围产期息护理模式的系统审查:未来的挑战和机遇
Anna Zanin1,2, Annalisa Salerno3, Maria Elena Cavicchiolo4
1Women, Children and Adolescent Department, HUG Children's Hospital, Hopitaux Universitaires de Genève, Geneva, Switzerland. anna.zanin@hug.ch.
围产期息护理 (PnPC) 的模型在全球范围内各不相同. 新生儿重症监护室 (NICU) 的多学科团队早期整合的PNPC可以改善婴儿终身护理和家庭支持,尽管证据质量各不相同.
科学领域:
- 新生儿科学 新生儿科学
- 抚慰性护理是一种缓解性护理.
- 医疗保健提供模式 医疗保健提供模式
背景情况:
- 围产期缓解护理 (PnPC) 对于优化极度早产婴儿和患有生命限制条件的婴儿的生活质量至关重要.
- 现有的PNPC实施显示了模型,时间和团队组成的全球显著差异.
- 建议早期整合PNPC以改善对婴儿,家庭和医疗保健团队的支持.
研究的目的:
- 系统地审查和比较新生儿重症监护室 (NICU) 实施的围产期息治疗 (PnPC) 模型.
- 确定最佳实践,挑战和改善PNPC交付的领域.
- 评估不同PNPC模型对婴儿和家庭结果的影响.
主要方法:
- 在PubMed,Embase和CINAHL上对过去十年的研究进行系统的文献搜索,遵循PRISMA指南.
- 包括14项描述PNPC交付模型的观察性研究,并提取研究设计,模型特征,团队组成和结果的数据.
- 综合提取的数据来比较不同的PNPC模型并确定关键发现.
主要成果:
- 确定了三种主要的PNPC模型:咨询型,整合型和团队协作型,大多数研究来自美国.
- 咨询模式显示推率有所提高,但可能存在延迟,而整合和协作模式提供了更持续的护理.
- 早期的PNPC整合,特别是在产前,与更好的结果相关,如更高的家长满意度,更明确的护理目标和更少的积极的生命终端干预措施.
结论:
- 由多学科团队提供的早期和综合的PNPC显著改善了NICU内的终身护理和家庭支持.
- 实践中的持续异质性和缺乏高级证据需要进一步调查.
- 未来的研究应侧重于干预设计,多样化的地理代表性和标准化,以家庭为中心的结果,以制定基于证据的PNPC指导方针.
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