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Mariani I, Vuillard CLJ, Bua J, Girardelli M, Lazzerini M. Family-centred care interventions in neonatal intensive care units: a scoping review of randomised controlled trials providing a menu of interventions, outcomes and measurement methods. BMJ Paediatr Open 2024; 8:e002537. [PMID: 39106991 DOI: 10.1136/bmjpo-2024-002537] [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: 01/31/2024] [Accepted: 07/12/2024] [Indexed: 08/09/2024] Open
Abstract
BACKGROUND Benefits of different types of family-centred care (FCC) interventions in neonatal intensive care units (NICUs) have been reported. However, a comprehensive review of existing FCC intervention studies was lacking. OBJECTIVE This review aimed at synthesising the characteristics of FCC interventions, related outcomes and measurement methods in randomised controlled trials (RCTs) in NICU, and providing menus of options to favour implementation and further research. METHODS We searched PubMed, EMBASE, Web of Science and the Cochrane Library up to 31 January 2022. Interventions were mapped according to five categories as defined by a previous Cochrane review. We described outcome types, measurement populations, measurement methods and timelines. Subgroup analyses were also performed. RESULTS Out of 6583 studies identified, 146 met eligibility criteria. Overall, 52 (35.6%) RCTs tested more than one category of intervention, with a large variety of combinations, with the most frequent category of intervention being the educational (138 RCTs, 94.5%). We identified a total of 77 different intervention packages, and RCTs comparing the same interventions were lacking. The 146 RCTs reported on 425 different outcomes, classified in 13 major categories with parental mental health (61 RCTs, 41.8% of total RCTs) being the most frequent category in parents, and neurobehavioural/developmental outcomes being the most frequent category in newborns (62 RCTs, 42.5%). For several categories of outcomes almost every RCT used a different measurement method. Educational interventions targeting specifically staff, fathers, siblings and other family members were lacking or poorly described. Only one RCT measured outcomes in health workers, two in siblings and none considered other family members. CONCLUSIONS A large variety of interventions, outcomes and measurement methods were used in FCC studies in NICU. The derived menus of options should be helpful for researchers and policy makers to identify interventions most suitable in each setting and to further standardise research methods.
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Affiliation(s)
- Ilaria Mariani
- WHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health - IRCCS 'Burlo Garofolo', Trieste, Italy
| | | | - Jenny Bua
- Neonatal Intensive Care Unit, Institute for Maternal and Child Health - IRCCS 'Burlo Garofolo', Trieste, Italy
| | - Martina Girardelli
- Department of Pediatrics, Institute for Maternal and Child Health - IRCCS 'Burlo Garofolo', Trieste, Italy
| | - Marzia Lazzerini
- WHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health - IRCCS 'Burlo Garofolo', Trieste, Italy
- London School of Hygiene & Tropical Medicine, London, UK
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Lazzerini M, Bua J, Vuillard CLJ, Squillaci D, Tumminelli C, Panunzi S, Girardelli M, Mariani I. Characteristics of intervention studies on family-centred care in neonatal intensive care units: a scoping review of randomised controlled trials. BMJ Paediatr Open 2024; 8:e002469. [PMID: 39103175 DOI: 10.1136/bmjpo-2023-002469] [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: 12/20/2023] [Accepted: 02/10/2024] [Indexed: 08/07/2024] Open
Abstract
BACKGROUND Different definitions of family-centred care (FCC) exist in the newborn setting, and many FCC interventions have been tested, while a comprehensive review synthesising characteristics of existing intervention studies is still lacking. OBJECTIVE This review aims at summarising the characteristics of randomised controlled trials (RCTs) on FCC interventions in neonatal intensive care units. METHODS We searched PubMed, Embase, Web of Science and the Cochrane Library up to 31 January 2022, and reference lists of included studies and other reviews. Interventions were grouped into five categories according to a previous Cochrane review: (1) family support, (2) educational, (3) communication, (4) environmental interventions and (5) family-centred policies. Subgroup analyses by time period (RCTs published before vs after 2016) and by country income (based on the World Bank Classification) were conducted. RESULTS Out of 6583 retrieved studies, 146 RCTs met the eligibility criteria, with 53 (36.3%) RCTs published after 2016. Overall, 118 (80.8%) RCTs were conducted in high-income countries, 28 (19.1%) in middle-income countries and none in low-income countries. Only two RCTs were multicountry. Although mothers were the most frequent caregiver involved, fathers were included in 41 RCTs (28.1%). Very few studies were conducted in at-term babies (nine RCTs); siblings (two RCTs) and other family members (two RCTs), maternity care units (two RCTs). The role of health professionals was unclear in 65 (44.5%) RCTs. A large variety of intervention combinations was tested, with 52 (35.6%) RCTs testing more than 1 category of interventions, and 24 (16.4%) RCTs including all 5 categories. CONCLUSION There is a large and rising number of RCTs on FCC interventions in neonatal intensive care units, with specific research gaps. The large variety of FCC interventions, their high complexity, the need to tailor them to the local context and major gaps in implementation suggest that implementation research is the current priority.
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Affiliation(s)
- Marzia Lazzerini
- WHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
- Maternal Adolescent Reproductive and Child Health Care Centre, Faculty of Epidemiology and Population Health, LSHTM, London, UK
| | - Jenny Bua
- Neonatal Intensive Care Unit, Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
| | | | - Domenica Squillaci
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Cristina Tumminelli
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Silvia Panunzi
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Martina Girardelli
- Department of Paediatrics, Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
| | - Ilaria Mariani
- WHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
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Ferraz L, Xavier MR, Gameiro M, Cardoso AF, Cardoso D, Paradela L, Dinis D, Coutinho E, Fernandes A. eHealth early intervention programs to support premature parents transitioning from NICU to home on parental and infant outcomes: a systematic review protocol. JBI Evid Synth 2024:02174543-990000000-00329. [PMID: 38973380 DOI: 10.11124/jbies-23-00422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/09/2024]
Abstract
OBJECTIVE This review aims to assess the effectiveness of eHealth early intervention programs in supporting premature infants and their parents transition from neonatal intensive care units (NICUs) to home and the impact of such programs on parental and infant outcomes. INTRODUCTION The literature has shown the benefits of eHealth early intervention programs to support premature infants and their parents after discharge from NICUs. Parents have reported benefits such as enhanced user-friendliness, increased confidence in infant care, satisfaction, and knowledge acquisition. However, the effectiveness of these programs on parental and infant outcomes remains unclear. INCLUSION CRITERIA This review will consider studies that assess any early intervention program using eHealth to support premature infants and their parents after discharge from NICU. The programs may be initiated during hospitalization or within the first month of discharge. The programs will include interventions that use eHealth components (eg, teleconsultation), either alone or in combination with face-to-face interventions (eg, home visits). This review will consider parental outcomes, including stress, anxiety, competence, and satisfaction, as well as infant outcomes, including health service utilization and cognitive, motor, and social development. METHODS This review will follow the JBI methodology for systematic reviews of effectiveness. The search strategy will aim to find both published and unpublished quantitative studies in English, Spanish, and Portuguese, without any geographical or cultural limitations. Two reviewers will independently perform study selection, critical appraisal, and data extraction. The results will be accompanied by a narrative synthesis. If possible, a meta-analysis will be conducted and the Summary of Findings will be presented using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO: CRD42023444721.
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Affiliation(s)
- Liliana Ferraz
- Health Sciences Research Unit: Nursing (UICISA: E), Coimbra, Portugal
- Nursing School of Coimbra, Coimbra, Portugal
| | - Maria Raul Xavier
- Universidade Católica Portuguesa, Faculty of Education and Psychology, Research Centre for Human Development (CEDH), Porto, Portugal
| | - Manuel Gameiro
- Health Sciences Research Unit: Nursing (UICISA: E), Coimbra, Portugal
- Nursing School of Coimbra, Coimbra, Portugal
| | - Ana Filipa Cardoso
- Health Sciences Research Unit: Nursing (UICISA: E), Coimbra, Portugal
- Nursing School of Coimbra, Coimbra, Portugal
- Portugal Centre for Evidence-Based Practice: A JBI Centre of Excellence, Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
| | - Daniela Cardoso
- Health Sciences Research Unit: Nursing (UICISA: E), Coimbra, Portugal
- Nursing School of Coimbra, Coimbra, Portugal
- Portugal Centre for Evidence-Based Practice: A JBI Centre of Excellence, Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
| | - Lúcia Paradela
- Coimbra Hospital and University Centre (CHUC), Coimbra, Portugal
| | - Daniela Dinis
- Coimbra Hospital and University Centre (CHUC), Coimbra, Portugal
| | - Estela Coutinho
- Associação Portuguesa de Apoio ao Bebé Prematuro / European Foundation for the Care of Newborn Infants (EFCNI), Portugal
| | - Ananda Fernandes
- Health Sciences Research Unit: Nursing (UICISA: E), Coimbra, Portugal
- Nursing School of Coimbra, Coimbra, Portugal
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Fang Z, Liu X, Zhang C, Lachman JM, Qiao D. Parenting Interventions That Promote Child Protection and Development for Preschool-Age Children with Developmental Disabilities: A Global Systematic Review and Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2024; 25:2128-2142. [PMID: 37978829 DOI: 10.1177/15248380231207965] [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: 11/19/2023]
Abstract
Global guidelines emphasize the critical role of responsive caregiving in terms of reducing violence against children and promoting early childhood development. However, there is an absence of global evidence synthesis on the effects of early childhood parenting programs for children with developmental disabilities. This systematic review and meta-analysis aims to investigate the effectiveness of parenting interventions delivered for preschool-age children with developmental disabilities in reducing violence against children, altering violence-related factors, and promoting child development. We searched for randomized controlled trials with inactive control. Estimates were pooled using robust variance estimations. Meta-regressions were conducted to explore sources of heterogeneity. In all, 33 studies met the inclusion criteria. The results showed that parenting programs improved child behavior, parental mental health, parenting practices, parental self-efficacy, parent-child interaction, child language skills, and child social skills post-intervention. No studies provided data on the actual occurrence of violence against children. Effects might vary by diagnosis, delivery modality, and world region. The findings supported the delivery of parenting programs to alter factors associated with violence against children and promote child language and social skills for families of young children with developmental disabilities, especially attention deficit hyperactivity disorder, autism, intellectual disability, and language disorders. More research using rigorous methods, long-term follow-ups, and transparent reporting is needed, particularly within more low- and middle-income countries.
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Affiliation(s)
| | | | | | - Jamie M Lachman
- University of Oxford, UK
- University of Cape Town, South Africa
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Silveira RC, Valentini NC, O’Shea TM, Mendes EW, Froes G, Cauduro L, Panceri C, Fuentefria RN, Procianoy RS. Parent-Guided Developmental Intervention for Infants With Very Low Birth Weight: A Randomized Clinical Trial. JAMA Netw Open 2024; 7:e2421896. [PMID: 39018071 PMCID: PMC11255911 DOI: 10.1001/jamanetworkopen.2024.21896] [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] [Received: 01/20/2024] [Accepted: 05/14/2024] [Indexed: 07/18/2024] Open
Abstract
Importance Early interventions improve neurodevelopmental outcomes after preterm birth, but few studies of early intervention have focused on preterm infants whose families reside in low- or middle-income countries (LMICs). Objective To evaluate whether parent-guided early intervention improves the neurodevelopmental outcomes of preterm infants in an LMIC. Design, Setting, and Participants This randomized clinical trial was performed at a high-risk obstetric referral hospital in Brazil, with outcome evaluations by examiners masked to randomization group. Eligibility criteria were (1) birth at the study hospital, (2) residence within 40 km of the birth hospital, and (3) gestational age of less than 32 weeks or birth weight of less than 1500 g. Of 138 enrolled infants, 19 died after randomization and 19 withdrew from the study; all other enrollees (50 per randomization group) were evaluated for the primary outcome. Data were collected from January 1, 2016, to May 31, 2022, and analyzed from June 10 to July 31, 2022. Interventions On postnatal day 7, infants were randomized to usual care, consisting of support for lactation, kangaroo care, and routine developmental therapies, or to a parent-guided enhanced developmental intervention, consisting of usual care plus infant massage and enhanced visual stimulation, auditory stimulation, social interactions, and support for motor development, instructed by developmental therapists. Main Outcomes and Measures The primary outcome was the Bayley Scales of Infant and Toddler Development-Third Edition score at 18 months of age adjusted for prematurity. Results Among the 100 infants included in the analysis, mean (SD) gestational age was 28.4 (2.2) weeks, and 57 (57%) were male. The mean (SD) gestational age for the intervention group was 28.3 (2.3) weeks; for the usual care group, 28.5 (2.2) weeks. Female infants accounted for 21 infants (42%) of the intervention group and 22 (44%) of the usual care group; male infants, 29 (58%) and 28 (56%), respectively. The enhanced developmental intervention group had higher cognitive scores at 18 months of corrected age (mean [SD], 101.8 [11.9] vs 97.3 [13.5]; mean difference, 4.5 [95% CI, 0.1-8.9]). Conclusions and Relevance In this randomized clinical trial of a parent-guided developmental intervention for early cognitive function of very preterm or very low birth weight infants implemented in an LMIC, the intervention improved very preterm infants' neurodevelopmental outcomes at 18 months of adjusted age. Parent-guided early intervention can improve neurodevelopmental outcome of very preterm infants born in LMICs. Trial Registration ClinicalTrials.gov Identifier: NCT02835612.
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Affiliation(s)
- Rita C. Silveira
- Neonatal Section, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Programa de Pós-Graduação em Saúde da Criança e Adolescente, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Nadia C. Valentini
- Programa de Pós-Graduação em Saúde da Criança e Adolescente, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - T. Michael O’Shea
- Department of Pediatrics, The University of North Carolina at Chapel Hill
| | - Eliane W. Mendes
- Neonatal Section, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Programa de Pós-Graduação em Saúde da Criança e Adolescente, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Graciela Froes
- Neonatal Section, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Lenir Cauduro
- Neonatal Section, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Carolina Panceri
- Neonatal Section, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Programa de Pós-Graduação em Saúde da Criança e Adolescente, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Rubia N. Fuentefria
- Neonatal Section, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Renato S. Procianoy
- Neonatal Section, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Programa de Pós-Graduação em Saúde da Criança e Adolescente, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Zorlular R, Akkaya KU, Elbasan B. The relationship between home environment affordances and motor development and sensory processing skills in premature infants. Infant Behav Dev 2024; 75:101944. [PMID: 38522347 DOI: 10.1016/j.infbeh.2024.101944] [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: 12/05/2023] [Revised: 03/17/2024] [Accepted: 03/17/2024] [Indexed: 03/26/2024]
Abstract
The availability of stimulating materials in the home environment is of great importance to optimizing an infant's development. This study, which has a cross-sectional study design, was conducted to examine the relationship between home environment conditions and equipment support and the motor development and sensory processing skills of premature infants. Children born premature, aged 10-16 months, were included in the study. Motor development was evaluated with the Peabody Motor Development Scale-2, and sensory processing skills were evaluated with the Test of Sensory Function in Infants. The Affordances in the Home Environment for Motor Development-Infant Scale was used to evaluate the home environment. A total of 51 premature infants were included in the study. It was determined that there was a significant relationship between physical space, stimulus variety and fine motor toys in the home environment and Peabody Motor Development Scale-2 gross motor and fine motor development scores. It was also shown that there was a relationship between the tactile and total scores of the Test of Sensory Function in Infants Scale and the variety of stimuli in the home environment and gross motor toy scores. These findings show that the opportunities provided in the home environment of premature infants may be related to their motor development and sensory processing skills. Consequently, the home environment may be associated with experiencing movements and sensory experiences.
