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1.
Neonatal Netw ; 38(2): 63-68, 2019 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-31470368

RESUMO

Numerous chromosome abnormalities are seen in NICUs around the world. With increased access to health care, in some cases, parents and practitioners are aware of an abnormality prior to birth, and a plan of care can be made. However, in many situations there is no prenatal diagnosis and these discoveries and diagnoses are made during the neonate's NICU stay. Providers in the NICU setting need to have a vast understanding of chromosome abnormalities, as they may be the first to guide parents through the maze of decisions that will follow. This case study analyzes a very rare deletion on chromosome 1q43q44. The 1q43q44 deletion is located at the subtelomeric region, the region farthest from the centromere, on the long arm of chromosome 1. This case study describes Baby D, who presented with multiple anomalies and was subsequently diagnosed with 1q43q44 deletion.


Assuntos
Anormalidades Múltiplas , Deleção Cromossômica , Testes Genéticos/métodos , Deficiência Intelectual , Enfermagem Neonatal/métodos , Triagem Neonatal/métodos , Pais , Anormalidades Múltiplas/diagnóstico , Anormalidades Múltiplas/fisiopatologia , Adulto , Assistência ao Convalescente/métodos , Cromossomos Humanos Par 1 , Feminino , Humanos , Recém-Nascido , Deficiência Intelectual/diagnóstico , Deficiência Intelectual/fisiopatologia , Unidades de Terapia Intensiva Neonatal , Trabalho de Parto Induzido/métodos , Exame Neurológico/métodos , Pais/educação , Pais/psicologia , Gravidez , Apoio Social , Avaliação de Sintomas/métodos
2.
Neonatal Netw ; 38(2): 80-87, 2019 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-31470370

RESUMO

PURPOSE: This evidence-based practice project evaluated the efficacy of a respiratory algorithm administered by specially trained transition nurses on the reduction of preventable NICU admissions for infants experiencing mild respiratory distress during transition. DESIGN: A retrospective chart review compared a cohort of newborn admission rates for seven months before and seven months after initiation of a respiratory algorithm. SAMPLE: Records of infants were included if they were born >35 weeks' gestation, had documented mild respiratory distress after birth, required <48 hours of noninvasive respiratory support, and had a length of stay less than four days. RESULTS: Ninety-six infants (before n = 34, after n = 62) were included. Before implementation of the respiratory algorithm, infants requiring noninvasive respiratory support were admitted to the NICU. Following implementation of the algorithm, NICU admissions for mild respiratory distress significantly decreased (86 percent), despite a concurrent increase in maternal acuity.


Assuntos
Manuseio das Vias Aéreas/enfermagem , Enfermagem Neonatal/métodos , Síndrome do Desconforto Respiratório do Recém-Nascido , Terapia Respiratória/métodos , Algoritmos , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Tempo de Internação , Masculino , Gravidade do Paciente , Medicina Preventiva/métodos , Síndrome do Desconforto Respiratório do Recém-Nascido/diagnóstico , Síndrome do Desconforto Respiratório do Recém-Nascido/terapia , Estudos Retrospectivos
3.
Neonatal Netw ; 38(2): 113-115, 2019 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-31470376

RESUMO

An expected complex outcome of a premature infant need not be assumed completely life limiting. Take Erik Zimmerman, an adult born early 40+ years ago that did end up with cerebral palsy. Yet he chose the gifts that the diagnosis provides and proves many people wrong in terms of what he can and cannot do. The result is a wonderful interview with an inspiring individual and tips for neonatal nurses that will inform them in the NICU as they carry forward wisdom to new families facing the same challenges.


Assuntos
Paralisia Cerebral , Erros de Diagnóstico/prevenção & controle , Pessoas com Deficiência , Enfermagem Neonatal , Paralisia Cerebral/diagnóstico , Paralisia Cerebral/psicologia , Erros de Diagnóstico/psicologia , Pessoas com Deficiência/psicologia , Pessoas com Deficiência/reabilitação , Diagnóstico Precoce , Inteligência Emocional , Humanos , Unidades de Terapia Intensiva Neonatal , Enfermagem Neonatal/métodos , Enfermagem Neonatal/normas , Competência Profissional
4.
Neonatal Netw ; 38(3): 144-150, 2019 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-31470381

