108 Developmental Care for Preterm Feeding McCain, 2003; Mc- Grath, & Braescu, scheduled feeding Saunders, Friedman, & Stramoski, 1991 Amai

Size: px

Start display at page:

Download "108 Developmental Care for Preterm Feeding McCain, 2003; Mc- Grath, & Braescu, scheduled feeding Saunders, Friedman, & Stramoski, 1991 Amai"

圳慰奚
5 years ago
Views:

1 107 發展性照護於早產兒餵食之應用林貞秀 1 張瑩如 2 林佳霓 3 黃美智 4* 1 國立成功大學醫學院附設醫院早產兒個案管理師科學研究所副教授兼國立成功大學護理學系主任護理師 2 國立成功大學護理學系暨健康照護 3 國立成功大學醫學院附設醫院 4 國立成功大學護理學系暨健康照護科學研究所教授摘要 : 發展性照護是早產兒照護之核心概念, 具有互動性個別性與逐步成長之特徵, 醫護人員應在早產兒住院期間即將父母納入照護團隊, 準備其照護能力, 以協助早產兒返家照護與居家適應而早產兒每天 6-8 次的進食需求, 是頻率最高也最需要注重安全性的照護活動母親在學習餵食時, 早產兒所呈現的呼吸急促發紺疲倦等行為常令母親感到壓力, 尤其母親為了增加早產兒的進食量可能出現過度刺激早產兒的行為, 反而更容易造成生理危機國外在 80 年代即逐漸發展早產兒餵食相關理論與照護準則, 但國內卻鮮有相關報告本文將介紹 ⑴ 早產兒之進食特性, ⑵ 早產兒進食暗示行為的類型,⑶ 發展性照護概念在餵食之應用 ; 最後提出發展性照護之餵食相關原則與建議流程, 以做為醫護人員執行餵食及衛教早產兒父母之參考關鍵詞 : 早產兒發展性照護餵食 37 developmental care 2005 Aita & Snider, 2003 Thoyre, 2001 Reyna, Pickler, & Thompson, 2006 McGrath, Medoff-Cooper, Hardy, & Darcy, Bu Lock, Woolridge, & Baum, 1990; Lau, Alagugurusamy, Schanler, Smith, & Shulman, 2000; Van der Meer, Holden, & Van der Weel, 2005 Als, McCain, 2003; Thoyre, Shaker, & Pridham, * meay@mail.ncku.edu.tw doi: /jn

2 108 Developmental Care for Preterm Feeding McCain, 2003; Mc- Grath, & Braescu, scheduled feeding Saunders, Friedman, & Stramoski, 1991 Amaizu, Shulman, Shanler, & Lau, suck-swallow synchrony Blackburn, 2007; McCain, 2003; Vice & Gewolb, 2008 Bu Lock Vice & Gewolb, 2008 Puckett, Grover, Holt, & Sankaran, 2008 Thoyre et al., 2005 McCain, 2003; McGrath, & Braescu, 2004; Pukett et al., 2008 Pukett et al., 2008; Sumner & Spietz, 1994 Als 1999synactive organization model McCain, 2003; McGrath, & Braescu, 2004; Thoyre & Brown, 2004; Isaacson, 2006 Mentro, Steward, & Garvin, Sumner & Spietz, 1994; Thoyre et al., Sumner & Spietz, 1994 Als, 1999 Als, 1999interaction

3 109 individualization evolving process Aita & Snider, 2003 Barnard Parent-Child Interaction Model Barnard, 1994 McGrath et al., Thoyre, & Brown, atbreast feeding Nyqvist, 2008 Buckley & Charles, Case-Smith & Humphry, McGrath & Braescu, 2004 Case-Smith & Humphry, 2005; Hwang, Lin, Coster, Bigsby, & Vergara, 2010 Brazelton quiet alert active alert Sumner & Spietz, 1994

