以家庭为中心的新生儿护理:全球视角与回顾。

IF 1.8 4区 医学 Q2 PEDIATRICS Journal of Tropical Pediatrics Pub Date : 2024-08-10 DOI:10.1093/tropej/fmae026
Saverio Bellizzi, Catello M Panu Napodano, Paola Murgia
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引用次数: 0

摘要

以人为本的护理模式建立在新生儿和家庭的需求和权利基础之上,如出生后立即和护理过程中的不分离,可以满足新生儿、家庭和医疗系统的复杂需求。这对于中低收入国家尤为重要,因为这些国家亟需具有成本效益的方式来加快新生儿的存活率。我们进行了一项系统性综述,以探索各国在实施以家庭为中心的新生儿护理模式方面的经验,以及在实施和推广这种护理模式方面所面临的挑战。我们检索了 MEDLINE、CINAHL、EMBASE 和 PsycINFO 数据库,以确定 1990 年至 2023 年期间有关以患者为中心的护理和新生儿的研究。我们对符合预定纳入标准的研究进行了质量评估,并提取了相关数据。我们利用世界卫生组织关于以人为本的综合医疗服务框架来总结和分析研究结果,同时突出研究模式。共有 41 项研究被纳入审查范围(其中约 60% 来自中低收入国家)。长期以来进行的不同研究强调了即时、不间断的皮肤接触护理如何促进新生儿、父母和医疗系统的一系列关键进程,包括母乳喂养的开始率和纯母乳喂养率、产后抑郁症发病率的降低以及感染和住院的预防。由于袋鼠式体位或皮肤接触的亲密接触,父母对婴儿越来越依恋和熟悉,很容易建立起一种关系。总之,各国可以通过以下三条简单的规则,在家庭中心护理方面转变新生儿护理服务:(i) 尽量减少母婴分离;(ii) 让父亲参与其中;(iii) 从婴儿出生时就赋予父母权力。需要转变模式,将以提供者为中心的传统护理模式转变为以人为本的新生儿医疗保健模式。这种方法在不同国家的环境中都是可行的,并应通过政治承诺和政策来推动,使母婴关系得到早期关注。反过来,这也有助于提高护理的尊严,帮助建立一个更高效、反应更迅速的卫生系统和社会。
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Family-centered care for newborns: a global perspective and review.

Person-centered models of care built on newborn and family needs and rights, such as nonseparation immediately after birth and during the care process, can address the complex needs of the newborn, family, and health system. This is particularly important in low- and middle-income countries, where cost-effective modalities are highly needed to accelerate the survival of newborn babies. We conducted a systematic review to explore country experiences on implementation and challenges to implement and scale-up family-centered newborn care models of care. MEDLINE, CINAHL, EMBASE, and PsycINFO databases were searched to identify studies on patient-centered care and newborns between 1990 and 2023. Studies meeting our predefined inclusion criteria were quality assessed and relevant data extracted. We utilized the World Health Organization framework on integrated people-centered health services to summarize and analyze findings while highlighting patterns. Forty-one studies were included for review (including approximately 60% from low- and middle-income countries). Different research conducted over time highlighted how immediate and uninterrupted skin-to-skin care facilitates a series of critical processes for newborns, parents, and health system, including breastfeeding initiation and exclusivity rates, reduced incidence of post-partum depression, and prevention of infection and hospitalization. Thanks to the close contact of the kangaroo position or skin-to-skin contact, parents recount becoming more and more attached to and familiar with their baby, easily establishing a relationship. Overall, countries could transform the newborn care service in terms of family center care by adopting three simple rules: (i) minimizing mother-child separation; (ii) involving fathers; (iii) empowering parents from the time of birth. A paradigm shift is required to change the conventional model of provider-centric care to one of person-centered neonatal health care. Such an approach is feasible in diverse country settings and should be facilitated through political commitment and policies enabling early focus on the maternal-infant relationship. This could, in turn, help achieve improved dignity of care and help create a more efficient and responsive health system and society.

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来源期刊
Journal of Tropical Pediatrics
Journal of Tropical Pediatrics 医学-热带医学
CiteScore
4.00
自引率
0.00%
发文量
97
审稿时长
6-12 weeks
期刊介绍: The Journal of Tropical Pediatrics provides a link between theory and practice in the field. Papers report key results of clinical and community research, and considerations of programme development. More general descriptive pieces are included when they have application to work preceeding elsewhere. The journal also presents review articles, book reviews and, occasionally, short monographs and selections of important papers delivered at relevant conferences.
期刊最新文献
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