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Byrne EM, Hunt K, Scala M. Introducing the i-Rainbow©: An Evidence-Based, Parent-Friendly Care Pathway Designed for Critically Ill Infants in the NICU Setting. Pediatr Phys Ther 2024; 36:266-273. [PMID: 38568275 DOI: 10.1097/pep.0000000000001094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
PURPOSE This study investigated the feasibility and effectiveness of a novel, evidence-based developmental care pathway to be used by health care providers and parents in the neonatal intensive care unit (NICU) setting. The i-Rainbow is based on current evidence and responds to individual infant health status. It is not based on infant age. METHODS After development and implementation of the i-Rainbow, pre- and postimplementation nurse and parent survey data were collected and pre- and post-developmental care rates were compared. RESULTS After i-Rainbow implementation, disagreement among providers on appropriate developmental care interventions significantly decreased, total minutes of daily developmental care and swaddled holding increased significantly, and parents reported that they would recommend the tool. CONCLUSION The i-Rainbow is a unique, parent-friendly, infant-based tool that guides sensory interventions in the NICU by staging infants based on cardiorespiratory status and physiologic maturity, not age. The i-Rainbow improved the delivery of developmental care activities in our unit and was well received by parents and nurses. VIDEO ABSTRACT Supplemental Digital Content available at: http://links.lww.com/PPT/A516.
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Affiliation(s)
- Eilish M Byrne
- University of Saint Augustine for Health Sciences (Dr Byrne), San Marcos, California; Lucile Packard Children's Hospital Stanford (Ms Hunt), Palo Alto, California; Stanford University School of Medicine (Dr Scala), Stanford University, Palo Alto, California
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2
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Landsman ZT, Kao AR, Gerling GJ. Human-Delivered Brushstroke Characterization using an Instrumented Brush Focused on Torque. WORLD HAPTICS CONFERENCE. WORLD HAPTICS CONFERENCE 2023; 2023:85-92. [PMID: 38618516 PMCID: PMC11015477 DOI: 10.1109/whc56415.2023.10224489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
Pleasant brush therapies may benefit those with autism, trauma, and anxiety. While studies monitor brushing velocity, hand-delivery of brush strokes introduces variability. Detailed measurements of human-delivered brushing physics may help understand such variability and subsequent impact on receivers' perceived pleasantness. Herein, we instrument a brush with multi-axis force and displacement sensors to measure their physics as 12 participants pleasantly stroke a receiver's forearm. Algorithmic procedures identify skin contact, and define four stages of arrival, stroke, departure, and airtime between strokes. Torque magnitude, rather than force, is evaluated as a metric to minimize inertial noise, as it registers brush bend and orientation. Overall, the results of the naturally delivered brushing experiments indicate force and velocity values in the range of 0.4 N and 3-10 cm/s, in alignment with prior work. However, we observe significant variance between brushers across velocity, force, torque, and brushstroke length. Upon further analysis, torque and force measures are correlated, yet torque provides distinct information from velocity. In evaluating the receiver's response to individual differences between brushers of the preliminary case study, higher pleasantness is tied to lower mean torque, and lower instantaneous variance over the stroke duration. Torque magnitude appears to complement velocity's influence on perceived pleasantness.
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Affiliation(s)
| | - Anika R Kao
- University of Virginia, Charlottesville, USA
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3
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Alinejad-Naeini M, Heidari-Beni F, Mohagheghi P, Sohrabi S. The effect of M technique massage on behavioral state and weight gain in preterm neonates: A randomized controlled trial. J Child Health Care 2023:13674935221147714. [PMID: 36592155 DOI: 10.1177/13674935221147714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
This study aimed to investigate the effect of M technique massage on behavioral state and weight gain in preterm neonates admitted to neonatal intensive care unit (NICU). This was a randomized controlled trial study in which a total of 64 preterm neonates were randomly allocated to intervention and control group. Intervention group received M technique massage and control group received routine care. Neonatal weight and behavioral state were measured for two weeks. After intervention, no statistically significant difference was found between groups in terms of neonatal weight (mean difference: 44.03, 95% CI [-180.66, 268.74]). At baseline, the mean score for behavioral state response was 5.84 ± 2.20 (mean ± SD) in control group and 5.68 ± 2.15 (mean ± SD) in intervention group and the difference was not significant (mean difference: 0.16, 95% CI [-1.21, 1.52]), but 2 weeks later, and also, after intervention, a statistically significant difference was found between groups (mean difference: 2.16, 95% CI [1.19, 3.17]) and (mean difference: 3.03, 95% CI [2.15, 3.91]), respectively, meaning that it was significantly lower in intervention group compared with control group. According to the findings, massage with M technique in premature neonates can have a positive effect on behavioral state, but no effect on their weight gain.
