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Bellizzi S, Panu Napodano CM, Murgia P. Family-centered care for newborns: a global perspective and review. J Trop Pediatr 2024; 70:fmae026. [PMID: 39142805 DOI: 10.1093/tropej/fmae026] [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: 08/16/2024]
Abstract
Person-centered models of care built on newborn and family needs and rights, such as nonseparation immediately after birth and during the care process, can address the complex needs of the newborn, family, and health system. This is particularly important in low- and middle-income countries, where cost-effective modalities are highly needed to accelerate the survival of newborn babies. We conducted a systematic review to explore country experiences on implementation and challenges to implement and scale-up family-centered newborn care models of care. MEDLINE, CINAHL, EMBASE, and PsycINFO databases were searched to identify studies on patient-centered care and newborns between 1990 and 2023. Studies meeting our predefined inclusion criteria were quality assessed and relevant data extracted. We utilized the World Health Organization framework on integrated people-centered health services to summarize and analyze findings while highlighting patterns. Forty-one studies were included for review (including approximately 60% from low- and middle-income countries). Different research conducted over time highlighted how immediate and uninterrupted skin-to-skin care facilitates a series of critical processes for newborns, parents, and health system, including breastfeeding initiation and exclusivity rates, reduced incidence of post-partum depression, and prevention of infection and hospitalization. Thanks to the close contact of the kangaroo position or skin-to-skin contact, parents recount becoming more and more attached to and familiar with their baby, easily establishing a relationship. Overall, countries could transform the newborn care service in terms of family center care by adopting three simple rules: (i) minimizing mother-child separation; (ii) involving fathers; (iii) empowering parents from the time of birth. A paradigm shift is required to change the conventional model of provider-centric care to one of person-centered neonatal health care. Such an approach is feasible in diverse country settings and should be facilitated through political commitment and policies enabling early focus on the maternal-infant relationship. This could, in turn, help achieve improved dignity of care and help create a more efficient and responsive health system and society.
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Affiliation(s)
- Saverio Bellizzi
- Unit of Infectious Diseases, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari 07100, Italy
| | - Catello M Panu Napodano
- Unit of Infectious Diseases, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari 07100, Italy
| | - Paola Murgia
- Unit of Infectious Diseases, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari 07100, Italy
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Lyu T, Ye R, Li LL, Zhang LL, Xiao J, Ma YL, Li F, Rong H, Liu D, Wang H, Wang Y, Gu WW, Xuan Y, Chen X, Fan QL, Tang YF, Huang XH, Qin A, Zhang YL, Dou Y, Hu XJ. The effect of developmental care on the length of hospital stay and family centered care practice for very low birth weight infants in neonatal intensive care units: A cluster randomized controlled trial. Int J Nurs Stud 2024; 156:104784. [PMID: 38788261 DOI: 10.1016/j.ijnurstu.2024.104784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 03/12/2024] [Accepted: 04/29/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND Despite previous studies suggesting that developmental care can provide benign stimulation to promote neural development of newborns, more evidence is needed regarding the other clinical benefits of developmental care. OBJECTIVE To evaluate the effect of implementing developmental care on the length of hospital stay, the improvement of care practice in neonatal intensive care units, as well as the short-term outcome of very low birth weight infants. DESIGN Cluster-randomized controlled trial. SETTING(S) AND PARTICIPANTS From March 1, 2021 to March 1, 2022, 1400 very low birth weight infants were recruited from 14 tertiary neonatal intensive care units in China. METHODS We assigned 14 neonatal intensive care units to either developmental care or standard care. The length of hospital stay of the infants was the primary outcome analyzed at the individual level. Secondary outcomes were family centered care practice including parental involvement, the skin to skin care, exclusive breast milk, oral immune therapy and breastfeeding. The environmental management (noise and light) and the short-term outcomes were also evaluated. RESULTS The length of hospital stay for the developmental care group was 65 % as long as that for the control group (HR: 0.65, 95 % CI, 0.451-0936, p = 0.021). After controlling the covariables, the adjusted HR = 0.755 (95 % CI, 0.515 to 1.107, p = 0.150). When compared to the control group, the developmental care group had greater access to SSC, with 22 infants (3.8 %) in the developmental care group compared to 13 infants (1.7 %) in the standard care group (p = 0.013). A greater proportion of infants in the developmental care group were fed at the breast, than those in the standard care group (136 [23.6 %] vs 9 [1.1 %]; p = 0.029). Compared to the control group, exclusively breast milk was significantly more favorable in the developmental care group (435 [75.6 %] vs 114 [15.0 %]; p = 0.001). The difference remained significant even after adjusting for covariates. However, the rate of oral immune therapy and parental involvement was similar in the two groups. The average noise and light levels in the developmental care group were significantly lower than those in the standard care group. After adjusting for confounders, the difference remained significant. There were no significant differences among groups in the mortality and major morbidity. CONCLUSIONS Developmental care might have developed an accumulated effect over time on the length of hospital stay among very low birth weight infants. The implementation of developmental care can greatly improve family centered care practices and the neonatal intensive care unit environment. REGISTRATION ClinicalTrials.govNCT05166720. Registration date: 1 March, 2021.
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Affiliation(s)
- TianChan Lyu
- Fujian Key Laboratory of Neonatal Diseases, Xiamen Key Laboratory of Neonatal Diseases, Xiamen Children's Hospital (Children's Hospital of Fudan University at Xiamen), Xiamen, China; Children's Hospital of Fudan University, Shanghai, China
| | - Ruming Ye
- Fujian Key Laboratory of Neonatal Diseases, Xiamen Key Laboratory of Neonatal Diseases, Xiamen Children's Hospital (Children's Hospital of Fudan University at Xiamen), Xiamen, China
| | - Li Ling Li
- Children's Hospital of Fudan University, Shanghai, China
| | - Li Li Zhang
- First Affiliated Hospital of Anhui Medical University, Anhui, China
| | - Juan Xiao
- First Affiliated Hospital of Anhui Medical University, Anhui, China
| | - Yue Lan Ma
- Suzhou Municipal Hospital, Jiangsu, China
| | - Fang Li
- Nanjing Children's Hospital, Jiangsu, China
| | - Hui Rong
- Nanjing Children's Hospital, Jiangsu, China
| | - Dan Liu
- Zhejiang Maternal Hospital, Zhejiang, China
| | - Hua Wang
- Zhejiang Maternal Hospital, Zhejiang, China
| | - Yan Wang
- Anhui Provincial Children's Hospital, Anhui, China
| | - Wei Wei Gu
- Ningbo Women and Children's Hospital, Zhejiang, China
| | - Yan Xuan
- Hainan Women and Children's Medical Center, Hainan, China
| | - XiaoChun Chen
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Zhejiang, China
| | | | | | - Xiang Hui Huang
- Fujian Key Laboratory of Neonatal Diseases, Xiamen Key Laboratory of Neonatal Diseases, Xiamen Children's Hospital (Children's Hospital of Fudan University at Xiamen), Xiamen, China
| | - An Qin
- Shanghai Jiao Tong University School of Medicine Affiliated International Peace Maternal and Child Health Hospital, Shanghai, China
| | | | - Yalan Dou
- Children's Hospital of Fudan University, Shanghai, China
| | - Xiao Jing Hu
- Fujian Key Laboratory of Neonatal Diseases, Xiamen Key Laboratory of Neonatal Diseases, Xiamen Children's Hospital (Children's Hospital of Fudan University at Xiamen), Xiamen, China; Children's Hospital of Fudan University, Shanghai, China; Research Unit of Early Intervention of Genetically Related Childhood Cardiovascular Diseases (2018RU002), Chinese Academy of Medical Sciences, China.
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Pavlyshyn H, Sarapuk I, Kozak K. The relationship between neonatal stress in preterm infants and developmental outcomes at the corrected age of 24-30 months. Front Psychol 2024; 15:1415054. [PMID: 38840740 PMCID: PMC11150848 DOI: 10.3389/fpsyg.2024.1415054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 05/10/2024] [Indexed: 06/07/2024] Open
Abstract
Aim The aim of research was to study the relationship between the stress experienced by preterm infants in the neonatal intensive care unit (NICU) and developmental status in the follow up, and to establish factors, associated with their neurodevelopment. Methods The first stage of research involved measuring stress markers (cortisol, melatonin) in infants (n = 56) during their NICU stay; the second phase assessed the developmental status at the corrected age of 24-30 months. Results The total ASQ-3 score, communication, problem solving, and personal-social skills scores at the corrected age of 24-30 months were positively correlated with melatonin level determined in the neonatal period (r = 0.31, p = 0.026; r = 0.36, p = 0.009; r = 0.30, p = 0.033, and r = 0.32; p = 0.022 respectively). In the same time, ASQ-3 communication and personal-social scores were negatively correlated with cortisol level (r = -0.31, p = 0.043; r = -0.35, p = 0.022). The ROC-curve analysis revealed that a decrease of melatonin below 3.44 ng/mL and 3.71 ng/mL during the neonatal period could predict communication and problem-solving delay, respectively. An increase in cortisol above 0.64 mcg/dl is predictive in personal-social delay. Negative correlation was identified between the NICU and total hospital stay duration and ASQ-3 communication scores in the follow-up (r = -0.27; p = 0.049 and r = -0.41; p = 0.002, respectively). The duration of mechanical ventilation was negatively correlated with gross motor scores (r = -0.46; p = 0.043). Apgar score was positively correlated with ASQ-3 communication (r = 0.29; p = 0.032) and personal-social scores (r = 0.28; p = 0.034); maternal age-with ASQ-3 total (r = 0.29; p = 0.034), communication (r = 0.37; p = 0.006), and personal-social scores (r = 0.29; p = 0.041). Positive correlations were observed between gestational age and communication scores (r = 0.28; p = 0.033). Infants who suffered neonatal sepsis had significantly often delay of communication (p = 0.014) and gross motor skills (p = 0.016). Children who required mechanical ventilation were more likely to have communication delay (p = 0.034). Conclusion Developmental outcomes in preterm infants at the corrected age of 24-30 months were associated with neonatal stress. Correlations between the communication, problem-solving and personal-social development in the follow up and cortisol and melatonin levels determined in the neonatal period supported this evidence. Factors as low gestational age, duration of hospital and NICU stay, mechanical ventilation, and sepsis were associated with more frequent delays in communication, gross motor and problems-solving skills.
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Affiliation(s)
- Halyna Pavlyshyn
- Department of Pediatrics, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
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Sizun J, Herbulot L, Krechting F. [Average prematurity: medical and developmental aspects]. SOINS. PEDIATRIE, PUERICULTURE 2024; 45:18-21. [PMID: 38697720 DOI: 10.1016/j.spp.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
Children born with moderate prematurity are at increased risk of neonatal morbidity, rehospitalization during the first year, and subsequent medical and neurodevelopmental disorders. Care in a specialized environment, at best without separation of mother and child, is necessary. Early developmental support, particularly through skin-to-skin contact, breastfeeding and couplet care, is recommended.