RESUMO

Down syndrome (DS) is a well-known genetic disorder that affects 700-1,000 infants per year. One particular comorbidity of DS is transient myeloproliferative disorder (TMD), a disease characterized by leukocytosis with elevated blast counts. Approximately 10 percent of DS infants develop TMD, which usually manifests during the first week of life and can lead to an extended hospitalization in a NICU. In addition to hallmark hematologic findings, other manifestations include jaundice, conjugated hyperbilirubinemia, hepatomegaly, and pericardial or pleural effusions. TMD generally resolves spontaneously in the first three months of life with the provision of timely medical management; however, survivors are at increased risk of developing acute myeloid leukemia (AML). Neonatal nurses need to have knowledge of this disorder to facilitate screening of DS infants and optimize family education and coordination of care.


Assuntos
Síndrome de Down/diagnóstico , Síndrome de Down/enfermagem , Reação Leucemoide/diagnóstico , Reação Leucemoide/enfermagem , Enfermagem Neonatal/educação , Enfermagem Neonatal/métodos , Enfermeiras Neonatologistas/educação , Guias de Prática Clínica como Assunto , Adulto , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade
6.
Indian J Pediatr ; 86(7): 595-598, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31020593

RESUMO

OBJECTIVES: Use of continuous positive airway pressure (CPAP) in neonates is associated with nasal injury (NI) for which various risk factors related to the neonatal characteristics and properties of interfaces used have been reported. "Privileging" of nursing staff may influence safety and incidence of adverse events. In this prospective cohort study, authors studied the incidence of NI and risk factors for NI in babies requiring CPAP after privileging staff for CPAP care bundles. METHODS: All neonates on CPAP over a 6-mo period were included. Standard operating procedures were formulated and staff of NICU (nurses and doctors) were educated at the start of the study and periodically in 6 comprehensive areas of care- encompassing position of head, prongs and cap; nasal suctioning and interruptions in pressure on the nose. The staff who completed the training and evaluation were declared as "privileged". NI (measured by a standard staging) and risk factors were predefined and studied. RESULTS: Of the 51 babies who required respiratory supports, 35 required CPAP care. Nine babies (25%) out of 35 who required CPAP had NI (2, 4, 3 babies had stages 1, II and III of NI respectively). Seventy seven percent of babies were cared for by privileged nurses. NI was significantly higher when cared for by non-privileged staff (66% vs. 11%, unadjusted RR = 6.75, 95%CI 2.16-21.09). All other risk factors were not significant. CONCLUSIONS: NI was noted in 25% neonates on CPAP, and those cared for by non-privileged staff had higher chances of NI. Quality processes and emphasis on continued monitoring and evaluation of nursing skills may help prevent these untoward complications.


Assuntos
Pressão Positiva Contínua nas Vias Aéreas/métodos , Pressão Positiva Contínua nas Vias Aéreas/normas , Enfermagem Neonatal/métodos , Nariz/lesões , Recursos Humanos de Enfermagem no Hospital/educação , Pressão Positiva Contínua nas Vias Aéreas/efeitos adversos , Escolaridade , Humanos , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Estudos Prospectivos , Fatores de Risco , Sucção/métodos
9.
Rev Bras Enferm ; 72(suppl 1): 129-136, 2019 Feb.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30942354

RESUMO

OBJECTIVE: To understand how care management in prenatal care in a Care Center in Angola happens. METHOD: A qualitative study, which used the Constructivist Grounded Theory (GT) as a methodological framework. The theoretical sample consisted of 22 participants, including nursing professionals, pregnant women and nursing students from Huambo, Angola. The data were collected by interviews and analyzed according to initial and focused coding. RESULTS: Five categories arose: Embracing the pregnant woman for prenatal care; Performing the prenatal consultation; Creating a bond and dialogical relationship with pregnant women; Establishing collaborative working relationships; and Inserting the pregnant woman's family into prenatal care. CONCLUSION: The management of nursing care in the study setting is effective through complementary and interdependent steps, based on collaborative relationships among professionals and in the effort to establish bonds with pregnant women and their families.


