發展支持性照護在臨床之應用──以早產兒洗澡為例

The Application of Developmentally Supportive Care in Clinical Practice: The Example of Bathing Preterm Infants

隨著新生兒醫療照護系統的進步，早產兒的存活率也漸漸提高，然而某些研究卻顯示早產兒在神經發展障礙的致病率仍然隨著其妊娠週數的減少而增加（趨等，1999）。這些結果使得新生兒加護中心必須由以臨床需求為基礎的照顧轉變為以早產兒行為為基礎的照煩，以便支持早產兒的神經成熟度、社交與情緒的發展，也就是發展支持性的照護。本篇文章主要是在強調發展支持性照護在促進早產兒健康與發展上的重要，並闡述支持性措施包括促進早產兒的穩定性、姿勢的支持、照護活動的時間安排與執行速度（Becher, Grunwald, &Brazy, 1999），最後將這個照護的概念與原則應用在幫早產兒洗澡的實務過程中，藉由洗澡的實例期望將發展支持性照護實際應用到其他醫療照護的活動，讓早產兒在接受任何醫療照護處置時能表現得更穩定更舒適而有更健康、更美好的未來。

Improvements in of medical care in Taiwan have led to rapid increases in the survival rates of preterm infants. However, some studies indicate that among preterm infants, neurodevelopmental impairments increase as gestational ages decrease. The results suggest that the focus of neonatal intensive caregiving has to shift from clinical-based care to cue-based care, and support the infants' neuromaturation and social and emotional development. That is to implement developmentally supportive care. The major purposes of this paper are to emphasize the importance of developmentally supportive care in improving the health and development of preterm infants, describe the elements of supportive interventions, and apply the concepts of developmentally supportive care to bathing preterm infants. Through the example of bathing preterm infants, supportive interventions can also be incorporated into other medical care procedures in clinical practice. Through the implementation of developmentally supportive care, these fragile infants are expected to have healthier outcomes and a healthier future.