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Affiliation(s)
- Jacques Sizun
- Service de néonatalogie, Hôpital des enfants, CHU de Toulouse, 330 avenue de Grande-Bretagne, 31300 Toulouse, France; Faculté de santé, Université Toulouse-III, 113 route de Narbonne, 31062 Toulouse, France.
| | - Léa Herbulot
- Service de néonatalogie, Hôpital des enfants, CHU de Toulouse, 330 avenue de Grande-Bretagne, 31300 Toulouse, France
| | - Floortje Krechting
- Faculté de santé, Université Toulouse-III, 113 route de Narbonne, 31062 Toulouse, France
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McAlinden B, Pool N, Harnischfeger J, Waak M, Campbell M. 'Baby Liberation' - Developing and implementing an individualised, developmentally-supportive care bundle to critically unwell infants in an Australian Paediatric Intensive Care Unit. Early Hum Dev 2024; 190:105944. [PMID: 38290275 DOI: 10.1016/j.earlhumdev.2024.105944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/21/2023] [Accepted: 01/17/2024] [Indexed: 02/01/2024]
Abstract
BACKGROUND Infants requiring high acuity care within a Paediatric Intensive Care Unit are at multifactorial risk of neurological injury to the immature brain, resulting in long-term developmental difficulties. In 2020, Queensland Children's Hospital implemented an individualised family-centred developmental care program, 'Baby Liberation', to address an identified service gap for critically unwell infants, aimed at optimising early neuroprotective strategies and minimising risk of suboptimal developmental outcomes. AIM To implement Baby Liberation for infants admitted to a quaternary paediatric intensive care referral centre. Secondary aims were to describe environmental changes, enablers and limitations related to implementation. STUDY DESIGN A single-centre, prospective implementation pilot study investigated the feasibility of implementing Baby Liberation. Subjects included infants less than six months of age admitted to Queensland Children's Hospital Paediatric Intensive Care Unit. OUTCOME MEASURES Primary measures comprised data collected during the implementation period, including number of eligible patients and number of developmental care plans provided. Environmental audit data were collected pre and post implementation to inform secondary outcomes. RESULTS Baby Liberation was feasibly implemented into the Queensland Children's Hospital Paediatric Intensive Care Unit. During implementation, 181 individualised care plans were provided to 313 eligible infants (57.8 %). Environmental audits showed improvements in all areas of developmental care, with greatest improvements noted in pain and stress management (+95 %) and staff support and development (+83.3 %). CONCLUSION Implementation of Baby Liberation was feasible within a large quaternary paediatric intensive care unit and has potential to be expanded into other clinical areas providing acute infant care.
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Affiliation(s)
- Bronagh McAlinden
- Physiotherapy Department, Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, Brisbane, Australia; Paediatric Intensive Care Unit, Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, Brisbane, Australia.
| | - Natasha Pool
- Paediatric Intensive Care Unit, Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, Brisbane, Australia
| | - Jane Harnischfeger
- Paediatric Intensive Care Unit, Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, Brisbane, Australia
| | - Michaela Waak
- Paediatric Intensive Care Unit, Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, Brisbane, Australia
| | - Miranda Campbell
- Paediatric Intensive Care Unit, Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, Brisbane, Australia; Occupational Therapy and Music Therapy Department, Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, Brisbane, Australia
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Pineda R, Kellner P, Gruskin BA, Smith J. Organizational Barriers to and Facilitators of the Successful Implementation and Sustainability of the Supporting and Enhancing NICU Sensory Experiences (SENSE) Program. Am J Occup Ther 2024; 78:7801205180. [PMID: 38271664 DOI: 10.5014/ajot.2024.050450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024] Open
Abstract
IMPORTANCE The Supporting and Enhancing NICU Sensory Experiences (SENSE) program is an evidence-based intervention that promotes daily, positive sensory exposures for infants in the neonatal intensive care unit (NICU). Understanding program implementation across sites may aid in optimizing strategies for uptake of the program and subsequently improve outcomes for infants and families. OBJECTIVE To investigate health care professionals' perceptions of implementing the SENSE program. DESIGN The SENSE Program Implementation Survey was developed using Proctor et al.'s model and the BARRIERS scale to probe organizational practices across sites worldwide. SETTING Survey distributed to 211 hospitals with a SENSE program license obtained before March 2020. PARTICIPANTS One hundred fourteen NICU personnel (response rate = 54%). OUTCOMES AND MEASURES The survey sought to understand barriers and facilitators, adaptations during implementation, and associated costs. RESULTS Of the 53% (n = 57 of 107) of respondents who had implemented the SENSE program, many (n = 14; 31%) experienced quick timing (<1 mo) to use, including spread to nearly all infants in their NICU within 6 mo (n = 18; 35%). Most reported the program was used to educate families ≤3 days of birth (n = 20/59; 34%). Most of the sensory interventions in the program were performed by parents (n = 38; 67%) and therapists (n = 44; 77%). Barriers and facilitators at the organizational and individual levels were identified. No additional staff were hired to implement the program. CONCLUSIONS AND RELEVANCE Given perceived successes and challenges, strategic enhancement of implementation can inform future administrations of the SENSE program. Plain-Language Summary: This study provides occupational therapists who are interested in implementing the SENSE program (Supporting and Enhancing NICU Sensory Experiences) with an understanding of common barriers, facilitators, costs, and adaptations, which can be used to advocate for program implementation in NICUs to improve outcomes for preterm infants worldwide.
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Affiliation(s)
- Roberta Pineda
- Roberta Pineda, PhD, OTR/L, CNT, is Associate Professor, Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles; Department of Pediatrics and Neonatology, Keck School of Medicine and Children's Hospital of Los Angeles, Los Angeles, CA; Gehr Family Center for Health Systems Science and Innovation, Keck School of Medicine, University of Southern California, Los Angeles; and Adjunct Faculty, Program in Occupational Therapy, Washington University in St. Louis, St. Louis, MO;
| | - Polly Kellner
- Polly Kellner, MSOT, OTR/L, is Clinical Research Specialist and Occupational Therapist, Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles
| | - Bethany A Gruskin
- Bethany A. Gruskin, MSOT, OTR/L, is PhD Student, Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles
| | - Joan Smith
- Joan Smith, PhD, RN, NNP-BC, FAAN, is Director, Department of Quality, Safety, and Practice Excellence, St. Louis Children's Hospital, St. Louis, MO
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Stern-Delfils A, Leray I, Caeymaex L, Dicky O, Akrich M, Reynaud A, Bouvard C, Evrard A, Sizun J, Tscherning C, Kuhn P. Father's perceptions and care involvement for their very preterm infants at French neonatal intensive care units. Front Psychiatry 2023; 14:1229141. [PMID: 38034931 PMCID: PMC10687630 DOI: 10.3389/fpsyt.2023.1229141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 10/30/2023] [Indexed: 12/02/2023] Open
Abstract
Objectives We aimed to evaluate (1) fathers' perceptions and care involvement for their very premature infants and their views of the hospitalization period based on parental reports and (2) their evolution over time. Methods We used an online parental survey to assess answers from parents of very preterm infants who were successfully discharged from French neonatal units. We analysed answers from February 2014 to January 2019 to an anonymous internet-based survey from the GREEN committee of the French Neonatal Society. Responses were compared for period 1 (P1, 1998 to 2013) and period 2 (P2, 2014 to 2019). Results We analyzed 2,483 surveys, 124 (5%) from fathers and 2,359 (95%) from mothers. At birth, 1,845 (80%) fathers were present in the hospital, but only 879 (38%) were near the mother. The presence of fathers in the NICU increased from P1 to P2 (34.5% vs. 43.1%, p = 0.03). Nearly two thirds of fathers accompanied their infants during transfer to the NICU (1,204 fathers, 60.6%). Fathers and mothers had similar perceptions regarding relationships with caregivers and skin-to-skin contact with their infants. However, more fathers than mothers felt welcome in the NICU and in care involvement regarding requests for their wishes when they met their infant (79% vs. 60%, p = 0.02) and in the presentation of the NICU (91% vs. 76%; p = 0.03). Mothers and fathers significantly differed in the caring procedures they performed (p = 0.01), procedures they did not perform but wanted to perform (p < 0.001), and procedures they did not perform and did not want to perform (p < 0.01). Conclusion Most fathers were present at the births of their very preterm infants, but fewer fathers were near the mother at this time. Less than two thirds of fathers accompanied their infants to the NICU. There should be further changes to better meet the specific needs of the fathers of infants requiring care in the NICU. Continuing assessment with an online questionnaire may be useful to monitor changes over time in father's involvement in NICUs.
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Affiliation(s)
| | - Isabelle Leray
- Department of Neonatology, University Hospital of Strasbourg, Strasbourg, France
| | - Laurence Caeymaex
- NICU, Centre Hospitalier Intercommunal de Créteil, Créteil, France
- Centre d’Etudes Discours Images Textes Ecrits Communication (CEDITEC), Paris Est Créteil University, Créteil, France
| | - Odile Dicky
- NICU, University Hospital, Toulouse, France
- U1027 INSERM, Paul Sabatier University, Toulouse, France
| | - Madeleine Akrich
- Collectif inter-associatif autour de la naissance (CIANE), Paris, France
| | | | | | - Anne Evrard
- Collectif inter-associatif autour de la naissance (CIANE), Paris, France
| | | | - Charlotte Tscherning
- NICU, University Hospital, Toulouse, France
- U1027 INSERM, Paul Sabatier University, Toulouse, France
- NICU, Sidra Medicine Hospital, Well Cornell University Hospital, Doha, Qatar
- Center for Pathophysiology Toulouse-Purpan (CPTP), Inserm Unviversity of Toulouse, Toulouse, France
| | - Pierre Kuhn
- Department of Neonatology, University Hospital of Strasbourg, Strasbourg, France
- Institut des Neurosciences Cellulaires et Intégratives, CNRS UPR, Strasbourg University, Strasbourg, France
- Neonatal Research Unit, Department of Women’s and Children’s Health, Karolinska Institute, Stockholm, Sweden
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Passini L, Le Bouedec S, Dassieu G, Reynaud A, Jung C, Keller ML, Lefebvre A, Katty T, Baleyte JM, Layese R, Audureau E, Caeymaex L. Error disclosure in neonatal intensive care: a multicentre, prospective, observational study. BMJ Qual Saf 2023; 32:589-599. [PMID: 36918264 DOI: 10.1136/bmjqs-2022-015247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 11/08/2022] [Indexed: 03/16/2023]
Abstract
IMPORTANCE Surveys based on hypothetical situations suggest that health-care providers agree that disclosure of errors and adverse events to patients and families is a professional obligation but do not always disclose them. Disclosure rates and reasons for the choice have not previously been studied. OBJECTIVE To measure the proportion of errors disclosed by neonatal intensive care unit (NICU) professionals to parents and identify motives for and barriers to disclosure. DESIGN Prospective, observational study nested in a randomised controlled trial (Study on Preventing Adverse Events in Neonates (SEPREVEN); ClinicalTrials.gov). Event disclosure was not intended to be related to the intervention tested. SETTING 10 NICUs in France with a 20-month follow-up, starting November 2015. PARTICIPANTS n=1019 patients with NICU stay ≥2 days with ≥1 error. EXPOSURE Characteristics of errors (type, severity, timing of discovery), patients and professionals, self-reported motives for disclosure and non-disclosure. MAIN OUTCOME AND MEASURES Rate of error disclosure reported anonymously and voluntarily by physicians and nurses; perceived parental reaction to disclosure. RESULTS Among 1822 errors concerning 1019 patients (mean gestational age: 30.8±4.5 weeks), 752 (41.3%) were disclosed. Independent risk factors for non-disclosure were nighttime discovery of error (OR 2.40; 95% CI 1.75 to 3.30), milder consequence (for moderate consequence: OR 1.85; 95% CI 0.89 to 3.86; no consequence: OR 6.49; 95% CI 2.99 to 14.11), a shorter interval between admission and error, error type and fewer beds. The most frequent reported reasons for non-disclosure were parental absence at its discovery and a perceived lack of serious consequence. CONCLUSION AND RELEVANCE In the particular context of the SEPREVEN randomised controlled trial of NICUs, staff did not disclose the majority of errors to parents, especially in the absence of moderate consequence for the infant. TRIAL REGISTRATION NUMBER NCT02598609.
