Nurses' Beliefs and Values about Doing Cue-Based Care in an NICU in Taiwan_

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題名：	Nurses' Beliefs and Values about Doing Cue-Based Care in an NICU in Taiwan
書刊名：	The Journal of Nursing Research
作者：	廖珍娟／陳淑月／尹引弟
作者(外文)：	Liaw, Jen-jiuan／Chen, Shu-yueh／Yin, Ying-ti
出版日期：	2004
卷期：	12:4
頁次：	頁275-286
主題關鍵詞：	以行為暗示為基礎之照顧；早產兒；新生兒加護中心；質性研究；信念；Cue-based care；Preterm infant；NICU；Qualitative research；Belief
原始連結：	連回原系統網址
相關次數：	被引用次數:期刊(2) 博士論文(0) 專書(0) 專書論文(0) 排除自我引用:2 共同引用:0 點閱:25

　　　　　雖然進步的醫療科技已提昇早產兒的存活率，但這些最精密的科技卻也對早產兒產生了一些問題，然而科學對這些高危險性的病人並不是萬靈丹。有愈來愈多的研究報導醫療照護措施往往會引起早產兒生理及行為的窘迫現象。這些研究結果促使新生兒加護中心的照護實務產生改變，嚐試努力減低壓力、加強保護早產兒，以促進早產兒的穩定與發展。本研究使用質性研究的方法來了解護理人員在照顧早產兒加護中心的護士如何照顧這些不成熟的早產兒？護理人員對以行為線索為基礎的照顧之看法如何？及護理人員使用這種照顧方式的程度為何？研究結果產生三個重要論點：（1）適時及有技巧的處理早產兒；（2）提供早產兒及其壓力高的家屬完整性的照顧；（3）良好護理照顧與滿足重症早產兒、家屬、醫生、單位及環境需求之間的關係。研究結果顯示：新生兒加護的照顧方式大部分仍是以臨床需求為主，提供以行為線索為基礎的照顧仍然是有困難的。理由是因照顧者知識缺乏、工作協作性不足及缺少行政系統的支持。為了要改善新生兒加護中心的照護品質及早產兒的發展結果，必須定期教育護理人員以行為線索為基礎的照顧，增進這整個醫療團隊的協作關系，減少非護理的工作量，重整新生兒加護中心的環境，以便提供以行為線索為基礎的理想照顧。

以文找文

　　　　　Although advances in medical technology have increased the survival rate of preterm infants, science is no cure-all for these high-risk patients. A growing number of studies report that caregiving interventions cause physiological and behavioral distress in such infants. The results have prompted changes in caregiving practices, attempting to reduce stress and strengthen protection for the infants, in order to promote their stability and development in the neonatal intensive care unit (NICU). This study uses qualitative research methods to grasp the richness and diversity of nurses’ beliefs and experience in the taking care of preterm infants. Ten groups of questions explore how NICU nurses take care of premature infants, nurses’ perspectives on cue-based care, and the extent to which NICU nurses practice cue-based care. The results generated three themes: (1) timely and skillful management of the preterm infants; (2) compassionate and holistic care for the infants and their highly stressed families; and (3) the relationship between good nursing care and meeting the needs of preterm infants, families, physicians, units, and the environment. It is apparent that the approach to care delivery in NICU practice is still clinical-based, and that there are some obstacles to the delivery of cue-based care. The reasons for this include lack of knowledge, incomplete collaboration with team members, and insufficient support from the administrative systems. To improve the quality of nursing care and preterm infant outcomes, it will be necessary to educate NICU nurses on cue-based care, to enhance collaboration among all team members, to reduce their non-nursing workload, and to re-design NICUs for optimal cue-based care.

