從發展支持性照護談早產兒行為狀態評估

Assessment of Preterm Infant's Behavioral State in Developmentally Supportive Care

即使是非常脆弱的早產兒都有其獨特的行為表現，因此新生兒加護病房提供給早產兒的環境是否合宜，確實是許多臨床醫療專業人員關注且認為需進行評估判斷的重要議題。發展支持性照護主要目的為支持早產兒盡可能穩定、減少傷害性刺激至最低的層次與提供早產兒適當的發展機會。當提供發展性照護時需有三點主要的先決條：具備有關早產兒發展的知識，所有新生兒加護病房醫療專業人員的合作，以及早產兒家庭的參與。本文除闡述發展支持性照護之概念外，亦說明評估早產兒行為狀態及壓力徵象的指引，期能是供照護者建立一致性的早玅兒發展性照護原則。

Even very fragile preterm infants have their unique behaviors; therefore, how the environment of a Neonatal Intensive Care Unit (NICU) can be made most conducive to the healthy development of preterm infants is a great concern and critical issue for many health professionals. The goal of developmentally supportive care is to enhance the preterm infant's stability, reduce harmful stimulation, and provide the most appropriate opportunities for development that is possible. The concept of developmental care has three principal antecedents: knowledge of infant development, collaboration of all professionals in the NICU, and involvement of the family. In addition to clarifying the concept of developmental care, this paper provides guidelines for health professionals to assess preterm infants' behavioral state and signs of stress, and to establish a consistent principle of developmental care for preterm infants.