4 110 Developmental Care for Preterm Feeding McCain, 2003; McGrath et al., 2010; Thomas, demanded or semi-demanded feeding scheduled feeding Mc- Grath et al., McCain, / McGrath et al., 2010 McGrath, & Braescu, [Chang, Y. M., & Chang, Y. J. (2008). The relationship between oral feeding and cardiorespiratory regulation of premature infants. The Journal of Nursing, 55(3), 5 10.] [Chen, Y. C., Chang, H. M., & Chen, C. H. (2005). Neonatal individualized developmental care and assessment program for preterm infants. VGH Nursing, 22(2), ] [Huang, H. W., Chen, P. S., Jeng, S. F., & Wang, L. Y. (2008). Evaluation and physical therapy intervention of oral feeding difficulty in preterm infants: Literature review. Formosan Journal of Physical Therapy, 33(3), ] Aita, M., & Snider, L. (2003). The art of developmental care in the NICU: A concept analysis. Journal of Advanced Nursing, 41(3), doi: /j x Als, H. (1999). Reading the premature infant. In E. Goldson (Ed.), Nurturing the premature infant: Developmental interventions in the neonatal intensive care nursery (pp ). New York, NY: Oxford. Amaizu, N., Shulman, R., Shanler, R., & Lau, C. (2008). Maturation of oral feeding skills in preterm infants. Acta Paediatrica, 97(1), doi: /j x

5 111 Barnard, K. E. (1994). The Barnard model. In G. Sumner & A. Spietz (Eds.), NCAST caregiver/parent-child interaction feeding manual (pp. 8 14). Seattle, WA: NCAST. Blackburn, S. T. (2007). Neurologic, muscular and sensory system. In S. T. Blackburn (Ed.), Maternal fetal and neonatal physiology: A clinical perspective (3rd ed., pp ). St. Louis, MO: W. B. Saunders. Bu Lock, F., Woolridge, M. W., & Baum, J. D. (1990). Development of co-ordination of sucking, swallowing and breathing: Ultrasound study of term and preterm infants. Developmental Medicine and Child Neurology, 32(8), doi: /j tb08427.x Buckley, K. M., & Charles, G. E. (2006, August 31). Benefits and challenges of transitioning preterm infants to at-breast feedings. International Breastfeeding Journal, 1(13), Article Retrieved from Case-Smith, J., & Humphry, R. (2005). Feeding intervention. In J. Case-Smith, A. S. Allen, & P. N. Pratt (Eds.), Occupational therapy for children (5th ed., pp ). St. Louis, MO: Mosby. Hwang, Y. S., Lin, C. H., Coster, W. J., Bigsby, R., & Vergara, E. (2010). Effectiveness of cheek and jaw support to improve feeding performance of preterm infants. The American Journal of Occupational Therapy, 64(6), doi: /ajot Isaacson, L. J. (2006). Steps to successfully breastfeed the premature infant. Neonatal Network, 25(2), doi: / Lau, C., Alagugurusamy, R., Schanler, R. J., Smith, E. O., & Shulman, R. J. (2000). Characterization of the developmental stages of sucking in preterm infants during bottle feeding. Acta Paediatrica, 89(7), doi: / j tb00393.x McCain, G. C. (2003). An evidence-based guideline for introducing oral feeding to healthy preterm infants. Neonatal Network, 22(5), McGrath, J. M., & Braescu, A. V. (2004). State of the science: Feeding readiness in the preterm infant. Journal of Perinatal and Neonatal Nursing, 18(4), McGrath, J. M., Medoff-Cooper, B., Hardy, W., & Darcy, A. M. (2010). Oral feeding and the high-risk infant. In C. Kenner, & M. J. McGrath (Eds.), Developmental care of newborns and infant: A guide for health professionals (2nd ed., pp ). Glenview, IL: National Association of Neonatal Nurses. Mentro, A. M., Steward, D. K., & Garvin, B. J. (2002). Infant feeding responsiveness: A conceptual analysis. Journal of Advanced Nursing, 37(2), doi: / j x Nyqvist, K. H. (2008). Early attainment of breastfeeding competence in very preterm infants. Acta Paediatrica, 97(6), doi: /j x Puckett, B., Grover, V. K., Holt, T., & Sankaran, K. (2008). Cue-based feeding for preterm infants: A prospective trial. American Journal of Perinatology, 25(10), doi: /s Reyna, B., Pickler, R., & Thompson, A. (2006). A descriptive study of mothers experiences feeding their preterm infants after discharge. Advances in Neonatal Care, 6(6), doi: /j.adnc Saunders, R. B., Friedman, C. B., & Stramoski, P. R. (1991). Feeding preterm infant schedule or demand? Journal of Obstetric, Gynecologic and Neonatal Nursing, 20(3), doi: /j tb02533.x Sumner, G., & Spietz, A. (1994). Child communication cues. In G. Sumner & A. Spietz (Eds.), NCAST caregiver/ parentchild interaction feeding manual (pp ). Seattle, WA: NCAST. Thomas, J. (2007). Guidelines for bottle feeding your premature baby. Advances in Neonatal Care, 7(6), Thoyre, S. M. (2001). Challenges mothers identify in bottle feeding their preterm infants. Neonatal Network, 20(1), Thoyre, S., & Brown, R. (2004). Factors contributing to preterm infant engagement during bottle-feeding. Nursing Research, 53(5), doi: / Thoyre, S., Shaker, C., & Pridham, K. (2005). The early feeding skills assessment for preterm infants. Neonatal Network, 24(3), doi: / Van der Meer, A., Holden, F., & Van der Weel, R. (2005). Coordination of sucking, swallowing, and breathing in healthy newborns. Journal of Pediatrics and Neonatology, 2(2), Vice, F., & Gewolb, I. (2008). Respiratory patterns and strategies during feeding in preterm infants. Developmental Medicine & Child Neurology, 50(6), doi: /j x

