早產兒進食準備評估工具之綜論

早產兒因生理發展未臻成熟，其吸吮、呼吸、吞嚥功能協調差，故初始進食時常常出現呼吸暫停及嗆咳而導致生命徵象不穩定。早產兒之口腔進食經驗需配合其發展階段逐步學習，護理人員需要精準評估早產兒由管灌餵食轉換到經口進食之時機，提供正向且安全的口腔進食經驗，則更顯重要。本文介紹三種具信效度之早產兒進食評估工具，並搭配臨床研究數據說明其臨床應用情形，包含：(1)新生兒口腔運動評估量表（Neonatal Oral Motor Assessment Scale），藉由觀察非營養吸吮表現與進食前兩分鐘的吸吮狀態來評估口腔運動能力；(2)早產兒口腔進食準備度量表（Premature Oral Feeding Readiness Assessment Scale），適用於早產兒開始經口進食前之口腔準備度評估；(3)早產兒早期進食技巧評估量表（Early Feeding Skills），適用於評估早產兒經口進食過程之進食技巧。藉此提供臨床相關應用成效供使用參考，並使護理人員更順暢地協助早產兒達到獨立口腔進食，得以早日出院返家。

Due to their underdeveloped physiological maturity, preterm infants often face challenges related to sucking, breathing, and swallowing coordination during initial feeding. This lack of coordination may lead to episodes of apnea and choking, resulting in unstable vital signs. Preterm infants with this issue must gradually learn oral feeding skills appropriate to their developmental stage. Registered nurses play a critical role in assessing the right time to transition from tube to oral feeding and in providing a safe and positive oral feeding experience. In this article, three validated assessment tools for feeding premature infants are introduced, accompanied by clinical research data demonstrating their use in clinical practice. These three tools include: (1) the Neonatal Oral Motor Assessment Scale, which is applied to evaluate oral motor skills using observations of nonnutritive sucking and the sucking state during the two minutes before feeding; (2) the Premature Oral Feeding Readiness Assessment Scale, which is used to assess readiness for oral feeding in preterm infants; and (3) the Early Feeding Skills assessment, which is used to evaluate the oral feeding skills of preterm infants. These tools aid nurses in helping preterm infants achieve independent oral feeding, facilitating earlier discharge and return to home. The clinical implications and effectiveness of these tools are also discussed to provide to nurses the means and confidence necessary to apply them appropriately in clinical settings.