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Affiliation(s)
- Rabia Zorlular
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Nigde Omer Halisdemir University, Nigde, Turkey.
| | - Kamile Uzun Akkaya
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Bulent Elbasan
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
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Torbert N, Taladay C, Kauer T, Hackenburg L, Weaver MS, Kellas JK. Providing "Compassionate Care" in the Neonatal Intensive Care Unit Through Infant and Family Needs-Based Care. Am J Perinatol 2024; 41:e863-e869. [PMID: 36451625 DOI: 10.1055/s-0042-1758725] [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: 12/05/2022]
Abstract
OBJECTIVE Provision of compassionate care to infants and their families in the neonatal intensive care unit (NICU) is a key component of competent critical care. Although recognized as an essential aspect of NICU care, compassionate care for infants and families in a NICU setting has been underexplored. This study defined and described compassionate care according to NICU staff. STUDY DESIGN Voice-recorded, face-to-face individual interviews occurred with NICU nurses (n = 45), NICU nurse practitioners (n = 15), and neonatologists (n = 9) from two NICUs in the midwestern United States. Semantic content analysis was used. Consolidated criteria for Reporting Qualitative research guidelines were followed. RESULTS Three dynamic and interactive qualitative themes emerged: excellent standard of intensive care, commitment, and engaged family communication. A conceptual framework entitled patient and family needs-based care was developed from the qualitative interviews. CONCLUSION The framework developed from this study supports the therapeutic journey of NICU infants and families by integrating a focus on compassionate personalized care within the context of keen clinical and communication skillsets that staff have gained throughout their NICU careers. KEY POINTS · While clinical competence is emphasized as a practice standard, compassion remains a core care value.. · A working definition of compassionate care and the description of its defining pillars has been underexplored.. · This study describes the perspectives of NICU staff on the actionable components of compassionate care for ill infant and their families..
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Affiliation(s)
- Nicholas Torbert
- Division of Neonatology, Department of Pediatrics, University of Nebraska Medical Center and Children's Hospital Medical Center, Omaha, Nebraska
| | - Cassidy Taladay
- Department of Communication Studies, University of Nebraska-Lincoln, Lincoln, Nebraska
| | - Trevor Kauer
- Department of Communication Studies, University of Nebraska-Lincoln, Lincoln, Nebraska
| | - Lucas Hackenburg
- Department of Communication Studies, University of Nebraska-Lincoln, Lincoln, Nebraska
| | - Meaghann S Weaver
- Division of Pediatric Palliative Care, Department of Pediatrics, University of Nebraska Medical Center and Children's Hospital Medical Center, Omaha, Nebraska
| | - Jody Koenig Kellas
- Department of Communication Studies, University of Nebraska-Lincoln, Lincoln, Nebraska
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Schneider J, Harari MM, Faure N, Lacroix A, Borghini A, Tolsa JF, Horsch A. Joint observation in NICU (JOIN): A randomized controlled trial testing an early, one-session intervention during preterm care to improve perceived maternal self-efficacy and other mental health outcomes. PLoS One 2024; 19:e0301594. [PMID: 38662661 PMCID: PMC11045081 DOI: 10.1371/journal.pone.0301594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 03/10/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Parents of preterm infants in the Neonatal Intensive Care Unit (NICU) environment may experience psychological distress, decreased perceived self-efficacy, and/or difficulties in establishing an adaptive parent-infant relationship. Early developmental care interventions to support the parental role and infant development are essential and their impact can be assessed by an improvement of parental self-efficacy perception. The aims were to assess the effects of an early intervention provided in the NICU (the Joint Observation) on maternal perceived self-efficacy compared to controls (primary outcome) and to compare maternal mental health measures (perceived stress, anxiety, and depression), perception of the parent-infant relationship, and maternal responsiveness (secondary outcomes). METHODS This study was a monocentric randomized controlled trial registered in clinicatrials.gov (NCT02736136), which aimed at testing a behavioural intervention compared with treatment-as-usual. Mothers of preterm neonates born 28 to 32 6/7 weeks gestation were randomly allocated to either the intervention or the control groups. Outcome measures consisted of self-report questionnaires completed by the mothers at 1 and 6 months after enrollment and assessing perceived self-efficacy, mental health, perception of the parent-infant relationship and responsiveness, as well as satisfaction with the intervention. RESULTS No statistically significant group effects were observed for perceived maternal self-efficacy or the secondary outcomes. Over time, perceived maternal self-efficacy increased for mothers in both groups, while anxiety and depression symptoms decreased. High satisfaction with the intervention was reported. CONCLUSIONS The joint observation was not associated with improved perceived maternal self-efficacy or other mental health outcomes, but may constitute an additional supportive measure offered to parents in a vulnerable situation during the NICU stay.
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Affiliation(s)
- Juliane Schneider
- Department of Woman-Mother-Child, Clinic of Neonatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- The Sense, Innovation, and Research Center, Lausanne, Switzerland
| | - Mathilde Morisod Harari
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Noémie Faure
- Centre Sages-Femmes, Vevey, Switzerland
- UniVers Famille, Châtel-St-Denis, Switzerland
| | - Alain Lacroix
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland
| | | | - Jean-François Tolsa
- Department of Woman-Mother-Child, Clinic of Neonatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Antje Horsch
- Department of Woman-Mother-Child, Clinic of Neonatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland
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Toma AI, Dima V, Alexe A, Bojan C, Nemeș AF, Gonț BF, Arghirescu A, Necula AI, Fieraru A, Stoiciu R, Mirea A, Calomfirescu Avramescu A, Isam AJ. Early Intervention Guided by the General Movements Examination at Term Corrected Age-Short Term Outcomes. Life (Basel) 2024; 14:480. [PMID: 38672751 PMCID: PMC11050901 DOI: 10.3390/life14040480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 03/17/2024] [Accepted: 04/03/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND AND AIM The early identification of the former premature neonates at risk of neurologic sequelae could lead to early intervention and a better prognosis. This pilot study aimed to investigate whether the General Movement patterns observed at term-equivalent age in former premature infants could serve as predictors for guiding early intervention and improving prognosis. MATERIALS AND METHODS In a population of 44 premature neonates (mean gestational age 33.59 weeks (+2.43 weeks)) examined at term-equivalent age, 10 neonates with a cramped-synchronized General Movements motor pattern were identified. These neonates were included in an early intervention program consisting of physiotherapy executed both by the therapist and by the parents at home. They were again examined at a corrected age of 12 weeks. The presence or absence of fidgety movements and the MOS-R (motor optimality score revised) was noted. The examinations were performed by certified specialists. RESULTS Normal fidgety movements and a MOS-R of 20-24 were presented in 9/10 of the former premature infants, with normal foot to foot contact present in 7/10, and normal hand to hand contact present in 5/10. The atypical patterns noted were side to side movements of the head in 5/10, a non-centered head in 9/10, asymmetric tonic neck reflex in 9/10 and jerky movements in 10/10. One patient presented with no fidgety movements and a MOS-R score of 9. CONCLUSION Early intervention in our group of patients allowed for an improvement in the neurologic status, demonstrated by the presence of fidgety movements. We suggest that early intervention should be indicated in all premature infants that present with a cramped-synchronized GM pattern during examination at term-equivalent age. However, due to the small sample size, the absence of statistical analysis and a control group, and the limited follow-up period, the conclusions must be approached with caution.
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Affiliation(s)
- Adrian Ioan Toma
- Life Memorial Hospital, 010719 Bucharest, Romania
- Faculty of Medicine, University Titu Maiorescu, 040441 Bucharest, Romania
| | - Vlad Dima
- Neonatology Department Filantropia Clinical Hospital, 011132 Bucharest, Romania
| | | | - Cristina Bojan
- Kinetotherapy Department, Pediatric Neurology Alexandru Obregia Hospital, 041914 Bucharest, Romania
| | - Alexandra Floriana Nemeș
- Life Memorial Hospital, 010719 Bucharest, Romania
- Faculty of Medicine, University Titu Maiorescu, 040441 Bucharest, Romania
| | | | | | | | | | | | - Andrada Mirea
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | | | - Al Jashi Isam
- Faculty of Medicine, University Titu Maiorescu, 040441 Bucharest, Romania
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Montoro-Pérez N, Oliver-Roig A, Montejano-Lozoya R, Richart-Martínez M. Psychometric properties of parental stress scales used in paediatric health care settings: A systematic review 1. J Clin Nurs 2024; 33:911-931. [PMID: 37926938 DOI: 10.1111/jocn.16920] [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: 02/15/2023] [Revised: 08/28/2023] [Accepted: 10/18/2023] [Indexed: 11/07/2023]
Abstract
AIM To identify scales that assess parental stress in the paediatric clinical population and to analyse their psychometric properties. METHODS Four electronic databases (PubMed, Web of Science, PsycINFO, and Scopus) and metasearch engines (Google Scholar and Open Grey) were searched with no time period limitations. Methodological quality was assessed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) and quality of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach modified by COSMIN. Finally, recommendations were made for the instruments with the highest quality of evidence. RESULTS A total of 38 studies reporting on 11 different instruments for assessing parental stress in the paediatric clinical setting were included. Six instruments were 'A' rated (recommended) in the final phase in line with COSMIN guidelines. The Paediatric Inventory for Parents was the instrument that evaluated the highest number of psychometric properties and obtained the highest methodological quality, global assessment, and quality of evidence for the different psychometric properties. CONCLUSIONS This systematic review provides an overview of the measurement properties of the parental stress instruments used in the paediatric clinical setting. The Paediatric Inventory for Parents stands out as being one of the most robust instruments for measuring stress in parents with a hospitalised or sick child. Evidence needs to be generated for all the parental stress scales used in the clinical setting. IMPACT Given that the psychometric properties of the existing parental stress scales used in paediatric health care settings have not been systematically assessed, the present review utilised comprehensive methods according to COSMIN. NO PATIENT OR PUBLIC CONTRIBUTION REPORTING METHOD: PRISMA statement and COSMIN reporting guidelines for studies on measurement properties of patient-reported outcome measures.
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Affiliation(s)
- Néstor Montoro-Pérez
- Department of Nursing, Faculty of Health Sciences, Person-centred Care and Health Outcomes Innovation Group, University of Alicante, San Vicente del Raspeig, Spain
- GREIACC Research Group, La Fe Health Research Institute, Valencia, Spain
| | - Antonio Oliver-Roig
- Department of Nursing, Faculty of Health Sciences, Person-centred Care and Health Outcomes Innovation Group, University of Alicante, San Vicente del Raspeig, Spain
| | | | - Miguel Richart-Martínez
- Department of Nursing, Faculty of Health Sciences, Person-centred Care and Health Outcomes Innovation Group, University of Alicante, San Vicente del Raspeig, Spain
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11
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Seppänen AV, Barros H, Draper ES, Petrou S, Andronis L, Kim S, Maier RF, Pedersen P, Gadzinowski J, Pierrat V, Sarrechia I, Lebeer J, Ådén U, Toome L, Thiele N, van Heijst A, Cuttini M, Zeitlin J. Variation in follow-up for children born very preterm in Europe. Eur J Public Health 2024; 34:91-100. [PMID: 37978865 PMCID: PMC10843937 DOI: 10.1093/eurpub/ckad192] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Children born very preterm (<32 weeks of gestation) face high risks of neurodevelopmental and health difficulties compared with children born at term. Follow-up after discharge from the neonatal intensive care unit is essential to ensure early detection and intervention, but data on policy approaches are sparse. METHODS We investigated the characteristics of follow-up policy and programmes in 11 European countries from 2011 to 2022 using healthcare informant questionnaires and the published/grey literature. We further explored how one aspect of follow-up, its recommended duration, may be reflected in the percent of parents reporting that their children are receiving follow-up services at 5 years of age in these countries using data from an area-based cohort of very preterm births in 2011/12 (N = 3635). RESULTS Between 2011/12 and 22, the number of countries with follow-up policies or programmes increased from 6 to 11. The policies and programmes were heterogeneous in eligibility criteria, duration and content. In countries that recommended longer follow-up, parent-reported follow-up rates at 5 years of age were higher, especially among the highest risk children, born <28 weeks' gestation or with birthweight <1000 g: between 42.1% and 70.1%, vs. <20% in most countries without recommendations. CONCLUSIONS Large variations exist in follow-up policies and programmes for children born very preterm in Europe; differences in recommended duration translate into cross-country disparities in reported follow-up at 5 years of age.
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Affiliation(s)
- Anna-Veera Seppänen
- Université de Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Obstetrical Perinatal and Paediatric Epidemiology Research Team (EPOPé), Paris, France
| | - Henrique Barros
- EPIUnit-Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
| | | | - Stavros Petrou
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Lazaros Andronis
- Division of Clinical Trials, Warwick Medical School, University of Warwick, Coventry, UK
| | - Sungwook Kim
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Rolf F Maier
- Children’s Hospital, University Hospital, Philipps University Marburg, Marburg, Germany
| | | | - Janusz Gadzinowski
- Department of Neonatology, Poznan University of Medical Sciences, Poznan, Poland
| | - Véronique Pierrat
- Université de Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Obstetrical Perinatal and Paediatric Epidemiology Research Team (EPOPé), Paris, France
| | - Iemke Sarrechia
- Department of Family Medicine & Population Health, Faculty of Medicine & Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Jo Lebeer
- Department of Family Medicine & Population Health, Faculty of Medicine & Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Ulrika Ådén
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
- Department of Neonatal Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Liis Toome
- Department of Neonatal and Infant Medicine, Tallinn Children's Hospital, Tallinn, Estonia
- Department of Paediatrics, University of Tartu, Tartu, Estonia
| | - Nicole Thiele
- European Foundation for the Care of Newborn Infants (EFCNI), Munich, Germany
| | - Arno van Heijst
- Department of Neonatology, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Neonatology, Erasmus MC—Sophia Children’s Hospital, Rotterdam, The Netherlands
| | - Marina Cuttini
- Clinical Care and Management Innovation Research Area, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Jennifer Zeitlin
- Université de Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Obstetrical Perinatal and Paediatric Epidemiology Research Team (EPOPé), Paris, France
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12
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Bowe AK, Lightbody G, Staines A, Murray DM, Norman M. Prediction of 2-Year Cognitive Outcomes in Very Preterm Infants Using Machine Learning Methods. JAMA Netw Open 2023; 6:e2349111. [PMID: 38147334 PMCID: PMC10751596 DOI: 10.1001/jamanetworkopen.2023.49111] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 11/09/2023] [Indexed: 12/27/2023] Open
Abstract
Importance Early intervention can improve cognitive outcomes for very preterm infants but is resource intensive. Identifying those who need early intervention most is important. Objective To evaluate a model for use in very preterm infants to predict cognitive delay at 2 years of age using routinely available clinical and sociodemographic data. Design, Setting, and Participants This prognostic study was based on the Swedish Neonatal Quality Register. Nationwide coverage of neonatal data was reached in 2011, and registration of follow-up data opened on January 1, 2015, with inclusion ending on September 31, 2022. A variety of machine learning models were trained and tested to predict cognitive delay. Surviving infants from neonatal units in Sweden with a gestational age younger than 32 weeks and complete data for the Bayley Scales of Infant and Toddler Development, Third Edition cognitive index or cognitive scale scores at 2 years of corrected age were assessed. Infants with major congenital anomalies were excluded. Exposures A total of 90 variables (containing sociodemographic and clinical information on conditions, investigations, and treatments initiated during pregnancy, delivery, and neonatal unit admission) were examined for predictability. Main Outcomes and Measures The main outcome was cognitive function at 2 years, categorized as screening positive for cognitive delay (cognitive index score <90) or exhibiting typical cognitive development (score ≥90). Results A total of 1062 children (median [IQR] birth weight, 880 [720-1100] g; 566 [53.3%] male) were included in the modeling process, of whom 231 (21.8%) had cognitive delay. A logistic regression model containing 26 predictive features achieved an area under the receiver operating curve of 0.77 (95% CI, 0.71-0.83). The 5 most important features for cognitive delay were non-Scandinavian family language, prolonged duration of hospitalization, low birth weight, discharge to other destination than home, and the infant not receiving breastmilk on discharge. At discharge from the neonatal unit, the full model could correctly identify 605 of 650 infants who would have cognitive delay at 24 months (sensitivity, 0.93) and 1081 of 2350 who would not (specificity, 0.46). Conclusions and Relevance The findings of this study suggest that predictive modeling in neonatal care could enable early and targeted intervention for very preterm infants most at risk for developing cognitive impairment.