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Affiliation(s)
- Loïc Passini
- Neonatal Intensive care Unit, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | | | - Gilles Dassieu
- Neonatal Intensive care Unit, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | | | - Camille Jung
- Clinical Research Center, Centre Hospitalier Intercommunal de Creteil, Creteil, France
| | - Marie-Laurence Keller
- Neonatal Intensive care Unit, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Aline Lefebvre
- Department of Child and Adolescent Psychiatry, APHP, Paris, France
- Human Genetics and Cognitive Functions, Institut Pasteur, UMR 3571 CNRS, University Paris Diderot, Paris, France
- Child and Adolescent Psychiatry Creteil, Centre Hospitalier Intercommunal de Creteil, Creteil, France
| | - Therese Katty
- Health Law Manager, Centre Hospitalier Intercommunal de Creteil, Creteil, France
| | - Jean-Marc Baleyte
- Child and Adolescent Psychiatry Creteil, Centre Hospitalier Intercommunal de Creteil, Creteil, France
- Faculty of Health, University Paris Est Creteil, Creteil, France
| | - Richard Layese
- INSERM IMRB, CEpiA Team, University Paris Est Creteil, Creteil, France, Créteil, France
- Unité de Recherche Clinique (URC), Hôpital Henri Mondor, Assistance Publique - Hôpitaux de Paris APHP, Créteil, France
| | - Etienne Audureau
- INSERM IMRB, CEpiA Team, University Paris Est Creteil, Creteil, France, Créteil, France
- Unité de Recherche Clinique (URC), Hôpital Henri Mondor, Assistance Publique - Hôpitaux de Paris APHP, Créteil, France
| | - Laurence Caeymaex
- Neonatal Intensive care Unit, Centre Hospitalier Intercommunal de Créteil, Créteil, France
- Clinical Research Center, Centre Hospitalier Intercommunal de Creteil, Creteil, France
- Faculty of Health, University Paris Est Creteil, Creteil, France
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Sizun J, Kuhn P, Tscherning C. Care with child development and André Bullinger's special look at prematurity. REVISTA PAULISTA DE PEDIATRIA : ORGAO OFICIAL DA SOCIEDADE DE PEDIATRIA DE SAO PAULO 2023; 41:e2022208. [PMID: 37194842 DOI: 10.1590/1984-0462/2023/41/2022208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Indexed: 05/18/2023]
Affiliation(s)
| | | | - Charlotte Tscherning
- Division of Neonatology, Sidra Medicine, Weill-Cornell Medical College, Doha, Qatar
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Early skin-to-skin contact and risk of late-onset-sepsis in very and extremely preterm infants. Pediatr Res 2022:10.1038/s41390-022-02383-3. [PMID: 36376509 DOI: 10.1038/s41390-022-02383-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 10/12/2022] [Accepted: 10/18/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND To evaluate the association between exposure to early skin-to-skin contact (SSC) and incidence of late-onset sepsis (LOS) in extremely and very preterm infants. METHODS Observational study using the national population-based EPIPAGE-2 cohort in 2011. A propensity score for SSC exposure was used to match infants with and without exposure to SSC before day 4 of life and binomial log regression used to estimate risk ratios and CIs in the matched cohort. The primary outcome was at least one episode of LOS during hospitalization. Secondary outcomes were the occurrence of any late-onset neonatal infection (LONI), LOS with Staphylococcus or Staphylococcus aureus, incidence of LOS and LONI per 1000 central venous catheter days. RESULTS Among the 3422 included infants, 919 were exposed to early SSC. The risk ratio (RR) for LOS was 0.86 (95% CI, 0.67-1.10), for LONI was 1.00 (95% CI, 0.83-1.21), and for LOS with Coagulase-negative Staphylococcus or Staphylococcus aureus infection was 0.91 (95% CI, 0.68-1.21) and 0.77 (95% CI, 0.31-1.87). The incidence RR for LOS per-catheter day was 0.87 (95% CI, 0.64-1.18). CONCLUSION Early SSC exposure was not associated with LOS or LONI risk. Thus, their prevention should not be a barrier to a wider use of SSC. IMPACT Kangaroo Mother Care decreased neonatal infection rates in middle-income countries. Skin-to-skin contact is beneficial for vulnerable preterm infants but barriers exist to its implementation. In a large population-based study using a propensity score methods, we found that skin-to-skin contact before day 4 of life was not associated with a decreased risk of late-onset-sepsis in very and extremely preterm infants. Early skin-to-skin contact was not associated with an increased risk of any late-onset-neonatal-infection, in particular with staphylococcus. The fear of neonatal infection should not be a barrier to a wider use of early skin-to-skin contact in this population.
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Guajardo‐Villar A, Demiguel V, Smaïli S, Boudet‐Berquier J, Pilkington H, Blondel B, Salanave B, Regnault N, Pelat C. Trends and disparities in breastfeeding initiation in France between 2010 and 2016: Results from the French National Perinatal Surveys. MATERNAL & CHILD NUTRITION 2022; 18:e13410. [PMID: 35909344 PMCID: PMC9480949 DOI: 10.1111/mcn.13410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 06/17/2022] [Accepted: 07/07/2022] [Indexed: 11/29/2022]
Abstract
Breastfeeding (BF) initiation rates in French maternity units are among the lowest in Europe. After increasing for several years, they decreased between 2010 and 2016, although several maternal characteristics known to be positively associated with BF in France were more frequent. We aimed to (1) quantify adjusted trends in BF initiation rates between 2010 and 2016; (2) examine associations between BF initiation rates and newborn, maternal, maternity unit, and department‐level characteristics. Using data from the 2010 (n = 12,224) and 2016 (n = 11,089) French National Perinatal Surveys, we analysed BF initiation (exclusive, mixed, and any) through a succession of six mixed‐effect multinomial regression models, progressively adding adjustment covariates. Adjusted exclusive and any BF initiation rates decreased by 9.6 and 4.5 points, respectively, versus by 7.7 and 1.8 points, respectively, in the crude analysis. In both years, adjusted exclusive and any BF initiation rates were lowest in the following categories of mothers: low education level, single, high body mass index and multiple or premature births. Exclusive BF initiation decreased most in primiparous mothers, those with the lowest household income, mothers that had a vaginal delivery, women born in an African country and those who delivered in a maternity unit without Baby‐Friendly Hospital Initiative designation. The 2010–2016 decrease in BF initiation rates in France cannot be explained by changes in mothers' characteristics; quite the opposite, adjustment increased its magnitude. Additional efforts should be put in place to understand why this decrease is particularly sharp in some subgroups of mothers. While some maternal characteristics previously known to be positively associated with breastfeeding (BF) in France were more frequent in 2016 than 2010, any BF initiation rate in maternity units in France decreased by 2 points (from 68.7% to 66.7%), and exclusive BF by 8 points (from 60.3% to 52.2%). Even greater decreases (4.5 and 9.6 points, respectively) were observed after adjusting for the characteristics of mothers, newborns, maternity units, and departments. Between 2010 and 2016, the largest decreases in adjusted exclusive BF initiation rates were observed in primiparous mothers, those with the lowest household income, mothers that had a vaginal delivery, women born in an African country and those who delivered in a maternity unit without Baby‐Friendly Hospital Initiative designation.
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Affiliation(s)
- Andrea Guajardo‐Villar
- Data Support, Processing and Analysis Department (DATA), Santé publique France French National Public Health Agency Saint‐Maurice France
| | - Virginie Demiguel
- Non‐Communicable Diseases and Trauma Department (DMNTT), Santé publique France French National Public Health Agency Saint‐Denis France
| | - Sabira Smaïli
- Data Support, Processing and Analysis Department (DATA), Santé publique France French National Public Health Agency Saint‐Maurice France
| | - Julie Boudet‐Berquier
- Non‐Communicable Diseases and Trauma Department (DMNTT), Santé publique France French National Public Health Agency Saint‐Denis France
| | - Hugo Pilkington
- Département de Géographie, UMR7533 Ladyss Université Paris 8 Vincennes‐Saint‐Denis Saint‐Denis France
| | - Beatrice Blondel
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Center of Research in Epidemiology and Statistics (CRESS), INSERM Université de Paris Cité Paris France
| | - Benoit Salanave
- Non‐Communicable Diseases and Trauma Department (DMNTT), Santé publique France French National Public Health Agency Saint‐Denis France
| | - Nolwenn Regnault
- Non‐Communicable Diseases and Trauma Department (DMNTT), Santé publique France French National Public Health Agency Saint‐Denis France
| | - Camille Pelat
- Data Support, Processing and Analysis Department (DATA), Santé publique France French National Public Health Agency Saint‐Maurice France
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12
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Zana‐Taïeb E, Sizun J, Kuhn P, Reynaud A, Allen A, Berne‐Audeoud F, Bouvard C, Brandicourt A, Caeymaex L, Denoual H, Duboz MA, Evrard A, Fichtner C, Fischer‐Fumeaux C, Girard L, Gonnaud F, Haumont D, Hüppi P, Knezovic N, Laprugne‐Garcia E, Legouais S, Mons F, Pelofy V, Picaud J, Pierrat V, Pladys P, Renesme L, Rideau A, Souet G, Tscherning C, Thiriez G, Tourneux P, Touzet M, Truffert P, Zaoui C, Zores‐Koenig C. Practical recommendations on room sizes for hospitalised newborn infants and their families based on a systematic review of the literature. Acta Paediatr 2022; 111:1109-1114. [PMID: 35194839 DOI: 10.1111/apa.16308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/18/2022] [Accepted: 02/21/2022] [Indexed: 11/30/2022]
Abstract
AIM Neonatal unit design may affect the neurodevelopment of hospitalised neonates and the well-being of parents and healthcare staff (HCS). We aimed to provide recommendations regarding the minimum area required for a hospital room for a single neonate and their family. METHODS We searched PubMed and Web of Science for relevant articles published from 1 January 2011 to 1 May 2021 by using the keywords NICU and facility design. Recommendations were developed after internal and external review by a multidisciplinary group including 15 professionals and parent representatives. RESULTS We identified 314 studies and developed six recommendations from four eligible studies. Recommendations for room size were developed according to three perspectives: opinions of users, who emphasised the need for a spacious room; proposals of organisations by HCS, which advocated for a minimum floor area of 11.2-18 m2 in a single non-family room and 15.3-24 m2 in a single-family room; and simulation methods indicating that the minimum floor area in the neonatal unit should be 18.5-24 m2 . CONCLUSION Units need to provide a minimum room size to allow for optimal newborn development and a better experience for parents and caregivers.