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Affiliation(s)
- Mona Alinejad-Naeini
- Department of Neonatal Intensive Care Nursing, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, 440827Iran University of Medical Sciences, Tehran, Iran
| | - Farshad Heidari-Beni
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, 440827Iran University of Medical Sciences, Tehran, Iran
| | - Parisa Mohagheghi
- Division of Neonataology, Newborn Intensive Care Unit (NICU), Department of Pediatrics, Hazrat rasoul Akram Hospital, 440827Iran University of Medical Sciences, Tehran, Iran
| | - Soroor Sohrabi
- Hazrat Ali Asghar Children's Hospital, 440827Iran University of Medical Sciences, Tehran, Iran
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4
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Vafeiadou A, Bowling NC, Hammond C, Banissy MJ. Assessing individual differences in attitudes towards touch in treatment settings: Introducing the touch & health scale. Health Psychol Open 2022; 9:20551029221137008. [DOI: 10.1177/20551029221137008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Individuals commonly receive touch in treatment settings, but there is limited research on how they perceive it. The current project sought to address this gap by: 1) developing the Touch & Health Scale (THS) - a novel instrument to measure attitudes to touch in treatment settings 2) assessing inter-individual differences in THS scores, and 3) examining the association between individuals’ THS scores and wellbeing. Data of a large U.K. adults sample ( N > 12,000) were used. THS showed Cronbach’s α between 0.636 and 0.816 and significant correlations ( p < 0.001) with day-to-day attitudes to touch. THS scores differed as a function of extraversion and avoidant attachment style. Participants with more positive attitudes to touch in treatment settings showed greater wellbeing. Overall, the study highlights the importance of a personalised approach to touch in treatment settings and provides a new scale that may act as a screening tool for this purpose.
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Affiliation(s)
| | | | | | - Michael J Banissy
- Department of Psychology, Goldsmiths, University of London, London, UK
- School of Psychological Science, University of Bristol, Bristol, UK
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5
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Ortega VA, Mercer EM, Giesbrecht GF, Arrieta MC. Evolutionary Significance of the Neuroendocrine Stress Axis on Vertebrate Immunity and the Influence of the Microbiome on Early-Life Stress Regulation and Health Outcomes. Front Microbiol 2021; 12:634539. [PMID: 33897639 PMCID: PMC8058197 DOI: 10.3389/fmicb.2021.634539] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 03/15/2021] [Indexed: 12/12/2022] Open
Abstract
Stress is broadly defined as the non-specific biological response to changes in homeostatic demands and is mediated by the evolutionarily conserved neuroendocrine networks of the hypothalamus-pituitary-adrenal (HPA) axis and the sympathetic nervous system. Activation of these networks results in transient release of glucocorticoids (cortisol) and catecholamines (epinephrine) into circulation, as well as activation of sympathetic fibers innervating end organs. These interventions thus regulate numerous physiological processes, including energy metabolism, cardiovascular physiology, and immunity, thereby adapting to cope with the perceived stressors. The developmental trajectory of the stress-axis is influenced by a number of factors, including the gut microbiome, which is the community of microbes that colonizes the gastrointestinal tract immediately following birth. The gut microbiome communicates with the brain through the production of metabolites and microbially derived signals, which are essential to human stress response network development. Ecological perturbations to the gut microbiome during early life may result in the alteration of signals implicated in developmental programming during this critical window, predisposing individuals to numerous diseases later in life. The vulnerability of stress response networks to maladaptive development has been exemplified through animal models determining a causal role for gut microbial ecosystems in HPA axis activity, stress reactivity, and brain development. In this review, we explore the evolutionary significance of the stress-axis system for health maintenance and review recent findings that connect early-life microbiome disturbances to alterations in the development of stress response networks.