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Affiliation(s)
- Andrea K. Bowe
- INFANT Research Centre, University College Cork, Cork, Ireland
| | - Gordon Lightbody
- INFANT Research Centre, University College Cork, Cork, Ireland
- Department of Electrical and Electronic Engineering, University College Cork, Cork, Ireland
| | - Anthony Staines
- School of Nursing, Psychotherapy, and Community Health, Dublin City University, Dublin, Ireland
| | - Deirdre M. Murray
- INFANT Research Centre, University College Cork, Cork, Ireland
- Department of Paediatrics, Cork University Hospital, Cork, Ireland
| | - Mikael Norman
- Department of Clinical Science, Intervention, and Technology, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
- Department of Neonatal Medicine, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
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13
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Kobus S, Diezel M, Dewan MV, Huening B, Dathe AK, Marschik PB, Felderhoff-Mueser U, Bruns N. Music therapy modulates mothers' perception of their preterm infants. Front Psychol 2023; 14:1231741. [PMID: 37928582 PMCID: PMC10620800 DOI: 10.3389/fpsyg.2023.1231741] [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: 05/30/2023] [Accepted: 10/06/2023] [Indexed: 11/07/2023] Open
Abstract
Premature birth imposes considerable challenges on the preterm infant, but also challenges the mother, who may not yet be prepared for motherhood and encounter psychological stress during the post-partum period. This secondary analysis of a prospective randomized controlled trial (RCT) aimed to investigate how mothers perceive their preterm infants. We surveyed 33 mothers of preterm infants born before 32 weeks of gestation, who were participating in an RCT on music therapy. We employed the neonatal perception inventory (NPI), an instrument designed to assess the mother's perception and expectations regarding her infant immediately after birth. Infants were randomly assigned to either standard care (control group) or standard care plus music therapy (intervention group). Eighteen mothers from the intervention group participated in the survey (mean age 34.1 ± 4.6 years) and 15 mothers from the control group (mean age 29.6 ± 4.2 years). At the time of the infant's hospital discharge, mothers rated their expectations of how they felt a baby should behave (NPI I) and how they perceived their own infant (NPI II). The NPI score difference was calculated by subtracting the NPI II from the NPI I. Mean NPI I scores were comparable between both groups, but NPI II scores in the intervention group were better [18.0, 95% confidence interval (CI) 16.6-19.4] than in the control group (19.1, 95% CI 18.0-20.3). The relative probability of mothers rating their own baby as better than average was 1.94 (95% CI 1.00-3.79) for mothers whose infants received music therapy. These findings suggest that music therapy in the neonatal intensive care unit can positively influence mothers' perception of their hospitalized preterm infant.
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Affiliation(s)
- Susann Kobus
- Department of Paediatrics I, University Hospital, University of Duisburg-Essen, Essen, Germany
- Faculty of Medicine, Centre for Translational Neuro- and Behavioural Sciences (C-TNBS), University Duisburg-Essen, Essen, Germany
- Center of Artistic Therapy, University Medicine Essen, Essen, Germany
| | - Marlis Diezel
- Department of Paediatrics I, University Hospital, University of Duisburg-Essen, Essen, Germany
- Faculty of Medicine, Centre for Translational Neuro- and Behavioural Sciences (C-TNBS), University Duisburg-Essen, Essen, Germany
| | - Monia Vanessa Dewan
- Department of Paediatrics I, University Hospital, University of Duisburg-Essen, Essen, Germany
- Faculty of Medicine, Centre for Translational Neuro- and Behavioural Sciences (C-TNBS), University Duisburg-Essen, Essen, Germany
| | - Britta Huening
- Department of Paediatrics I, University Hospital, University of Duisburg-Essen, Essen, Germany
- Faculty of Medicine, Centre for Translational Neuro- and Behavioural Sciences (C-TNBS), University Duisburg-Essen, Essen, Germany
| | - Anne-Kathrin Dathe
- Department of Paediatrics I, University Hospital, University of Duisburg-Essen, Essen, Germany
- Faculty of Medicine, Centre for Translational Neuro- and Behavioural Sciences (C-TNBS), University Duisburg-Essen, Essen, Germany
- Department of Health and Nursing, Occupational Therapy, Ernst-Abbe-University of Applied Sciences, Jena, Germany
| | - Peter B. Marschik
- Child and Adolescent Psychiatry and Psychotherapy, Systemic Ethology and Developmental Science, University Medical Center Göttingen and Leibniz ScienceCampus Primate Cognition, Göttingen, Germany
- iDN - Interdisciplinary Developmental Neuroscience, Division of Phoniatrics, Medical University of Graz, Graz, Austria
- Center of Neurodevelopmental Disorders (KIND), Center for Psychiatry Research, Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
| | - Ursula Felderhoff-Mueser
- Department of Paediatrics I, University Hospital, University of Duisburg-Essen, Essen, Germany
- Faculty of Medicine, Centre for Translational Neuro- and Behavioural Sciences (C-TNBS), University Duisburg-Essen, Essen, Germany
| | - Nora Bruns
- Department of Paediatrics I, University Hospital, University of Duisburg-Essen, Essen, Germany
- Faculty of Medicine, Centre for Translational Neuro- and Behavioural Sciences (C-TNBS), University Duisburg-Essen, Essen, Germany
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14
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Ernst M, Schuster AK, Mildenberger E, Otten D, Brähler E, Tesarz J, Urschitz MS, Pfeiffer N, Beutel ME, Fieß A. Recalled parental rearing behavior shapes mental health after preterm birth: Evidence from the Gutenberg Prematurity Study. Psychiatry Res 2023; 327:115374. [PMID: 37574598 DOI: 10.1016/j.psychres.2023.115374] [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: 11/13/2022] [Revised: 07/14/2023] [Accepted: 07/25/2023] [Indexed: 08/15/2023]
Abstract
Associations of preterm birth with later-life mental distress are well-established. A research gap concerns the role of psychosocial factors such as the family context. This study investigated associations of recalled parental rearing behavior with both preterm birth characteristics and psychological symptom burden later in life. Based on birth registry data of the Mainz University Hospital in Germany (infants born between 1969 and 2002) and using a selection algorithm, a cohort study comprising four gestational age (GA) strata was conducted (≥ 37 weeks: n = 138; 33-36 weeks: n = 132; 29-32 weeks: n = 106; ≤ 28 weeks: n = 132). Participants underwent a medical examination and completed standardized questionnaires. We investigated differences in dimensions of recalled parental rearing behavior according to GA and tested pre-/perinatal stress indicators and recalled parental rearing behavior as statistical predictors of depression and anxiety symptoms later in life. Lower GA was associated with more recalled emotional warmth and overprotection. Recalled emotional warmth was associated with fewer depression and anxiety symptoms, while recalled overprotection co-occurred with more depression symptoms. The findings indicate the relevance of parental rearing behavior for the offspring's mental health. As preterm birth implicates stress for the whole family requiring adaptive parental behavior, the latter could be an important modifiable risk factor.
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Affiliation(s)
- Mareike Ernst
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; Department of Clinical Psychology, Psychotherapy and Psychoanalysis, Institute of Psychology, University of Klagenfurt, Klagenfurt am Wörthersee, Austria.
| | - Alexander K Schuster
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Eva Mildenberger
- Division of Neonatology, Department of Pediatrics, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Daniëlle Otten
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; Department of Child and Adolescent Psychiatry-Psychotherapy, University Hospital Ulm, Ulm, Germany
| | - Elmar Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; Integrated Research and Treatment Center Adiposity Diseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Jonas Tesarz
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg University, Heidelberg, Germany
| | - Michael S Urschitz
- Division of Pediatric Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Achim Fieß
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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15
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Hirschel J, Carlhan-Ledermann A, Ferraz C, Brand LA, Filippa M, Gentaz E, Lejeune F, Baud O. Maternal Voice and Tactile Stimulation Modulate Oxytocin in Mothers of Hospitalized Preterm Infants: A Randomized Crossover Trial. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1469. [PMID: 37761430 PMCID: PMC10528509 DOI: 10.3390/children10091469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 08/25/2023] [Accepted: 08/27/2023] [Indexed: 09/29/2023]
Abstract
Prematurity is a major risk factor for perinatal stress and neonatal complications leading to systemic inflammation and abnormal mother-infant interactions. Oxytocin (OT) is a neuropeptide regulating the inflammatory response and promoting mother-infant bonding. The release of this hormone might be influenced by either vocal or tactile stimulation. The main objective of the current randomized, crossover, clinical trial was to assess the salivary OT/cortisol balance in mothers following the exposure of their baby born preterm to two types of sensorial interventions: maternal voice without or with contingent tactile stimulation provided by the mother to her infant. Among the 26 mothers enrolled, maternal voice intervention alone had no effect on OT and cortisol levels in the mothers, but when associated with tactile stimulation, it induced a significant increase in maternal saliva oxytocin (38.26 ± 30.26 pg/mL before vs 53.91 ± 48.84 pg/mL after, p = 0.02), particularly in the mothers who delivered a female neonate. Maternal voice intervention induced a significant reduction in cortisol and an increase in OT levels in mothers when the maternal voice with a tactile stimulation intervention was performed first. In conclusion, exposure to the maternal voice with a contingent tactile stimulation was associated with subtle changes in the maternal hormonal balance between OT and cortisol. These findings need to be confirmed in a larger sample size and may ultimately guide caregivers in providing the best intervention to reduce parental stress following preterm delivery.
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Affiliation(s)
- Jessica Hirschel
- Division of Neonatology and Pediatric Intensive Care, Children’s University Hospital of Geneva, University of Geneva, 1205 Geneva, Switzerland; (J.H.); (A.C.-L.); (C.F.); (L.-A.B.)
| | - Audrey Carlhan-Ledermann
- Division of Neonatology and Pediatric Intensive Care, Children’s University Hospital of Geneva, University of Geneva, 1205 Geneva, Switzerland; (J.H.); (A.C.-L.); (C.F.); (L.-A.B.)
| | - Céline Ferraz
- Division of Neonatology and Pediatric Intensive Care, Children’s University Hospital of Geneva, University of Geneva, 1205 Geneva, Switzerland; (J.H.); (A.C.-L.); (C.F.); (L.-A.B.)
| | - Laure-Anne Brand
- Division of Neonatology and Pediatric Intensive Care, Children’s University Hospital of Geneva, University of Geneva, 1205 Geneva, Switzerland; (J.H.); (A.C.-L.); (C.F.); (L.-A.B.)
| | - Manuela Filippa
- Division of Development and Growth, Department of Pediatrics, University Hospital of Geneva, 1205 Geneva, Switzerland;
- Department of Psychology and Educational Sciences, University of Geneva, 1211 Geneva, Switzerland
| | - Edouard Gentaz
- Sensorimotor, Affective and Social Development Unit, Faculty of Psychology, University of Geneva, 1211 Geneva, Switzerland; (E.G.); (F.L.)
| | - Fleur Lejeune
- Sensorimotor, Affective and Social Development Unit, Faculty of Psychology, University of Geneva, 1211 Geneva, Switzerland; (E.G.); (F.L.)
| | - Olivier Baud
- Division of Neonatology and Pediatric Intensive Care, Children’s University Hospital of Geneva, University of Geneva, 1205 Geneva, Switzerland; (J.H.); (A.C.-L.); (C.F.); (L.-A.B.)
- Inserm U1141, University of Paris, Paris 75019, France
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16
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Affiliation(s)
- Terrie E Inder
- From the Center for Neonatal Research, Children's Hospital of Orange County, Orange, and the Department of Pediatrics, University of California, Irvine, Irvine - both in California (T.E.I.); the Department of Neurology, Boston Children's Hospital, and Harvard Medical School - both in Boston (J.J.V.); and the School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia (P.J.A.)
| | - Joseph J Volpe
- From the Center for Neonatal Research, Children's Hospital of Orange County, Orange, and the Department of Pediatrics, University of California, Irvine, Irvine - both in California (T.E.I.); the Department of Neurology, Boston Children's Hospital, and Harvard Medical School - both in Boston (J.J.V.); and the School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia (P.J.A.)
| | - Peter J Anderson
- From the Center for Neonatal Research, Children's Hospital of Orange County, Orange, and the Department of Pediatrics, University of California, Irvine, Irvine - both in California (T.E.I.); the Department of Neurology, Boston Children's Hospital, and Harvard Medical School - both in Boston (J.J.V.); and the School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia (P.J.A.)
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17
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Jones L, Mariapun J, Tan AXQ, Kassim Z, Su TT. Maternal wellbeing of Malaysian mothers after the birth of a preterm infant. BMC Pregnancy Childbirth 2023; 23:510. [PMID: 37442958 DOI: 10.1186/s12884-023-05823-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 06/29/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND In Malaysia approximately 7% of births result in a preterm birth (< 37 weeks). Research in many other countries has found that mothers of preterm infants experience poorer psychological wellbeing. However, there has been limited research in Malaysia. We examined wellbeing, using the WHO Quality of Life brief version questionnaire (WHOQOL-BREF), in mothers who have preterm and full-term infants. METHODS Data was collected as part of the South East Asian Community Observatory MISS-P project. A total of 3221 mothers (7.9% with a preterm and 92.1 with a full-term birth) completed a survey, with a range of measures, including the WHOQoL-BREF and sociodemographic questions. RESULTS For the physical health, psychological wellbeing and quality of their environment WHOQOL-BREF domains, a lower gestational age, a lower education level, and having had an emergency caesarean delivery were significantly associated (p < 0.05) with a lower quality of life, and there was a weak effect for ethnicity for some domains. The effects were strongest for mothers' education level. CONCLUSIONS There is a weak but significant relationship between the gestational age of an infant and the mother's quality of life. Mothers in Malaysia with a preterm infant or a lower level of education may benefit from additional support.
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Affiliation(s)
- Liz Jones
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University (Malaysia), Jalan Lagoon Selatan, Bandar Sunway, Selangor, Malaysia.
| | - Jeevitha Mariapun
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University (Malaysia), Jalan Lagoon Selatan, Bandar Sunway, Selangor, Malaysia
| | - Abbey Xiao Qian Tan
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University (Malaysia), Jalan Lagoon Selatan, Bandar Sunway, Selangor, Malaysia
| | - Zaid Kassim
- 2Segamat District Public Health Office, Ministry of Health, 85000, Segamat, Johor, Malaysia
| | - Tin Tin Su
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University (Malaysia), Jalan Lagoon Selatan, Bandar Sunway, Selangor, Malaysia
- South East Asia Community Observatory (SEACO), Monash University (Malaysia), Jalan Lagoon, Selatan, Bandar Sunway, Selangor State, Malaysia
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18
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Øberg GK, Sørvoll M, Labori C, Girolami GL, Håkstad RB. A systematic synthesis of qualitative studies on parents' experiences of participating in early intervention programs with their infant born preterm. Front Psychol 2023; 14:1172578. [PMID: 37519356 PMCID: PMC10374197 DOI: 10.3389/fpsyg.2023.1172578] [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: 02/25/2023] [Accepted: 06/26/2023] [Indexed: 08/01/2023] Open
Abstract
Early intervention programs involving both the parent and the infant born preterm have demonstrated positive effects on developmental outcomes for the children. However, studies have also shown that parental engagement and adherence when implementing intervention programs can be challenging. The aim of this review was to provide a comprehensive description and new insights into key messages gleaned from the parent reports on participating in early intervention with their infant born preterm; knowledge vital to facilitate implementation of early interventions into clinical practice when using a model of direct parent involvement. Early intervention is broadly defined as a multi-interdisciplinary field provided to children from birth to five years of age to foster child health, wellbeing, development, adapting parenting and family function. For this systematic synthesis we define early intervention as programs with specific activities completed with the infant during the first year after birth. We assembled qualitative interview studies on parents' experiences with participation in early intervention and applied Malterud's qualitative systematic meta-synthesis to synthesize and translate the original findings across studies. In the analysis we applied enactive concepts of embodiment, autonomy, participatory sensemaking, and agency. 10 qualitative studies were identified and included. The systematic synthesis reveals how parents' successful and meaningful participation in early intervention programs were facilitated by their "active embodied doing." The "embodied doing" appeared as the basis for the parents' sense-making processes, development of confidence, and the ability for parents to see new possibilities for actions within themselves, with and in the child. In that respect, a perception of mutuality in the interaction between parent, infant and interventionist was central. Consequently, an important consideration when implementing early intervention into clinical practice is to promote embodied parent-infant interactions as well as trust between the parent and the interventionist.