Assuntos
Enfermagem Neonatal/métodos , Cuidados de Enfermagem/métodos , Angola , Teoria Fundamentada , Humanos , Entrevistas como Assunto/métodos , Enfermagem Neonatal/normas , Enfermeiras e Enfermeiros/psicologia , Cuidados de Enfermagem/normas , Satisfação do Paciente , Gestantes/psicologia , Cuidado Pré-Natal/métodos , Pesquisa Qualitativa , Estudantes de Enfermagem/psicologia
10.
J Clin Nurs ; 28(11-12): 2124-2134, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30786101

RESUMO

AIMS AND OBJECTIVES: To explore the experiences of mothers of extremely premature babies during their Neonatal Intensive Care Unit stay and transition home. BACKGROUND: Mothers of extremely preterm infants (28 weeks' gestation or less) experience a continuum of regular and repeated stressful and traumatic events, during the perinatal period, during the Neonatal Intensive Care Unit stay, and during transition home. METHOD: An interpretive description method guided this study. Ten mothers of extremely premature infants who had been at home for less than six months were recruited via a Facebook invitation to participate in semi-structured telephone interviews exploring their experiences in the Neonatal Intensive Care Unit and the transition home. The data were examined using a six-phase thematic analysis approach. The COREQ checklist has been used. RESULTS: Two main themes emerged: (a) things got a bit dire; and (b) feeling a failure as a mother. Participants had a heightened risk of developing a mental disorder from exposure to multiple risk factors prior to and during birth, as well as during the postnatal period in the Neonatal Intensive Care Unit and their infant's transition to home. Mothers highlighted the minimal support for their mental health from healthcare professionals, despite their regular and repeated experience of traumatic events. CONCLUSION: The mothers were at high risk of developing post-traumatic stress symptoms and/or other mental health issues. Of note, study participants relived the trauma of witnessing their infant in the Neonatal Intensive Care Unit, demonstrated hypervigilance behaviour and identified lack of relevant support needed when their infant was at home. RELEVANCE TO CLINICAL PRACTICE: This study highlights the need for nurses to include a focus on the mothers' psychosocial needs. Supporting maternal mental health both improves maternal well-being and enables mothers to be emotionally available and responsive to their extremely preterm infant.


Assuntos
Lactente Extremamente Prematuro , Mães/psicologia , Adulto , Feminino , Humanos , Lactente , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Enfermagem Neonatal/métodos , Gravidez , Pesquisa Qualitativa , Fatores de Risco , Transtornos de Estresse Pós-Traumáticos/etiologia
13.
Adv Neonatal Care ; 19(3): 236-243, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30664521

RESUMO

BACKGROUND: Premature infants experience stressors such as external stimulation with sounds, light, touch, and open positioning in NICU that negatively affect outcomes. PURPOSE: The purpose of this study was to measure the effectiveness of a developmental positioning intervention on length of stay, weight gain, and tone/flexion compared with neonates without structured positioning. METHODS: Study design was quasi-experimental with nonequivalent groups. A retrospective chart review of 50 neonates with the inclusion criteria of 34 weeks of gestation or less and no anomalies provided a preintervention sample. After the education in-service on positioning, a convenience sample of 27 infants was enrolled. Infant Position Assessment Tool was used as a visual guide for positioning and scoring by the researcher for intervention fidelity. Hammersmith scoring was completed by the occupational therapist prior to discharge. FINDINGS: The postintervention group was younger and sicker than the control group (P < .05). The postintervention sample (M = 7.05 where 7 = 29 to <30 weeks of gestation) was younger than the preintervention sample (M = 7.22). The postintervention sample was smaller (M = 1302.15 g) than the preintervention sample (M = 1385.94 g). Results showed that the postintervention group had clinically significant weight gain and mean Hammersmith score (3.28) was higher showing positioning positively affected tone and flexion scores. IMPLICATIONS FOR PRACTICE: With greater structure and consistent attention to developmental positioning, outcomes are positively affected. IMPLICATIONS FOR FUTURE RESEARCH: Further research with larger sample sizes will identify stronger associations and relationships between positioning and outcome measures.


Assuntos
Tempo de Internação/estatística & dados numéricos , Tono Muscular , Enfermagem Neonatal/métodos , Posicionamento do Paciente/métodos , Ganho de Peso , Feminino , Estudo Historicamente Controlado , Humanos , Lactente Extremamente Prematuro , Recém-Nascido , Recém-Nascido Prematuro , Capacitação em Serviço , Unidades de Terapia Intensiva Neonatal , Masculino , Enfermagem Neonatal/educação , Terapeutas Ocupacionais/educação , Profissionais de Enfermagem Pediátrica/educação , Projetos Piloto , Melhoria de Qualidade
14.
Worldviews Evid Based Nurs ; 16(1): 60-69, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30609254

