Comparisons of Three Measures of Maternal Engagement Activities in the Neonatal Intensive Care Unit.
Comparisons of Three Measures of Maternal Engagement Activities in the Neonatal Intensive Care Unit.
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新生儿重症监护病房母亲参与活动的三种措施的比较。
DOI：
10.1097/nnr.0000000000000582
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发表时间：
2022-05-01
期刊：
影响因子：
2.5
通讯作者：
Neu, Madalynn
中科院分区：
文献类型：
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作者：
Greenfield, Jennifer C.;Weikel, Blair W.;Bourque, Stephanie L.;Hwang, Sunah S.;Klawetter, Susanne;Roybal, Kristi L.;Palau, Mauricio A.;Scott, Jessica;Shah, Pari;Brown, Kyria;Neu, Madalynn
母亲与住院早产儿的互动被认为是新生儿重症监护病房（NICU）治疗的一个重要方面。然而，衡量母亲互动并没有金标准，而且用于衡量母亲时间的各种方法都存在记录在案的局限性。
本研究试图比较三种衡量母亲互动的方法（一项包含5个条目的母亲横断面调查、时间使用日记以及电子健康记录[EHR]），以确定这些方法是否能获取一致的数据以及在检测到的互动衡量差异方面是否存在一致的模式。
母亲互动被定义为在NICU看望婴儿所花费的时间（在场）；怀抱（母亲怀抱婴儿或通过袋鼠式护理[KC]）；以及护理（例如，洗澡、换尿布）。在研究登记时，即入院至少2周后，在两个三级NICU和一个四级NICU进行了估计母亲每日互动情况的调查。然后母亲们填写每日时间使用日记，直至婴儿出院。数据也从参与者的电子健康记录中收集，这些记录由护理人员记录。对母亲互动活动的三种衡量方法进行成对分析时使用了威尔科克森符号秩检验。
共有146名参与者拥有所有三种测量类型的数据，并被纳入分析。在三级NICU（n = 101）中，电子健康记录数据显示在所有互动活动上花费的时间明显多于日记数据。在四级数据中，当比较电子健康记录数据和调查数据时，只有怀抱时间的差异具有显著性，母亲报告进行袋鼠式护理的时间更多，而怀抱婴儿的时间更少。电子健康记录数据与日记数据的比较显示，除袋鼠式护理外，在所有活动上花费的时间都更多。
在大多数情况下，电子健康记录中衡量的互动活动所花费的时间高于调查或时间使用日记中的时间。由于数据收集的局限性，无法确定测量的准确性，而且也没有用于比较的金标准。然而，这些研究结果有助于持续努力开发最有价值和最准确的衡量母亲互动的策略——母亲互动是母婴健康的一个重要预测因素。
Mothers’ engagement with their hospitalized preterm infant(s) is recognized as an important aspect of treatment in neonatal intensive care units (NICU). However, no gold standard exists for measuring maternal engagement, and the various methods used to measure mothers’ time have documented limitations. This study sought to compare three measurement methods of maternal engagement (a 5-item maternal cross-sectional survey, time-use diaries, and electronic health records [EHRs]) to identify whether these methods capture consistent data and patterns in detected differences in measures of engagement. Maternal engagement was defined as time spent visiting the infant in the NICU (presence); holding (blanket holding in the mother’s arms or by kangaroo care [KC]); and caregiving (e.g., bathing, changing diapers). The survey estimating daily maternal engagement was administered in two level III NICUs and one level IV NICU at study enrollment, at least 2 weeks after admission. Mothers then completed the daily time-use diaries until infant discharge. Data also were collected from participants’ EHRs, charted by nursing staff. Wilcoxon signed-rank tests were used for pairwise analysis of the three measures for maternal engagement activities. A total of 146 participants had data across all three measurement types and were included in the analysis. In the level III NICUs (n = 101), EHR data showed significantly more time spent with all engagement activities than the diary data. In the level IV data, only differences in time holding were significant when comparing EHR data with survey data, with mothers reporting more time doing KC and less time blanket holding. Comparison of EHR data with diary data showed more time in all activities except KC. In most cases, time spent in engagement activities measured in the EHR was higher than in the surveys or time-use diaries. Accuracy of measurements could not be determined due to limitations in data collection, and there is no gold standard for comparison. Nevertheless, findings contribute to ongoing efforts to develop the most valuable and accurate strategies for measuring maternal engagement—a significant predictor of maternal and infant health.