Obravnava odtegnitvenega sindroma pri novorojenčkih v slovenskih porodnišnicah : empirična raziskava

Marinček, Nina (author), Fister, Petja (mentor)

Uvod: V svetu se vse pogosteje pojavlja problem odvisnosti od drog, ki pušča hude posledice. Kadar se zloraba drog pojavlja v obdobju nosečnosti, lahko posledice utrpi tudi plod. Pomembni so odkrivanje problema in ustrezno preprečevanje oz. poznejša obravnava in zdravljenje. Namen: Strnjeno povzeti in opisati, kaj je odtegnitveni sindrom novorojenčka, nato pa v nadaljevanju opisati možnosti za njegovo zdravljenje ter postopke obravnave mater in njihovih novorojenčkov, ki trpijo za odtegnitvenim sindromom. V raziskavi je cilj pridobiti vpogled v način dela z novorojenčki z odtegnitvenim sindromom na poporodnih oddelkih in intenzivnih negah porodnišnic in bolnišnic po Sloveniji ter jih primerjati s trenutnimi sodobnimi smernicami in priporočili. Metode dela: Pri pisanju smo uporabili opisno ali deskriptivno metodo dela, s katero smo kritično pregledali strokovno in znanstveno literaturo. Izvedli smo tudi kvantitativno raziskavo med zaposlenimi na poporodnih oddelkih in intenzivnih negah slovenskih porodnišnic ter pediatričnih klinikah po Sloveniji. Podatke smo pridobivali s strukturiranim anketnim vprašalnikom, ki smo ga oblikovali s pomočjo zbrane slovenske in predvsem tuje literature. Skupaj je bilo poslanih 180 anket, od tega smo prejeli vrnjenih in pravilno izpolnjenih 129 anket. Stopnja odgovora je bila 72%. Rezultati: V ljubljanski in mariborski porodnišnici ter na Kliničnem oddelku za neonatologijo v Ljubljani in enoti za intenzivno nego in terapijo otrok v mariborski pediatrični kliniki je frekvenca primerov novorojenčkov z odtegnitvenim sindromom največja. 67 % anketiranih meni, da se za obravnavo novorojenčkov najpogosteje uporabljata tako farmakološki kot tudi nefarmakološki pristop zdravljenja odtegnitvenega sindroma novorojenčka, 22 % anketirancev meni, da so obravnavani samo z nefarmakološkim pristopom, 10 % da se največkrat uporablja samo farmakološki pristop, 1 % anketirancev pa ni vedelo, kateri pristop zdravljenja se uporablja najpogosteje. Osnovni nefarmakološki pristopi so uporabljeni v vsakdanji praksi v slovenskih porodnišnicah pri obravnavi novorojenčkov z odtegnitvenim sindromom. 53 % mater svoje otroke hrani po steklenički, doji jih le 21 %, sledi še hranjenje z lastnim izčrpanim mlekom po steklenički s 6 %. 20 % anketirancev je pod odgovor »drugo« navedlo, da matere uporabljajo vse tri oblike hranjenja ali kombinacijo dojenja in mlečne formule. Mnenje glede uporabe protokolov pri obravnavi je deljeno. 44 % anketiranih meni, da protokoli za obravnavo teh primerov v njihovi porodnišnici obstajajo, medtem ko jih 45 % meni ravno nasprotno, 11 % jih ne ve gotovo, ali protokol imajo ali ne. Razprava in zaključek: Ovrgli smo hipotezi o frekvenci primerov novorojenčkov z odtegnitvenim sindromom v Sloveniji in najpogostejšem pristopu za obravnavo odtegnitvenega sindroma novorojenčka. Potrdili smo hipotezi o hranjenju in uporabi najpogostejših nefarmakoloških pristopov. Hipotezo o uporabi protokolov bi bilo treba še dodatno raziskati.

• Language: Slovenian
• Keywords: odtegnitveni sindrom novorojenčka, zdravljenje neonatalnega abstinenčnega sindroma, odvisnost, dojenje, zloraba drog v nosečnosti
• Work type: Bachelor thesis/paper
• Organization: ZF - Faculty of Health Sciences
• Year: 2017
• PID: 20.500.12556/RUL-92668
• COBISS.SI-ID: 5272939
• Publication date in RUL: 25.06.2017

Secondary language

• Language: English
• Title: Management of neonatal abstinence syndrome in slovenian maternity hospitals : empirical research

Abstract

Introduction: The problem of drug addiction has been increasing worldwide and leaving serious consequences. After drug abuse during pregnancy, there are possible consequences for the fetus. It is important that the problem is detected and prevented or an appropriate therapy introduced. Purpose: To sum up and concisely describe neonatal abstinence syndrome and to describe the possibilities for treatment of mothers and their newborns who suffer from neonatal abstinence syndrome. The aim of the study was to get an insight into the work with newborns with neonatal abstinence syndrome in postnatal wards and intensive care units in maternity hospitals and general hospitals throughout Slovenia and compare them with current guidelines and recommendations. Methods: A descriptive method was used to critically review published text books and scientific literature. A quantitative survey among employees in postnatal wards and intensive care units in maternity hospitals and paediatric clinics across Slovenia was also carried out. Data were collected by using a structured questionnaire, which was drawn up through the study of mainly foreign literature. 180 questionnaires were sent and 129 were correctly filled and returned. The response rate was 72%. Results: The highest frequency of neonatal abstinence syndrome was reported in Ljubljana and Maribor maternity hospitals, in the Ljubljana Department of neonatology and in the Intensive care department of Paediatrics Division in Maribor. 67% of respondents suggested that both pharmacological and non-pharmacological approaches are most commonly used, whereas 22% of respondents believe that neonatal abstinence syndrome is treated mostly with non-pharmacological approach. 10% responded that only pharmacological approach is used. 1 % of respondents did not know which approach is used most commonly. General non-pharmacological approaches are used in everyday practice in all Slovenian hospitals which treat cases of neonatal abstinence syndrome. 53% of mothers feed their newborns with milk formula, only 21% try to breastfeed and 6 % of mothers bottle-feed their newborns with their own pumped milk. 20% of respondents under the answer option “other” listed that mothers feed their newborns using all three forms of feeding or a combination of breastfeeding and milk formula for their newborns. The opinion of respondents regarding the use of protocols is mixed. 44% of respondents think that protocols for the treatment of neonatal abstinence syndrome are present in their maternity hospitals, while 45% of respondents think just the opposite. 11% are not sure about the existence of the protocols. Discussion and conclusion: The hypothesis about the frequency of neonatal abstinence syndrome cases in Slovenia and the most common approach to treatment of neonatal abstinence syndrome was refuted. The hypothesis on most common feeding approach and the use of the most common non-pharmacological approaches was confirmed. The hypothesis about using the protocols should be further explored.

• Keywords: neonatal abstinence syndrome, treatment of neonatal abstinence syndrome, addiction, breastfeeding, drug abuse in pregnancy