RESUMO

BACKGROUND AND AIMS: Accumulation of real-world evidence from practice-based perinatal nurse home visits to pregnant women with diabetes prompted this translational perinatal health disparities research. Given the global diabetes epidemic, this academic-community partnered research team is studying the utilization, processes, and outcomes of this understudied model of perinatal nurse home visiting that provide home-based enhanced diabetes care to pregnant women. Because the nursing records provide the rich source of data for the study, our aim is to provide an in-depth description of the Philadelphia Pregnancy and Diabetes Home Visiting (PPD-HV) research database developed from data in the longitudinal nursing records. METHODS: This descriptive study uses retrospective data abstracted from paper-based perinatal nurse home visiting clinical records to create the PPD-HV, a HIPAA compliant, secure REDCap electronic research database. The sample includes 248 urban, pregnant women with diabetes who received a total of 1,644 home visits during the year 2012. The setting was Philadelphia, a large metropolitan city in the northeastern part of the United States. The PPD-HV database followed the information fields of the paper-based clinical nursing forms, which were originally designed by following the Omaha System to guide documenting the nursing process used in caring for patients in their homes. RESULTS: Using REDCap, the PPD-HV research database is robust with 239 variables and captures longitudinal clinical nursing data. Among the pregnant women with diabetes receiving nurse home visits, the mean age was 30.7 years, most were single, and had given birth to other children. LINKING EVIDENCE TO ACTION: Real-world clinical nursing practice data provide a rich source of research data to advance understandings about this model of enhanced diabetes care and the pregnant women with diabetes receiving the care. Considering the global epidemic of diabetes, this is a perinatal nurse home visiting model to replicate and evaluate.


Assuntos
Bases de Dados Factuais/normas , Diabetes Mellitus/enfermagem , Prática Clínica Baseada em Evidências/métodos , Serviços de Assistência Domiciliar/tendências , Enfermagem Neonatal/normas , Adulto , Bases de Dados Factuais/tendências , Prática Clínica Baseada em Evidências/estatística & dados numéricos , Feminino , Humanos , Enfermagem Neonatal/métodos , Philadelphia , Gravidez , Estudos Retrospectivos
15.
Rev. pesqui. cuid. fundam. (Online) ; 11(1): 80-87, jan.-mar. 2019.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-968598

RESUMO

Objetivo: Analizar el conocimiento de los profesionales de enfermería en la realización de las estrategias para el manejo clínico de la lactancia materna. Método: Descriptivo, exploratorio, cualitativo, siendo 47 participantes de enfermería de las maternidad públicas en la Región Metropolitana II en el estado de Río de Janeiro, los datos fueron recolectados por medio de entrevista semiestructurada, los datos recogidos se sometieron a análisis de contenido en modo temático. En el análisis, hemos decidido por la formulación de categorías temáticas. Resultados: El manejo clínico de la lactancia materna muestra los conocimientos teóricos y científicos sobre la lactancia materna por los profesionales de enfermería, además de ser facilitadores de la práctica de lá lactancia materna, intervenido en daños y perjuicios resultantes de la práctica de la lactancia materna inadecuada. Conclusión: Se observó que los profesionales de enfermería fueron capacitadas con conocimientos y habilidades necesarias para promover la salud de lãs mujeres y niños para el éxito de la lactancia materna


Objective: To analyze the knowledge of nurses in carrying out the strategies for clinical management of breastfeeding. Method: A descriptive, exploratory qualitative study, with forty participants and seven nurses from public hospitals in the Metropolitan Region II of the State of Rio de Janeiro, interviewed based on a semi-structured interview, and the data collected subjected to content analysis in the thematic mode. In the analysis, we opted for the formation of thematic categories. Results: In the clinical management of breastfeeding shows the theoretical and scientific knowledge about breastfeeding by nurses, and are they facilitators of breastfeeding practice, intervening in injuries resulting from inappropriate practice of breastfeeding. Conclusion: It was noticed that nurses are empowered with competence and skills required to promote the health of women and children for the sake of successful breastfeeding


