早产儿母亲认知行为干预对母婴互动的效果研究

目的 探讨早产儿母亲认知行为干预对母婴互动效果的影响.方法 选择2007年8月至2008年5月我院新生儿重症监护病房住院的胎龄28～36周的适于胎龄儿,且危重指数评分＜40分、经过新生儿重症监护病房治疗、病情稳定转入早产儿病房且不需氧气支持的低危早产儿及其母亲,按照早产儿人院先后依次分为干预组和对照组各19对.对照组母亲常规探视,并阅读自行制定的"读懂早产宝宝行为"的宣教手册.干预组母亲在此基础上接受4次、每次2 h的认知行为干预.干预内容包括指导母亲"读懂早产儿行为"、指导喂养、指导个人卫生和急救复苏等.干预方式主要包括理论辅导和实践参与.干预效果通过母婴互动评价量表--婴儿哺喂评估量表(Nursing ChildAssessment Feeding Scale,NCAFS)进行评价.结果 母婴NCAFS总分在干预后即早产儿纠正胎龄40周时,干预组评分为(46.4±8.5)分,高于对照组的(42.7±5.9)分,但差异无统计学意义(t=1.55,P＞0.05);干预组母亲总分为(35.8±6.3)分,高于对照组母亲的(33.3±5.6)分,但差异无统计学意义(t=1.28,P＞0.05),其中母亲对早产儿暗示行为敏感得分为(12.2±1.7)分,显著高于对照组母亲的(10.7±2.4)分(t=2.10,P＜0.05);干预组婴儿总分为(10.6±3.2)分,高于对照组婴儿的(9.5±3.1)分,但差异无统计学意义(t=1.08,P＞0.05).结论 通过对早产儿母亲认知行为进行短期干预,可以提高母亲对早产儿暗示的敏感度,但对母婴互动总的影响需要进一步研究.

Abstract：

Objective To examine the impact of cognitive behavior intervention (CBI) on mother-infant interaction in the neonatal department. Methods Low-risk appropriate for gestational age premature infants with gestational age 28-36 weeks, who were admitted to the neonatal intensive care unit in our hospital between August 2007 and May 2008, and their mothers were assigned to intervention group and control group respectively. Intervention group mothers (n = 19)participated in CBI. Control group mothers (n= 19) were asked to read educational materials. Mothers in the intervention group, all received 4 times interventions and 2 h for each time. The CBI process include assessment, plan, implementation and evaluation. Mothers were educated for knowledge about appearance and behavioral characteristics of preterm infants and were guided about how to take care of their babies and participate in nursing care process. Mothers completed measures on mother-infant interaction (Nursing Child Assessment Feeding Scale, NCAFS) in the first follow-up after infant discharge. Results The results showed that the scores of NCAFS and total scores of the mothers in the intervention mother-infant dyads were 46.4 ± 8.5 and 35.8±6.3,higher than in the control group (42.7±5.9 and 33.3 ± 5.6), respectively, but there were no statistic difference between the two groups (t = 1.55 and 1.28, P＞ 0. 05). The scores of "mother's response to distress" were significantly higher in the intervention mother-infant group (12. 2± 1.7) than in the control group (10.7±2.4)(t=2.10,P＜0.05). Conclusions The levels of premature infant-mother interactions are low. CBI can improve mother's response to premature infant's distress. Further study is needed to investigate the effects of CBI in improving mother-infant interaction.

Impact of mother's cognitive behavior intervention on premature infant-mother interaction

Objective To examine the impact of cognitive behavior intervention (CBI) on mother-infant interaction in the neonatal department. Methods Low-risk appropriate for gestational age premature infants with gestational age 28-36 weeks, who were admitted to the neonatal intensive care unit in our hospital between August 2007 and May 2008, and their mothers were assigned to intervention group and control group respectively. Intervention group mothers (n = 19)participated in CBI. Control group mothers (n= 19) were asked to read educational materials. Mothers in the intervention group, all received 4 times interventions and 2 h for each time. The CBI process include assessment, plan, implementation and evaluation. Mothers were educated for knowledge about appearance and behavioral characteristics of preterm infants and were guided about how to take care of their babies and participate in nursing care process. Mothers completed measures on mother-infant interaction (Nursing Child Assessment Feeding Scale, NCAFS) in the first follow-up after infant discharge. Results The results showed that the scores of NCAFS and total scores of the mothers in the intervention mother-infant dyads were 46.4 ± 8.5 and 35.8±6.3,higher than in the control group (42.7±5.9 and 33.3 ± 5.6), respectively, but there were no statistic difference between the two groups (t = 1.55 and 1.28, P＞ 0. 05). The scores of "mother's response to distress" were significantly higher in the intervention mother-infant group (12. 2± 1.7) than in the control group (10.7±2.4)(t=2.10,P＜0.05). Conclusions The levels of premature infant-mother interactions are low. CBI can improve mother's response to premature infant's distress. Further study is needed to investigate the effects of CBI in improving mother-infant interaction.