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Affiliation(s)
- Elodie Zana‐Taïeb
- Department of Neonatal Medicine Cochin‐Port Royal Hospital FHU PREMA Paris AP‐HP France
| | - Jacques Sizun
- Department of Neonatal Medicine Children Hospital Toulouse France
| | - Pierre Kuhn
- Department of Neonatal Medecine. CHU Hautepierre Strasbourg France
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13
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Almutairi WM. Survey of Skin-to-Skin Contact with Obstetrics and Pediatric Nurses. NURSING REPORTS 2022; 12:13-21. [PMID: 35076611 PMCID: PMC8788535 DOI: 10.3390/nursrep12010002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 11/28/2021] [Accepted: 12/08/2021] [Indexed: 11/23/2022] Open
Abstract
Skin-to-skin, or chest-to-chest, contact (SSC) between newborns and their mothers is known as kangaroo mother care. The physiological and psychological benefits of SSC for infants and mothers are well established. The World Health Organization (WHO) recommends practicing SSC for term and preterm newborns. However, in Saudi Arabia, SSC is not practiced as widely as recommended. There is insufficient evidence of the nurses' knowledge and attitudes regarding SSC in Saudi Arabia. The aims of this study were to describe and determine relationships between knowledge, education, beliefs/attitudes, and the implementation of SSC in Jeddah, Saudi Arabia. Thank You for Your Time and Kind Suggestion Methods: Cross-sectional descriptive data were collected from 40 nurses using an English-language version of a knowledge, beliefs/attitudes, education, and implementation questionnaire used by others. Results: The mean age of the nurses was 42.4 years (SD = 3.2), with a mean experience of 12 years (SD = 2.1). The mean total score of SSC knowledge was 13.6 (SD = 2.3), the mean of total score of attitudes/beliefs was 12.3 (SD = 3.1), the SSC education mean score was 17.1 (SD = 3.4), and the SSC implementation mean score was 17.0 (SD = 4.1). In total, 55% of the nurses were not sure of the impact of SSC on brain development in neonates, 45% could not interpret infants' responses during SSC; 67% disagreed that it was the nurses' responsibility to facilitate SSC, 37.5% were not aware of SSC guidelines, and 47% of the nurses had not received any continuing education on SSC in their units. Pearson correlations revealed a significant association between SSC implementation and nurses' knowledge level (r = 0.297, p = 0.031), education (r = 0.85, p = 0.015), and beliefs (r = 0.31, p = 0.024). Conclusions: Once nurses have improved their knowledge, education, and beliefs/attitudes, SSC implementation may concomitantly increase. A continuing education program and clear guidelines are needed to promote SSC adoption in practice.
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Affiliation(s)
- Wedad M Almutairi
- Maternity and Child Department, Faculty of Nursing, King Abdulaziz University, Jeddah 21551, Saudi Arabia
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14
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Lisle J, Buma K, Smith J, Richter M, Satpute P, Pineda R. Maternal Perceptions About Sensory Interventions in the Neonatal Intensive Care Unit: An Exploratory Qualitative Study. Front Pediatr 2022; 10:884329. [PMID: 35783324 PMCID: PMC9240393 DOI: 10.3389/fped.2022.884329] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 05/10/2022] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Mothers play an important role in providing positive sensory experiences to their infants during NICU hospitalization. However, little is known regarding maternal perceptions about sensory-based interventions in the NICU. Further, understanding maternal perceptions was an important part of the process during development of the Supporting and Enhancing NICU Sensory Experiences (SENSE) program. METHODS Twenty mothers of very preterm infants were interviewed after NICU discharge and asked open-ended questions about sensory-based interventions they performed in the NICU and probed about their perceptions related to the development of a sensory-based guideline and the use of volunteers to provide sensory-based interventions when unable to be present in the NICU. Interviews were transcribed and uploaded into NVivoV.12 for content analysis. RESULTS Mothers reported that kangaroo care was a common sensory intervention they performed in the NICU. Of the 18 mothers who commented on the development of a sensory-based guideline, 17 (94%) said they would be accepting of one. Among 19 mothers, 18 (95%) supported volunteers conducting sensory-based interventions in their absence. Identified themes included: 1) Perceptions about development of a sensory-based guideline, 2) Perceptions of interactions with healthcare providers, 3) Maternal participation in sensory interventions, 4) Maternal experience, and 5) Emotions from mothers. CONCLUSION Maternal perceptions regarding the development of a sensory-based guideline were favorable, and the SENSE program has since been finalized after incorporating important insights learned from stakeholders in this study. Mothers' perceptions were tied to their NICU experiences, which elicited strong emotions. These findings highlight important considerations when developing family-centered interventions.
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Affiliation(s)
- Julia Lisle
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, United States
| | - Kylie Buma
- Program in Occupational Therapy, Washington University School of Medicine in St. Louis, St. Louis, MO, United States
| | - Joan Smith
- Department of Quality, Safety and Practice Excellence St. Louis Children's Hospital, St. Louis, MO, United States
| | - Marinthea Richter
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, United States
| | - Prutha Satpute
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, United States
| | - Roberta Pineda
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, United States.,Program in Occupational Therapy, Washington University School of Medicine in St. Louis, St. Louis, MO, United States.,Department of Pediatrics, Keck School of Medicine, Los Angeles, CA, United States.,Gehr Family Center for Health Systems Science and Innovation, University of Southern California, Los Angeles, CA, United States
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15
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Lorthe E, Benhammou V, Marchand-Martin L, Pierrat V, Lebeaux C, Durox M, Goffinet F, Kaminski M, Ancel PY. Cohort Profile: The Etude Epidémiologique sur les Petits Ages Gestationnels-2 (EPIPAGE-2) preterm birth cohort. Int J Epidemiol 2021; 50:1428-1429m. [PMID: 34165536 PMCID: PMC8580281 DOI: 10.1093/ije/dyaa282] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 12/16/2020] [Indexed: 01/20/2023] Open
Affiliation(s)
- Elsa Lorthe
- Université de Paris, Epidemiology and Statistics Research Center/CRESS, INSERM (U1153 - Obstetrical, Perinatal and Pediatric Epidemiology Research Team [EPOPé]), INRA, F-75004 Paris, France
- EPIUnit—Institute of Public Health, University of Porto, Porto, Portugal
- Corresponding author. Inserm U1153, Maternité Port-Royal, 123 boulevard de Port-Royal, 75014 Paris, France. E-mail:
| | - Valérie Benhammou
- Université de Paris, Epidemiology and Statistics Research Center/CRESS, INSERM (U1153 - Obstetrical, Perinatal and Pediatric Epidemiology Research Team [EPOPé]), INRA, F-75004 Paris, France
| | - Laetitia Marchand-Martin
- Université de Paris, Epidemiology and Statistics Research Center/CRESS, INSERM (U1153 - Obstetrical, Perinatal and Pediatric Epidemiology Research Team [EPOPé]), INRA, F-75004 Paris, France
| | - Véronique Pierrat
- Université de Paris, Epidemiology and Statistics Research Center/CRESS, INSERM (U1153 - Obstetrical, Perinatal and Pediatric Epidemiology Research Team [EPOPé]), INRA, F-75004 Paris, France
- CHU Lille, Department of Neonatal Medicine, Jeanne de Flandre Hospital, Lille, France
| | - Cécile Lebeaux
- Université de Paris, Epidemiology and Statistics Research Center/CRESS, INSERM (U1153 - Obstetrical, Perinatal and Pediatric Epidemiology Research Team [EPOPé]), INRA, F-75004 Paris, France
- Neonatal Intensive Care Unit, Centre Hospitalier Intercommunal de Créteil, Ile de France, France
- Reseau Perinatal, Val de Marne, Ile-de-France, France
| | - Mélanie Durox
- Université de Paris, Epidemiology and Statistics Research Center/CRESS, INSERM (U1153 - Obstetrical, Perinatal and Pediatric Epidemiology Research Team [EPOPé]), INRA, F-75004 Paris, France
| | - François Goffinet
- Université de Paris, Epidemiology and Statistics Research Center/CRESS, INSERM (U1153 - Obstetrical, Perinatal and Pediatric Epidemiology Research Team [EPOPé]), INRA, F-75004 Paris, France
- Maternité Port-Royal, AP-HP, APHP.Centre - Université de Paris, FHU PREMA, Paris, France
| | - Monique Kaminski
- Université de Paris, Epidemiology and Statistics Research Center/CRESS, INSERM (U1153 - Obstetrical, Perinatal and Pediatric Epidemiology Research Team [EPOPé]), INRA, F-75004 Paris, France
| | - Pierre-Yves Ancel
- Université de Paris, Epidemiology and Statistics Research Center/CRESS, INSERM (U1153 - Obstetrical, Perinatal and Pediatric Epidemiology Research Team [EPOPé]), INRA, F-75004 Paris, France
- Clinical Research Unit, Center for Clinical Investigation P1419, APHP.CUP, F-75014, Paris, France
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16
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Chandebois L, Nogue E, Bouschbacher C, Durand S, Masson F, Mesnage R, Nagot N, Cambonie G. Dissemination of newborn behavior observation skills after Newborn Individualized Developmental Care and Assessment Program (NIDCAP) implementation. Nurs Open 2021; 8:3547-3557. [PMID: 33956404 PMCID: PMC8510744 DOI: 10.1002/nop2.904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 01/06/2021] [Accepted: 02/17/2021] [Indexed: 11/23/2022] Open
Abstract
Aim To assess nurses’ ability to observe newborn behaviour after in situ training provided by caregivers with advanced practice certification in the Newborn Individualized Developmental Care and Assessment Program (NIDCAP). Design Prospective observational study. Methods Twelve nurses viewed 20‐min films showing the behaviour of 10 premature newborns before, during and after the usual caregiving. The behaviour was rated on an observation sheet with 88 items distributed into six systems. The responses were compared to the reference ratings established by two professionals certified for this programme. Results Despite less accurate observations during care and for some components, the nurses generally showed a satisfactory ability to observe newborn behaviour after training by NIDCAP expert professionals. The dissemination of observation skills among caregivers may result in an improved quality of patient care and better communication among professionals in a department of neonatology.
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Affiliation(s)
- Laurence Chandebois
- Department of Neonatal Medicine, Arnaud de Villeneuve Hospital, Montpellier University Hospital Centre, Montpellier, France
| | - Erika Nogue
- Clinical Research and Epidemiology Unit, Montpellier University Hospital Centre, University of Montpellier, Montpellier, France
| | - Catherine Bouschbacher
- Department of Neonatal Medicine, Arnaud de Villeneuve Hospital, Montpellier University Hospital Centre, Montpellier, France
| | - Sabine Durand
- Department of Neonatal Medicine, Arnaud de Villeneuve Hospital, Montpellier University Hospital Centre, Montpellier, France
| | - Florence Masson
- Department of Neonatal Medicine, Arnaud de Villeneuve Hospital, Montpellier University Hospital Centre, Montpellier, France
| | - Renaud Mesnage
- Department of Neonatal Medicine, Arnaud de Villeneuve Hospital, Montpellier University Hospital Centre, Montpellier, France
| | - Nicolas Nagot
- Clinical Research and Epidemiology Unit, Montpellier University Hospital Centre, University of Montpellier, Montpellier, France.,Pathogenesis and Control of Chronic Infection, INSERM UMR 1058, University of Montpellier, Montpellier, France
| | - Gilles Cambonie
- Department of Neonatal Medicine, Arnaud de Villeneuve Hospital, Montpellier University Hospital Centre, Montpellier, France.,Pathogenesis and Control of Chronic Infection, INSERM UMR 1058, University of Montpellier, Montpellier, France
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17
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Mother's Own Milk Feeding in Preterm Newborns Admitted to the Neonatal Intensive Care Unit or Special-Care Nursery: Obstacles, Interventions, Risk Calculation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084140. [PMID: 33919856 PMCID: PMC8070824 DOI: 10.3390/ijerph18084140] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/07/2021] [Accepted: 04/08/2021] [Indexed: 01/24/2023]
Abstract
Early nutrition of newborns significantly influences their long-term health. Mother's own milk (MOM) feeding lowers the incidence of complications in preterm infants and improves long-term health. Unfortunately, prematurity raises barriers for the initiation of MOM feeding and its continuation. Mother and child are separated in most institutions, sucking and swallowing is immature, and respiratory support hinders breastfeeding. As part of a quality-improvement project, we review the published evidence on risk factors of sustained MOM feeding in preterm neonates. Modifiable factors such as timing of skin-to-skin contact, strategies of milk expression, and infant feeding or mode of delivery have been described. Other factors such as gestational age or neonatal complications are unmodifiable, but their recognition allows targeted interventions to improve MOM feeding. All preterm newborns below 34 weeks gestational age discharged over a two-year period from our large German level III neonatal center were reviewed to compare institutional data with the published evidence regarding MOM feeding at discharge from hospital. Based on local data, a risk score for non-MOM feeding can be calculated that helps to identify mother-baby dyads at risk of non-MOM feeding.