Objetivo: Analisar o conhecimento dos enfermeiros na realização das estratégias para o manejo clínico da amamentação. Método: Estudo descritivo, exploratório, qualitativo, sendo participantes 47 enfermeiros das maternidades públicas da Região Metropolitana II do Estado do Rio de Janeiro, entrevistados com base em um roteiro de entrevista semi estruturada, sendo os dados coletados submetidos à análise de conteúdo na modalidade temática. Na análise, optou-se pela formulação de categorias temáticas. Resultados: No manejo clínico do aleitamento materno, evidencia-se o conhecimento teórico e científico acerca da amamentação pelos enfermeiros, além de serem eles facilitadores da prática da amamentação, intervindo nos agravos resultantes da prática do aleitamento materno inadequado. Conclusão: Percebeu-se que os enfermeiros estão capacitados com competência e habilidades necessárias para favorecer a saúde da mulher e da criança em prol do sucesso da amamentação


Assuntos
Humanos , Masculino , Feminino , Aleitamento Materno , Enfermagem Neonatal/métodos , Enfermagem Neonatal/tendências , Saúde da Mulher
16.
J Clin Nurs ; 28(5-6): 1022-1031, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30302843

RESUMO

AIM: This discursive paper aims to bring to the foreground the ongoing influence of Cartesian dualism and other important contextual complexities on breastfeeding in the neonatal intensive care unit (NICU). BACKGROUND: Breastfeeding is widely supported as the optimal form of nutrition for the first 6 months of life and beyond. Amidst a myriad of contextual factors, current breastfeeding rates are below globally targeted goals. For premature and/or critically ill infants, the importance of receiving breast milk is often encouraged based on its immunological and nutritive benefits as opposed to the entirety of the breastfeeding interaction, underscoring the influence of dualism in the NICU. DESIGN: The impact of Cartesian dualism and other sociocultural underpinnings of breastfeeding focused within the NICU environment are illustrated through a critical, philosophical discussion. METHODS: Relevant historical context is provided followed by an overview of the realities of contemporary breastfeeding. These are presented as a frame of reference for the NICU breastfeeding experiences currently encountered by many mothers of preterm and critically ill neonates, further illustrated using a clinical exemplar as well as the author's own observations from neonatal nursing practice. RELEVANCE TO CLINICAL PRACTICE: Shifting away from a dualistic approach requires rethinking breastfeeding support interactions between NICU nurses and mothers. To address the disembodied and often mechanistic approach to care inherent in the dominant Western medical model, a relational approach to breastfeeding support in the NICU is suggested and discussed. CONCLUSION: Future research from a more critical lens is needed to examine the complex dynamics involved when nurses and mothers are negotiating decisions and processes related to infant feeding. In focusing on the relational dimensions of the breastfeeding experience, nurses can resist the dualistic influence and dominant discourses impacting infant feeding and motherhood in the 21st century.


Assuntos
Aleitamento Materno , Lactação , Enfermagem Neonatal/métodos , Adulto , Feminino , Humanos , Lactente , Recém-Nascido , Unidades de Terapia Intensiva Neonatal/organização & administração , Mães , Filosofia
17.
Adv Neonatal Care ; 19(1): 65-72, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28953056

RESUMO

BACKGROUND: Parental presence in the neonatal intensive care unit (NICU) is essential for families to participate in infant care and prepare them to transition from hospital to home. Nurses are the principal caregivers in the NICU. The nurse work environment may influence whether parents spend time with their hospitalized infants. PURPOSE: To examine the relationship between the NICU work environment and parental presence in the NICU using a national data set. METHODS: We conducted a cross-sectional, observational study of a national sample of 104 NICUs, where 6060 nurses reported on 15,233 infants cared for. Secondary analysis was used to examine associations between the Practice Environment Scale of the Nursing Work Index (PES-NWI) (subscale items and with a composite measure) and the proportion of parents who were present during the nurses' shift. RESULTS: Parents of 60% (SD = 9.7%) of infants were present during the nurses' shift. The PES-NWI composite score and 2 domains-Nurse Participation in Hospital Affairs and Manager Leadership and Support-were significant predictors of parental presence. A 1 SD higher score in the composite or either subscale was associated with 2.5% more parents being present. IMPLICATIONS FOR PRACTICE: Parental presence in the NICU is significantly associated with better nurse work environments. NICU practices may be enhanced through enhanced leadership and professional opportunities for nurse managers and staff. IMPLICATIONS FOR RESEARCH: Future work may benefit from qualitative work with parents to illuminate their experiences with nursing leaders and nurse-led interventions in the NICU and design and testing of interventions to improve the NICU work environment.