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Affiliation(s)
- Gunn Kristin Øberg
- Department of Health and Care Sciences, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway
- Department of Clinical Therapeutic Services, University Hospital North Norway, Tromsø, Norway
| | - Marit Sørvoll
- Department of Health and Care Sciences, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway
| | - Cathrine Labori
- Department of Clinical Therapeutic Services, University Hospital North Norway, Tromsø, Norway
| | - Gay L. Girolami
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States
| | - Ragnhild B. Håkstad
- Department of Health and Care Sciences, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway
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Pierce SK, Reynolds KA, Jakobson LS, Ricci MF, Roos LE. Unmet Parental Mental Health Service Needs in Neonatal Follow-Up Programs: Parent and Service Provider Perspectives. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1174. [PMID: 37508670 PMCID: PMC10378703 DOI: 10.3390/children10071174] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 06/23/2023] [Accepted: 06/29/2023] [Indexed: 07/30/2023]
Abstract
Parental mental health services in neonatal follow-up programs (NFUPs) are lacking though needed. This study aimed to determine (1) the unmet mental health needs of parents and (2) the parent and provider perspectives on barriers and opportunities to increase mental health service access. Study 1: Parents in a central Canadian NFUP (N = 49) completed a mixed-method online survey (analyzed descriptively and by content analysis) to elucidate their mental health, related service use, barriers to service use, and service preferences. Study 2: Virtual focus groups with NFUP service providers (N = 5) were run to inform service improvements (analyzed by reflexive thematic analysis). The results show that parents endorsed a 2-4 times higher prevalence of clinically significant depression (59.2%), anxiety (51.0%), and PTSD (26.5%) than the general postpartum population. Most parents were not using mental health services (55.1%) due to resource insecurity among parents (e.g., time, cost) and the organization (e.g., staffing, training, referrals). Consolidating parents' and service providers' perspectives revealed four opportunities for service improvements: bridging services, mental health screening, online psychoeducation, and peer support. Findings clarify how a central Canadian NFUP can address parental mental health in ways that are desired by parents and feasible for service providers.
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Affiliation(s)
- Shayna K Pierce
- Department of Psychology, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
| | - Kristin A Reynolds
- Department of Psychology, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
- Department of Psychiatry, University of Manitoba, Winnipeg, MB R3E 3N4, Canada
- Children's Hospital Research Institute of Manitoba, Winnipeg, MB R3E 3P4, Canada
| | - Lorna S Jakobson
- Department of Psychology, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
| | - M Florencia Ricci
- Children's Hospital Research Institute of Manitoba, Winnipeg, MB R3E 3P4, Canada
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB R3A 1S1, Canada
- Manitoba Neonatal Follow-Up Program, Winnipeg, MB R3E 3G1, Canada
| | - Leslie E Roos
- Department of Psychology, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
- Children's Hospital Research Institute of Manitoba, Winnipeg, MB R3E 3P4, Canada
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB R3A 1S1, Canada
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Séassau A, Munos P, Gire C, Tosello B, Carchon I. Neonatal Care Unit Interventions on Preterm Development. CHILDREN (BASEL, SWITZERLAND) 2023; 10:999. [PMID: 37371231 DOI: 10.3390/children10060999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 05/24/2023] [Accepted: 05/26/2023] [Indexed: 06/29/2023]
Abstract
Prematurity is becoming a real public health issue as more and more children are being born prematurely, alongside a higher prevalence of neurodevelopmental disorders. Early intervention programs in Neonatal Intensive Care Units (NICUs) correspond to these uni- or multi-sensorial solicitations aiming to prevent and detect complications in order to support the development of preterm infants. This article aims to distinguish sensory intervention programs according to the gradient of the type of solicitations, uni- or multi-modal, and according to the function of the person who performs these interventions. Uni-sensorial interventions are essentially based on proprioceptive, gustatory, or odorant solicitations. They allow, in particular, a reduction of apneas that support the vegetative states of the preterm infant. On the other hand, the benefits of multi-sensory interventions seem to have a longer-term impact. Most of them allow the support of the transition from passive to active feeding, an increase in weight, and the improvement of sleep-wake cycles. These solicitations are often practiced by caregivers, but the intervention of parents appears optimal since they are the main co-regulators of their preterm child's needs. Thus, it is necessary to co-construct and train the parents in this neonatal care.
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Affiliation(s)
- Alexia Séassau
- Centre Hospitalier du Pays d'Aix, 13100 Aix-en-Provence, France
| | | | - Catherine Gire
- Department of Neonatology, Hôpital Nord de Marseille, 13015 Marseille, France
| | - Barthélémy Tosello
- Department of Neonatology, Hôpital Nord de Marseille, 13015 Marseille, France
| | - Isabelle Carchon
- CHART Human and Artificial Cognition Laboratory at Ephe, École Pratique des Hautes Études-PSL Paris-Sciences-Lettres, 93322 Aubervilliers, France
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21
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Synnes A, Luu TM, Afifi J, Khairy M, de Cabo C, Moddemann D, Hendson L, Reichert A, Coughlin K, Nguyen KA, Richter LL, Bacchini F, Aziz K. Parent-Integrated Interventions to Improve Language Development in Children Born Very Preterm. CHILDREN (BASEL, SWITZERLAND) 2023; 10:953. [PMID: 37371185 DOI: 10.3390/children10060953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 05/10/2023] [Accepted: 05/18/2023] [Indexed: 06/29/2023]
Abstract
Neurodevelopmental challenges in children born very preterm are common and not improving. This study tested the feasibility of using Evidence-based Practice to Improve Quality (EPIQ), a proven quality improvement technique that incorporates scientific evidence to target improving language abilities in very preterm populations in 10 Canadian neonatal follow-up programs. Feasibility was defined as at least 70% of sites completing four intervention cycles and 75% of cycles meeting targeted aims. Systematic reviews were reviewed and performed, an online quality improvement educational tool was developed, multidisciplinary teams that included parents were created and trained, and sites provided virtual support to implement and audit locally at least four intervention cycles of approximately 6 months in duration. Eight of ten sites implemented at least four intervention cycles. Of the 48 cycles completed, audits showed 41 (85%) met their aim. Though COVID-19 was a barrier, parent involvement, champions, and institutional support facilitated success. EPIQ is a feasible quality improvement methodology to implement family-integrated evidence-informed interventions to support language interventions in neonatal follow-up programs. Further studies are required to identify potential benefits of service outcomes, patients, and families and to evaluate sustainability.
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Affiliation(s)
- Anne Synnes
- Department of Pediatrics, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- BC Women's Hospital and Health Centre, Vancouver, BC V5Z 4H4, Canada
- BC Children's Hospital Research Institute, Vancouver, BC V5Z 4H4, Canada
| | - Thuy Mai Luu
- Department of Pediatrics and Research Center, Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montreal, QC H3T 1C5, Canada
| | - Jehier Afifi
- Department of Pediatrics, Dalhousie University, Halifax, NS B3H 4R2, Canada
- Division of Neonatal Perinatal Medicine, IWK Health Centre, Halifax, NS B3K 6R8, Canada
| | - May Khairy
- Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC H4A 3J1, Canada
| | - Cecilia de Cabo
- Department of Paediatrics and Child Health, University of Manitoba, Winnipeg, MB R3A 1S1, Canada
| | - Diane Moddemann
- Department of Paediatrics and Child Health, University of Manitoba, Winnipeg, MB R3A 1S1, Canada
| | - Leonora Hendson
- Department of Pediatrics, Alberta Children's Hospital, University of Calgary, Calgary, AB T3B 6A8, Canada
| | - Amber Reichert
- Glenrose Rehabilitation Hospital, Edmonton, AB T5G 0B7, Canada
| | - Kevin Coughlin
- Children's Hospital at London Health Sciences Centre, London, ON N6A 5W9, Canada
| | | | - Lindsay L Richter
- Department of Pediatrics, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Fabiana Bacchini
- Canadian Premature Babies Foundation, Etobicoke, ON M8X 1Y3, Canada
| | - Khalid Aziz
- The Office of Lifelong Learning, University of Alberta, Edmonton, AB T6G 1C9, Canada
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22
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Cardenas A, Esser K, Wright E, Netten K, Edwards A, Rose J, Vigod S, Cohen E, Orkin J. Caring for the Caregiver (C4C): An Integrated Stepped Care Model for Caregivers of Children With Medical Complexity. Acad Pediatr 2023; 23:236-243. [PMID: 35680082 DOI: 10.1016/j.acap.2022.06.001] [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: 12/13/2021] [Revised: 05/19/2022] [Accepted: 06/01/2022] [Indexed: 11/23/2022]
Abstract
Children with medical complexity (CMC) are a medically fragile subset of children who rely on parental caregivers for substantial care needs. Caregivers of CMC often experience adverse health outcomes such as depression and anxiety, sleep deprivation, financial hardships, and social isolation. Caregivers of CMC are at risk of premature mortality, which is thought to be mediated by chronic and elevated stress, as well as psychiatric morbidity risk. Access to mental health care, where the needs of both the caregiver and child are considered, can enable caregivers to meet high caregiving demands and improve both child and caregiver outcomes. We describe the Caring for the Caregiver (C4C) model, a novel integrated stepped care model consisting of collaboration between a psychiatrist and a pediatric complex care program. This model provides support in 3 steps: 1) early identification of distress, 2) social work assessment, intervention and psychotherapy, and 3) psychiatric care, including diagnosis or medication initiation, for caregivers of CMC. This innovative model will be the first to embed support for the mental health needs of caregivers of CMC within a pediatric team, facilitating access to psychiatric care and serving as a foundation for future integrated stepped care models.
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Affiliation(s)
- Analyssa Cardenas
- Child Health Evaluative Sciences (A Cardenas, K Esser, E Cohen, and J Orkin), The Hospital for Sick Children, Toronto, ON, Canada
| | - Kayla Esser
- Child Health Evaluative Sciences (A Cardenas, K Esser, E Cohen, and J Orkin), The Hospital for Sick Children, Toronto, ON, Canada
| | - Elisabeth Wright
- Department of Psychiatry (E Wright, S Vigod), Women's College Hospital, Toronto, ON, Canada; Department of Psychiatry (E Wright, S Vigod), University of Toronto, Toronto, ON, Canada
| | - Kathy Netten
- Division of Pediatric Medicine (K Netten, A Edwards, E Cohen, and J Orkin), The Hospital for Sick Children, , Toronto, ON, Canada
| | - Ashley Edwards
- Division of Pediatric Medicine (K Netten, A Edwards, E Cohen, and J Orkin), The Hospital for Sick Children, , Toronto, ON, Canada
| | - Julie Rose
- SickKids Family Advisory Network (J Rose), The Hospital for Sick Children, Toronto, ON, Canada
| | - Simone Vigod
- Department of Psychiatry (E Wright, S Vigod), Women's College Hospital, Toronto, ON, Canada; Department of Psychiatry (E Wright, S Vigod), University of Toronto, Toronto, ON, Canada
| | - Eyal Cohen
- Child Health Evaluative Sciences (A Cardenas, K Esser, E Cohen, and J Orkin), The Hospital for Sick Children, Toronto, ON, Canada; Division of Pediatric Medicine (K Netten, A Edwards, E Cohen, and J Orkin), The Hospital for Sick Children, , Toronto, ON, Canada; Department of Pediatrics (E Cohen, J Orkin), University of Toronto, Toronto, ON, Canada; Edwin S.H. Leong Centre for Healthy Children (E Cohen), University of Toronto, Toronto, ON, Canada
| | - Julia Orkin
- Child Health Evaluative Sciences (A Cardenas, K Esser, E Cohen, and J Orkin), The Hospital for Sick Children, Toronto, ON, Canada; Division of Pediatric Medicine (K Netten, A Edwards, E Cohen, and J Orkin), The Hospital for Sick Children, , Toronto, ON, Canada; Department of Pediatrics (E Cohen, J Orkin), University of Toronto, Toronto, ON, Canada.
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23
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Abbasinia N, Rad ZA, Qalehsari MQ, Gholinia H, Arzani A. The effect of instructing mothers in attachment behaviors on short-term health outcomes of premature infants in NICU. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:59. [PMID: 37113418 PMCID: PMC10127468 DOI: 10.4103/jehp.jehp_514_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 06/16/2022] [Indexed: 06/19/2023]
Abstract
BACKGROUND The birth of a pre-mature infant and subsequent hospitalization and separation from the family can impair maternal and neonatal attachment and quality of maternal care. This study aimed to assess the effect of instructing mothers in attachment behaviors on short-term health outcomes of pre-mature infants admitted to neonatal intensive care units (NICUs). MATERIAL AND METHODS In this quasi experimental study, 80 mothers of pre-mature infants who were admitted to NICUs at two referral health centers in northern Iran were studied in two groups in 2018. Attachment behaviors were taught to mothers in the test group during four consecutive sessions. Mother-infant attachment behaviors were evaluated at both the beginning and the end of this study using a checklist derived from Avant's Maternal Attachment Assessment Strategy. Moreover, infants' short-term health consequences were investigated in two groups. SPSS 18 statistical software was used for data analysis. RESULTS On average, it took respectively 34.90 ± 12/65 and 31/15 ± 14/35 days for the infants in the control and the intervention group to reach full oral feeding and 38/5 (38/4-42/11) and 37 (31/85-42/14) days to gain the minimum weight required for discharge. Moreover, the mean length of stay for the infants in the control and the intervention group was 41/80 ± 13/86 and 39/02 ± 16/01 days, respectively (P > 0/05). CONCLUSION Instructing mothers in attachment behaviors clinically improved short-term health-related outcomes. Hence, this intervention is recommended to be incorporated in the care program for mothers with pre-mature infants.
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Affiliation(s)
- Narges Abbasinia
- Master of Newborn Intensive Care Nursing, School of Nursing and Midwifery, Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Zahra Akbarian Rad
- Associate Professor of Neonatal-Perinatal Medicine, Non-Communicable Pediatric Diseases Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mojtaba Qanbari Qalehsari
- Nursing Care Research Center, Health Research Institute, School of Nursing and Midwifery, Babol University of Medical Sciences, Babol, Iran
| | - Hemmat Gholinia
- Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Afsaneh Arzani
- Non-Communicable Pediatric Diseases Research Center, Health Research Center, Nursing and Midwifery School, Babol University of Medical Sciences, Babol, Iran
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24
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Campbell-Yeo M, Dol J, McCulloch H, Hughes B, Hundert A, Bacchini F, Whitehead L, Afifi J, Alcock L, Bishop T, Dorling J, Earle R, Elliott Rose A, Inglis D, Leighton C, MacRae G, Melanson A, Simpson CD, Smit M. The Impact of Parental Presence Restrictions on Canadian Parents in the NICU During COVID-19: A National Survey. JOURNAL OF FAMILY NURSING 2023; 29:18-27. [PMID: 35915967 PMCID: PMC9850074 DOI: 10.1177/10748407221114326] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The purpose of this research was to explore parental perspectives on the impact of parent restrictions imposed in response to the COVID-19 pandemic across Canadian Neonatal Intensive Care Units (NICUs). A co-designed online survey was conducted targeting parents (n = 235) of infants admitted to a Canadian NICU from March 1, 2020, until March 5, 2021. Parents completed the survey from 38 Canadian NICUs. Large variation in the severity of policies regarding parental presence was reported. Most respondents (68.9%) were classified as experiencing high restrictions, with one or no support people allowed in the NICU, and felt that policies were less easy to understand, felt less valued and respected, and found it more challenging to access medicine or health care. Parents reported gaps in care related to self-care, accessibility, and mental health outcomes. There is significant variation in parental restrictions implemented across Canadian NICUs. National guidelines are needed to support consistent and equitable care practices.
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Affiliation(s)
| | | | | | | | | | | | | | - Jehier Afifi
- Dalhousie University, Halifax, NS,
Canada
- IWK Health, Halifax, NS, Canada
| | | | | | - Jon Dorling
- University Hospital Southampton NHS
Foundation Trust, Southampton, UK
| | | | | | | | | | | | | | - C. David Simpson
- Dalhousie University, Halifax, NS,
Canada
- IWK Health, Halifax, NS, Canada
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25
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Santos Sampaio SS, de Amorim Rodrigues NA, Moura JR, de Lima-Alvarez CD, Pereira SA. Effects of Prone Positioning on Head Control in Preterm Infants: Randomized and Controlled Clinical Trial Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2375. [PMID: 36767742 PMCID: PMC9915948 DOI: 10.3390/ijerph20032375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/09/2022] [Accepted: 12/15/2022] [Indexed: 06/18/2023]
Abstract
PURPOSE The primary aim will be to assess the effects of prone positioning (tummy time) on cervical extension (angular kinematics and time) in preterm infants. The secondary aim will be to assess the effects of tummy time on gross motor function. METHODS This randomized, controlled clinical trial will include 40 preterm infants weighing less than 2500 g, randomly allocated into control or experimental group (n = 20) and followed up from birth to six months of corrected age by the team of the neonatal follow-up clinic. Caregivers will be routinely guided on bonding, developmental milestones, and how to perform the tummy time for 30 min throughout the day (experimental group). An illustrative booklet will be provided as support material. The hypothesis will be tested using inferential analysis, considering an alpha of 5%. DISCUSSION We expect tummy time to strengthen cervical muscles needed to overcome gravity, master motor skills, and stimulate the integration between family activity and environmental experiences, considerable challenges to which preterm infants are exposed. TRIAL REGISTRATION Registered in the Brazilian Registry of Clinical Trials (identifier RBR-2nwkr47) on 17 February 2022.
