Construction Of Continuous Nursing Path For Newborn Enterostomy:Based On The Theory Of "Timing It Right"

Objective:Based on the theory of “Timing it Right” and oriented to the needs of the main caregivers in the enterostomy family,the content of neonatal enterostomy continuity care is enriched,and a set of scientific,systematic,perfect,specific and practical value of neonatal enterostomy continuity care path is constructed to provide theoretical basis for neonatal enterostomy continuity care practice.Methods:This study is divided into two parts.In the first part,the phenomenological research method of qualitative research was applied.Through objective sampling and convenience sampling,11 primary family caregivers of children who underwent neonatal enterostomy in a Grade～A hospital in Jilin Province from December 2021 to October 2022 were selected for semi～structured interviews,and the interview data were analyzed by Colaizzi analysis method.According to the results of qualitative study and related literature review,the continuity nursing path of neonatal enterostomy was preliminarily formed based on the timing theory.In the second part,18 experts were consulted by Delphi method,and the contents of the path were revised according to the feedback of experts.After two rounds of correspondence consultation,expert opinions were reached,and the continuity care path of neonatal enterostomy was finally formed.Result:Through qualitative interviews with 11 primary caregivers of children with enterostomy,five main problems were identified: complex emotions,increased sense of uncertainty,strong need for support,anxiety and helplessness,harvest and growth;And 10 specific problems: fear,self～blame,uncertainty about the child’s situation in the NICU,uncertainty about the child’s prognosis,lack of nursing confidence,lack of knowledge about enterostomy care,anxiety,urgent need for professional help,adapting to the caregiver role,and harvest growth experience.A total of 18 experts were consulted by letter in this study: the questionnaire recovery rate was 100%,indicating that the experts were highly motivated;The expert authority coefficient was 0.82,indicating that the experts included in this study had good authority and representativeness.After the two rounds of expert letter consultation,the coordination coefficients of the importance and feasibility of the specific content were 0.131 and 0.264,respectively,indicating that the experts’ opinions tended to be consistent.The final formation of neonatal enterostomy continuity care path contains 5 periods,10 specific problems and specific measures taken for each problem.Conclusion:This study obtained the experience and needs of the main caregivers of neonates with enterostomy from the hospital admission to the operation of endostomy reduction,and determined the continuity care path of neonates with enterostomy based on the timing theory,including the diagnosis period(before admission),stable period(after surgery),discharge preparation period(three days before discharge),adjustment period(discharge ～ one month after discharge),adjustment period(return of endostomy)Before the operation)5 primary indicators,10 secondary indicators,22 specific content,a total of 54 entries,will provide reference and reference for the continuity of care practice of enterostomy children.