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18
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Dicky O, Kuhn P, Akrich M, Reynaud A, Caeymaex L, Tscherning C. Emotional responses of parents participating for the first time in caregiving for their baby in a neonatal unit. Paediatr Perinat Epidemiol 2021; 35:227-235. [PMID: 33029809 DOI: 10.1111/ppe.12718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 07/22/2020] [Accepted: 07/26/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Parents of term and preterm infants hospitalised at birth experience a stressful situation. They are considered as primary caregivers in neonatal units and are encouraged to participate in their child's care. OBJECTIVES The aim of our study was to analyse the feelings of parents participating for the first time in caregiving for their baby admitted at birth in a neonatal unit in France and to compare the feelings reported by parents of term and preterm infants. METHODS An online survey was created in 2014 for parents who had a baby hospitalised at birth. We analysed parents' responses to this open-ended question: "How did you feel when you participated in caregiving for your baby for the first time?" using a qualitative discourse analysis by two analysts. Themes were identified and coded. RESULTS Between February 2014 and March 2018, 1603 parents of preterm infants and 239 parents of term infants responded to this open-ended question. Twenty-five per cent of parents expressed positive feelings exclusively (confidence, ease, joy, pride, feeling supported by healthcare professionals, by their family and feeling of being a parent), 41% expressed negative feelings exclusively (stress, fear, feeling of being judged, frustration, anger, uselessness and clumsiness) and 34% expressed mixed feelings (both positive and negative). Parents of term infants expressed less frequent feelings of stress and fear than parents of preterm infants: with a relative risk (RR) of 0.69, 95% confidence interval (CI) 0.56, 0.87. Parents of term babies more frequently expressed feelings of frustration: RR 2.40 (95% CI 1.33, 4.32). CONCLUSIONS Infant- and Family-Centred Developmental Care supportive programmes are recommended within neonatal units in order to improve the experience of parents participating in caregiving for their baby hospitalised at birth.
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Affiliation(s)
- Odile Dicky
- NICU, University Hospital, Toulouse, France.,U1027 INSERM, Paul Sabatier University, Toulouse, France
| | - Pierre Kuhn
- NICU, University Hospital, Strasbourg, France.,Cellular and Integrative Neuroscience Institute, CNRS, Paris, France
| | - Madeleine Akrich
- Collectif inter-associatif autour de la naissance (CIANE), Paris, France
| | | | - Laurence Caeymaex
- NICU, Centre Hospitalier Intercommunal de Créteil, Créteil, France.,Centre d'Etudes Discours Images Textes Ecrits Communication (CEDITEC), Paris Est Créteil University, Créteil, France
| | - Charlotte Tscherning
- NICU, University Hospital, Toulouse, France.,U1027 INSERM, Paul Sabatier University, Toulouse, France.,NICU, Sidra Medecine Hospital, Well Cornell University Hospital, Doha, Qatar.,Center for Pathophysiology Toulouse-Purpan (CPTP), Inserm Unviversity of Toulouse, Toulouse, France
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19
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Herrera S, Pierrat V, Kaminski M, Benhammou V, Bonnet AL, Ancel PY, Germa A. Factors associated with non-nutritive sucking habits at 2 years of age among very preterm children: EPIPAGE-2 cohort study. Paediatr Perinat Epidemiol 2021; 35:217-226. [PMID: 33016411 DOI: 10.1111/ppe.12725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 08/30/2020] [Accepted: 08/23/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND The association between prolonged non-nutritive sucking habits (NNSHs, ie, sucking pacifiers or fingers) and maxillofacial growth anomalies in the general population has been widely described. Because maturation of sucking abilities is not fully achieved in very preterm infants (<32 weeks' gestation), neonatal services worldwide rely on the use of pacifiers to promote the development of adequate sucking reflexes, possibly prolonging NNSHs during infancy. OBJECTIVE We aimed to describe the frequency and to identify factors associated with NNSHs at age 2 years in very preterm children. METHODS The study was based on data from EPIPAGE-2, a French national prospective cohort study of preterm births during 2011 that included 2593 children born between 24 and 31 weeks' gestation. The primary outcome was NNSHs at 2 years. Multivariable log-linear regression models with generalized estimation equations were used to study the association between the characteristics studied and NNSHs. Multiple imputations were used to take into account missing data. RESULTS The frequency of NNSHs was 69% in the overall sample but higher among girls (adjusted risk ratio [RR] 1.12, 95% confidence interval [CI] 1.05, 1.17), children born from multiple pregnancies (eg, twins/triplets) (RR 1.07, 95% CI 1.00, 1.11), children who were fed by nasogastric tube (RR 1.07, 95% CI 1.01, 1.13), or those who benefitted from developmental care programmes (RR 1.10, 95% CI 1.02, 1.19). The NNSHs frequency was lower if mothers were not born in France (RR 0.70, 95% CI 0.64, 0.77), children had 2 or more older siblings (RR 0.88, 95% CI 0.82, 0.96), or children were breast-fed at discharge (RR 0.90, 95% CI 0.85, 0.95). CONCLUSIONS NNSHs at 2 years seemed associated with cultural background, development care programmes, and breast feeding. Whether NNSHs at 2 years among very preterm children are associated with future maxillofacial growth anomalies deserves further attention.
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Affiliation(s)
| | - Véronique Pierrat
- Université de Paris, CRESS, INSERM, INRA, Paris, France.,Department of Neonatal Medicine, Jeanne de Flandre Hospital, CHU Lille, Lille, France
| | | | | | - Anne-Laure Bonnet
- Université de Paris, EA2496, Montrouge, France.,Department of Odontology, AP-HP, Charles Foix Hospital, Paris, France
| | - Pierre-Yves Ancel
- Université de Paris, CRESS, INSERM, INRA, Paris, France.,Clinical Research Unit, Centre for Clinical Investigation P1419, Cochin Broca Hôtel-Dieu Hospital, Paris, France
| | - Alice Germa
- Université de Paris, CRESS, INSERM, INRA, Paris, France.,Department of Odontology, AP-HP, Charles Foix Hospital, Paris, France
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Artese C, Paterlini G, Mascheroni E, Montirosso R. Barriers and Facilitators to Conducting Kangaroo Mother Care in Italian Neonatal Intensive Care Units. J Pediatr Nurs 2021; 57:e68-e73. [PMID: 33189484 DOI: 10.1016/j.pedn.2020.10.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 10/20/2020] [Accepted: 10/29/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE This work aimed to investigate obstacles and facilitators for carrying out Kangaroo Mother Care (KMC) across Italian NICUs. DESIGN AND METHODS A survey that investigated Unit's characteristics, policies toward parents and KMC practice and policies was carried out. Data from 86 NICUs (80.4%) was collected. Descriptive statistics and Multiple Regression Models were computed. RESULTS Eighty-one NICUs provided KMC. These NICUs had a less restricted parental access policies (chi2 = 7.373, p = .007). More than the 70% of the units did not have adequate facilities for parents. KMC daily length was positively predicted (R2 = 0.18, F = 7.91, p = .001) by repeated sessions and documentation of KMC. CONCLUSION The implementation of KMC is characterized by different barriers and facilitators that determine the parent's possibility to provide KMC. Structural factors (e.g., adequate space and facilities) can support families in providing KMC. A unique result of this survey is that KMC documentation on medical records appears critical for improving its practice. PRACTICE IMPLICATIONS Although most of the Italian units provide KMC as a routine practice, improving its practical support would be beneficial to its implementation. A more formalized approach to KMC may strengthen staff habits to consider KMC like a standard care treatment.
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Affiliation(s)
- Claudia Artese
- SOD Neonatology and Neonatal Intensive Care Unit, Careggi Hospital-University, Italy
| | - Giuseppe Paterlini
- Department of Mother's and Child's Health, Neonatology and Neonatal Intensive Care Unit, Poliambulanza Foundation Hospital Institute, Italy
| | - Eleonora Mascheroni
- 0-3 Center for the at-Risk Infant, Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Italy.
| | - Rosario Montirosso
- 0-3 Center for the at-Risk Infant, Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Italy
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21
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Klein V, Zores-Koenig C, Dillenseger L, Langlet C, Escande B, Astruc D, Le Ray I, Kuhn P. Changes of Infant- and Family-Centered Care Practices Administered to Extremely Preterm Infants During Implementation of the NIDCAP Program. Front Pediatr 2021; 9:718813. [PMID: 34540769 PMCID: PMC8446645 DOI: 10.3389/fped.2021.718813] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 08/05/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Many studies have evaluated the Neonatal Individualized Developmental Care and Assessment Program (NIDCAP), but few studies have assessed changes in infant- and family-centered developmental care (IFCDC) practices during its implementation. Objectives: The primary objective of this single center study was to investigate the impact of the implementation of the NIDCAP program on IFCDC practices used for management of extremely preterm infants (EPIs). The secondary objective was to determine during implementation the impact of this program on the short-term medical outcomes of all EPIs hospitalized at our center. Methods: All EPIs (<28 weeks gestational age) who were hospitalized at Strasbourg University Hospital from 2007 to 2014 were initially included. Outborn infants were excluded. The data of EPIs were compared for three time periods: 2007 to 2008 (pre-NIDCAP), 2010 to 2011, and 2013 to 2014 (during-NIDCAP implementation) using appropriate statistical tests. The clinical and caring procedures used during the first 14 days of life were analyzed, with a focus on components of individualized developmental care (NIDCAP observations), infant pain management (number of painful procedures, clinical pain assessment), skin-to-skin contact (SSC; frequency, day of initiation, and duration), and family access and involvement in the care of their children (duration of parental presence, parental participation in care). The short-term mortality and morbidity at discharge were evaluated. Results: We examined 228 EPIs who received care during the three time periods. Over time, painful procedures decreased, but pain evaluations, parental involvement in care, individualized observations, and SSC increased (all p < 0.01). In addition, the first SSC was performed earlier (p = 0.03) and lasted longer (p < 0.01). There were no differences in mortality and morbidity, but there were reductions in the duration of mechanical ventilation (p = 0.02) and the time from birth to first extubation (p = 0.02), and an increase of weight gain at discharge (p = 0.02). Conclusion: NIDCAP implementation was accompanied by progressive, measurable, and significant changes in IFCDC strategies. There were, concomitantly, moderate but statistically significant improvements in multiple important outcome measures of all hospitalized EPI.
