Research On Content Of Parental Care For Postoperative Rehabilitation Of Ventricular Septal Defect Infants

Background:The high incidence of congenital heart disease has been at the top of birth defects in China.Ventrical septal defect(VSD)is the most common congential heart disease,account for 50%.Surgical operation is the best treatment for children with VSD,it is essential to receive surgery within the first year after birth if the children have severe VSD.Infants with VSD and their parents still face a series of problems after surgery,active rehabilitation is needed,the key stage of rehabilitation comprise nosocomial rehabilitation stage and domiciliary rehabilitation stage.Parents of infants with VSD play the significant role in different postoperative rehabilitation stage.At nosocomial rehabilitation stage,the theory of family-centered care encourages parents to participate in nursing care,due to different cognition of parent’s involvement in care at present,the provision of instructions for parents lack for standardization.Though the postoperative family-centered care involvement content of children with congenital heart disease has been formed,the definition of parental involvement in the content of care is still unclear,it is not effectively guide parents to participate in practice,standard involvement content need defining further.At domiciliary rehabilitation stage,however,clinical guidance and communities’ support were far from meeting the needs of parents,for example,nurtrition management and pigeon chest prevention need to perfect and normalize.This research will determine the content of nursing care that parents could involve in at nosocomial rehabilitation stage and construct the content of homecare for parents at domiciliary rehabilitation stage for postoperative infants,aimming at defining the standard involvement content for parents and constructing complete,elaborate and normative content of homecare,so as to instruct the involvement of care and enhance homecare training for parents.Objective:To determine the content of parental care for postoperative rehabilitation of ventricular septal defect infants:to define the content of nursing care that parents could involve in at nosocomial rehabilitation stage and to construct the content of homecare for parents at domiciliary rehabilitation stage.Methods:The study was conducted from April 2017 to February 2018.Based on questionnaire survey,the content of nursing care that parents could involve in at nosocomial rehabilitation stage was formed by two rounds of Deiphi methods.Based on literature review and semi-structed interviews,the content of homecare for parents at domiciliary rehabilitation stage was constructed by two rounds of Deiphi methods.With inquiry of 16 experts from the fields of management of clinical nursing,nursing administration,nursing education,clinical nursing and clinical medicine,the research has formed the content of nursing care that parents could involve in and the content of homecare for parents for postoperative infants.Results:Surveying 65 pediatric cardiac department nurses and two rounds of Delphi consultation,it has concluded that the content of nursing care that parents could involve in at nosocomial rehabilitation stage.It is comprised of 4 first order index,23 second-class indexes,including living care,care related with postoperative recovery,parents presence at specific invasive nursing procedure and family presence on rounds,thus a total of 42 entries.Through retrieving the relevant literatures in recent 10 years,interviewing 11 senior nurses of pediatric cardiac wards and 9 parents of postoperative infants with re-examination and two rounds of Delphi consultation,it has constructed the content of homecare for parents at domiciliary rehabilitation stage.It is comprised of 11 first order index,35 second-class indexes,including diet,micronutrient deficiency prevention and treatment recommendations,exercise,observation and care of surgery wound,judgement and coping of fever,drug care,complications observation and abnormalities prevention,infection prevention and vaccination and mental nusing,thus a total of 53 entries.Conclusion:This research has formed the content of nursing care that parents could involve in at nosocomial rehabilitation stage and constructed the content of homecare for parents at domiciliary rehabilitation stage for infants,providing a preference for parent’ s willingness of involvement in postoperative family-centered care in infants with ventricular septal defect and perfection of homecare practice.