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Affiliation(s)
- Sabrinne Suelen Santos Sampaio
- Post-Graduation Program of Physiotherapy, Universidade Federal do Rio Grande do Norte (UFRN), Natal 59078-970, Rio Grande do Norte, Brazil
| | | | - Julia Raffin Moura
- Post-Graduate Program in Sciences of Rehabilitation, Universidade de Brasília (UNB), Brasília 72220-275, Distrito Federal, Brazil
| | - Carolina Daniel de Lima-Alvarez
- Departament of Physiotherapy, Universidade Federal do Rio Grande do Norte (UFRN), Natal 59078-970, Rio Grande do Norte, Brazil
| | - Silvana Alves Pereira
- Post-Graduation Program of Physiotherapy, Universidade Federal do Rio Grande do Norte (UFRN), Natal 59078-970, Rio Grande do Norte, Brazil
- Departament of Physiotherapy, Universidade Federal do Rio Grande do Norte (UFRN), Natal 59078-970, Rio Grande do Norte, Brazil
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26
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Hunter LL, Vannest J, Moore DR, Barnes-Davis M, Blankenship C, Prather L, Caldwell-Kurtzman J, Parikh N. Hearing, Speech, and Language in Infants and Toddlers Born Prematurely. THE VOLTA REVIEW 2023; 123:1-20. [PMID: 39070928 PMCID: PMC11281542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 07/30/2024]
Affiliation(s)
- Lisa L. Hunter
- Communication Sciences Research Center, College of Allied Health, University of Cincinnati Cincinnati, Ohio 45229
- Department of Otolaryngology, College of Allied Health, University of Cincinnati Cincinnati, Ohio 45229
| | - Jennifer Vannest
- Communication Sciences Research Center, College of Allied Health, University of Cincinnati Cincinnati, Ohio 45229
- College of Medicine, Department of Communication Sciences and Disorders, College of Allied Health, University of Cincinnati Cincinnati, Ohio 45229
| | - David R. Moore
- Communication Sciences Research Center, College of Allied Health, University of Cincinnati Cincinnati, Ohio 45229
- Department of Otolaryngology, College of Allied Health, University of Cincinnati Cincinnati, Ohio 45229
| | - Maria Barnes-Davis
- Perinatal Institute, College of Allied Health, University of Cincinnati Cincinnati, Ohio 45229
- Cincinnati Children’s Hospital Medical Center Department of Pediatrics, College of Allied Health, University of Cincinnati Cincinnati, Ohio 45229
| | - Chelsea Blankenship
- Communication Sciences Research Center, College of Allied Health, University of Cincinnati Cincinnati, Ohio 45229
| | - Lauren Prather
- Communication Sciences Research Center, College of Allied Health, University of Cincinnati Cincinnati, Ohio 45229
- College of Medicine, Department of Communication Sciences and Disorders, College of Allied Health, University of Cincinnati Cincinnati, Ohio 45229
| | - Jody Caldwell-Kurtzman
- Communication Sciences Research Center, College of Allied Health, University of Cincinnati Cincinnati, Ohio 45229
| | - Nehal Parikh
- Perinatal Institute, College of Allied Health, University of Cincinnati Cincinnati, Ohio 45229
- Cincinnati Children’s Hospital Medical Center Department of Pediatrics, College of Allied Health, University of Cincinnati Cincinnati, Ohio 45229
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Collette K, Feeley N, Galipeau R, Lebel V. Acceptability and feasibility of a digital educational intervention designed to improve the psychological well-being of parents with a preterm infant at the neonatal intensive care unit: A pilot project. Early Hum Dev 2023; 176:105717. [PMID: 36724661 DOI: 10.1016/j.earlhumdev.2023.105717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/21/2023] [Accepted: 01/22/2023] [Indexed: 01/28/2023]
Abstract
BACKGROUND Families experience psychological distress when their preterm infant is in the Neonatal Intensive Care Unit. A tailored educational intervention may be beneficial for their psychological well-being. Unfortunately, existing websites have moderate to low information quality and there is no educational website for French-speaking parents. AIM To measure the acceptability and feasibility of a digital educational intervention designed to improve the psychological well-being of parents with a preterm infant, as well as the acceptability and feasibility of the study methods used. METHODS A pilot randomized controlled trial was conducted. Participants were randomized to have access to either an educational website or information pamphlet. They were invited to complete an online questionnaire about stress and depressive symptoms 2 and 4 weeks after recruitment. An online questionnaire regarding the acceptability of the intervention and the data collection process was completed 5 weeks after recruitment. RESULTS Twenty parents participated. All participants with access to the website considered it was acceptable in terms of the appropriateness, convenience, and efficiency to meet their informational needs. 85 % of participants assigned to the website viewed it 1 to 3 times per day during the data collection period and 69.4 % consulted the website for 5 to 20 min each time. The data collection process was acceptable for 85 % to 95 % of participants. DISCUSSION The educational website was an acceptable and feasible intervention and the data collection process used was acceptable according to participants.
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Affiliation(s)
- Kimberley Collette
- Université du Québec en Outaouais, Nursing Department, 5 rue St-Joseph, St-Jérôme, Québec J7Z 0B7, Canada.
| | - Nancy Feeley
- Ingram School of Nursing at McGill University, Montreal, Québec, Canada; Jewish General Hospital Centre for Nursing Research, Lady Davis Institute, Montreal, Québec, Canada
| | - Roseline Galipeau
- Université du Québec en Outaouais, Nursing Department, 5 rue St-Joseph, St-Jérôme, Québec J7Z 0B7, Canada
| | - Valérie Lebel
- Université du Québec en Outaouais, Nursing Department, 5 rue St-Joseph, St-Jérôme, Québec J7Z 0B7, Canada.
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Fernandes RO, Bernardi JR, da Fonseca JD, Gomes da Silva F, Procianoy RS, Silveira RC. The impact of an early intervention home-based program on body composition in preterm-born preschoolers with very low birth weight. Front Nutr 2022; 9:981818. [PMID: 36337669 PMCID: PMC9631204 DOI: 10.3389/fnut.2022.981818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 09/21/2022] [Indexed: 11/24/2022] Open
Abstract
Background and aims Early child interventions focused on the family prevented neurodevelopmental and behavioral delays and can provide more knowledge regarding responsive feeding, thus creating learning opportunities to promote better quality nutrition and preventing failure to thrive. The aim is to verify the impact of a continuous program of early home-based intervention on the body composition of preschool infants who were born preterm with very low birth weight (VLBW). Methods This is a longitudinal analysis from a randomized controlled trial, including VLBW preterm children, born in a tertiary hospital in Southern Brazil and followed up at the high-risk institutional ambulatory clinic. Participants were divided into the intervention group (IG): skin-to-skin care with the mother (kangaroo care), breastfeeding policy, and tactile-kinesthetic stimulation by mothers until hospital discharge. Subsequently, they received a program of early intervention with orientation and a total of 10 home visits, independently from the standard evaluation and care that was performed following the 18 months after birth; conventional group (CG): standard care according to the routine of the newborn intensive care unit (NICU), which includes kangaroo care, and attending to their needs in the follow-up program. Body composition estimation was performed using bioelectrical impedance analyses (BIA), and physical activity and feeding practices questionnaires were evaluated at preschool age, as well as anthropometric measurements and biochemical analysis. Results Data of 41 children at 4.6 ± 0.5 years old were evaluated (CG n = 21 and IG n = 20). Body weight, height, body mass index, waist and arm circumferences, and triceps and subscapular skinfold did not differ between groups. The IG presented higher segmented fat-free mass (FFM) when compared to the CG (right arm FFM: 0.74 vs. 0.65 kg, p = 0.040; trunk FFM: 6.86 vs. 6.09 kg, p = 0.04; right leg FFM: 1.91 vs. 1.73 kg, p = 0.063). Interaction analyses showed that segmented FFM and FFM Index were associated with higher iron content in the IG. In the CG, interaction analyses showed that increased visceral fat area was associated with higher insulin resistance index. Conclusion An early intervention protocol from NICU to a home-based program performed by the mothers of VLBW preterm children of low-income families presents a small effect on FFM.
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Affiliation(s)
- Rafael Oliveira Fernandes
- Graduate Program in Child and Adolescent Health (PPGSCA), Medical School of Universidade Federal do Rio Grande do Sul (UFRGS), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
- *Correspondence: Rafael Oliveira Fernandes,
| | - Juliana Rombaldi Bernardi
- Graduate Program in Child and Adolescent Health (PPGSCA), Medical School of Universidade Federal do Rio Grande do Sul (UFRGS), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
- Graduate Program in Food, Nutrition and Health, Medical School of Universidade Federal do Rio Grande do Sul (UFRGS), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
- Juliana Rombaldi Bernardi,
| | - Júlia Delgado da Fonseca
- Graduate Program in Food, Nutrition and Health, Medical School of Universidade Federal do Rio Grande do Sul (UFRGS), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | - Franciéle Gomes da Silva
- Graduate Program in Child and Adolescent Health (PPGSCA), Medical School of Universidade Federal do Rio Grande do Sul (UFRGS), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | - Renato Soibelmann Procianoy
- Graduate Program in Child and Adolescent Health (PPGSCA), Medical School of Universidade Federal do Rio Grande do Sul (UFRGS), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | - Rita C. Silveira
- Graduate Program in Child and Adolescent Health (PPGSCA), Medical School of Universidade Federal do Rio Grande do Sul (UFRGS), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
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Treyvaud K, Eeles AL, Spittle AJ, Lee KJ, Cheong JLY, Shah P, Doyle LW, Anderson PJ. Preterm Infant Outcomes at 24 Months After Clinician-Supported Web-Based Intervention. Pediatrics 2022; 150:189551. [PMID: 36130917 DOI: 10.1542/peds.2021-055398] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/12/2022] [Indexed: 11/24/2022] Open
Abstract
UNLABELLED The authors of this study evaluated infant and parent outcomes at 12 and 24 months after a clinician-supported, web-based early intervention for preterm infants. OBJECTIVE To examine the efficacy of a clinician-supported, web-based intervention delivered over the first year after birth compared with standard care in children born after <34 weeks' gestation, on child development at 24 months corrected age (CA), parental mental health, and the parent-child relationship at 24 months. METHODS We randomly allocated 103 preterm infants to clinician-supported, web-based intervention (n = 50) or standard care control (n = 53) groups. At 24 months CA, child cognitive, language, motor, social-emotional development, and the parent-child relationship were assessed. Parental mental health and quality of life were assessed at 12 and 24 months CA. RESULTS At 24 months, child development, maternal mental health, and maternal quality of life were similar for the intervention and control groups. There was some evidence that mothers in the intervention group had lower odds of being in the elevated category for depression at 12 months (odds ratio: 0.19; 95% confidence interval [CI]: 0.04-0.90; P = .04). Scores were higher in the intervention group for child responsiveness (mean difference: 0.57; 95% CI: 0.03-1.11; P = .04), child involvement (mean difference: 0.61; 95% CI: 0.09-1.13; P = .02), and maternal structuring (mean difference: 0.72; 95% CI: 0.22-1.21; P = .01) during the parent-infant interaction at 24 months. CONCLUSIONS This study provides preliminary evidence that a clinician-supported, web-based early intervention program for preterm infants had a positive effect on the parent-child relationship and maternal mental health immediately after the intervention but potentially little effect on child development.
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Affiliation(s)
- Karli Treyvaud
- La Trobe University, Victoria, Australia.,Murdoch Children's Research Institute, Victoria, Australia.,University of Melbourne, Victoria, Australia.,Royal Women's Hospital, Victoria, Australia
| | - Abbey L Eeles
- Murdoch Children's Research Institute, Victoria, Australia.,University of Melbourne, Victoria, Australia.,Turner Institute for Brain & Mental Health, School of Psychological Sciences, Monash University, Victoria, Australia
| | - Alicia J Spittle
- Murdoch Children's Research Institute, Victoria, Australia.,University of Melbourne, Victoria, Australia.,Royal Women's Hospital, Victoria, Australia
| | - Katherine J Lee
- Murdoch Children's Research Institute, Victoria, Australia.,University of Melbourne, Victoria, Australia
| | - Jeanie L Y Cheong
- Murdoch Children's Research Institute, Victoria, Australia.,University of Melbourne, Victoria, Australia.,Royal Women's Hospital, Victoria, Australia
| | - Parool Shah
- Life's Little Treasures Foundation, Ringwood, VIC, Australia
| | - Lex W Doyle
- Murdoch Children's Research Institute, Victoria, Australia.,University of Melbourne, Victoria, Australia.,Royal Women's Hospital, Victoria, Australia
| | - Peter J Anderson
- Murdoch Children's Research Institute, Victoria, Australia.,Turner Institute for Brain & Mental Health, School of Psychological Sciences, Monash University, Victoria, Australia
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Shafey A, Benzies K, Amin R, Stelfox HT, Shah V. Fathers' Experiences in Alberta Family Integrated Care: A Qualitative Study. J Perinat Neonatal Nurs 2022; 36:371-379. [PMID: 36288445 DOI: 10.1097/jpn.0000000000000684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The Family Integrated Care (FICare) program adapted for Alberta (AB) level II neonatal intensive care units (NICUs) aims to increase parental involvement and support during their NICU stay. The experience of fathers of preterm infants in a FICare program is currently unknown. PURPOSE To describe the experiences of fathers of preterm infants born at 320/7 to 346/7 weeks' gestational age with AB FICare. METHODS A qualitative substudy of a multicenter prospective cluster randomized controlled trial of FICare in 10 level II NICUs across Alberta. Fathers of preterm infants participated in a semistructured interview after discharge when their infants were at least 2 months' corrected gestational age. Journal entries written by fathers while in the NICU from the FICare intervention sites were also collected. Data were analyzed thematically and the interview and journal data were triangulated. FINDINGS Thirteen fathers (9 from the FICare intervention and 4 from standard care) participated in semistructured interviews and there were 24 journals collected. Seven themes emerged: fear of the unknown, mental preparation, identifying the father's role, parenting with supervision, effective communication, postneonatal intensive care transition, and family life. Fathers enrolled in AB FICare attributed their level of confidence and positive neonatal intensive care experience that continued postdischarge to the care and attention they received during hospitalization. CONCLUSION AB FICare may improve experiences for fathers of preterm infants in the NICU with continuation postdischarge. Future research should include designing and evaluating father-specific NICU programs.
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Affiliation(s)
- Amy Shafey
- Department of Pediatrics, University of Alberta, Edmonton, Canada (Dr Shafey); Departments of Pediatrics and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada (Dr Benzies); Department of Pediatrics, University of Toronto, Toronto, Canada (Drs Amin and Shah); and Department of Critical Care Medicine, University of Calgary, Calgary, Canada (Dr Stelfox)
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Home-Based Care for Children with Serious Illness: Ecological Framework and Research Implications. CHILDREN 2022; 9:children9081115. [PMID: 35892618 PMCID: PMC9330186 DOI: 10.3390/children9081115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 07/15/2022] [Accepted: 07/22/2022] [Indexed: 11/25/2022]
Abstract
Care for U.S. children living with serious illness and their families at home is a complex and patchwork system. Improving home-based care for children and families requires a comprehensive, multilevel approach that accounts for and examines relationships across home environments, communities, and social contexts in which children and families live and receive care. We propose a multilevel conceptual framework, guided by Bronfenbrenner’s ecological model, that conceptualizes the complex system of home-based care into five levels. Levels 1 and 2 contain patient and family characteristics. Level 3 contains factors that influence family health, well-being, and experience with care in the home. Level 4 includes the community, including community groups, schools, and providers. Level 5 includes the broader regional system of care that impacts the care of children and families across communities. Finally, care coordination and care disparities transcend levels, impacting care at each level. A multilevel ecological framework of home-based care for children with serious illness and families can be used in future multilevel research to describe and test hypotheses about aspects of this system of care, as well as to inform interventions across levels to improve patient and family outcomes.