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Affiliation(s)
- Valérie Klein
- Service de Pédiatrie, Centre Hospitalier de Haguenau, Haguenau, France
| | - Claire Zores-Koenig
- Service de Médecine et Réanimation du Nouveau-né, Centre Hospitalier Universitaire de Strasbourg, Strasbourg, France
| | - Laurence Dillenseger
- Service de Médecine et Réanimation du Nouveau-né, Centre Hospitalier Universitaire de Strasbourg, Strasbourg, France
| | - Claire Langlet
- Service de Médecine et Réanimation du Nouveau-né, Centre Hospitalier Universitaire de Strasbourg, Strasbourg, France
| | - Benoît Escande
- Service de Médecine et Réanimation du Nouveau-né, Centre Hospitalier Universitaire de Strasbourg, Strasbourg, France
| | - Dominique Astruc
- Service de Médecine et Réanimation du Nouveau-né, Centre Hospitalier Universitaire de Strasbourg, Strasbourg, France
| | - Isabelle Le Ray
- Service de Médecine et Réanimation du Nouveau-né, Centre Hospitalier Universitaire de Strasbourg, Strasbourg, France.,Service d'Obstétrique-Gynécologie, Centre Hospitalier Universitaire de Strasbourg, Strasbourg, France
| | - Pierre Kuhn
- Service de Médecine et Réanimation du Nouveau-né, Centre Hospitalier Universitaire de Strasbourg, Strasbourg, France.,Institut de Neurosciences Cellulaires et Intégratives, CNRS, Université de Strasbourg, Strasbourg, France
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22
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Neurodevelopmental impairment at 2 years of age in children born before 29 weeks' gestation with bronchopulmonary dysplasia. Arch Pediatr 2020; 28:23-28. [PMID: 33257210 DOI: 10.1016/j.arcped.2020.10.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 07/30/2020] [Accepted: 10/02/2020] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Very preterm children are at a high risk for neurological impairment, especially those with bronchopulmonary dysplasia (BPD). The main goal of this study was to describe the neurodevelopmental impairment (NDI) at 2 years of corrected age in children born before 29 weeks' gestation between 2010 and 2015 and affected by BPD at 28 days of life. We also searched for risk factors associated with NDI, especially postnatal steroid (PNS) administration. MATERIAL AND METHODS This was a retrospective study comprising a cohort of children hospitalized at the university hospital in Grenoble, born before 29 weeks' gestation between 2010 and 2015, and included in the monitoring network "Naitre et Devenir" (RND). Infants at 2 years of corrected age were classified as having NDI if they had at least one of the following outcomes: a global developmental quotient (DQ) on the revised Brunet-Lézine scale of<85, blindness, deafness, or cerebral palsy (CP) graded as level 3 or more according to the Gross Motor Function Classification System. RESULTS A total of 129 children were included, of whom 99 were monitored at the age of 2 years: 31.3% of the population had NDI and 4% had CP. The median DQ test result was 90 (interquartile 82-97). Factors associated with NDI in univariate analysis were low gestational age, low birth weight, a cord pH<7.2, chorioamnionitis, treatment for persistent ductus arteriosus, longer oxygen therapy, and outborn status, which almost reached statistical significance. In multivariate analysis, low gestational age and outborn status remained statistically significant, while chorioamnionitis was found to have some association with NDI. While 13.1% of the followed-up population was treated with PNS, this risk factor was not associated with NDI. CONCLUSION In a population of very preterm children, one third had NDI at 2 years of corrected age. Low gestational age, outborn status, and perinatal inflammation are associated with this unfavorable outcome. The frequency of sequelae confirms the importance of following up these children.
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Accès et rôle des parents en néonatalogie en période d’épidémie COVID-19 — Propositions du GREEN de la SFN. PERFECTIONNEMENT EN PÉDIATRIE 2020. [PMCID: PMC7833627 DOI: 10.1016/j.perped.2020.07.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Pierrat V, Burguet A, Marchand-Martin L, Cambonie G, Coquelin A, Roze JC, Durox M, Guillois B, Morgan AS, Kaminski M. Variations in patterns of care across neonatal units and their associations with outcomes in very preterm infants: the French EPIPAGE-2 cohort study. BMJ Open 2020; 10:e035075. [PMID: 32571857 PMCID: PMC7311036 DOI: 10.1136/bmjopen-2019-035075] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES To describe patterns of care for very preterm (VP) babies across neonatal intensive care units (NICUs) and associations with outcomes. DESIGN Prospective cohort study, EPIPAGE-2. SETTING France, 2011. PARTICIPANTS 53 (NICUs); 2135 VP neonates born at 27 to 31 weeks. OUTCOME MEASURES Clusters of units, defined by the association of practices in five neonatal care domains - respiratory, cardiovascular, nutrition, pain management and neurodevelopmental care. Mortality at 2 years corrected age (CA) or severe/moderate neuro-motor or sensory disabilities and proportion of children with scores below threshold on the neurodevelopmental Ages and Stages Questionnaire (ASQ). METHODS Hierarchical cluster analysis to identify clusters of units. Comparison of outcomes between clusters, after adjustment for potential cofounders. RESULTS Three clusters were identified: Cluster 1 with higher proportions of neonates free of mechanical ventilation at 24 hours of life, receiving early enteral feeding, and neurodevelopmental care practices (26 units; n=1118 babies); Cluster 2 with higher levels of patent ductus arteriosus and pain screening (11 units; n=398 babies); Cluster 3 with higher use of respiratory, cardiovascular and pain treatments (16 units; n=619 babies). No difference was observed between clusters for the baseline maternal and babies' characteristics. No differences in outcomes were observed between Clusters 1 and 3. Compared with Cluster 1, mortality at 2 years CA or severe/moderate neuro-motor or sensory disabilities was lower in Cluster 2 (adjusted OR 0.46, 95% CI 0.25 to 0.84) but with higher proportion of children with an ASQ below threshold (adjusted OR 1.49, 95% CI 1.07 to 2.08). CONCLUSION In French NICUs, care practices for VP babies were non-randomly associated. Differences between clusters were poorly explained by unit or population differences, but were associated with mortality and development at 2 years. Better understanding these variations may help to improve outcomes for VPT babies, as it is likely that some of these discrepancies are unwarranted.
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Affiliation(s)
- Veronique Pierrat
- Equipe EPOPé, U 1153, Université de Paris, CRESS, INSERM, INRA, Paris, France
- Department of Neonatal Medicine, Jeanne de Flandre Hospital, CHU Lille, Lille, France
| | - Antoine Burguet
- Department of Neonatal Pediatrics, Dijon University Hospital, Dijon, France
| | | | - Gilles Cambonie
- Neonatology and Neonatal Intensive Care Unit, Montpellier University Hospital Centre, Montpellier cedex 5, France
| | - Anaëlle Coquelin
- Equipe EPOPé, U 1153, Université de Paris, CRESS, INSERM, INRA, Paris, France
| | - J C Roze
- Paediatric Intensive Care, University Hospital Centre Nantes Clinic of Medical Paediatrics, Nantes, France
- Centre d'Investigation Clinique (CIC004), University Hospital Centre Nantes, Nantes, France
| | - Melanie Durox
- Equipe EPOPé, U 1153, Université de Paris, CRESS, INSERM, INRA, Paris, France
| | - Bernard Guillois
- Department of Neonatal Pediatrics and Intensive Care, University Hospital, Caen, France
| | - Andrei S Morgan
- Equipe EPOPé, U 1153, Université de Paris, CRESS, INSERM, INRA, Paris, France
- Institute for Womens' Health, University College London, London, UK
| | - Monique Kaminski
- Equipe EPOPé, U 1153, Université de Paris, CRESS, INSERM, INRA, Paris, France
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Franck LS, Waddington C, O'Brien K. Family Integrated Care for Preterm Infants. Crit Care Nurs Clin North Am 2020; 32:149-165. [PMID: 32402313 DOI: 10.1016/j.cnc.2020.01.001] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Parent-infant separation is a major source of stress for parents of hospitalized preterm infants and has negative consequences for infant health and development. Family Integrated Care (FICare) uses a strengths-based approach, based on family-centered care principles to promote parental empowerment, learning, shared decision making, and positive parent-infant caregiving experiences. Outcomes of FICare include increased self-efficacy upon discharge and improved parent-infant relationships and infant developmental outcomes. In this article, the authors describe the FICare model and emerging evidence regarding outcomes of FICare for infants and families and discuss challenges and opportunities in implementing and maintaining high-quality FICare.
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Affiliation(s)
- Linda S Franck
- Department of Family Health Care Nursing, School of Nursing, University of California, San Francisco, Box 0606, San Francisco, CA 94143, USA.
| | - Chandra Waddington
- School of Nursing, University of British Columbia, T201-2211 Wesbrook Mall, Vancouver, British Columbia V6T1Z7, Canada
| | - Karel O'Brien
- Department of Pediatrics, Sinai Health System, Toronto, Ontario, Canada; Department of Paediatrics, University of Toronto, 19-231A -600 University Avenue, Toronto, Ontario M5G 1X5, Canada
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Mendizabal‐Espinosa RM, Warren I. Non-evidence-based beliefs increase inequalities in the provision of infant- and family-centred neonatal care. Acta Paediatr 2020; 109:314-320. [PMID: 31421061 DOI: 10.1111/apa.14972] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 08/06/2019] [Accepted: 08/15/2019] [Indexed: 12/01/2022]
Abstract
AIM To identify barriers that might explain why healthcare staff struggle to implement infant- and family-centred developmental care programmes in two neonatal intensive care units in Mexico. METHODS Ethnographic fieldwork over the course of 10 months examined interactions among healthcare professionals, parents and babies in two Mexican publicly funded hospitals. Data are drawn from interviews with 29 parents and 34 healthcare professionals and participant observations in the hospitals' neonatal units. RESULTS Healthcare professionals believed they acted in babies' best interests by excluding parents from the neonatal unit. Professional frustration with working conditions seemed to be increased by the belief that parents were ignorant and unhygienic. Parents were perceived as a source of infection; in contrast, healthcare professionals failed to see themselves as a possible source of cross-contamination. CONCLUSIONS Beliefs and biases increase health inequalities when evidenced-based measures to prevent cross-infection and potentially life-saving programmes, such as kangaroo mother care and breastfeeding, are not implemented. It is imperative to develop context-appropriate education and practice guidelines to implement basic programmes.
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Affiliation(s)
| | - Inga Warren
- University College London Hospital London UK
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27
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Perceived maternal information on premature infant's pain during hospitalization: the French EPIPAGE-2 national cohort study. Pediatr Res 2020; 87:153-162. [PMID: 31086294 DOI: 10.1038/s41390-019-0422-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 03/26/2019] [Accepted: 03/26/2019] [Indexed: 11/08/2022]
Abstract
BACKGROUND Parents of preterm neonates wish greater involvement in pain management; little is known about factors associated with this involvement. We aim to describe perceived maternal information on infants' pain during hospitalization (PMIP), to study associations between PMIP and mothers' attitudes during painful procedures, and to identify individual and contextual factors associated with PMIP. METHODS Analyses of questionnaires from the French national cohort study of preterm neonates, EPIPAGE-2. PMIP was derived from mothers' answers to questions about information perceived on both pain assessment and management. RESULTS Among 3056 eligible neonates born before 32 weeks, 1974, with available maternal reports, were included in the study. PMIP was classified as "sufficient," "little, not sufficient," or "insufficient, or none" for 22.7, 45.9, and 31.3% of neonates, respectively. Mothers reporting PMIP as "sufficient" were more frequently present and more likely comforting their child during painful procedures. Factors independently associated with "sufficient" PMIP were high maternal education, gestational age <29 weeks, daily maternal visits, perception of high team support, and implementation of the neonatal and individualized developmental care and assessment program. CONCLUSION Perceived maternal information on premature infants' pain reported as sufficient increased maternal involvement during painful procedures and was associated with some units' policies.