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Affiliation(s)
- Van A Ortega
- Department of Physiology and Pharmacology, University of Calgary, Calgary, AB, Canada.,International Microbiome Centre, Cumming School of Medicine, Health Sciences Centre, University of Calgary, Calgary, AB, Canada
| | - Emily M Mercer
- Department of Physiology and Pharmacology, University of Calgary, Calgary, AB, Canada.,International Microbiome Centre, Cumming School of Medicine, Health Sciences Centre, University of Calgary, Calgary, AB, Canada.,Department of Pediatrics, University of Calgary, Calgary, AB, Canada
| | - Gerald F Giesbrecht
- Department of Pediatrics, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada.,Owerko Centre, The Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| | - Marie-Claire Arrieta
- Department of Physiology and Pharmacology, University of Calgary, Calgary, AB, Canada.,International Microbiome Centre, Cumming School of Medicine, Health Sciences Centre, University of Calgary, Calgary, AB, Canada.,Department of Pediatrics, University of Calgary, Calgary, AB, Canada
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6
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Manzotti A, Cerritelli F, Esteves JE, Lista G, Lombardi E, La Rocca S, Gallace A, McGlone FP, Walker SC. Dynamic touch reduces physiological arousal in preterm infants: A role for c-tactile afferents? Dev Cogn Neurosci 2019; 39:100703. [PMID: 31487608 PMCID: PMC6969366 DOI: 10.1016/j.dcn.2019.100703] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 06/27/2019] [Accepted: 08/19/2019] [Indexed: 01/08/2023] Open
Abstract
Gentle, dynamic touch plays a central role in many perinatal care strategies. C-tactile afferents, unmyelinated mechanoreceptors, respond optimally to low force and velocity touch. CT targeted produced a significant decrease in infants’ heart-rates and increase in their blood oxygenation levels. Static touch did not generate significant change in heart-rate or blood oxygenation levels. Findings from this study provide support for the hypothesis that CTs signal the affective quality of nurturing touch.
Preterm birth is a significant risk factor for a range of long-term health problems and developmental disabilities. Though touch plays a central role in many perinatal care strategies, the neurobiological basis of these approaches is seldom considered. C-Tactile afferents (CTs) are a class of unmyelinated nerve fibre activated by low force, dynamic touch. Consistent with an interoceptive function, touch specifically targeted to activate CTs activates posterior insular cortex and has been reported to reduce autonomic arousal. The present study compared the effect of 5 min of CT optimal velocity stroking touch to 5 min of static touch on the heart-rate and oxygen saturation levels of preterm infants between 28- & 37-weeks gestational age. CT touch produced a significant decrease in infants’ heart-rates and increase in their blood oxygenation levels, which sustained throughout a 5-min post-touch period. In contrast, there was no significant change in heart-rate or blood oxygenation levels of infants receiving static touch. These findings provide support for the hypothesis that CTs signal the affective quality of nurturing touch, providing a neurobiological substrate for the apparent beneficial effects of neonatal tactile interventions and offering insight for their optimisation.
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Affiliation(s)
- Andrea Manzotti
- RAISE Lab, Clinical-Based Human Research Department, Foundation COME Collaboration, Pescara, Italy; Division of Neonatology, "V. Buzzi" Children's Hospital, ASST-FBF-Sacco, Milan, Italy; Research Department, SOMA, Istituto Osteopatia Milano, Milan, Italy
| | - Francesco Cerritelli
- RAISE Lab, Clinical-Based Human Research Department, Foundation COME Collaboration, Pescara, Italy.
