改善社区围产期息护理:一个基于人口的区域性研究
Kohei Takashima1,2, Masahito Hitosugi3, Masahito Yamamoto1,4
1Department of Legal Medicine, Shiga University of Medical Science, Tsukinowa, Seta, Otsu, Shiga, 520-2192, Japan.
Maternal and child health journal
|September 13, 2025
概括
社区围产期息护理面临的挑战在于支持有生命危险胎儿疾病的家庭. 需要改善决策支持和专业护理,以获得更好的结果和家庭福祉.
科学领域:
- 围产儿医学 围产儿医学
- 抚慰性护理是一种缓解性护理.
- 公共卫生 公共卫生
背景情况:
- 围产期息护理 (PPC) 对患有危及生命的胎儿疾病的家庭至关重要,需要量身定制的,以社区为基础的系统.
- 共享决策和多学科的护理是有效的PPC的重要组成部分.
- 医疗资源的变化需要可适应的PPC模型.
研究的目的:
- 通过使用儿童死亡评估 (CDR) 数据,检查区域社区中PPC交付的现状和挑战.
- 在PPC中分析决策过程,护理计划和家庭护理过渡.
- 为了比较家庭选择舒适护理与重症监护之间的护理过程和结果.
主要方法:
- 使用2018-2020年区域CDR数据的回顾性队列研究,在日本石家庄县.
- 从18岁以下有资格条件的儿童的围产中心和合作医院收集的数据.
- 分析的重点是17个案例,讨论了对危及生命的胎儿疾病的护理计划.
主要成果:
- 在17个病例中,65%选择了舒适护理,35%选择了重症监护.
- 舒适护理组经历了显著更长的决策时间 (中位数为29天而不是9天).
- 缺乏专门的心理和息护理支持;17名患者中只有4人被送回家.
结论:
- 实施基于社区的PPC带来了重大挑战,包括长时间的决策和对家庭的心理负担.
- 个性化支持至关重要,因为护理计划会影响家庭负担.
- 由于缺乏专业支持,家庭护理过渡率低,因此需要对PPC系统进行重大改进.
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