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28
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Mitha A, Piedvache A, Khoshnood B, Fresson J, Glorieux I, Roué JM, Blondel B, Durox M, Burguet A, Ancel PY, Kaminski M, Pierrat V. The impact of neonatal unit policies on breast milk feeding at discharge of moderate preterm infants: The EPIPAGE-2 cohort study. MATERNAL AND CHILD NUTRITION 2019; 15:e12875. [PMID: 31310706 DOI: 10.1111/mcn.12875] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 06/26/2019] [Accepted: 07/09/2019] [Indexed: 01/30/2023]
Abstract
Facilitating factors and barriers to breast milk feeding (BMF) for preterm infants have been mainly studied in very preterm populations, but little is known about moderate preterm infants. We aimed to analyze hospital unit characteristics and BMF policies associated with BMF at discharge for infants born at 32 to 34 weeks' gestation. EPIPAGE-2, a French national cohort of preterm births, included 883 infants born at 32 to 34 weeks' gestation. We investigated kangaroo care in the first 24 hr, early involvement of parents in feeding support, volume of the unit, BMF information given to mothers hospitalized for threatened preterm delivery, protocols for BMF, presence of a professional trained in human lactation, unit training in neurodevelopmental care, and regional BMF initiation rates in the general population. Multilevel logistic regression analysis was used to investigate associations between unit policies and BMF at discharge, adjusted for individual characteristics and estimating odds ratios (ORs) and 95% confidence intervals (CIs). Overall, 59% (490/828) of infants received BMF at discharge (27% to 87% between units). Rates of BMF at discharge were higher with kangaroo care (adjusted OR 2.03 [95% CI 1.01, 4.10]), early involvement of parents in feeding support (1.94 [1.23, 3.04]), unit training in a neurodevelopmental care programme (2.57 [1.18, 5.60]), and in regions with a high level of BMF initiation in the general population (1.85 [1.05, 3.28]). Creating synergies by interventions at the unit and population level may reduce the variability in BMF rates at discharge for moderate preterm infants.
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Affiliation(s)
- Ayoub Mitha
- French National Institute of Health and Medical Research Unit 1153, Obstetrical, Perinatal, and Pediatric Epidemiology Team, Centre of Research in Epidemiology and Statistics Sorbonne Paris Cité, Paris Descartes University, Paris, France.,Department of Neonatal Medicine, CHU Lille, Jeanne de Flandre Hospital, Lille, France
| | - Aurélie Piedvache
- French National Institute of Health and Medical Research Unit 1153, Obstetrical, Perinatal, and Pediatric Epidemiology Team, Centre of Research in Epidemiology and Statistics Sorbonne Paris Cité, Paris Descartes University, Paris, France
| | - Babak Khoshnood
- French National Institute of Health and Medical Research Unit 1153, Obstetrical, Perinatal, and Pediatric Epidemiology Team, Centre of Research in Epidemiology and Statistics Sorbonne Paris Cité, Paris Descartes University, Paris, France
| | - Jeanne Fresson
- French National Institute of Health and Medical Research Unit 1153, Obstetrical, Perinatal, and Pediatric Epidemiology Team, Centre of Research in Epidemiology and Statistics Sorbonne Paris Cité, Paris Descartes University, Paris, France.,Department of Clinical Epidemiology and Biostatistics, CHRU Nancy, Nancy, France
| | - Isabelle Glorieux
- Department of Neonatology, Toulouse University Hospital, Toulouse, France
| | - Jean-Michel Roué
- Department of Neonatal Pediatrics and Intensive Care, Brest University Hospital, Brest, France
| | - Béatrice Blondel
- French National Institute of Health and Medical Research Unit 1153, Obstetrical, Perinatal, and Pediatric Epidemiology Team, Centre of Research in Epidemiology and Statistics Sorbonne Paris Cité, Paris Descartes University, Paris, France
| | - Mélanie Durox
- French National Institute of Health and Medical Research Unit 1153, Obstetrical, Perinatal, and Pediatric Epidemiology Team, Centre of Research in Epidemiology and Statistics Sorbonne Paris Cité, Paris Descartes University, Paris, France
| | - Antoine Burguet
- Department of Neonatal Pediatrics, Dijon University Hospital, Dijon, France
| | - Pierre-Yves Ancel
- French National Institute of Health and Medical Research Unit 1153, Obstetrical, Perinatal, and Pediatric Epidemiology Team, Centre of Research in Epidemiology and Statistics Sorbonne Paris Cité, Paris Descartes University, Paris, France.,Clinical Research Unit, Center for Clinical Investigation P1419, Cochin Broca Hôtel-Dieu Hospital, Paris, France
| | - Monique Kaminski
- French National Institute of Health and Medical Research Unit 1153, Obstetrical, Perinatal, and Pediatric Epidemiology Team, Centre of Research in Epidemiology and Statistics Sorbonne Paris Cité, Paris Descartes University, Paris, France
| | - Véronique Pierrat
- French National Institute of Health and Medical Research Unit 1153, Obstetrical, Perinatal, and Pediatric Epidemiology Team, Centre of Research in Epidemiology and Statistics Sorbonne Paris Cité, Paris Descartes University, Paris, France.,Department of Neonatal Medicine, CHU Lille, Jeanne de Flandre Hospital, Lille, France
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Cuttini M, Croci I, Toome L, Rodrigues C, Wilson E, Bonet M, Gadzinowski J, Di Lallo D, Herich LC, Zeitlin J. Breastfeeding outcomes in European NICUs: impact of parental visiting policies. Arch Dis Child Fetal Neonatal Ed 2019; 104:F151-F158. [PMID: 29954880 DOI: 10.1136/archdischild-2017-314723] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 05/08/2018] [Accepted: 05/09/2018] [Indexed: 01/03/2023]
Abstract
OBJECTIVE The documented benefits of maternal milk for very preterm infants have raised interest in hospital policies that promote breastfeeding. We investigated the hypothesis that more liberal parental policies are associated with increased breastfeeding at discharge from the neonatal unit. DESIGN Prospective area-based cohort study. SETTING Neonatal intensive care units (NICUs) in 19 regions of 11 European countries. PATIENTS All very preterm infants discharged alive in participating regions in 2011-2012 after spending >70% of their hospital stay in the same NICU (n=4407). MAIN OUTCOME MEASURES We assessed four feeding outcomes at hospital discharge: any and exclusive maternal milk feeding, independent of feeding method; any and exclusive direct breastfeeding, defined as sucking at the breast. We computed a neonatal unit Parental Presence Score (PPS) based on policies regarding parental visiting in the intensive care area (range 1-10, with higher values indicating more liberal policies), and we used multivariable multilevel modified Poisson regression analysis to assess the relation between unit PPS and outcomes. RESULTS Policies regarding visiting hours, duration of visits and possibility for parents to stay during medical rounds and spend the night in unit differed within and across countries. After adjustment for potential confounders, infants cared for in units with liberal parental policies (PPS≥7) were about twofold significantly more likely to be discharged with exclusive maternal milk feeding and exclusive direct breastfeeding. CONCLUSION Unit policies promoting parental presence and involvement in care may increase the likelihood of successful breastfeeding at discharge for very preterm infants.
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Affiliation(s)
- Marina Cuttini
- Clinical Care and Management Innovation Research Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Ileana Croci
- Clinical Care and Management Innovation Research Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Liis Toome
- Department of Neonatal and Infant Medicine, Tallinn Children's Hospital, Tallinn, Estonia.,Department of Pediatrics, University of Tartu, Tartu, Estonia
| | - Carina Rodrigues
- EPI Unit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Emilija Wilson
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Mercedes Bonet
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Centre for Epidemiology and Biostatistics (U1153), Inserm UMR 1153, Paris, France.,Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, Paris, France
| | - Janusz Gadzinowski
- Department of Neonatology, Poznan University of Medical Sciences, Poznan, Poland
| | - Domenico Di Lallo
- Hospital Network Planning and Research Area, Lazio Regional Health Authority, Rome, Italy
| | - Lena Carolin Herich
- Clinical Care and Management Innovation Research Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Jennifer Zeitlin
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Centre for Epidemiology and Biostatistics (U1153), Inserm UMR 1153, Paris, France
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Devouche E, Buil A, Genet MC, Bobin-Bègue A, Apter G. [Supporting the establishment of the parent-child bond in cases of prematurity]. SOINS. PÉDIATRIE, PUÉRICULTURE 2019; 38:15-19. [PMID: 29162253 DOI: 10.1016/j.spp.2017.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The evolution of the care of premature babies is having an effect on a particular difficulty, that of the development of parenthood and the parent-baby relationship hampered by an early birth. The short- and long-term consequences of any disruption to these two dimensions can be considerable and the hospital must take into account the issue when caring for parents and their premature baby.
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Affiliation(s)
- Emmanuel Devouche
- Université Paris-Descartes, Laboratoire Psychopathologie et processus de santé (EA4057), 71 avenue Édouard-Vaillant, 92774, Boulogne-Billancourt cedex, France; EPS Erasme, Laboratoire RePPEr, 14 rue de l'Abbaye, 92160, Antony, France.
| | - Aude Buil
- Université Paris-Descartes, Laboratoire Psychopathologie et processus de santé (EA4057), 71 avenue Édouard-Vaillant, 92774, Boulogne-Billancourt cedex, France; Centre Hospitalier Sud Francilien, Service de médecine néonatale, 40 avenue Serge-Dassault, 91106, Corbeil-Essonnes cedex, France; Centre d'action médico-sociale précoce, 55 rue d'Aguesseau, 92100, Boulogne-Billancourt, France
| | | | - Anne Bobin-Bègue
- EPS Erasme, Laboratoire RePPEr, 14 rue de l'Abbaye, 92160, Antony, France; Université Paris-Ouest Nanterre la Défense, 200 avenue de la République, 92000, Nanterre, France
| | - Gisèle Apter
- Groupe hospitalier du Havre et Faculté de médecine, Université de Rouen Normandie, 55 bis rue Gustave-Flaubert, 76600, Le Havre, France
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Mitha A, Piedvache A, Glorieux I, Zeitlin J, Roué JM, Blondel B, Durox M, Burguet A, Kaminski M, Ancel PY, Pierrat V. Unit policies and breast milk feeding at discharge of very preterm infants: The EPIPAGE-2 cohort study. Paediatr Perinat Epidemiol 2019; 33:59-69. [PMID: 30698887 DOI: 10.1111/ppe.12536] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 11/02/2017] [Accepted: 12/10/2017] [Indexed: 12/24/2022]
Abstract
BACKGROUND Facilitating factors and barriers to breast milk feeding (BMF) very preterm (VP) infants have been widely studied at the individual level. We aimed to describe and analyse factors associated with BMF at discharge for VP infants, with a special focus on unit policies aiming to support BMF. METHODS We described BMF at discharge in 3108 VP infants enrolled in EPIPAGE-2, a French national cohort. Variables of interest were kangaroo care during the 1st week of life (KC); unit's policies supporting BMF initiation (BMF information systematically given to mothers hospitalised for threatened preterm delivery and breast milk expression proposed within 6 hours after birth) and BMF maintenance (availability of protocols for BMF and a special room for mothers to pump milk); the presence in units of a professional trained in human lactation and regional BMF initiation rates in the general population. Associations were investigated by multilevel logistic regression analysis, with adjustment on individual factors. RESULTS In total, 47.2% of VP infants received BMF at discharge (range among units 21.1%-84.0%). Unit policies partly explained this variation, regardless of individual factors. BMF at discharge was associated with KC (adjusted odds ratio (aOR) 2.26 (95% confidence interval (CI) 1.40, 3.65)), with policies supporting BMF initiation (aOR 2.19 (95% CI 1.27, 3.77)) and maintenance (aOR 2.03 (95% CI 1.17, 3.55)), but not with BMF initiation rates in the general population. CONCLUSION Adopting policies of higher performing units could be an effective strategy for increasing BMF rates at discharge among VP infants.