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32
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Li S, Liu S, Zhang X, Chen Y, Ren X. Effectiveness of the PRECEDE-PROCEED model for improving the care knowledge, skill, and sense of competence in mothers of preterm infants. J Int Med Res 2022; 50:3000605221110699. [PMID: 35822278 PMCID: PMC9284223 DOI: 10.1177/03000605221110699] [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] [Indexed: 11/16/2022] Open
Abstract
Objective This quasi-randomized controlled trial was performed to evaluate the effects
of the PRECEDE-PROCEED model (PPM) in enabling mothers of preterm infants to
develop care knowledge, skill, and a sense of competence. Methods Among 116 mothers of preterm infants, 60 received traditional discharge
education (control group) and 56 received PPM discharge education (PPM
group). Improvement in knowledge and skills was transformed into the
mothers’ routine daily care of infants. The primary outcome was knowledge of
preterm infant care. The secondary outcomes were preterm infant care skills
and a sense of competence, routine intervention compliance among mothers,
and the readmission rate of infants 6 months after discharge. Results Six months after discharge, the mean knowledge score and mean skills score
were significantly higher in the PPM group than in the control group. The
mothers’ sense of competence with respect to both self-efficacy and
satisfaction was also significantly better in the PPM group than in the
control group. Moreover, intervention behavior compliance and the
readmission rate were significantly better in the PPM group than in the
control group. Conclusion Care knowledge, skills, and sense of competence in mothers of preterm infants
improved after implementation of the PPM.
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Affiliation(s)
- Shaoli Li
- Department of Pediatrics, Baoji Maternal and Child Health Hospital, Baoji, Shaanxi Province, China
| | - Shufang Liu
- Department of Neonatal Intensive Care Unit, Baoji Maternal and Child Health Hospital, Baoji, Shaanxi Province, China
| | - Xinchun Zhang
- Department of Neonatal Intensive Care Unit, Baoji Maternal and Child Health Hospital, Baoji, Shaanxi Province, China
| | - Yali Chen
- Department of Nursing Management, Baoji Maternal and Child Health Hospital, Baoji, Shaanxi Province, China
| | - Xiaohong Ren
- Department of Neonatal Intensive Care Unit, Baoji Maternal and Child Health Hospital, Baoji, Shaanxi Province, China
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Ochandorena-Acha M, Terradas-Monllor M, López Sala L, Cazorla Sánchez ME, Fornaguera Marti M, Muñoz Pérez I, Agut-Quijano T, Iriondo M, Casas-Baroy JC. Early Physiotherapy Intervention Program for Preterm Infants and Parents: A Randomized, Single-Blind Clinical Trial. CHILDREN 2022; 9:children9060895. [PMID: 35740832 PMCID: PMC9222162 DOI: 10.3390/children9060895] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/11/2022] [Accepted: 06/13/2022] [Indexed: 11/20/2022]
Abstract
Background: The early developmental interventions might be designed with a preventative approach to improving the development of at-risk preterm infants. The present study aimed to evaluate the effectiveness of an early physiotherapy intervention on preterm infants’ motor and global development, and on parents’ stress index. Methods: 48 infants were enrolled and randomized into two groups. Infants allocated to the intervention group received an early physiotherapy intervention, based on parental education sessions and tactile and kinesthetic stimulation during the NICU period, as well as a home-based activity program. The intervention commenced after 32 weeks post-menstrual age and ended at 2 months corrected age. Infants allocated to the control group received the usual care based on the NIDCAP-care. Results: No differences were found between groups on the Alberta Infant Motor Scale at 2- or 8-months corrected age. Infants in the intervention group showed more optimal fine motor, problem-solving, personal-social, and communication development at 1 month corrected age. Conclusions: The results showed no effect on the early physiotherapy intervention. Results might be related to the dose or intensity of the intervention, but also to the poor parental compliance. ClinicalTrials.gov NCT03313427.
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Affiliation(s)
- Mirari Ochandorena-Acha
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), C.Sagrada Família, 7, 08500 Vic, Barcelona, Spain; (M.O.-A.); (J.C.C.-B.)
- Sant Joan de Deu Barcelona Children’s Hospital, Passeig de Sant Joan de Déu, 2, 08950 Esplugues de Llobregat, Barcelona, Spain; (L.L.S.); (M.E.C.S.); (M.F.M.); (I.M.P.); (T.A.-Q.); (M.I.)
| | - Marc Terradas-Monllor
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), C.Sagrada Família, 7, 08500 Vic, Barcelona, Spain; (M.O.-A.); (J.C.C.-B.)
- Pain Medicine Section, Anaesthesiology Department, Hospital Clínic de Barcelona, 08036 Barcelona, Catalonia, Spain
- Correspondence:
| | - Laura López Sala
- Sant Joan de Deu Barcelona Children’s Hospital, Passeig de Sant Joan de Déu, 2, 08950 Esplugues de Llobregat, Barcelona, Spain; (L.L.S.); (M.E.C.S.); (M.F.M.); (I.M.P.); (T.A.-Q.); (M.I.)
| | - Maria Engracia Cazorla Sánchez
- Sant Joan de Deu Barcelona Children’s Hospital, Passeig de Sant Joan de Déu, 2, 08950 Esplugues de Llobregat, Barcelona, Spain; (L.L.S.); (M.E.C.S.); (M.F.M.); (I.M.P.); (T.A.-Q.); (M.I.)
| | - Montserrat Fornaguera Marti
- Sant Joan de Deu Barcelona Children’s Hospital, Passeig de Sant Joan de Déu, 2, 08950 Esplugues de Llobregat, Barcelona, Spain; (L.L.S.); (M.E.C.S.); (M.F.M.); (I.M.P.); (T.A.-Q.); (M.I.)
| | - Isabel Muñoz Pérez
- Sant Joan de Deu Barcelona Children’s Hospital, Passeig de Sant Joan de Déu, 2, 08950 Esplugues de Llobregat, Barcelona, Spain; (L.L.S.); (M.E.C.S.); (M.F.M.); (I.M.P.); (T.A.-Q.); (M.I.)
| | - Thais Agut-Quijano
- Sant Joan de Deu Barcelona Children’s Hospital, Passeig de Sant Joan de Déu, 2, 08950 Esplugues de Llobregat, Barcelona, Spain; (L.L.S.); (M.E.C.S.); (M.F.M.); (I.M.P.); (T.A.-Q.); (M.I.)
| | - Martín Iriondo
- Sant Joan de Deu Barcelona Children’s Hospital, Passeig de Sant Joan de Déu, 2, 08950 Esplugues de Llobregat, Barcelona, Spain; (L.L.S.); (M.E.C.S.); (M.F.M.); (I.M.P.); (T.A.-Q.); (M.I.)
| | - Joan Carles Casas-Baroy
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), C.Sagrada Família, 7, 08500 Vic, Barcelona, Spain; (M.O.-A.); (J.C.C.-B.)
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Yu NKK, Shum KKM, Lam YY, Kwan QKL, Ng SYP, Chan NTT. Sensitivity Training for Mothers With Premature Infants: A Randomized Controlled Trial. J Pediatr Psychol 2022; 47:1167-1184. [PMID: 35666133 DOI: 10.1093/jpepsy/jsac051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 05/18/2022] [Accepted: 05/21/2022] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE This single-blind parallel design randomized controlled trial evaluated the feasibility and effectiveness of a modified version of the Mother-Infant Transaction Program (MITP) in enhancing Chinese mothers' sensitivity towards their premature infants' physiological and social cues. METHODS Sixty mothers of hospitalized premature infants (mean gestational age = 32.1 weeks; SD = 2.8) were randomly assigned to either the MITP group or the treatment-as-usual control group. The intervention group (n = 30) received four sessions of parental sensitivity training adapted from the MITP, delivered by clinical psychologists before the infants were discharged. The control group (n = 30) received standard care provided by the hospitals. Each dyad was assessed at baseline (Time 1), immediately after intervention (Time 2), and when the infants were at the gestation-corrected ages of 3, 6, 9, and 12 months (Times 3-6). Maternal sensitivity, mother-infant interaction quality, parenting stress, postpartum depression, and mother's perception of infant's temperament were measured at Times 1-4, whereas infants' weight gain and developmental performance were assessed at Times 3-6. RESULTS The MITP group showed significantly higher maternal sensitivity and better mother-infant interaction quality after completing the training. They also reported less parenting stress and postnatal depression than the control group at Time 2 and subsequent follow-ups. The intervention significantly predicted better weight gain and developmental outcomes in infants across Times 3-6, mediated by maternal wellbeing and interaction quality. CONCLUSION Our results demonstrated the feasibility and effectiveness of this adapted sensitivity training among Chinese mothers with premature infants. [ClinicalTrials.gov NCT04383340].
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Affiliation(s)
- Nicky Ka Ki Yu
- Department of Psychology, The University of Hong Kong, Hong Kong.,Department of Clinical Psychology, Kwong Wah Hospital, Hong Kong
| | | | - Yuen Yu Lam
- Department of Pediatrics, Kwong Wah Hospital, Hong Kong
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Harniess PA, Gibbs D, Bezemer J, Purna Basu A. Parental engagement in early intervention for infants with cerebral palsy-A realist synthesis. Child Care Health Dev 2022; 48:359-377. [PMID: 34622968 PMCID: PMC9298289 DOI: 10.1111/cch.12916] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 09/15/2021] [Accepted: 10/04/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND Emphasis on parental engagement strategies within occupational therapy and physiotherapy early intervention (EI) programmes for infants at high risk of cerebral palsy (CP) has increased. This reflects consensus that increasing parent participation enhances treatment efficacy, potentially improving infant and parent outcomes. However, evaluation of parental engagement in EI is complex. Despite the growing application of parental engagement strategies, aligned with family-centred care practice, theoretical evaluation is currently lacking within the literature. This realist synthesis aimed to identify component theories underlying EI strategies to support parental engagement and to use empirical findings to evaluate how these work in practice. METHODS Realist synthesis: Databases Medline, Embase, Amed, CINAHL and PsychInfo were searched (from February 1985 - February 2020); further articles were sourced from reference lists. A data extraction form was used, and a Critical Appraisal Skills Programme tool was used to assess study rigour. RESULTS Twenty-six articles were included. Quality of relationships, parent education and intervention co-design were the key themes related to parental engagement strategies. Findings indicate that constructive parent reasoning mechanisms of trust, belief, sense of control, perceived feasibility of home programme delivery and ultimately motivation are linked to the underlying intervention resources afforded by specific strategies (e.g., coaching pedagogy). These responses are precursors to engagement outcomes that include increased parental self-efficacy and adherence. Importantly, parental self-efficacy can initiate a process of change leading to improved parental confidence and anxiety. CONCLUSIONS Sensitively designed programme strategies, centred on relational quality between parent, infant and therapist, are fundamental for effective parent connection, involvement and investment within EI for infants with CP.
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Affiliation(s)
- Phillip Antony Harniess
- Physiotherapy DepartmentGreat Ormond Street HospitalLondonUK,Institute of EducationUniversity College LondonLondonUK
| | - Deanna Gibbs
- Children's ResearchBarts Health NHS TrustLondonUK
| | - Jeff Bezemer
- Institute of EducationUniversity College LondonLondonUK
| | - Anna Purna Basu
- Population Health Sciences InstituteNewcastle UniversityNewcastle upon TyneUK,Department of Paediatric NeurologyNewcastle upon Tyne Hospitals NHS Foundation TrustNewcastle upon TyneUK
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McGuire-Brown M, Banihani R, Watson J, Ng E, Rocha C, Borges L, Church PT. The STEP Program—A Qualitative Study of the Supportive Therapeutic Excursion Program and Its Effect on Enabling Parental Self-Efficacy and Connectedness after the Stress-Experience of the NICU. CHILDREN 2022; 9:children9050591. [PMID: 35626768 PMCID: PMC9139833 DOI: 10.3390/children9050591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 04/19/2022] [Accepted: 04/20/2022] [Indexed: 11/16/2022]
Abstract
As a child is born, so are the parents with new roles assumed. Attachment is secured, and parents quickly become the experts in their child. With preterm birth, however, this quiet and essential period of discovery is interrupted. It is described as a traumatic and stressful experience. Programs that aim to address this focus on education and support. This qualitative study explores the effect on parents and staff of a novel and simple intervention of parents walking their baby in a stroller (Supportive Therapeutic Excursion Program, STEP). This study used a qualitative methodology that included 20 semi-structured interviews for content saturation to explore the experiences of parents and staff participating in the STEP program. We found an overall positive experience reported by both parents and nursing staff with STEP. Analysis revealed that as autonomy is fostered with parent education around transition to home, STEP brought a normalcy that was reported to bolster participating parents’ self-efficacy and connectedness, two important elements for recovery from stressful situations. The potential impact of STEP can be far reaching because, although future research is needed, these data suggest that inexpensive programs that promote normalcy may enable self-efficacy and connectedness prior to hospital discharge.
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Affiliation(s)
| | - Rudaina Banihani
- DAN Women and Babies Program, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada; (R.B.); (J.W.); (E.N.); (C.R.); (L.B.)
| | - Jo Watson
- DAN Women and Babies Program, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada; (R.B.); (J.W.); (E.N.); (C.R.); (L.B.)
| | - Eugene Ng
- DAN Women and Babies Program, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada; (R.B.); (J.W.); (E.N.); (C.R.); (L.B.)
| | - Colleen Rocha
- DAN Women and Babies Program, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada; (R.B.); (J.W.); (E.N.); (C.R.); (L.B.)
| | - Laura Borges
- DAN Women and Babies Program, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada; (R.B.); (J.W.); (E.N.); (C.R.); (L.B.)
| | - Paige Terrien Church
- DAN Women and Babies Program, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada; (R.B.); (J.W.); (E.N.); (C.R.); (L.B.)
- Correspondence:
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Lovato I, Vanes LD, Sacchi C, Simonelli A, Hadaya L, Kanel D, Falconer S, Counsell S, Redshaw M, Kennea N, Edwards AD, Nosarti C. Early Childhood Temperamental Trajectories following Very Preterm Birth and Their Association with Parenting Style. CHILDREN (BASEL, SWITZERLAND) 2022; 9:508. [PMID: 35455552 PMCID: PMC9025945 DOI: 10.3390/children9040508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 03/21/2022] [Accepted: 04/01/2022] [Indexed: 11/30/2022]
Abstract
Childhood temperament is an early characteristic shaping later life adjustment. However, little is currently known about the stability of early temperament and its susceptibility to the environment in children born very preterm (VPT; <33 weeks’ gestation). Here, we investigated infant-to-childhood temperamental trajectories, and their interaction with parental practices, in VPT children. Maternal reports of infant temperament were collected in 190 infants (mean age: 11.27 months; range 9−18 months) enrolled in the longitudinal Evaluation of Preterm Imaging (ePrime; Eudra: CT 2009-011602-42) study, using the ePrime questionnaire on infant temperament. At 4−7 years of age, further assessments of child temperament (Children’s Behavior Questionnaire—Very Short Form) and parenting style (Arnold’s Parenting Scale) were conducted. Results showed that more difficult temperament in infancy was associated with increased Negative Affectivity in childhood, regardless of parenting practices. This lends support to the stability of early temperamental traits reflecting negative emotionality. In contrast, a lax parenting style moderated the relationship between easy infant temperament and Negative Affectivity at 4−7 years, such that an easier infant temperament was increasingly associated with higher childhood Negative Affectivity scores as parental laxness increased. These results highlight a potential vulnerability of VPT infants considered by their mothers to be easy to handle, as they may be more susceptible to the effects of suboptimal parenting in childhood.
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Affiliation(s)
- Irene Lovato
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King’s College London, London SE1 7EH, UK; (I.L.); (L.D.V.); (L.H.); (D.K.); (S.F.); (S.C.); (A.D.E.)
- Department of Developmental Psychology and Socialization, University of Padova, 35151 Padova, Italy; (C.S.); (A.S.)
| | - Lucy D. Vanes
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King’s College London, London SE1 7EH, UK; (I.L.); (L.D.V.); (L.H.); (D.K.); (S.F.); (S.C.); (A.D.E.)