| | - Jorge E Esteves
- Gulf National Centre, Foundation COME Collaboration, Riyadh, Saudi Arabia; MYO Osteopathy, Riyadh, Saudi Arabia; University College of Osteopathy, London, UK; Instituto Piaget, Lisbon, Portugal
| | - Gianluca Lista
- Division of Neonatology, "V. Buzzi" Children's Hospital, ASST-FBF-Sacco, Milan, Italy
| | - Erica Lombardi
- RAISE Lab, Clinical-Based Human Research Department, Foundation COME Collaboration, Pescara, Italy; Research Department, SOMA, Istituto Osteopatia Milano, Milan, Italy
| | - Simona La Rocca
- RAISE Lab, Clinical-Based Human Research Department, Foundation COME Collaboration, Pescara, Italy; Research Department, SOMA, Istituto Osteopatia Milano, Milan, Italy
| | - Alberto Gallace
- Department of Psychology and Milan Center for Neuroscience (NeuroMI), University of Milano-Bicocca, Milan, Italy
| | - Francis P McGlone
- Research Centre for Brain & Behaviour, School of Natural Sciences & Psychology, Liverpool John Moores University, UK; Institute of Psychology, Health & Society, University of Liverpool, UK
| | - Susannah C Walker
- Research Centre for Brain & Behaviour, School of Natural Sciences & Psychology, Liverpool John Moores University, UK
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Mueller SM, Grunwald M. Frühgeborenenmassage: taktile Körperstimulation in der Neonatalmedizin. MANUELLE MEDIZIN 2019. [DOI: 10.1007/s00337-019-0546-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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8
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Dumont V, Bulla J, Bessot N, Gonidec J, Zabalia M, Guillois B, Roche-Labarbe N. The manual orienting response habituation to repeated tactile stimuli in preterm neonates: Discrimination of stimulus locations and interstimulus intervals. Dev Psychobiol 2018; 59:590-602. [PMID: 28605017 DOI: 10.1002/dev.21526] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 03/21/2017] [Accepted: 04/18/2017] [Indexed: 11/06/2022]
Abstract
Preterm infants frequently develop atypical sensory profiles, the tactile modality being particularly affected. However, there is a lack of recent investigation of neonatal tactile perception in a passive context, especially in preterms who are particularly exposed to this tactile stimuli. Our aims were to provide evidence of orienting responses (behavioral modifications directing subject's attention towards stimuli) and habituation to passive tactile stimuli in preterm neonates, to explore their ability to perceive spatial and temporal aspects of the stimulus, and to evaluate the effect of clinical factors on these abilities. We included 61 preterm neonates, born between 32 and 34 weeks of gestational age. At 35 weeks of corrected gestational age, we measured orienting responses (forearm, hand, and fingers movements) during vibrotactile stimulation of their hand and forearm; during a habituation and dishabituation paradigm, the dishabituation being either a location change or a pause in the stimulation sequence. Preterm newborns displayed a manual orienting response to vibrotactile stimuli which significantly decreased when the stimulus was repeated, regardless of the stimulated location on the limb. Habituation was delayed in subjects born at a younger gestational age, smaller birth weight, and having experienced more painful care procedures. Preterm neonates perceived changes in stimulus location and interstimulus time interval. Our findings provide insights on several aspects of the perception of repeated tactile stimuli by preterm neonates, and the first evidence of the early development of temporal processing abilities in the tactile modality. Future work will investigate the links between this ability and neurodevelopmental disorders.
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Affiliation(s)
| | - Jan Bulla
- Department of Mathematics, University of Bergen, Bergen, Norway
| | - Nicolas Bessot
- Normandie University, UNICAEN, INSERM, COMETE, Caen, France
| | | | - Marc Zabalia
- Normandie University, UNICAEN, EA7452, Caen, France
| | - Bernard Guillois
- Normandie University, UNICAEN, EA7452, Caen, France.,Service de Néonatologie, CHU de Caen, Caen, France
| | - Nadège Roche-Labarbe
- Normandie University, UNICAEN, EA7452, Caen, France.,Normandie University, UNICAEN, INSERM, COMETE, Caen, France
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9
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Abstract
PURPOSE To review and analyze studies evaluating the effects of massage on term and preterm infants. DESIGN A systematic review of literature. RESULTS Benefits of massage for term infants are: improved weight gain, growth, and sleep and decreased hyperbilirubinemia. Benefits for preterm infants are: improved weight gain, decreased response to pain, and increased interactions with parents. However, the few studies use different interventions related to timing and number of massages, and the outcomes vary among studies. There is not enough evidence to support the use of massage for term and preterm infants, but massage may be considered on a case-by-case basis.
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10
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Malloch S, Shoemark H, Črnčec R, Newnham C, Paul C, Prior M, Coward S, Burnham D. Music therapy with hospitalized infants-the art and science of communicative musicality. Infant Ment Health J 2012; 33:386-399. [PMID: 28520171 DOI: 10.1002/imhj.21346] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Infants seek contingent, companionable interactions with others. Infants in a Neonatal Intensive Care Unit (NICU), while receiving care that optimizes their chances of survival, often do not have the kind of interactions that are optimal for their social development. Live music therapy (MT) with infants is an intervention that aims for contingent, social interaction between therapist and infant. This study, with a limited numbers of infants, examined the effectiveness of an MT intervention in the NICU at The Royal Children's Hospital Melbourne. Two groups of late pre-term and full-term infants were recruited to the study; one was given MT and the other was not. A healthy group of infants not given MT served as an additional control. The effect of MT was indexed using two measures reflecting infant social engagement: the Neurobehavioral Assessment of the Preterm Infant (NAPI) and the Alarm Distress Baby Scale (ADBB). Results suggest that the MT intervention used at The Royal Children's Hospital Melbourne supports infants' neurobehavioral development. In particular, hospitalized infants who received MT were better able to maintain self-regulation during social interaction with an adult, were less irritable and cried less, and were more positive in their response to adult handling, when compared with infants who did not receive the intervention. These are important prerequisites for social interaction and development. Further and larger scale research using MT with this population is indicated.
