生。结论蓝光新生儿黄疸过程中精心护理,严密观察,可有效提高新生儿黄疸的治愈率,促进患儿早日康复。     

循证护理在牛奶蛋白过敏性腹泻新生儿中的价值

目的 探究对牛奶蛋白过敏性腹泻新生儿实施循证护理的效果。方法 将 2021 年 1 月至 2022 年 8 月我院收治的 60 例牛 奶蛋白过敏性腹泻新生儿,随机分为对照组和观察组,每组各 30 例。对照组实施常规护理,观察组实施循证护理。对比两组 患儿护理效果、家属护理满意度及心理状况。结果 观察组患儿护理效果,家属护理满意度和心理状况优于对照组（P<0.05）。 结论 牛奶蛋白过敏性腹泻新生儿实施循证护理,能够增加护理效果及治疗依从性,改善家属心理状况,提高家属护理满意度。     

新生儿重症监护病房两种探视模式的效果比较

新生儿重症监护病房是高危科室,一般收治早产儿、多胎儿、新生儿窒息、新生儿缺血缺氧性脑病及其他病情危重的新生儿,由于新生儿各系统发育不完善、抵抗力低下,医院感染发生率高．以胃肠道、下呼吸道和皮肤黏膜感染为主,严重者可引起败血症和脑炎。患儿家属的期望值较高,万一发生医院感染,     

新生儿科患儿家属的心理护理

目的：对新生儿科的患儿家属进行心理护理，提高家属对病区的满意度。方法：对每一个患儿家属进行心理护理，并贯穿于整个住院过程。结果：正确的心理护理可以有效减轻患儿家属焦虑、抑郁、消沉情绪。结论：正确有效的心理护理使患儿家属对本病区的满意度明显提高，从91％升到98．7％。无发生医疗纠纷，提高了医院和本病区的社会声誉。     

新生儿游泳的实施与效果分析

目的探讨新生儿游泳在临床应用的效果。方法将368例新生儿分为阴道分：晓组和剖宫产组,每组随机分为2组,观察组出生后24h进行游泳,对照组出生后采用常规护理。比较观察组与对照组新生儿出生时、出院时体重以及胎便初排至转黄时间情况。结果阴道分娩组和剖宫产组的观察组新生儿出院时体重,与对照组比较有显著性差异（P〈0．001）．观察组新生儿的胎便初排至转黄时间〈24h,与对照组比较有显著性差异（P〈0．01）。结论新生儿游泳促进新生儿体重增长,胎便初排至转黄时间缩短,深受产妇、家属欢迎,也收到了良好的社会效益和经济效益。     

Beta2-microglobulin in human colostrum and milk: effect of breast feeding and physico-chemical characterization.

A statistically significant increase in beta2-microglobulin concentration in babies' sera after birth was accompanied by a decrease in beta2-microglobulin concentration in sera of nursing and non-nursing mothers; the amount by which babies' sera concentrations increased was not correlated with the decrease in serum or milk concentrations in their mothers. These results suggest that breast feeding does not affect the concentration of beta2-microglobulin in babies' sera. Furthermore, there was no relationship between serum beta2-microglobulin concentration of mothers and their babies at either point of observation. In all instances, however, the beta2-microglobulin concentration was significantly higher in infants' sera than in mothers' sera.     

The follow-up care of babies discharged from special care baby units in England and Wales between 1988 and 1989.

This survey of District Health Authorities in England and Wales forms part of a wider study into the needs of babies discharged from special care baby units in South Glamorgan Health Authority. The aim of the survey was to find out what types of care were offered to babies who had been in a Special Care Baby Unit (SCBU) and their families following the babies' discharge from hospital. This in turn raised interesting issues concerning the community care of these babies and their families which are discussed in this article.     

210例婴幼儿智力发育的结果分析

目的探讨出生时高危儿与正常儿在0~3岁婴幼儿期智力发育的轨迹。方法采用Gesell量表对210例婴幼儿进行测试,根据孕母孕期正常与否和有无出生缺陷分为对照组和观察组,对测试的发育商数加以分析。结果在0~3岁婴幼儿的智力发育中,0~2岁是婴幼儿语言发育的关键时期;对照组婴幼儿虽其出生时脑结构和功能正常,但出生后所处不良环境将影响其智力发育;观察组的婴幼儿虽出生时脑结构功能的受损,但由于从环境中获得连续的适宜感知刺激,其智力发育得到了有效的改善。结论早期丰富的环境刺激对婴幼儿的智力发育有明显的促进作用。     