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Affiliation(s)
- Ayoub Mitha
- French National Institute of Health and Medical Research Unit 1153, Obstetrical, Perinatal, and Pediatric Epidemiology Team, Epidemiology and Biostatistics Sorbonne Paris Cité Research Center, Paris, France.,Paris Descartes University, Paris, France.,CHU Lille, Department of Neonatal Medicine, Jeanne de Flandre Hospital, Lille, France
| | - Aurélie Piedvache
- French National Institute of Health and Medical Research Unit 1153, Obstetrical, Perinatal, and Pediatric Epidemiology Team, Epidemiology and Biostatistics Sorbonne Paris Cité Research Center, Paris, France
| | - Isabelle Glorieux
- Department of Neonatology, Toulouse University Hospital, Toulouse, France
| | - Jennifer Zeitlin
- French National Institute of Health and Medical Research Unit 1153, Obstetrical, Perinatal, and Pediatric Epidemiology Team, Epidemiology and Biostatistics Sorbonne Paris Cité Research Center, Paris, France
| | - Jean-Michel Roué
- Department of Neonatal Pediatrics and Intensive Care, Brest University Hospital, Brest, France
| | - Béatrice Blondel
- French National Institute of Health and Medical Research Unit 1153, Obstetrical, Perinatal, and Pediatric Epidemiology Team, Epidemiology and Biostatistics Sorbonne Paris Cité Research Center, Paris, France
| | - Mélanie Durox
- French National Institute of Health and Medical Research Unit 1153, Obstetrical, Perinatal, and Pediatric Epidemiology Team, Epidemiology and Biostatistics Sorbonne Paris Cité Research Center, Paris, France
| | - Antoine Burguet
- Department of Neonatal Pediatrics, Dijon University Hospital Dijon, France
| | - Monique Kaminski
- French National Institute of Health and Medical Research Unit 1153, Obstetrical, Perinatal, and Pediatric Epidemiology Team, Epidemiology and Biostatistics Sorbonne Paris Cité Research Center, Paris, France
| | - Pierre-Yves Ancel
- French National Institute of Health and Medical Research Unit 1153, Obstetrical, Perinatal, and Pediatric Epidemiology Team, Epidemiology and Biostatistics Sorbonne Paris Cité Research Center, Paris, France.,Paris Descartes University, Paris, France.,Clinical Research Unit, Center for Clinical Investigation P1419, Cochin Broca Hôtel-Dieu Hospital, Paris, France
| | - Véronique Pierrat
- French National Institute of Health and Medical Research Unit 1153, Obstetrical, Perinatal, and Pediatric Epidemiology Team, Epidemiology and Biostatistics Sorbonne Paris Cité Research Center, Paris, France.,CHU Lille, Department of Neonatal Medicine, Jeanne de Flandre Hospital, Lille, France
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Kuhn P, Sizun J, Casper C. Recommendations on the environment for hospitalised newborn infants from the French neonatal society: rationale, methods and first recommendation on neonatal intensive care unit design. Acta Paediatr 2018; 107:1860-1866. [PMID: 30025190 DOI: 10.1111/apa.14501] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 07/11/2018] [Accepted: 07/16/2018] [Indexed: 11/30/2022]
Abstract
AIM Hospitalised newborn infants may be stressed due to inappropriate sensory stimuli and early separation from their families, that can negatively impact their neurodevelopment. The French Group of Reflection and Evaluation of the Environment of Newborns (GREEN) issues guidelines based on environmental neonatology and family-centred care. The first recommendation focuses on private family rooms versus large shared rooms. METHODS These guidelines are based on a systematic evaluation of the literature providing different grades of evidence. Internal and external reviews by multidisciplinary experts examined the scientific evidence of all recommendations. The literature search was performed for the period January 1, 2000 to January 1, 2016 with the keywords 'single room' or 'private room' and 'neonatal intensive care unit'. RESULTS A total of 25 studies were retained. Most studies reported a positive impact of private rooms on the health of newborn infants and satisfaction of families. Private rooms could lead to sensory deprivation if there is low parental involvement with limited presence and to reduced interaction among caregivers. CONCLUSION We recommend that neonatal units should mostly have private rooms. With this architectural design, we recommend supporting the staff's needs for changes in the organisation and philosophy of care and to provide improved family support.
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Affiliation(s)
- Pierre Kuhn
- Service de Médecine et de Réanimation du nouveau-né; Hôpital Hautepierre; Strasbourg France
| | - Jacques Sizun
- Pôle de la Femme, de la Mère et de l'Enfant; CHRU de Brest; Brest France
| | - Charlotte Casper
- Unité de Néonatologie; Hôpital des Enfants; CHU Toulouse; Toulouse France
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Cambonie G, Muller JB, Ehlinger V, Roy J, Guédeney A, Lebeaux C, Kaminski M, Alberge C, Denizot S, Ancel PY, Arnaud C. Mother-infant interaction assessment at discharge and at 6 months in a French cohort of infants born very preterm: The OLIMPE study. PLoS One 2017; 12:e0188942. [PMID: 29216238 PMCID: PMC5720768 DOI: 10.1371/journal.pone.0188942] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 11/15/2017] [Indexed: 01/18/2023] Open
Abstract
Objectives The principal aim was to investigate the feasibility of assessing mother-infant interactions at discharge and at 6 months infant corrected age in singletons born before 32 weeks of gestation. The secondary aims were to describe these interactions and their disorders, explore the association between maternal emotional state and the interactions, and assess the relationship between disordered interactions and infant social withdrawal behaviour. Methods OLIMPE is an ancillary study of the population-based study EPIPAGE 2, which recruited preterm neonates in France in 2011. 163 dyads participated at discharge and 148 at 6 months. Interactions were observed with the Attachment During Stress (ADS) scale, which includes two behavioural subscales, for the mother (m-ADS) and her infant (i-ADS). Two professionals independently completed the ADS scales for one third of the observations. Maternal emotional state was assessed using self-administered questionnaires of depression, anxiety, and stress. Infant’s social withdrawal behaviour at 6 months was measured by the Alarm Distress Baby scale. Results At discharge, 15.3% of the m-ADS scales and 43.3% of the i-ADS scales had at least one unobserved component. At 6 months, all items on both scales were noticeable in >90% of the dyads. Reliability, estimated by the kappa coefficient, ranged between 0.39 and 0.76 at discharge, and between 0.21 and 0.69 at 6 months. Disordered interactions were indicated on 48.6% of the m-ADS scales and 36.5% of the i-ADS scales at discharge. At 6 months, these rates were 32.6% and 26.0%. Disordered interactions at 6 months were associated with identified disorder at discharge. Insecure infant attachment was not influenced by maternal mental health but was strongly associated with infant social withdrawal behaviour. Conclusions The ADS scale can be used to screen for early interaction disorders after premature birth and may help to target dyads that would most benefit from early intervention.
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Affiliation(s)
- Gilles Cambonie
- Department of Neonatal Medicine, Arnaud de Villeneuve University Hospital, Montpellier, France
- * E-mail:
| | - Jean-Baptiste Muller
- Department of Neonatal Medicine, Women’s and Children’s University Hospital, Nantes, France
| | - Virginie Ehlinger
- UMR 1027 INSERM, University Paul Sabatier Toulouse III, Toulouse, France
| | - Joël Roy
- Child and Adolescent Psychiatry Unit, Nîmes University Hospital, Nîmes, France
| | - Antoine Guédeney
- Child and Adolescent Psychiatry Unit, Bichat-Claude Bernard University Hospital, Paris, France
| | - Cécile Lebeaux
- Inserm UMR 1153 Obstetrical, Perinatal and Paediatric Epidemiology Research Team (Epopé), Centre for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, Paris, France
| | - Monique Kaminski
- Inserm UMR 1153 Obstetrical, Perinatal and Paediatric Epidemiology Research Team (Epopé), Centre for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, Paris, France
| | - Corine Alberge
- Department of Neonatal Medicine, Children's University Hospital, Toulouse, France
| | - Sophie Denizot
- Department of Neonatal Medicine, Women’s and Children’s University Hospital, Nantes, France
| | - Pierre-Yves Ancel
- Inserm UMR 1153 Obstetrical, Perinatal and Paediatric Epidemiology Research Team (Epopé), Centre for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, Paris, France
| | - Catherine Arnaud
- UMR 1027 INSERM, University Paul Sabatier Toulouse III, Toulouse, France
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Ratynski N, Minguy S, Kerleroux B. [Developmental care for the premature newborn]. SOINS. PEDIATRIE, PUERICULTURE 2017; 38:32-35. [PMID: 29162257 DOI: 10.1016/j.spp.2017.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Prematurity is linked to risks of developmental disorders later in life. Developmental care aims to improve the comfort of premature babies and to support their physiological, neurological, behavioural and relational skills. Centred on the infant and their parents, it is based on scientific evidence.
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Affiliation(s)
- Nathalie Ratynski
- Centre de formation Nidcap, Université de Bretagne occidentale, Pôle de la femme, de la mère et de l'enfant, CHRU Brest, Avenue Foch, 29609, Brest cedex, France.
| | - Sylvie Minguy
- Centre de formation Nidcap, Université de Bretagne occidentale, Pôle de la femme, de la mère et de l'enfant, CHRU Brest, Avenue Foch, 29609, Brest cedex, France
| | - Béatrice Kerleroux
- Centre de formation Nidcap, Université de Bretagne occidentale, Pôle de la femme, de la mère et de l'enfant, CHRU Brest, Avenue Foch, 29609, Brest cedex, France
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Coughlin McNeil M. Take Care and Care Well. Can J Nurs Res 2017; 49:43-45. [PMID: 28841055 DOI: 10.1177/0844562117701599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Evidence-based practice supports the patient care process by integrating patient values and preferences with clinician expertise and the best available evidence. This approach to patient care focuses on quality and safety with the aim of improving patient outcomes. Despite its obvious value, healthcare professionals struggle to integrate evidence-based best practices into their clinical practice.
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Abstract
The quality of care that families and infants receive during their time on the neonatal unit will be influenced by the well-being of the people who care for them. The emotional work of caring for infants and families in this demanding setting often goes unrecognized and can result in stress, burnout, and compassion fatigue, which in turn are a threat to the quality of care. Resilience and well-being can be fostered by encouraging self-maintenance, supportive systems organization, providing a healthy working environment, education, and opportunities for reflection.
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