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK
| | - Chiara Sacchi
- Department of Developmental Psychology and Socialization, University of Padova, 35151 Padova, Italy; (C.S.); (A.S.)
| | - Alessandra Simonelli
- Department of Developmental Psychology and Socialization, University of Padova, 35151 Padova, Italy; (C.S.); (A.S.)
| | - Laila Hadaya
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King’s College London, London SE1 7EH, UK; (I.L.); (L.D.V.); (L.H.); (D.K.); (S.F.); (S.C.); (A.D.E.)
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK
| | - Dana Kanel
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King’s College London, London SE1 7EH, UK; (I.L.); (L.D.V.); (L.H.); (D.K.); (S.F.); (S.C.); (A.D.E.)
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK
| | - Shona Falconer
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King’s College London, London SE1 7EH, UK; (I.L.); (L.D.V.); (L.H.); (D.K.); (S.F.); (S.C.); (A.D.E.)
| | - Serena Counsell
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King’s College London, London SE1 7EH, UK; (I.L.); (L.D.V.); (L.H.); (D.K.); (S.F.); (S.C.); (A.D.E.)
| | - Maggie Redshaw
- National Perinatal Epidemiology Unit, University of Oxford, Oxford OX3 7LF, UK;
| | - Nigel Kennea
- Neonatal Unit, St George’s Hospital, London SW17 0QT, UK;
| | - Anthony David Edwards
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King’s College London, London SE1 7EH, UK; (I.L.); (L.D.V.); (L.H.); (D.K.); (S.F.); (S.C.); (A.D.E.)
| | - Chiara Nosarti
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King’s College London, London SE1 7EH, UK; (I.L.); (L.D.V.); (L.H.); (D.K.); (S.F.); (S.C.); (A.D.E.)
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK
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Mclean MA, Scoten OC, Yu W, Ye XY, Petrie J, Church PT, Soraisham AS, Mirea LS, Weinberg J, Synnes AR, O'Brien K, Grunau RE. Lower Maternal Chronic Physiological Stress and Better Child Behavior at 18 Months: Follow-Up of a Cluster Randomized Trial of Neonatal Intensive Care Unit Family Integrated Care. J Pediatr 2022; 243:107-115.e4. [PMID: 34971651 DOI: 10.1016/j.jpeds.2021.12.055] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 12/15/2021] [Accepted: 12/22/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To assess whether Family Integrated Care (FICare) in the neonatal intensive care unit improves maternal chronic physiological stress and child behavior at 18 months of corrected age for infants born preterm. STUDY DESIGN Follow-up of a multicenter, prospective cluster-randomized controlled trial comparing FICare and standard care of children born at <33 weeks of gestation and parents, stratified by tertiary neonatal intensive care units, across Canada. Primary outcomes at 18 months of corrected age were maternal stress hormones (cortisol, ie, hair cumulative cortisol [HCC], dehydroepiandrosterone [DHEA]) assayed from hair samples. Secondary outcomes included maternal reports of parenting stress, child behaviors (Internalizing, Externalizing, Dysregulation), and observer-rated caregiving behaviors. Outcomes were analyzed using multilevel modeling. RESULTS We included 126 mother-child dyads from 12 sites (6 FICare sites, n = 83; 6 standard care sites, n = 43). FICare intervention significantly lowered maternal physiological stress as indicated by HCC (B = -0.22 [-0.41, -0.04]) and cortisol/DHEA ratio (B = -0.25 [-0.48, -0.02]), but not DHEA (B = 0.01 [-0.11, 0.14]). Enrollment in FICare led to lower child Internalizing (B = -0.93 [-2.33, 0.02]) and Externalizing behavior T scores (B = -0.91 [-2.25, -0.01]) via improvements to maternal HCC (mediation). FICare buffered the negative effects of high maternal HCC on child Dysregulation T scores (B = -11.40 [-23.01, 0.21]; moderation). For mothers reporting high parenting stress at 18 months, FICare was related to lower Dysregulation T scores via maternal HCC; moderated mediation = -0.17 (-0.41, -0.01). CONCLUSIONS FICare has long-term beneficial effects for mother and child, attenuating maternal chronic physiological stress, and improving child behavior in toddlerhood. CLINICAL TRIAL REGISTRATION NCT01852695.
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Affiliation(s)
- Mia A Mclean
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada; BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Olivia C Scoten
- BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Wayne Yu
- Department of Cellular & Physiological Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Xiang Y Ye
- Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Julie Petrie
- BC Women's Hospital, Vancouver, British Columbia, Canada
| | - Paige T Church
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | | | | | - Joanne Weinberg
- Department of Cellular & Physiological Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Anne R Synnes
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada; BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada; BC Women's Hospital, Vancouver, British Columbia, Canada
| | - Karel O'Brien
- Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, Ontario, Canada; Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada; Department of Pediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Ruth E Grunau
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada; BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada; BC Women's Hospital, Vancouver, British Columbia, Canada.
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Fernández X. Revisión sistemática de intervenciones tempranas en bebés prematuros para fomentar las interacciones sensibles padres-bebé y el vínculo de apego. CLÍNICA CONTEMPORÁNEA 2022. [DOI: 10.5093/cc2022a3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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PreEMPT (Preterm infant Early intervention for Movement and Participation Trial): Feasibility outcomes of a randomised controlled trial. Early Hum Dev 2022; 166:105551. [PMID: 35152175 DOI: 10.1016/j.earlhumdev.2022.105551] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 01/06/2022] [Accepted: 01/31/2022] [Indexed: 11/22/2022]
Abstract
PURPOSE Investigate feasibility of PreEMPT: a novel participation-focused, early physiotherapy intervention for preterm infants in regional Australia. MATERIALS AND METHODS Participants were infants born <35 weeks, residing in regional Australia. Sixteen infants were recruited then randomised to usual physiotherapy care (UPC: n = 8) or PreEMPT (n = 8). PreEMPT involved 14-weeks of alternating clinic- or telehealth-based, participation-focused intervention. Feasibility was evaluated by: demand, practicality, acceptability, implementation and limited efficacy testing for infants (motor, participation) and parents (mental well-being, self-efficacy). RESULTS Demand was lower than expected (45% recruitment rate). For practicality, attrition was high in the PreEMPT group (mean assessment attendance 3.8/5 sessions, range 2-5) compared to UPC (4.8/5 sessions, range 4-5). In addition, mean PreEMPT treatment dose received was approximately half intended (overall: 7.3/14 sessions, range 0-12; equivalent for face-to-face: 3.9/7, range 0-6, versus telehealth 3.4/7, range 0-6). The most common reason cited for treatment non-attendance was maternal mental health (22 sessions). Treatment acceptability for parents was high, with PreEMPT parents reporting they were offered choices in sessions (p = .02), and increased their knowledge (p = .01) and confidence (p = .009). There was a large effect size in favour of PreEMPT for increased parental self-efficacy (p = .021, ES = 1.34). CONCLUSION Early post-discharge physiotherapy for preterm infants in regional Australia is beneficial according to families but logistically challenging.
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Liu CH, Hyun S, Mittal L, Erdei C. Psychological risks to mother-infant bonding during the COVID-19 pandemic. Pediatr Res 2022; 91:853-861. [PMID: 34645943 PMCID: PMC9008072 DOI: 10.1038/s41390-021-01751-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 03/09/2021] [Accepted: 04/20/2021] [Indexed: 11/13/2022]
Abstract
BACKGROUND The purpose of this study was to examine the association between mental health symptoms, along with psychological experiences and coronavirus disease 2019 (COVID-19) related concerns, and self-reported maternal-infant bonding experiences of postpartum women. METHODS Using data collected from May 19 to August 17, 2020, this cross-sectional online study assessed 429 women to better understand the impact of the COVID-19 pandemic on women during the postpartum period. Enrolled respondents were asked to participate in a 30-45-min online survey about COVID-19-related experiences, pregnancy, stress, and well-being. RESULTS Postpartum women's depressive symptoms were related to lower quality maternal-infant bonding, but the anxiety symptoms were not associated with bonding. Maternal self-efficacy, but not social support, was associated with mothers' higher quality of maternal-infant bonding. COVID-19-related grief was significantly associated with lower quality bonding. On the other hand, COVID-19-related health worries were associated with higher quality of maternal-infant bonding. CONCLUSIONS We describe potential psychological risk factors to maternal-infant bonding among postpartum women during the pandemic period. To best support the medical and psychological well-being of the mothers and infants, enhanced interdisciplinary partnerships among perinatal healthcare professionals involved in primary and/or specialty care is needed. IMPACT Unique COVID-19-related health and grief concerns exist, with implications for maternal-infant bonding. Depression but not anxiety is associated with lower maternal-infant bonding. Caregiving confidence, but not social support, is associated with higher maternal-infant bonding. It is critical to screen for postpartum depression and COVID-19-related grief during maternal follow-up and pediatric visits. Study findings inform and prioritize pediatric interventions toward enhancing maternal-infant bonding during the COVID-19 era.
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Affiliation(s)
- Cindy H. Liu
- Department of Newborn Medicine, Brigham and Women’s Hospital, Boston, MA,Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA,Harvard Medical School, Boston, MA,Corresponding Author: Cindy H. Liu, PhD, Brigham and Women’s Hospital, Harvard Medical School, 221 Longwood Avenue, Boston, MA 02115, USA, Tel: 617-525-4131, Fax: 617-582-6026,
| | - Sunah Hyun
- Department of Newborn Medicine, Brigham and Women’s Hospital, Boston, MA,Harvard Medical School, Boston, MA
| | - Leena Mittal
- Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA,Harvard Medical School, Boston, MA
| | - Carmina Erdei
- Department of Newborn Medicine, Brigham and Women’s Hospital, Boston, MA,Harvard Medical School, Boston, MA
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Reliability Study of the Items of the Alberta Infant Motor Scale (AIMS) Using Kappa Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031767. [PMID: 35162790 PMCID: PMC8835356 DOI: 10.3390/ijerph19031767] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 01/24/2022] [Accepted: 01/28/2022] [Indexed: 11/16/2022]
Abstract
Purpose: We evaluated the interrater and intrarater reliabilities of the Korean version of the Alberta Infant Motor Scale (K-AIMS). Methods: For the interrater reliability test, six raters participated in the K-AIMS evaluation using video clips of 70 infants (aged between 0 and 18 months). One rater participated in an intrarater reliability test. Among 70 infants, 46 were born preterm and 24 were born full term. A total of 58 AIMS items were evaluated for supine, prone, sitting, and standing positions. A reliability analysis was conducted using ICC and Fleiss’ kappa. Results: The highest Fleiss’ kappa was found for the 4–7 months group for sitting (K = 0.701–1.000) and standing (K = 0.721–1.000), while the lowest K was the 3 months or under group for standing (K = 0.153–1.000). We found higher Fleiss’ kappa statistics when all infants were evaluated without grouping for the three positions (K = 0.727–1.000), except standing (K = 0.192–1.000), for the interrater analysis. Conclusion: Our results demonstrate the good reliability for the Korean version of the AIMS for Korean infants (preterm and full term).
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Keys EM, Benzies KM, Kirk VG, Duffett-Leger L. Effect of Play2Sleep on mother-reported and father-reported infant sleep: a sequential explanatory mixed-methods study of a randomized controlled trial. J Clin Sleep Med 2022; 18:439-452. [PMID: 34409935 PMCID: PMC8805006 DOI: 10.5664/jcsm.9618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
STUDY OBJECTIVES This study evaluated the effect on infant sleep of a novel intervention (Play2Sleep) that combined infant sleep information with self-modeled video feedback on parent-infant interactions. METHODS An explanatory sequential mixed-methods design consisting of a randomized controlled trial with 63 mother-father-infant triads randomized to Play2Sleep or comparison home visit interventions was used. We used repeated measures analysis of covariance to detect changes in infant night wakings, nocturnal wakefulness, and sleep durations and Wilcoxon signed rank test to evaluate changes in perception of infant sleep problems. Family interviews (n = 20) were used to explain the quantitative findings and analyzed qualitatively using thematic analysis. RESULTS Play2Sleep was effective in reducing maternal-reported infant wakefulness, F(1,55) = 5.33, P = .03, partial η2 = .09, and the number of paternal-reported naps, F(1,58) = 4.90, P = .03, partial η2 = .08. Parents in the Play2Sleep group reported significant improvements in problematic infant sleep that were not observed in the comparison group; however, Play2Sleep was not effective in reducing the number of parent-reported night wakings. Information overwhelm, learning infant cues, and working together with a subtheme of father involvement were key qualitative themes developed to explain the quantitative results. Unplanned exploratory analyses revealed a significant improvement in maternal depression symptoms in the Play2Sleep group. CONCLUSIONS This study suggests Play2Sleep could improve infant sleep by promoting parental awareness of infant cues and father involvement and improving maternal depression. Additional research is needed to determine the optimal number and timing of sessions. CLINICAL TRIAL REGISTRATION Registry: ClinicalTrials.gov; Name: Play2Sleep: Using Play to Improve Sleep; URL: https://clinicaltrials.gov/ct2/show/NCT02742155; Identifier: NCT02742155. CITATION Keys EM, Benzies KM, Kirk VG, Duffett-Leger L. Effect of Play2Sleep on mother-reported and father-reported infant sleep: a sequential explanatory mixed-methods study of a randomized controlled trial. J Clin Sleep Med. 2022;18(2):439-452.
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Affiliation(s)
- Elizabeth M. Keys
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada,School of Nursing, Faculty of Health and Social Development, The University of British Columbia, Kelowna, British Columbia, Canada,Address correspondence to: Dr. Elizabeth Keys, PhD, RN, CCHN(C), School of Nursing, Faculty of Health and Social Development, The University of British Columbia, 1147 Research Road, Kelowna, BC, V1V 1V7 Canada;
| | - Karen M. Benzies
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada,Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Valerie G. Kirk
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada,Alberta Children's Hospital, Alberta Health Services, Calgary, Alberta, Canada
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Attachment- and Relationship-Based Interventions during NICU Hospitalization for Families with Preterm/Low-Birth Weight Infants: A Systematic Review of RCT Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031126. [PMID: 35162150 PMCID: PMC8834457 DOI: 10.3390/ijerph19031126] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/13/2022] [Accepted: 01/17/2022] [Indexed: 12/11/2022]
Abstract
This study conducts a systematic review and meta-analysis of the randomized-controlled clinical trials (RCTs) of attachment- and relationship-based interventions in the NICU. A systematic search of the PubMed, MEDLINE, Embase (OVID), PsycINFO, and CINAHL databases and the Cochrane Database of Systematic Reviews was conducted in February 2021. Of the 32,904 studies examined, 15 were identified as relevant, and 10 RCTs were eligible for meta-analysis. Cochrane’s risk of bias tool was used to assess the quality of the trial reporting. Interventions were categorized as (1) parent–infant interactions, (2) parent education, and/or (3) support through qualitative synthesis. The attachment- or relationship-based intervention was effective in relieving maternal traumatic stress, maternal depression, infant weight growth, and infant development. Subgroup analyses suggested that interventions significantly improved sub-domains of mothers’ and children’s interactive behavior. Tailored, staged interventions may contribute to better health outcomes in preterm infants and their families.