游泳与抚触对新生儿健康的临床观察

目的观察游泳与抚触活动对新生儿健康的影响。方法选择2004年7月~2005年11月在我院妇产科分娩的足月正常新生儿200例,征得家属同意后,按分娩顺序分为观察组和对照组各100例,观察记录2组新生儿第3天、第7天的平均摄奶量、睡眠总时间、皮测胆红素值的变化和第4天生理体重下降、第7天体重增加的数值。结果观察组第3天、第7天平均摄奶量均比对照组多;睡眠时间也比对照组长;第3天皮测胆红素值变化不大,第7天皮测胆红素值观察组低于对照组。第4天生理性体重下降值观察组比对照组小,第7天体重增加值比对照组大。结论新生儿“游泳”与“抚触”可以增加摄奶量,延长睡眠时间,促进生理性体重下降的恢复,减轻新生儿黄疸,对新生儿的健康起着重要的促进作用。     

Serial measurements of C-reactive protein and interleukin-6 in the immediate postnatal period: reference intervals and analysis of maternal and perinatal confounders

BACKGROUND: There is a wide range of reported sensitivities and specificities for C-reactive protein (CRP) and interleukin-6 (IL-6) in the detection of early-onset neonatal infection. This prompted us to assess reference intervals for CRP and IL-6 during the 48-h period immediately after birth and to identify maternal and perinatal factors that may affect them. METHODS: CRP and IL-6 values were prospectively obtained for 148 healthy babies (113 term, 35 near-term) at birth and at 24 and 48 h of life, and from their mothers at delivery. RESULTS: Upper reference limits for CRP at each neonatal age were established. At birth, CRP was significantly lower than at 24 and 48 h of life. Rupture of membranes > or =18 h, perinatal distress, and gestational hypertension significantly affected the neonatal CRP dynamics, but at specific ages. There was no correlation between CRP concentrations in mothers and their offspring at birth. The IL-6 values observed in the delivering mothers and in their babies at all three neonatal ages were negatively associated with gestational age. In the immediate postnatal period, IL-6 dynamics for term babies were significantly different from those for near-term babies. Maternal IL-6 concentrations correlated with babies' IL-6 concentrations only for term deliveries. Apgar score had a significant effect on babies' IL-6 values at birth. CONCLUSIONS: The patterns of CRP and IL-6 responses in the healthy neonate should be taken into account to optimize their use in the diagnosis of early-onset neonatal sepsis.     

上海市宝山区手足口病患者家庭密切接触者和健康儿童家庭成员肠道病毒感染率调查

目的 了解手足口病患者家庭密切接触者肠道病毒携带状况,为手足口病防控措施制定提供依据. 方法 选取2014年6-8月辖区内手足口病实验室确诊病例以及预防接种门诊健康儿童,入户调查患者家庭密切接触者及健康儿童家庭成员人口学信息、家庭卫生习惯及卫生状况等,采集其粪便标本,比较两者肠道病毒感染情况并分析影响感染的危险因素. 结果 30户手足口病患者家庭的79名密切接触者中检出肠道病毒阳性24人,阳性率为30.38%;11户健康儿童家庭的25名家庭成员,未发现肠道病毒隐性感染者.病例与其家庭密切接触者病原型别一致率为88.89%.病例家庭密切接触者中看护时间 6 h/d(40.48%)的肠道病毒感染率高于看护时间 6 h/d(14.71%),差异有统计学意义(2=6.07,P 0.05). 结论 手足口病患者家庭密切接触者肠道病毒感染率高于健康人群,建议加强手足口病患者家庭密切接触者尤其是看护人的管理和健康教育.     

Supporting breastfeeding mothers in hospital: part 2a

The first article in this series highlighted the challenges that mothers face in establishing breastfeeding (Wallis and Harper 2007). Breastfeeding a sick infant in hospital presents additional challenges such as small, sleepy babies, babies who may be nil by mouth for prolonged periods and babies who may find breastfeeding difficult due to mechanical problems. There is very little published abut the needs of babies with complex medical or surgical conditions who may have had significant delays in their feeding or numerous starts and stops along the way. This article and Part 2b in the November issue illustrate some of the common challenges and propose principles of care that are transferable to caring for other sick babies with similar problems.     

健康教育对儿童哮喘治疗效果的影响

目的:探讨健康教育对儿童哮喘治疗效果影响。方法:将哮喘专科门诊及住院治疗的患儿按随机同期配对原则分为实验组和对照组各77例。实验组实施健康教育加常规护理,对照组实施常规护理。对比两组的临床疗效。结果:健康教育组无1例发生因哮喘急诊或住院,临床总有效率98.7%。大部分患儿及家属对治疗依从性和哮喘知识掌握情况有显著改善和提高。结论:健康教育可使患儿及家属主动与医务人员合作,进行自我护理,提高其治疗依从性和疗效。     

Putting families at the heart of their baby's care

Bliss is the UK's leading charity for babies born premature or sick, this paper explores the vital role of Bliss in supporting babies born premature or sick and in particular, the role Bliss plays in promoting family-centred care. The philosophy and benefits of family-centred care are well recognised yet there are still some barriers to implementing family-centred care in a neonatal setting. Bliss developed the Bliss Baby Charter in 2009 to standardise high quality family-centred care across the UK. This paper will discuss the principles of the Bliss Baby Charter and explore the emerging model of Family Integrated care and its relationship to family-centred care.