Parent Activation in the Neonatal Intensive Care Unit.
Parent Activation in the Neonatal Intensive Care Unit.
复制标题
新生儿重症监护病房的家长激活。
DOI：
10.1055/s-0041-1736294
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发表时间：
2023
影响因子：
2
通讯作者：
Jackson,GretchenP
中科院分区：
文献类型：
--
作者：
Skeens,Ryan;Cavanaugh,KerriL;Cronin,Robert;Chen,QinGxia;Liu,Yuhan;Huth,Hannah;Jackson,GretchenP
患者激活是管理自己健康的知识、技能和信心;父母激活是与父母管理孩子健康的能力相关的类似概念。成人的激活是一个可改变的风险因素，与临床结局和医疗保健利用相关。我们研究了激活在住院新生儿的父母观察时间趋势和社会人口学特征，新生儿的特点，和outcomes.Study DesignParticipants包括新生儿的成年父母承认在一个学术医学中心的一个水平，IV新生儿重症监护室。在入院、出院和出院后30天，使用患者激活测量（P-PAM）的10项父母版本测量激活。与社会人口统计学变量，健康素养，临床变量，和卫生保健utilizations.ResultsA共96成人64新生儿入组。入院时的总体平均P-PAM评分为81.8（标准差[SD] = 18），出院时为88.8（SD = 13），30天随访时为86.8（SD = 16）。使用线性混合回归模型，P-PAM评分与测量时间显著相关。较高的P-PAM评分与较高的健康素养（p= 0.002）和较高的母亲相比，父亲（p= 0.040）。入院P-PAM评分与社会人口学特征无显著相关性。有手术诊断的新生儿父母的得分比没有手术诊断的新生儿父母的得分低，差异有统计学意义（p= 0.003）。出院P-PAM评分和新生儿的住院时间或其他指标的疾病severity.ConclusionParental激活在新生儿重症监护室设置高于成人和有限的儿科文献报道，分数增加，从入院到出院和30天出院后。健康素养较高的母亲和父母的激活程度较高。还需要进行更多更大规模的研究，以确定父母的激活是否与成人的长期医疗保健结果相关。
ObjectivePatient activation is the knowledge, skills, and confidence to manage one's health; parent activation is a comparable concept related to a parent's ability to manage a child's health. Activation in adults is a modifiable risk factor and associated with clinical outcomes and health care utilization. We examined activation in parents of hospitalized newborns observing temporal trends and associations with sociodemographic characteristics, neonate characteristics, and outcomes.Study DesignParticipants included adult parents of neonates admitted to a level-IV neonatal intensive care unit in an academic medical center. Activation was measured with the 10-item Parent version of the Patient Activation Measure (P-PAM) at admission, discharge, and 30 days after discharge. Associations with sociodemographic variables, health literacy, clinical variables, and health care utilization were evaluated.ResultsA total of 96 adults of 64 neonates were enrolled. The overall mean P-PAM score on admission was 81.8 (standard deviation [SD] = 18), 88.8 (SD = 13) at discharge, and 86.8 (SD = 16) at 30-day follow-up. Using linear mixed regression model, P-PAM score was significantly associated with timing of measurement. Higher P-PAM scores were associated with higher health literacy (p= 0.002) and higher in mothers compared to fathers (p= 0.040). There were no significant associations of admission P-PAM scores with sociodemographic characteristics. Parents of neonates who had a surgical diagnosis had a statistically significant (p= 0.003) lower score than those who did not. There were no associations between discharge P-PAM scores and neonates' lengths of stay or other indicators of illness severity.ConclusionParental activation in the NICU setting was higher than reported in the adult and limited pediatric literature; scores increased from admission to discharge and 30-day postdischarge. Activation was higher in mothers and parents with higher health literacy. Additional larger scale studies are needed to determine whether parental activation is associated with long-term health care outcomes as seen in adults.Key Points