目的 探讨基于主客体互倚模型的住院早产儿家庭支持计划对早产儿父母产后抑郁、母乳喂养及家庭亲密度和适应性的影响。方法 采用便利抽样法,选择 2024年3月—9月在湖南省某三级甲等综合医院新生儿监护室住院的97例早产儿及其家庭,按随机数字表法分为试验组和对照组,对照组实施健康教育、早期活动指导等常规护理措施;试验组实施基于主客体互倚模型的家庭支持计划。于早产儿出院后1个月收集母乳喂养情况,产后42天收集早产儿父母产后抑郁情况及家庭亲密度和适应性得分情况。结果 干预过程中5组家庭退出,最终试验组49例、对照组43例早产儿家庭完成研究。试验组早产儿纯母乳喂养、混合喂养、配方奶粉喂养分别为39、7、3例,对照组为24、15、4例,试验组早产儿的母乳喂养情况优于对照组（Z=2.323,P<0.05）;试验组38例、对照组22例父母均无抑郁,试验组父母产后抑郁的检出率低于对照组（χ2=7.450,P<0.05）;试验组家庭的亲密度得分为（56.50±8.59）,高于对照组的（45.65±6.58）（t=6.827,P<0.05）,试验组家庭的适应性得分为（46.80±10.43）,高于对照组的（40.77±9.01）（t=2.974,P=0.004）。结论 基于主客体互倚模型的住院早产儿家庭支持计划可以提升早产儿母乳喂养成功率,降低早产儿父母罹患产后抑郁的概率,提升家庭亲密度与适应性,可以在临床上借鉴推广。
Abstract
Objective To explore the effects of a family support program for hospitalized preterm infants based on Actor-Partner Interdependence Model on postnatal depression, breastfeeding, and Family Intimacy and Adaptability of preterm infants' parents. Methods A convenience sampling method was used to select 97 cases of preterm infants and their families who were hospitalized in the neonatal care unit of a tertiary general hospital in Hunan Province from March to September 2024, and divided into the experimental group and the control group according to the method of randomized numerical tables. The control group implemented routine nursing measures such as health education and early activity guidance; the experimental group implemented a family intervention program based on Actor-Partner Interdependence Model. Breastfeeding was collected at 1 month after discharge of preterm infants, and postnatal depression and Family Intimacy and Adaptability scores of preterm infants' parents were collected at 42 days postpartum. Results Five groups of families dropped out during the intervention, and ultimately 49 families with preterm infants in the experimental group and 43 families with preterm infants in the control group completed the study. Exclusive breastfeeding, mixed feeding, formula feeding were 39, 7, and 3 cases in the experimental group and 24, 15, and 4 cases in the control group, respectively, and the breastfeeding of preterm infants in the experimental group was better than that in the control group (Z=2.323, P<0.05); 38 cases of parents in experimental group and 22 cases of parents in control group were free of depression, and the detection rate of postnatal depression in preterm infants' parents was lower in the experimental group than in the control group (χ2=7.450, P<0.05); the intimacy score of families in the experimental groups was (56.50±8.59), higher than that of families in the control group (45.65±6.58) (t=6.827, P<0.05), and the adaptability score of families in the experimental groups was (46.80±10.43), higher than that of families in the control group (40.77±9.01) (t=2.974, P=0.004). Conclusion The family support program for hospitalized preterm infants based on Actor-Partner Interdependence Model can improve the breastfeeding success rate of preterm infants, reduce the probability of postnatal depression in preterm fathers and mothers, and improve family intimacy and adaptability, which can be used in clinical practice.
关键词
早产儿 /
产后抑郁 /
母乳喂养 /
主客体互倚模型 /
家庭亲密度与适应性
Key words
preterm infants /
postpartum depression /
breast-feeding /
actor-partner interdependence model /
family intimacy and adaptability
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基金
2023年度常德市科技创新指导性项目“改良式机械辅助排痰并俯卧位通气对治疗NRDS效果观察研究”（2023ZD81）
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