社会生态系统理论视角下新生儿重症监护室早产儿家庭功能的质性研究  

Family functioning among preterm infants in the NICU from the perspective of social ecosystem theory:a qualitative study

作　　者：张清 周雪梅[2] 霍秋桂[2] 戴薇薇 张文燕 Zhang Qing;Zhou Xuemei;Huo Qiugui;Dai Weiwei;Zhang Wenyan(Department of Hematology,Children′s Hospital of Soochow University,Suzhou 215025,China;Department of Neonatology,Children′s Hospital of Soochow University,Suzhou 215025,China;Department of Nursing,Suzhou Wujiang District Children′s Hospital,Suzhou 215200,China;Department of Nursing,Children′s Hospital of Soochow University,Suzhou 215025,China)

机构地区：[1]苏州大学附属儿童医院血液科,苏州215025 [2]苏州大学附属儿童医院新生儿科,苏州215025 [3]苏州市吴江区儿童医院护理部,苏州215200 [4]苏州大学附属儿童医院护理部,苏州215025

出　　处：《中国实用护理杂志》2024年第31期2442-2448,共7页Chinese Journal of Practical Nursing

基　　金：2023年度苏州市护理学会姑苏护理人才"青苗"计划立项项目(SHQM202303)。

摘　　要：目的了解早产儿的出生对其家庭功能的影响,为制订针对性的干预方案提供参考。方法以社会生态系统理论为理论框架,采用现象学研究方法,2023年9月至2024年1月以目的抽样法对16名符合纳入、排除标准的苏州大学附属儿童医院新生儿重症监护室(NICU)早产儿照顾者进行半结构式访谈,运用Colaizzi 7步分析法对访谈资料进行分析。结果接受访谈的16名NICU早产儿照顾者均为患儿母亲,年龄26~34岁。共归纳出3个主题,10个亚主题。(1)微观系统:照顾者身心疲惫与角色成长并存(身心健康受到影响、心理调适后获得积极体验、适应角色转变)。(2)中间系统:家庭相处模式改变(家庭满意度下降、家庭困境影响家庭和睦、家庭沟通内容改变、家庭和谐与冲突并存、主动化解家庭矛盾)。(3)外层系统:社会支持体系有待完善(从社会支持中获益、尚未感知外部支持)。结论医护人员可从完善多元支持体系,提供持续性、个性化的家庭支持方面着手,提升NICU早产儿家庭的调适能力,改善其家庭功能。ObjectiveTo investigate the impact of the birth of preterm infants on their family functioning,and to provide a reference for the formulation of targeted intervention programs.MethodsBased on the socio ecosystem theory,phenomenological research methods and objective sampling were used to conduct semi-structured interviews with 16 preterm infants in the neonatal intensive care unit(NICU)of Children′s Hospital of Soochow University from September 2023 to January 2024,who meet the inclusion and exclusion criteria,and the Colaizzi 7-step analysis method was used to analyze the interview data.ResultsAll 16 caregivers of the NICU preterm infants who participated in the interviews were the infants′mothers,aged from^(2)6 to 34 years.A total of 3 themes and 10 sub-themes were summarized.The micro system:physical and mental exhaustion coexisted with role growth of caregivers(physical and mental health was affected,positive experience after psychological adjustment,and adaptation to role change).The intermediate system:family relationship mode change(family satisfaction decreased,family difficulties affected family harmony,family communication content changed,family harmony and conflict coexisted,and family conflict resolution was actively resolved).The outer system:social support system needed to be improved(benefited from social support and not yet perceived external support).ConclusionsMedical staff can improve the multiple support system and provide continuous and personalized family support,so as to improve the family adjustment ability and improve the family functioning of preterm infants in the NICU.

关 键 词：定性研究 家庭功能 社会生态系统理论 重症监护病房 新生儿 早产儿 照顾者 

分 类 号：R473.72[医药卫生—护理学]