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Sentenac M, Benhammou V, Aden U, Ancel PY, Bakker LA, Bakoy H, Barros H, Baumann N, Bilsteen JF, Boerch K, Croci I, Cuttini M, Draper E, Halvorsen T, Johnson S, Källén K, Land T, Lebeer J, Lehtonen L, Maier RF, Marlow N, Morgan A, Ni Y, Raikkonen K, Rtimi A, Sarrechia I, Varendi H, Vollsaeter M, Wolke D, Ylijoki M, Zeitlin J. Maternal education and cognitive development in 15 European very-preterm birth cohorts from the RECAP Preterm platform. Int J Epidemiol 2022; 50:1824-1839. [PMID: 34999864 DOI: 10.1093/ije/dyab170] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Studies are sparse and inconclusive about the association between maternal education and cognitive development among children born very preterm (VPT). Although this association is well established in the general population, questions remain about its magnitude among children born VPT whose risks of medical and developmental complications are high. We investigated the association of maternal education with cognitive outcomes in European VPT birth cohorts. METHODS We used harmonized aggregated data from 15 population-based cohorts of children born at <32 weeks of gestational age (GA) or <1500 g from 1985 to 2013 in 13 countries with information on maternal education and assessments of general development at 2-3 years and/or intelligence quotients between 4 and 15 years. Term-born controls (≥37 weeks of GA) were available in eight cohorts. Maternal education was classified as: low (primary/lower secondary); medium (upper secondary/short tertiary); high (bachelor's/higher). Pooled standardized mean differences (SMDs) in cognitive scores were estimated (reference: high educational level) for children assessed at ages 2-3, 4-7 and 8-15 years. RESULTS The study included 10 145 VPT children from 12 cohorts at 2-3 years, 8829 from 12 cohorts at 4-7 years and 1865 children from 6 cohorts at 8-15 years. Children whose mothers had low, compared with high, educational attainment scored lower on cognitive measures [pooled unadjusted SMDs: 2-3 years = -0.32 (95% confidence intervals: -0.43 to -0.21); 4-7 years = -0.57 (-0.67; -0.47); 8-15 years = -0.54 (-0.72; -0.37)]. Analyses by GA subgroups (<27 vs ≥27 weeks) in children without severe neonatal morbidity and term controls yielded similar results. CONCLUSIONS Across diverse settings and regardless of the degree of prematurity, low maternal education was associated with lower cognition.
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Affiliation(s)
- Mariane Sentenac
- Université de Paris, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, Inserm, INRA, Paris, France
| | - Valérie Benhammou
- Université de Paris, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, Inserm, INRA, Paris, France
| | - Ulrika Aden
- Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
| | - Pierre-Yves Ancel
- Université de Paris, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, Inserm, INRA, Paris, France
| | - Leonhard A Bakker
- Child Health, Netherlands Organization for Applied Scientific Research (TNO), Leiden, The Netherlands
| | - Hannah Bakoy
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Paediatric and Adolescent Medicine, Haukeland University Hospital, Bergen, Norway
| | - Henrique Barros
- EPIUnit-Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
| | - Nicole Baumann
- Department of Psychology, University of Warwick, Coventry, UK
| | - Josephine Funck Bilsteen
- Department of Pediatrics, Hvidovre University Hospital, Hvidovre, Denmark
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Klaus Boerch
- Department of Pediatrics, Hvidovre University Hospital, Hvidovre, Denmark
| | - Ileana Croci
- Clinical Care and Management Innovation Research Area, Bambino Gesù Pediatric Hospital, Roma, Lazio, Italy
| | - Marina Cuttini
- Clinical Care and Management Innovation Research Area, Bambino Gesù Pediatric Hospital, Roma, Lazio, Italy
| | - Elizabeth Draper
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Thomas Halvorsen
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Samantha Johnson
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Karin Källén
- Department of Obstetrics and Gynecology, Unit of Reproduction Epidemiology, Institution of Clinical Sciences, University of Lund, Lund, Sweden
| | - Tuuli Land
- Department of Pediatrics, University of Tartu, Children's Clinic of Tartu University Hospital, Tartu, Estonia
| | - Jo Lebeer
- Department of Family Medicine & Population Health, Disability Studies, Faculty of Medicine & Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Liisa Lehtonen
- Department of Pediatrics and Adolescent Medicine, Turku University Hospital Turku, Turku, Finland
- Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Rolf F Maier
- Children's Hospital, University Hospital, Philipps University Marburg, Marburg, Germany
| | - Neil Marlow
- UCL Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK
| | - Andrei Morgan
- Université de Paris, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, Inserm, INRA, Paris, France
- UCL Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK
| | - Yanyan Ni
- Department of Psychology, University of Warwick, Coventry, UK
- UCL Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK
| | - Katri Raikkonen
- Department of Psychology and Logopedics, University Of Helsinki, Helsinki, Finland
| | - Anass Rtimi
- Université de Paris, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, Inserm, INRA, Paris, France
| | - Iemke Sarrechia
- Department of Family Medicine & Population Health, Disability Studies, Faculty of Medicine & Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Heili Varendi
- Department of Pediatrics, University of Tartu, Children's Clinic of Tartu University Hospital, Tartu, Estonia
| | - Maria Vollsaeter
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Paediatric and Adolescent Medicine, Haukeland University Hospital, Bergen, Norway
| | - Dieter Wolke
- Department of Psychology, University of Warwick, Coventry, UK
| | - Milla Ylijoki
- Department of Pediatrics and Adolescent Medicine, Turku University Hospital Turku, Turku, Finland
- Department of Paediatric Neurology, University of Turku and Turku University Hospital, Turku, Finland
| | - Jennifer Zeitlin
- Université de Paris, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, Inserm, INRA, Paris, France
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Smythe T, Almasri NA, Moreno Angarita M, Berman BD, Kraus de Camargo O, Hadders-Algra M, Lynch P, Samms-Vaughan M, Olusanya BO. The Role of Parenting Interventions in Optimizing School Readiness for Children With Disabilities in Low and Middle Income Settings. Front Pediatr 2022; 10:927678. [PMID: 35837237 PMCID: PMC9274111 DOI: 10.3389/fped.2022.927678] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 06/10/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Tracey Smythe
- International Centre for Evidence in Disability, Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Stellenbosch University, Cape Town, South Africa
- *Correspondence: Tracey Smythe
| | - Nihad A. Almasri
- Department of Physiotherapy, The University of Jordan, Amman, Jordan
| | - Marisol Moreno Angarita
- Research Group on Disability, Policies and Social Justice, School of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Brad D. Berman
- UCSF Benioff Children's Hospital, San Francisco, CA, United States
| | - Olaf Kraus de Camargo
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - Mijna Hadders-Algra
- University of Groningen, University Medical Center Groningen, Department of Paediatrics, Institute of Developmental Neurology, Groningen, Netherlands
| | - Paul Lynch
- School of Education, University of Glasgow, Glasgow, United Kingdom
| | - Maureen Samms-Vaughan
- Department of Child and Adolescent Health, University of the West Indies, Mona Campus, Kingston, Jamaica
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Dollberg DG, Harlev Y, Malishkevitch S, Leitner Y. Parental Reflective Functioning as a Moderator of the Link Between Prematurity and Parental Stress. Front Psychiatry 2022; 13:804694. [PMID: 35280157 PMCID: PMC8905191 DOI: 10.3389/fpsyt.2022.804694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 01/27/2022] [Indexed: 11/13/2022] Open
Abstract
We examined group differences between parents, both mothers and fathers, of premature and full-term infants to determine whether they differed in their reports of subjective parenting stress and in their level of parental reflective functioning (PRF). We also tested whether each parent's reflective functioning moderated the links between birth status (prematurity vs. full-term) and parenting stress. A sample of 73 cohabiting, heterosexual Israeli families with a premature (28-36th week gestational age, N = 34) or full-term infant (37th week and above gestational age, N = 39) participated, comprising the two parents' groups. Infants' age averaged 7.07 months (SD = 1.28). Each parent completed the Parent Stress Inventory (PSI) individually to determine his/her subjective personal and childrearing stress levels. The Parent Development Interview (PDI-R2-S) was used to obtain each parent's PRF (self and child/relation-focused) level. Findings showed that the premature and full-term parents did not differ in their PSI scores or PRF levels. However, mothers' self-focused PRF moderated the link between prematurity and personal parenting stress, whereas fathers' self-focused PRF moderated the link between prematurity and childrearing parenting stress. Furthermore, fathers' and mothers' PRF operated differently in the premature and full-term parents' groups. The findings highlight the importance of mothers' and fathers' PRF in predicting parents' subjective stress in general and particularly in the case of infant prematurity. We discuss these findings and their relevance for preventive and therapeutic perinatal interventions.
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Affiliation(s)
- Daphna G Dollberg
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Tel Aviv, Israel
| | - Yael Harlev
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Tel Aviv, Israel
| | - Sivan Malishkevitch
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Tel Aviv, Israel
| | - Yael Leitner
- Child Development Center, Dana-Dwek Children's Hospital, Sourasky Medical Center, Tel Aviv, Israel
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Axelin A, Feeley N, Cambell-Yeo M, Silnes Tandberg B, Szczapa T, Wielenga J, Weis J, Pavicic Bosnjak A, Jonsdottir RB, George K, Blomqvist YT, Bohlin K, Lehtonen L. Symptoms of depression in parents after discharge from NICU associated with family-centred care. J Adv Nurs 2021; 78:1676-1687. [PMID: 34897769 PMCID: PMC9299776 DOI: 10.1111/jan.15128] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 11/03/2021] [Accepted: 11/27/2021] [Indexed: 12/01/2022]
Abstract
Aims The aim of this study was to examine the potential association of family‐centred care as perceived by parents during a NICU stay with parents’ depressive symptoms at discharge and at 4 months corrected for infant age. Design A longitudinal, multicentre cohort study was conducted from 2018 to 2020 in 23 NICUs across 15 countries. Methods Parents (n = 635 mothers, n = 466, fathers) of infants (n = 739) born before 35 weeks of gestation and admitted to the participating NICUs were enrolled to the study during the first weeks of their infants’ hospitalizations. They responded to Digi‐FCC daily text messages inquiring about their perception of family‐centred care provided by NICU staff. In addition, they completed a questionnaire assessing their overall perception of family‐centred care at discharge. Parents’ depressive symptoms were measured by the Edinburgh Postnatal Depression Scale at discharge and again after discharge when their infants were at 4 months corrected for age. Results The mothers’ and the fathers’ perceptions of family‐centred care were associated with their depressive symptoms at discharge and at 4 months corrected age, controlling for gestational age, multiple birth, parent education and relationship status. Parents’ participation in infant care, care‐related decisions and emotional support provided to parents by staff explained the variation in the parents’ perceptions of family‐centred care. The factors facilitating the implementation of family‐centred care included unlimited access to the unit for the parents and for their significant others, as well as amenities for parents. Conclusions Our study shows that family‐centred NICU care associates with parents’ depressive symptoms after a NICU stay. Impact Depression is common in parents of preterm infants. The provision of family‐centred care may protect the mental well‐being of parents of preterm infants.
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Affiliation(s)
- Anna Axelin
- Department of Nursing Science, University of Turku, Turku, Finland.,Department of Women's and Children's Health, University of Uppsala, Uppsala, Sweden
| | - Nancy Feeley
- Ingram School of Nursing, McGill University, Montréal, Canada.,Centre for Nursing Research, Lady Davis Institute, Jewish General Hospital, Montréal, Canada
| | - Marsha Cambell-Yeo
- School of Nursing, Faculty of Health and Departments of Pediatrics, Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Bente Silnes Tandberg
- Department of Pediatric and Adolescent Medicine, Drammen Hospital, Vestre Viken Hospital Trust, Drammen, Norway
| | - Tomasz Szczapa
- Department of Neonatology, Neonatal Biophysical Monitoring and Cardiopulmonary Therapies Research Unit, Poznan University of Medical Sciences, Poznan, Poland
| | - Joke Wielenga
- IC Neonatology, Emma Children's Hospital, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Janne Weis
- Department of Neonatology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Anita Pavicic Bosnjak
- Department of Obstetrics and Gynecology, Clinical Hospital Sveti Duh Zagreb, Zagreb, Croatia.,Division on Breastfeeding Support, Human Milk Bank, Croatian Tissue and Cell Bank, Department for Transfusion Medicine and Transplantation Biology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Rakel B Jonsdottir
- Faculty of Nursing, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Kendall George
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Sippy Downs, Qld, Australia
| | - Ylva T Blomqvist
- Neonatal Intensive Care Unit, University Children's Hospital, Uppsala, Sweden.,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Kajsa Bohlin
- Department of Neonatology, Karolinska University Hospital, Stockholm, Sweden.,Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Liisa Lehtonen
- Department of Pediatrics and Adolescent Medicine, Turku University Hospital, Turku, Finland.,Department of Clinical Medicine, University of Turku, Turku, Finland
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Primary prevention of depression: An umbrella review of controlled interventions. J Affect Disord 2021; 294:957-970. [PMID: 34375224 DOI: 10.1016/j.jad.2021.07.101] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 07/14/2021] [Accepted: 07/26/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Primary prevention has the potential to modify the course of depression, but the consistency and magnitude of this effect are currently undetermined. METHODS PRISMA and RIGHT compliant (PROSPERO:CRD42020179659) systematic meta-review, PubMed/Web of Science, up to June 2020. Meta-analyses of controlled interventions for the primary prevention of depressive symptoms [effect measures: standardized mean difference (SMD)] or depressive disorders [effect measure: relative risk (RR)] were carried out. Results were stratified by: (i) age range; (ii) target population (general and/or at-risk); (iii) intervention type. Quality (assessed with AMSTAR/AMSTAR-PLUS content) and credibility (graded as high/moderate/low) were assessed. USPSTF grading system was used for recommendations. RESULTS Forty-six meta-analyses (k=928 individual studies, n=286,429 individuals, mean age=22.4 years, 81.1% female) were included. Effect sizes were: SMD=0.08-0.53; for depressive symptoms; RR=0.90-0.28 for depressive disorders. Sensitivity analyses including only RCTs did not impact the findings. AMSTAR median=9 (IQR=8-9); AMSTAR-PLUS content median=4.25 (IQR=4-5). Credibility of the evidence was insufficient/low in 43 (93.5%) meta-analyses, moderate in two (4.3%), and high in one (2.2%): reduction of depressive symptoms using psychosocial interventions for young adults only, and a combination of psychological and educational interventions in primary care had moderate credibility; preventive administration of selective serotonin reuptake inhibitors (SSRIs) for depressive disorders in individuals with a stroke had high credibility. LIMITATIONS Intervention heterogeneity and lack of long-term efficacy evaluation. CONCLUSIONS Primary preventive interventions for depression might be effective. Among them, clinicians may offer SSRIs post-stroke to prevent depressive disorders, and psychosocial interventions for children/adolescents/young adults with risk factors or during the prenatal/perinatal period.
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Kynø NM, Fugelseth D, Knudsen LMM, Tandberg BS. Starting parenting in isolation a qualitative user-initiated study of parents' experiences with hospitalization in Neonatal Intensive Care units during the COVID-19 pandemic. PLoS One 2021; 16:e0258358. [PMID: 34714832 PMCID: PMC8555791 DOI: 10.1371/journal.pone.0258358] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 09/25/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Worldwide, strict infection control measures including visitation regulations were implemented due to the COVID-19 pandemic at Neonatal Intensive Care Units (NICUs). These regulations gave restricted access for parents to their hospitalized infants. The consequence was limited ability to involve in the care of their infants. At Oslo University Hospital entry to NICU was denied to all except healthy mothers in March 2020. The absolute access ban for fathers lasted for 10 weeks. The aim of this study was to explore parental experiences with an infant hospitalized in the NICU during this absolute visitation ban period. METHODS We invited post discharge all parents of surviving infants that had been hospitalized for at least 14 days to participate. They were interviewed during autumn 2020 using an explorative semi-structured interview approach. Data were analyzed via inductive thematic analysis. RESULTS Nine mothers and four fathers participated. The COVID-19 regulations strongly impacted the parent's experiences of their stay. The fathers' limited access felt life-impacting. Parents struggled to become a family and raised their voices to be heard. Not being able to experience parenthood together led to emotional loneliness. The fathers struggled to learn how to care for their infant. The regulations might lead to a postponed attachment. On the other hand, of positive aspect the parents got some quietness. Being hospitalized during this first wave was experienced as exceptional and made parents seeking alliances by other parents. Social media was used to keep in contact with the outside world. CONCLUSIONS The regulations had strong negative impact on parental experiences during the NICU hospitalization. The restriction to fathers' access to the NICU acted as a significant obstacle to early infant-father bonding and led to loneliness and isolation by the mothers. Thus, these COVID-19 measures might have had adverse consequences for families.
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Affiliation(s)
- Nina M. Kynø
- Division of Paediatric and Adolescent Medicine, Department of Neonatal Intensive Care, Oslo University Hospital, Oslo, Norway
- Department of Nursing and Health Promotion, Acute and Critical Illness, Oslo Metropolitan University, Faculty of Health Sciences, Oslo, Norway
- * E-mail:
| | - Drude Fugelseth
- Division of Paediatric and Adolescent Medicine, Department of Neonatal Intensive Care, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | | | - Bente Silnes Tandberg
- Department of Paediatric and Adolescent Medicine, Drammen Hospital, Vestre Viken Hospital Trust, Drammen, Norway
- Lovisenberg Diaconal University College, Oslo, Norway
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