diplomsko delo
Iva Kovačič (Author), Martina Bizjak (Reviewer), Renata Vettorazzi (Mentor), Jana Lozar Krivec (Co-mentor)

Abstract

Uvod: Prezgodaj rojeni otroci se na zunajmaternično življenje težje prilagodijo, saj jim ta, v svojem pestrem naboru različnih dražljajev, lahko predstavlja vir stresa. Celostna individualizirana razvojna oskrba je pristop, ki temelji na razumevanju otrokovega vedenja in prilagajanju okolja, da to postane razvojnopodporno. Deli se na organizacijo neposrednega fizičnega okolja novorojenčka in organizacijo oskrbe. Z zmanjševanjem stresnih dejavnikov, kot so svetloba, hrup in bolečina, ter z zagotavljanjem pozitivnih izkušenj, ki jih omogočajo kožni stik, dojenje, podporni položaji, terapevtska masaža in zgodnja vokalizacija, je novorojenčku omogočeno, da pri oskrbi ni preobremenjen niti spregledan glede svojih razvojnih sposobnosti in postaja aktivni udeleženec v procesu oskrbe. Namen: Predstaviti pomen Celostne individualizirane razvojne oskrbe za razvoj prezgodaj rojenih otrok, posameznih elementov pristopa in vlogo medicinske sestre pri izvajanju oskrbe. Metode dela: Uporabljen je bil deskriptivni raziskovalni pristop s pregledom. Pregledana in analizirana je bila literatura, napisana v slovenskem ali angleškem jeziku. Literatura je bila iskana s pomočjo podatkovnih baz CINAHL, Pubmed, Medline in Google učenjak, v času od oktobra 2020 do aprila 2021. Razprava in zaključek: Mnoge študije dokazujejo, da ima Celostna individualizirana razvojna oskrba pomemben vpliv na razvoj otrokovega vedenja. To se oblikuje skozi pet podsistemov (avtonomni, motorični, organizacije stanj, pozornosti in interakcije, samoregulacije), na katere ima vsak izmed elementov oskrbe svoj vpliv. Medicinska sestra mora poleg ureditve okolice poskrbeti tudi za organizacijo zdravstvene nege. Kožni stik in dojenje vplivata na stabilizacijo avtonomnega, motoričnega in samoregulacijskega podsistema. Podporno pozicioniranje in terapevtska masaža pripomoreta pri organizaciji razvoja ritma spanja in drugih stanj čuječnosti ter pripomoreta k boljšemu uravnavanju stresnega odziva na okoljske dražljaje. Zmanjšan stresni odziv na bolečino omogoča tudi povijanje. Uravnavanje svetlobe in jakosti okoljskega zvoka imata vpliv na vseh pet podsistemov. Medicinske sestre največ omejitev pri izvajanju Celostne individualizirane razvojne oskrbe novorojenčka vidijo v delovanju sodelavcev. Starši pa poudarjajo željo po podpori pri razumevanju in vključevanju v oskrbo otroka. Za implementacijo sprememb v delovno okolje je potrebno usmerjeno izobraževanje, saj so primerno znanje in vidiki medicinskih sester prvi korak za uvajanje sprememb v prakso.

Keywords

diplomska dela;zdravstvena nega;nedonošenčki;celostna oskrba;razvojna podpora;organizacija vedenja;

Data

Language: Slovenian
Year of publishing:
Typology: 2.11 - Undergraduate Thesis
Organization: UL ZF - University College of Health Studies
Publisher: [I. Kovačič]
UDC: 616-083
COBISS: 79137283 Link will open in a new window
Views: 265
Downloads: 65
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Other data

Secondary language: English
Secondary title: Neonatale [!] individualized developmental care
Secondary abstract: Introduction: Adaptation to extrauterine life is harder for preterm newborn, because their sensitive stress treshold causes more stressful response to different stimuli. Individualized developmental care is based on understanding neborn's behavior and environmental adjustment to achieve conditions, important for development of susceptible newborn. Minimalizing stressful factors like light, noise, pain and creating positive sensory environment by initiating skin-to-skin contact, breastfeeding, nesting, hammock positioning, therapeutic massage and early vocalization are important elements of creating healing environment, where newborn is recognized as acitve participant in process of care. Purpose: To present importance of Individualized developmental care, different elements and nurse's role in Individualized developmental care. Methods: A descriptive research approach was used to review the literature written in Slovene and English. Literature was reviewed and analyzed. Literature was searched by CINAHL, Pubmed, Medline databases and Google Schoolar from October 2020 to April 2021. Discussion and conclusion: Many studies show impact of Individualized developmental care on behavior development. Organization of behavior consist of five subsystems, wich differentiate by constant interaction with environment. Every element of Individualized developmental care impact some of this five subsystemes. Nurse's role is to create optimal environmet and organize process of care. Skin-to-skin contact and breastfeednig impact stabilization of autonomic, motoric and self-regulatory subsystems. Nesting, hammock positioning and therapeutic massage support development of healthy sleep rhythm, state systems and strees regulation. Lower stress response to pain can also be achieved by swadling newborn during painful procedures. Elements that have impact on every behavior subsysteme are reducing light and sound intensity. Perceptions and work of medical staff are considered as the biggest limitations that impact the success of implementing Individualized developmental care. Parents recognize opportunity for improvement in nurse's relations and communication with family. They also want to get more comprehensible informations and be more active participations in process of care of their newborn. Implementation of changes can be accomplished by constant education, wich change nurse's perceptions and enable improvement of care.
Secondary keywords: diploma theses;nursing care;preterms;holistic care;developmental support;behavioral organization;
Type (COBISS): Bachelor thesis/paper
Study programme: 0
Thesis comment: Univ. v Ljubljani, Zdravstvena fak., Oddelek za zdravstveno nego
Pages: 47 str.
ID: 13641399