Assuntos
Cuidado do Lactente/métodos , Unidades de Terapia Intensiva Neonatal , Terapia Intensiva Neonatal/psicologia , Enfermagem Neonatal/métodos , Pais/psicologia , Estudos Transversais , Feminino , Humanos , Cuidado do Lactente/psicologia , Recém-Nascido , Masculino , Papel do Profissional de Enfermagem , Relações Enfermeiro-Paciente , Pesquisa em Avaliação de Enfermagem
18.
J Pediatr Nurs ; 44: e36-e44, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30420167

RESUMO

PURPOSE: To explore factors predicting neonatal nurses' attitude towards end-of-life decisions in neonates, and to describe the nurses' viewpoints on end-of-life decisions; barriers to end-of-life decision making; parents', nurses', and ethical committees' involvement in the process of end-of-life decision making; and who should regulate end-of-life decisions regarding neonates. DESIGN AND METHODS: A cross-sectional descriptive correlational design was applied. Sample included 279 neonatal nurses working in 24 neonatal intensive care units across Jordan. Data were collected using internationally-accepted questionnaires. Descriptive and inferential statistics were applied in data analysis. RESULTS: Most nurses perceived that everything possible should be done to ensure a neonate's survival, even when they suffer severe prognosis (80%) and irrespective of the burden of the child's disability on the family (75%). Almost all nurses (96%) were against administering drugs with the purpose of ending the neonate's life and 63% were against continuing current treatment without adding others. The nurses' perceived effect of end-of-life decisions on their everyday life, and the importance of religious values to the nurses' personal lives, significantly predicted pro-life attitude scores. According to 80% of the nurses, legal constraints were the most significant barriers to end-of-life decision making. The majority of nurses (84%) indicated that non-religious bodies should establish end-of-life regulations for neonates. CONCLUSION: Generally, nurses' attitude was supportive of life saving decisions at end-of-life, regardless of the survival odds and the probable health outcomes of the neonates. PRACTICE IMPLICATIONS: Neonates' end-of-life care, and parents' bereavement care, should be standard practices in every NICU, worldwide.


Assuntos
Atitude do Pessoal de Saúde , Tomada de Decisão Clínica/métodos , Enfermagem Neonatal/métodos , Assistência Terminal/métodos , Adulto , Tomada de Decisão Clínica/ética , Estudos Transversais , Países em Desenvolvimento , Feminino , Humanos , Recém-Nascido , Unidades de Terapia Intensiva Neonatal/ética , Jordânia , Masculino , Pessoa de Meia-Idade , Enfermagem Neonatal/ética , Assistência Terminal/psicologia
19.
J Pediatr Nurs ; 45: e2-e8, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30581066

RESUMO

PURPOSE: The purpose of this study was to describe and understand the experiences of mothers of extremely preterm infants during the first twelve months at home following discharge from a neonatal intensive care unit. DESIGN AND METHODS: A qualitative, interpretative approach using Gadamer's philosophical hermeneutics was carried out. One focus group and fifteen in-depth, semi-structured interviews were conducted twelve months after hospital discharge. Responses were recorded, transcribed and analyzed using computer-assisted qualitative data analysis. RESULTS: The study´s participants were twenty women. The following themes emerged from the data analysis: 1) 'The journey home: the discharge process', which included the sub-themes 'escaping the hospital environment: between desire and fear' and 'preparing parents for hospital discharge: practice and formal support'; and 2) 'The difficulty of living with an extremely preterm infant', including the sub-themes 'the challenge of an unexpected form of childcare', 'overprotection of and bond with a child with special needs' and 'disturbance in the social/familiar setting: when a mother becomes a nurse'. CONCLUSIONS: The process of hospital discharge and the first months at home are difficult. The birth and care of an extremely preterm infant affect the mothers' quality of life as well as their family and social life. Practice and early discharge programmes can make the discharge process easier. PRACTICE IMPLICATIONS: The knowledge and understanding of the experience of mothers of extremely preterm infants in the first months at home after hospital discharge could help healthcare professionals to develop educational strategies and counselling interventions in accordance with the mothers' needs.


Assuntos
Lactente Extremamente Prematuro/psicologia , Relações Mãe-Filho , Mães/psicologia , Apego ao Objeto , Adulto , Feminino , Humanos , Cuidado do Lactente/métodos , Recém-Nascido , Enfermagem Neonatal/métodos , Alta do Paciente , Pesquisa Qualitativa , Qualidade de Vida
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