以文找文

期刊論文
1.	Als, H.、Gilkerson, L.(1997)。The role of relationhip-based developmentally supportive newborn intensive care in strengthening outcome of preterm infants。Seminars in Perinatology，21(3)，178-189。
2.	Becker, P. T.、Grunwald, P. C.、Brazy, J. E.(1999)。Motor organization in very low birth weight infants during caregiving: Effects of a developmental intervention。Developmental and Behavioral Pediatrics，20(5)，344-354。
3.	Biel, M.、Eastwood, J. A.、Muenzen, P.、Greenberg, S.(1999)。Evolving trends in critical care nursing practice: Results of a certification role delineation study。American Journal of Critical Care，8(5)，285-290。
4.	Brandon, D. H.、Holditch-Davis, D.、Beylea, M.(1999)。Nursing care and the development of sleeping and walking behaviors in preterm infants。Research in Nursing & Health，22，217-229。
5.	Brown, L. D.、Heermann, J. A.(1997)。The effects of developmental care on preterm infant outcomes。Applied Nursing Research，10(4)，190-197。
6.	Buehler, D. M.、Als, H.、Duffy, F. H.、McAnulty, G. B.、Liederman, J.(1995)。Effectiveness of individualized developmental care for low-risk preterm infants: Behavioral and electrophysiological evidence。Pediatrics，96(5)，923-932。
7.	Byers, J. F.(2003)。Components of developmental care and the evidence for their use in the NICU。The American Journal of Maternal/Child Nursing，28(3)，174-180。
8.	Chen, C. H.、Wang, T. M.、Chi, C. S.(2000)。Individualized developmental care in the newborn intensive care unit。Acta Paediatrica Taiwanica，41(3)，119-122。
9.	Cochrane, C. G.(1986)。Vesitbular-proprioceptive and tactile-kinesthetic intervention for premature infants。Physical & Occupational Therapy in Pediatrics，6(2)，87-95。
10.	Fleisher, B. E.、Vandenberg, K.、Constantinou, J.、Heller, C.、Benitz, W. E.、Johnson, A.(1995)。Individualized developmental care for very-low-birth-weight infants。Clinical Pediatrics，34(10)，523-529。
11.	Harrison, L.、Olivet, L.、Cunningham, K.、Bodin, M. B.、Hicks, C.(1996)。Effects of gentle human touch on preterm infants: Pilot study。Neonatal Network，15(7)，35-42。
12.	Horns, K. M.(1998)。Being-in-tune caregiving。Journal of Perinatal Neonatal Nursing，12(3)，38-49。
13.	Ikuta, L. M.(1998)。An exemplary service: Neonatal individualized developmental care and assessing program in the NICU。Journal of Perinatal Education，7(1)，27-31。
14.	Lawbon, G.(2003)。Challenges in providing developmentally supportive care: A case presentation。Journal of Obstetric, Gynecological and Neonatal Nursing，32(3)，387-392。
15.	Leib, S.、Benfield, G.、Guiidubaldi, J.(1980)。Effects of early intervention and stimulation on the preterm infants。Pediatrics，66(1)，83-89。
16.	Peters, K.(1998)。Bathing premature infants: Physiological and behavioral consequences。American Journal of Critical Care，7(2)，90-100。
17.	Raines, D. A.(1994)。Values influencing neonatal nurses' perceptions and choice。Western Journal of Nursing Research，16(6)，675-691。
18.	Shannon, J. D.、Gorski, P. A.(1994)。Health-care professionals' attitudes toward the current level and need for developmental services in neonatal intensive care units。Journal of Perinatology，14(6)，467-472。
19.	Starr, N. M.、Hoye, L.(1998)。An overview of developmentally supportive care of the premature infant。Journal of Pediatric Health Care，12(1)，33-34。
20.	Taquino, L. T.、Lockridge, T.(1999)。Caring for critically ill infants: Strategies to promote physiological stability and improve the developmental outcomes。Critical Care Nurse，19(6)，64-79。
21.	Westrup, B.、Kleberg, A.、Eichwald, K.、Stjemqvist, K.、Lagercrantz, H.(2000)。A randomized, controlled trial to evaluate the effects of the newborn individualized developmental care and assessment program in a Swedish setting。Pediatrics，105(1)，66-72。
22.	Als, H.(1998)。Developmental care in the newborn intensive care unit。Current Opinion in Pediatrics，10(2)，138-142。

圖書
1.	Chenitz, W. C.、Swanson, J. M.(1986)。From practice to grounded theory: Qualitative research in nursing。Menlo Park, CA：Addison-Wesley。
2.	Rokeach, Milton J.(1973)。The Nature of Human Values。Free Press。
3.	Strauss, Anselm、Corbin, Juliet(1998)。Basics of Qualitative Research: Techniques and Procedures for Developing Grounder Theory。Sage。
4.	Strauss, Anselm Leonard、Corbin, J.(1987)。Qualitative analysis for social scientists。Cambridge University Press。

其他
1.	Premature Baby Foundation(2000)。Medical information of premature infants: Understanding preterm labor，http://pbf.org.tw， 2004/10/28。

圖書論文
1.	Als, H.(1999)。Reading the premature infants。Nurturing the premature infants: Developmental interventions in the Neonatal Intensive Care Unit。New York：Oxford University Press。
2.	Barnard, K. E.(1994)。Instructional concepts and issues。NCAST learner manual。Seattle：NCAST Publication。
3.	Bronfenbrenner, U.(1989)。Ecological systems theory。Annals of Child Development Vol. 6 six theories of child development: Revised formulations and current issues。New York：Academic。
4.	Gottfried, A. W.(1985)。Environment of newborn infants in special care units。Infant stress under intensive care。Baltimore, MD：University Park Press。

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