极低出生体质量儿母亲初乳管理的质性研究

Management of mother′s colostrum for very low birth weight infant: a qualitative study

  • 摘要:
    目的 探讨母婴分离情况下新生儿重症监护病房(NICU)极低出生体质量儿母亲初乳管理相关问题,为实施初乳口腔免疫治疗和早期微量喂养提供参考。
    方法 参照解释性描述方法开展质性研究,采用目的抽样法选取24位NICU极低出生体质量儿的母亲作为访谈对象,开展一对一半结构化深度访谈。逐字记录每次访谈的内容,采用持续比较的方法进行分析。
    结果 极低出生体质量儿母亲初乳管理过程中所遇困难可归纳为5个主题: ①早吸乳、规律性吸乳不能有效实施; ②初乳采集技巧及吸乳设备使用方法掌握不足; ③压力及心理支持需引起关注; ④初乳运送质量无法控制; ⑤缺乏系统化初乳管理的健康教育。
    结论 医护人员应以临床实践为基础,在初乳分泌、收集、运送、健康教育等环节应用系统化管理措施给予产妇支持和帮助,解决其初乳管理过程中遇到的问题,从而提高极低出生体质量儿初乳口腔免疫治疗和早期微量喂养的实施率,促进其生长发育。

     

    Abstract:
    Objective To explore the problems of colostrum management in mothers of very low birth weight infants in the neonatal intensive care unit (NICU) under the condition of mother-infant separation so as to provide reference for the colostrum oral immunization treatment and early micro-feeding.
    Methods Qualitative research was carried out based on explanatory descriptive methods, and 24 mothers of very low birth weight infants were selected from the NICU as interviewees. One to one structured in-depth semi-structured interviews were performed, and each sentence of every interview was recorded. The analysis was carried out by continuous comparison.
    Results Five difficulties during colostrum management in mothers of very low birth weight infants included ineffective implementation of early and regular milk, lack of knowledge and technical skills in collecting colostrum, attention needed for stress and psychological support, uncontrolled colostrum quality during transfer, and lack of systematic management in health education support of colostrum management.
    Conclusion Medical staff should support and help puerperas by systematic management measures in the early milk secretion, collection, transport, health education application, solve the problems encountered during the colostrum management on the basis of clinical practice, so as to improve the implementation rates of oral immunotherapy and early microfeeding for very low birth weight infant and promote the growth and development.

     

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