出院準備對早產兒母親照護知識、能力及母育信心之成效

Effects of Discharge Planning on the Knowledge, Competence, and Maternal Confidence of the Mother with Preterm Infant

背景：早產兒於生理上較新生兒未成熟，早產兒母親需學習更多的照顧技巧；護理指導介入能提升母親與早產兒有更好的互動，目前國內有關之研究較少。因此，期望探討以社會認知理論內之自我效能為基礎之出院準備服務介入對早產兒母親照護知識、能力及信心之成效。
方法：採前後測準實驗研究設計與方便取樣，收集四家區域醫院以上之新生兒中重度病房，對象為早產兒母親共63位，隨機分配至實驗組32位、對照組31位；實驗組接受病房的一般常規指導與出院準備，對照組只接受病房的一般常規指導。研究地點於早產兒轉至新生兒中重度病房進行前測，出院當日及返家一週進行後測1與後測2，而研究結果以廣義估計方程模式(Generalized Estimating Equations, GEE)進行統計分析。
結果：研究結果顯示二組在照護知識、照護能力及母育信心於後測1並無顯著提昇(p > .05)，但於後測2，實驗組較對照組於照護知識、能力及母育信心均顯著提昇(p < .05)；再經加入控制變項後，實驗組較對照組於後測1與後測2其在照護知識、照護能力及母育信心均顯著提昇(p < .05)。
結論：故以班杜拉(Albert Bandura)為基礎之出院準備介入，可提升早產兒母親照護能力，可作為醫院規畫早產兒照護課程之參考。

Background : Compared to full-term infants, preterm infants are physiologically immature. Thus, the mothers of preterm infants must acquire more caring skills than the mothers of full-term infants do. Implementing nursing interventions may improve the interactions between mothers and preterm infants. However, few local studies had been conducted before. The aim of this study was to evaluate the effect of discharge planning intervention on the caring knowledge, caring ability, and maternal confidence of mothers of preterm infants, based on the Social Cognitive Theory of Self-efficacy.
Methods: The study was conducted with a pre- and post-test quasi-experimental design. Sixty-three mothers and their preterm infants admitted to the neonatal intermediate-to-intensive care units of four regional hospitals were recruited. The participants were randomly assigned to the experimental group (n=32) and control group (n=31). The participants in the experimental group received general instructions and discharge planning, while the participants in the control group only received general instructions. The pre-test was conducted when the preterm infants were transferred to the neonatal intermediate-to-intensive care units, the post-test 1 was conducted on the day of discharge, and the post-test 2 was conducted one week after discharge. The test results were analyzed by generalized estimating equations.
Results: The results indicated that overall, the participants in both groups did not improve considerably in their caring knowledge, caring ability, and maternal confidence at post-test 1. However, the participants in the experimental group showed considerable improvements in their caring knowledge, caring ability, and maternal confidence compared with those in the control group at post-test 2. When potential difference were controlled for , the participants in the experimental group exhibited considerable improvements in their caring knowledge, caring ability, and maternal confidence compared with those in the control group at post-test 1 and 2.
Conclusion: Discharge planning based on Social Cognitive Theory proposed by Bandura may improve the caring ability of mothers of preterm infants and may be used as a reference for hospitals’ preterm infant care programs.