研究背景：早產兒父母在嬰兒剛出生時，經常需要因應嬰兒複雜的病情及治療，加上加護病房的限制使得親子互動的時機被迫延宕，父母常有焦慮及憂鬱等負向情緒，在面對陌生的醫療環境下，自覺無能為力及不瞭解嬰兒需求而影響親職表現、親子互動及日後的早產兒健康發展。因此，早產兒父母增能則為促進正向親子互動，幫助嬰兒成長與發展之重要課題。本研究以Melnyk教授的COPE (Creating Opportunities for Parent Empowerment) 計畫為基礎，發展台灣本土化早產兒父母增能之計畫措施，並驗證此措施之可行性。措施包括提供知識與早產兒相關資訊，協助父母認識及學習照顧早產兒，強化父母角色功能，賦予正視自己為主要照顧者的親職責任且有勝任的能力，進而促進嬰兒健康。
研究方法：研究執行參考COPE計畫步驟並分成兩個部分：第一部分為措施發展階段，包含翻譯COPE工具書及現況評估。以訪談2位早產兒母親及3位護理師關於早產兒在加護病房時之親子互動經驗及情緒感受之結果，修增成COPE工具書中文版；第二部分為措施驗證階段，採方便取樣南台灣某醫學中心新生兒加護病房之10對早產兒父母及為單胞胎、出生時妊娠週數大於28週且體重大於1000公克之早產兒與2位新生兒加護病房護理師參與本計畫。共執行四次介入措施，分別於(1)早產兒入院後2-4天，(2)第一次措施執行後2-4天，(3)出院前1-7天，(4)出院後1-2週。每一次措施會請父母預先閱讀工具書對應的章節後討論。除研究者外，有兩位護理師依照收案歷程所發展的護理人員手冊內容引導，分別執行兩位早產兒母親（共四位）之介入措施，完成措施後早產兒母親與護理師填寫措施分別填寫可行性之問卷。
研究結果：第一部份發展本土化中文版COPE工具書，除完成工具書翻譯及校對文字外，增加引導父母親情緒宣洩的訊息及親子互動的方式。第二部分驗證階段結果發現母親與護理師高度肯定介入措施，分別評值其可行性 (母親：4.57分；護理師：4.5分) 、實用性 (母親：4.47；護理師：4.37) 及滿意度為 (母親：4.57；護理師：4.6)，整體平均分數為4.3分以上。其中，母親部分的各項目得分偏高且差異少 (4.4-4.6分) (潛在範圍為1至5分，分數高代表越可行/實用/滿意)，整體顯示母親及護理師認同工具書在情緒支持、親子互動及返家後照顧有幫助。工具書內容的4個Phases的評估部分，護理師在Phase 4的分數最低 (3.5-4分)且回應執行難度高而母親則在Phase 4覺得助益最高，顯示母親與護理師的不同看法。完成撰編一份引導COPE-TW工具書之護理人員手冊。
結論：本研究為發展及驗證台灣第一個透過COPE工具書發展之台灣本土化早產兒父母增能計畫。早產兒父母對於照護早產兒知識技能的需求高，且情緒的支持對於增能也很重要。期待此COPE-TW能提供台灣早產兒具文化性、更全面性的照護，藉由推廣至各層級醫院的早產兒出院準備服務照護。研究收案過程經歷全球COVID-19疫情的影響，疫情時期應用視訊或通訊軟體可避免接觸感染，但相較於人與人實體接觸的成效差異則需進一步評估。後續研究之護理應用期望能提供早產兒父母在早產兒出生後透過閱讀工具書內容，引導父母階段性的認識早產兒和早期建立親子連結與照顧的信心，進而幫助更多的早產兒家庭。

This study amied to develop and validate a localized program to empower parents of premature infants to enable them better care for their infants in Taiwan. The COPE (creating opportunities for parent empowerment) program was used as a foundation to develop this localized program, COPE-TW. The COPE-TW program intends to provide early intervention about knowledge, information, and skills to take care preterm infants.
This study was carried out in two stages: the first stage was the development stage, including the translation of the COPE book into Chinese version (the COPE-Taiwan book). In-depth interviews were conducted with two parents with a preterm infant (their premature infants who were singletons with gestational age of equal to or above 28 weeks and birth body weight of above than 1000 grams) and 3 nurses in NICU to explor the current practices on helping parents with preterm infant(s) to take care of and interact with their premature infants. The second stage was the validation stage using a convenient sample of 10 parents and 2 nurses in NICU to test the feasibility of the localized COPE-TW. The intervention was carried out in four steps: (1) 2-4 days after admission of preterm infants, (2) 2-4 days after the first time, (3) 1-7 days before discharge, and (4) 1-2 weeks after discharge. Both the mother of the premature infants and nurses have filled out the fesasiblity questionaires for the COPE-TW. The results of the feasibility questionnaires indicating the COPE-TW was feasible, practical, and satisfactory with an averaged score being above 4.3. Mothers scored high in all three aspects (Mean = 4.4-4.6 with a potential score range of 1 to 5).
This study developed and validated a localized, Chinese version of COPE-TW, which was the first empowerment program for preterm infants’ parents in Taiwan. It is expected the COPE-TW can provide parents of preterm infants with information and skills they need to understand their preterm infants, to establish parent-infant connection, and to increase parenting confidence.

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