1. Construct intelligent management intervention plan for parents of preterm infants from hospital to family based on the medical and health system suitable for China's national conditions. 2. Clinical randomized controlled trials were conducted to verify and evaluate the feasibility and application effect of the intervention program.
Inclusion criteria for premature infants ① gestational age < 37 weeks；② Premature infants admitted to NICU；③ The duration of hospitalization is more than 5 days.
Inclusion and
Exclusion criteria for preterm infants ① intrauterine developmental retardation of preterm infants. ② Preterm infants with a history of major surgery. ③ Unplanned discharge, transfer, transfer or death of premature infants.
Exclusion criteria for primary caregivers of preterm infants ① There are recent major mental trauma injuries caused by non-hospitalization factors. ② the caregiver suffers from serious diseases of the heart, brain, lung, kidney and other organs. 3. Shedding criteria: Caregivers who voluntarily asked to withdraw for various reasons during the study.
Parallel
Information support
BehavioralThe experimental group was given intervention measures. According to the general data survey, discharge readiness and self-efficacy assessment, parents were divided into low, middle and high discharge readiness groups and low, middle and high self-efficacy groups, respectively, using WeChat mini programs to push different content.
Stress and coping
BehavioralAccording to the results of self-efficacy and anxiety assessment, different interventions were based on different scores. Give encouragement and affirmation to parents with low anxiety and high self-efficacy. Parents with high anxiety and low self-efficacy should push stress relief methods such as mindfulness relaxation therapy in time. And through the wechat mini program to provide parents to respond to the pressure of the problem, the medical staff to give timely feedback.
Specialist guidance
BehavioralCarry out offline science popularization education and specialized training, and highly qualified specialist doctors and nurses will train parents, and parents will be assessed after training, and personalized guidance will be given according to the weak points of each parent\'s assessment.
Social support and interaction
Other interventionSupport and encouragement for parents continue from admission to discharge, so that parents feel that even after discharge, there are people to accompany and support them.
Parentage development
BehavioralSince parents and children are separated during the hospitalization of preterm infants, we will create an environment where parents still play the role of parents, and stimulate parental competence through kangaroo care, parental touch, and breastfeeding.
Parental readiness for discharge
The Discharge Readiness Scale - Parent Edition This scale was developed by Weiss Equals in 2006 to assess the discharge readiness of parents of hospitalized children aged 0-18 years. The scale consists of 5 dimensions and 29 items. The scale was scored on a Likert 10-level scale, with scores ranging from 0 to 10 for each item (" complete "to" incomplete ") and an overall score ranging from 0 to 290. The higher the score, the higher the parents' readiness to leave the hospital. Cronbach's α coefficient of the total volume table was 0.85, and Cronbach's α coefficient of each dimension (personal status of parents, personal status of children, knowledge, coping ability and expected support) was 0.71, 0.70, 0.85, 0.86 and 0.84, respectively, indicating good reliability. Chinese scholar Chen et al. Sinicized the scale and verified its good reliability and validity.
Parents' self-efficacy
First developed by German clinical and health psychologist Ralf Schwarzer in 1981, the General self-efficacy Scale has been translated into at least 25 languages and is widely used internationally. In this study, the Chinese version of GSEA was adopted, which was jointly revised by Zhang Jianxin and Schwarzer, and has been proved to have good reliability and validity. The scale has one dimension, a total of 10 items, grades 1 to 4, the test subjects according to their actual situation, "completely correct" counts for 4 points, "mostly correct" counts for 3 points, "somewhat correct" counts for 2 points, "completely incorrect" counts for 1 point, all items are positive, the lowest theoretical score is 10 points. The highest score was 40, and the higher the score, the better the general sense of self-efficacy.
Anxiety
Self-rating Anxiety Scales (SAS) The self-rating Anxiety Scales (SAS), compiled by William W.K. Zung in 1971, is a commonly used self-rating tool for adult anxiety symptoms. It includes 20 items and scores are divided into 1 to 4 levels. There are 15 positive items and 5 negative items in the scale. The 15 positive entries were scored as 1, 2, 3 and 4 points in turn, and the 5 reverse entries (5, 9, 13, 17 and 19) were scored as 4, 3, 2 and 1 points. The score of 20 entries is added to obtain the total score, standard score =SAS total score x 1.25 Take the integer part. Less than 50 is classified as no anxiety, 50 to 59 is classified as mild anxiety, 60 to 69 is classified as moderate anxiety, and more than 69 is classified as severe anxiety. Cronbach's α coefficient is 0.931.
Growth and development indicators of premature infants
The weight and length of premature infants were measured. Use the same brand weight scale and calibrate it regularly, taking the average of the two measurements as the measurement result.
Readmission rate of preterm infants
Whether to be readmitted to hospital.
Parental care ability
Ability to care for premature infants: ability to care for premature infants refers to the ability of parents or primary caregivers to care for premature infants, including care knowledge, care skills, care attitude and other aspects. This study mainly studies the caring ability of parents of preterm infants and adopts the self-assessment questionnaire of family caring ability of preterm infants compiled by Meng Jingwen et al for quantitative measurement. The questionnaire includes 18 items in 3 parts: caring knowledge of preterm infants, caring technology and caring ability, and adopts Likert 5-level scoring method, with no understanding =1 point. Not very clear =2 points, general understanding =3 points, relatively understanding =4 points, very understanding =5 points. The total score is 18 to 90, and the higher the total score, the higher the caring ability. The content validity of the questionnaire was 0.98, and the Cronbach's α value of the questionnaire was 0.958.
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