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Affiliation(s)
| | - Helen Shoemark
- Murdoch Childrens Research Institute and The Royal Children's Hospital, Melbourne
| | - Rudi Črnčec
- MARCS Auditory Laboratories, University of Western Sydney
| | - Carol Newnham
- Parent-Infant Research Institute, Austin Medical Centre, Melbourne
| | - Campbell Paul
- The Royal Children's Hospital, Melbourne and Murdoch Childrens Research Institute
| | | | - Sean Coward
- MARCS Auditory Laboratories, Univeristy of Western Sydney
| | - Denis Burnham
- MARCS Auditory Laboratories, Univeristy of Western Sydney
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11
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Gooding JS, Cooper LG, Blaine AI, Franck LS, Howse JL, Berns SD. Family support and family-centered care in the neonatal intensive care unit: origins, advances, impact. Semin Perinatol 2011; 35:20-8. [PMID: 21255703 DOI: 10.1053/j.semperi.2010.10.004] [Citation(s) in RCA: 327] [Impact Index Per Article: 25.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Family-centered care (FCC) has been increasingly emphasized as an important and necessary element of neonatal intensive care. FCC is conceptualized as a philosophy with a set of guiding principles, as well as a cohort of programs, services, and practices that many hospitals have embraced. Several factors drive the pressing need for family-centered care and support of families of infants in NICUs, including the increase in the number of infants in NICUs; growth in diversity of the population and their concurrent needs; identification of parental and familial stress and lack of parenting confidence; and gaps in support for families, as identified by parents and NICU staff. We explore the origins of and advances in FCC in the NICU and identify various delivery methods and aspects of FCC and family support in the NICU. We examine the research and available evidence supporting FCC in the NICU and offer recommendations for increased dissemination and for future study.
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Affiliation(s)
- Judith S Gooding
- NICU Initiatives and Chapter Program Strategy, Chapter Program Support, March of Dimes Foundation, White Plains, NY 10605, USA.
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12
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The development of potentially better practices to support the neurodevelopment of infants in the NICU. J Perinatol 2007; 27 Suppl 2:S48-74. [PMID: 18034182 DOI: 10.1038/sj.jp.7211844] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To review the existing evidence used to identify potentially better care practices that support newborn brain development. STUDY DESIGN Literature review. RESULT Sixteen potentially better practices are identified and grouped into two operational clinical bundles based upon timing for recommended implementation. CONCLUSION Existing evidence supports the implementation of selected care practices that potentially may support newborn brain development.
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Abstract
The purpose of this article is to provide a review of current nursing research that supports best practices during the newborn period. The literature review of peer-reviewed research articles published between January 2000 and October 2004 was conducted via keyword searches using the databases of the Cochrane Library, CINAHL, and MEDLINE. Key words included neonatal nursing, newborn, neonate, premature infant, preterm infant, and low birthweight. Content analysis revealed the following primary categories of studies that provide solid evidence for nursing practice: developmentally focused nursing care, neonatal skin care, feeding, skin-to-skin care, and pain management. Neonatal nurse researchers have made many important contributions to the research literature. Future research should expand the findings to date on the effective use of pain scales, the outcomes of skin-to-skin care and infant massage as standard practice for all neonates, and the effectiveness of nursing interventions to support the developmental sequelae of prematurity. Neonatal nurses should become familiar with and implement those findings from nursing research that strongly support evidence-based nursing practice.
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Affiliation(s)
- Judy A Beal
- School for Health Studies, Simmons College, Boston, USA.
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14
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Abstract
Infant massage has been practiced for centuries by segments on the continents of Africa and South America and in the Far East. Infant massage is a relatively new modality in North America. Numerous studies support its use in preterm infants, who have exhibited decreased stress levels, increased weight gain, and improved motor function when compared with non-massaged controls. Research has recently turned to the benefits of massage in the cocaine-exposed population and in those with human immunodeficiency virus. Massage in ill preterms has been targeted for clinical testing.
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Affiliation(s)
- Rosalie O Mainous
- Graduate Program, School of Nursing, University of Louisville, Louisville, Kentucky, USA
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