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目的 探讨新生儿重症监护病房(neonatal intensive care unit, NICU)中危重新生儿父母行代理决策时面临的决策困境，为医护人员制订针对性的决策辅助干预策略提供参考。方法 于2024年6—10月应用现象学研究方法，采用目的抽样方法选取桂林市某三级甲等综合医院NICU接受治疗的危重新生儿父母进行半结构化访谈，采用Colaizzi 7步分析法进行资料分析。结果 共16名危重新生儿的家属完成研究。共提炼出3个主题和9个亚主题。(1)决策现实需求困境：患儿疾病变化轨迹不确定、患儿病情及诊疗信息获取受限、父母医学认知水平不足、客观经济条件有限；(2)决策心理调节困境：对患儿预后的消极性感知、负性情绪伴发躯体化反应、情感与理智交织的矛盾冲突；(3)决策支持环境困境：家庭内部支持缺失、社会支持网络不健全。结论 危重新生儿父母面临多重决策困境，NICU医护人员可通过提供多途径医疗信息支持及决策指导、实施有效心理干预策略、调动家庭及社会资源等多种方式合力提高患儿父母的决策意识与能力，突破决策困境，促进共同决策。
Abstract：Objective To explore the decision-making dilemmas faced by parents of critically ill newborns acting as proxy decision-makers in the neonatal intensive care unit(NICU) and to provide references for medical staff in developing targeted decision-support intervention strategies. Methods Parents of critically ill newborns receiving treatment in the NICU of a tertiary Grade A general hospital in Guilin from June to October 2024 were conducted with semi-structured interviews by the phenomenological research method. Data were analyzed using Colaizzi's 7-step analysis method. Results A total of 16 parents of critically ill newborns copleted the study. A total of 3 themes and 9 sub-themes were identified.(1) Dilemmas in practical decision-making needs: uncertainty in the trajectory of the infant's condition, limited access to medical information about the infant's status and treatment, insufficient parental medical knowledge, and constrained financial resources;(2)Dilemmas in psychological adjustment during decision-making: negative perceptions of the infant's prognosis, negative emotions accompanied by somatic reactions, and conflicting emotions intertwined with rational judgment;(3)Dilemmas in decision-making support environment: lack of internal family support and underdeveloped social support network. Conclusion Parents of critically ill newborns face multiple decision-making dilemmas. NICU healthcare professionals can collaboratively enhance parental decision-making awareness and capabilities while alleviating their decision-making stress through various approaches, including providing multi-channel medical information support with decision guidance, implementing effective psychological intervention strategies, and mobilizing family and social resources, thereby facilitating shared decision-making.
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基本信息:
DOI：10.16821/j.cnki.hsjx.2026.02.009
中图分类号:R473.72
引用信息:
[1]谷粤,高燕,冯月清,等.危重新生儿父母代理决策困境的质性研究[J].护士进修杂志,2026,41(02):162-167.DOI:10.16821/j.cnki.hsjx.2026.02.009.
基金信息:
广西高校中青年教师科研基础能力提升项目(编号：2024KY0530); 广西研究生教育创新计划项目(编号：YCSW2024444)
2026-01-28
2026-01-28