6 112 Developmental Care for Preterm Feeding Feeding Preterm Infants: Application of Developmental Care Chen-Hsiu Lin 1 Ying-Ju Chang 2 Chia-Ni Lin 3 Mei-Chih Huang 4 * 1 RN, MSN, Preterm Infant Case Manager, Department of Nursing, National Cheng Kung University Hospital; 2 RN, PhD, Associate Professor, Department of Nursing / Institute of Allied Health Sciences, National Cheng Kung University & Chairperson, Department of Nursing, National Cheng Kung University; 3 RN, BSN, Department of Nursing, National Cheng Kung University Hospital; 4 RN, PhD, Professor, Department of Nursing / Institute of Allied Health Sciences, National Cheng Kung University. Abstract: Developmental care is the core concept of the preterm infant caring model. It is characterized by interaction, individualization, and evolving process. In order to enhance family competency with regard to preterm infant care, health professionals should include parents as team members when preterm infants are hospitalized so that parents can provide care helpful to facilitate preterm infant adaptation to external environmental stimulation. The preterm infant s 6-8 feedings per day represent the most frequent daily activity and an activity in which safety is essential. Potential adverse feeding responses in preterm infants such as tachypnea, cyanosis, and fatigue may stress the mother. This is a particular risk when the mother tries to increase her infant s intake volume by over-stimulating oral-motor activity. Theories and guidelines for feeding preterm infants in western societies have been evolving since the 1980s. However, little has been done in this area in Taiwan. This article addresses preterm infant feeding characteristics and cues, the application of developmental care in feeding infants, and proposes guidelines for feeding preterm infants. Healthcare professionals may reference our suggestions in feeding preterm infants and educating parents. Key Words: preterm infant, developmental care, feeding. Accepted for publication: January 18, 2012 *Address correspondence to: Mei-Chih Huang, No. 1, University Rd., Tainan City 70101, Taiwan, ROC. Tel: +886 (6) ext. 5032; meay@mail.ncku.edu.tw

Oral Feeding and Cardiorespiratory & Braescu, 2004 32 SaO 2 Medoff & Ray, 199 Daniel, Julie, & William, 2002 Ludwig 14 respiratory sinus arrhythmia, R

Oral Feeding and Cardiorespiratory & Braescu, 2004 32 SaO 2 Medoff & Ray, 199 Daniel, Julie, & William, 2002 Ludwig 14 respiratory sinus arrhythmia, R 早產兒口腔餵食與心肺功能調節之關係張雅雯張瑩如 * 由於早產兒生理成熟及疾病因素, 導致其在學習口腔餵食時心肺功能調節反應有個別性的差異, 因而影響其餵食成效由於觀察餵食過程的生理反應是護理人員的重要職責, 故本文