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LaManna S, Hatfield B, McCann E. Considering the Influence of Social Determinants of Health on Parent Feeding Practices: A Case Example. Adv Neonatal Care 2024; 24:110-118. [PMID: 38241685 DOI: 10.1097/anc.0000000000001138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2024]
Abstract
BACKGROUND Social determinants of health (SDOH) are the nonmedical factors that influence health outcomes. SDOH can be grouped into 5 domains: economic stability, education access and quality, healthcare access and quality, neighborhood and built environment, and social and community context. SDOH impact people's health and quality of life but may also contribute to disparities in access to food, education, and healthcare. SDOH uniquely influence parent feeding practices in the neonatal intensive care unit (NICU) in a variety of ways, ranging from logistical considerations for parent visitation to cultural beliefs such as family perception of human milk feeding. EVIDENCE ACQUISITION A hypothetical case example of a preterm infant with a feeding disorder in the NICU is used to connect SDOH that influence prenatal health, parental lived experience, and postnatal medical care to maternal and infant outcomes with implications for feeding practices. Barriers and facilitators to successful feeding practices in the NICU and at discharge are considered for each SDOH domain. RESULTS This case example increases awareness of SDOH and how they influence parent feeding practices in the NICU, focusing on the intersection of SDOH, parent stress, and oral feeding outcomes. Examples were provided for how to support applying findings into practice. IMPLICATIONS FOR PRACTICE AND RESEARCH By being creating a culture of SDOH awareness, NICU staff can assist families in overcoming barriers by putting supports in place to increase equitable participation in developmentally supportive feeding practices during the NICU stay.
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Affiliation(s)
- Stefanie LaManna
- Author Affiliation: American Speech-Language-Hearing Association, Rockville, Maryland (Mss LaManna and Hatfield); and Independent Researcher, Voorhees, New Jersey (Ms McCann)
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Joosten K, Vermeulen M. Principles of feeding the preterm infant. Clin Nutr ESPEN 2024; 59:320-327. [PMID: 38220393 DOI: 10.1016/j.clnesp.2023.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 12/07/2023] [Accepted: 12/14/2023] [Indexed: 01/16/2024]
Affiliation(s)
- Koen Joosten
- Erasmus MC-Sophia Childrens's Hospital, Department of Pediatric & Neonatal Intensive Care, Rotterdam NL.
| | - Marijn Vermeulen
- Erasmus MC-Sophia Childrens's Hospital, Department of Pediatric & Neonatal Intensive Care, Rotterdam NL
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Hendy A, El-sayed S, Bakry S, Mohammed SM, Mohamed H, Abdelkawy A, Hassani R, Abouelela MA, Sayed S. The Stress Levels of Premature Infants' Parents and Related Factors in NICU. SAGE Open Nurs 2024; 10:23779608241231172. [PMID: 38384386 PMCID: PMC10880535 DOI: 10.1177/23779608241231172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 12/10/2023] [Accepted: 01/20/2024] [Indexed: 02/23/2024] Open
Abstract
Introduction Parental stress related to their infants' hospitalization is a significant concern that affects both parents and their infants. Fathers' experiences tend to be understudied compared to mothers. Further research on fathers' stress levels is necessary. While parental stress has been correlated with infant health severity, the specific causes and risk factors contributing to heightened stress levels in parents of neonatal intensive care unit (NICU) infants are not yet fully understood and require further investigation. Objective This study aimed to examine the stress levels experienced by parents of premature infants in the NICU and to explore the factors associated with parental stress in this specific context. Methods A cross-sectional observational design was used to accomplish this study, which was carried out on 743 parents from nine different NICUs located in governmental hospitals across various locations in Egypt. We used characteristics of parents and premature infants, and Parent Stress Scale was used for data collection. Results A majority of parents reported experiencing high stress in the following domains: sight and sound (80.3%), infants' appearance (69%), and the parent-infant relationship (81.4%). Additionally, about three-quarters (73.6%) of parents experienced high stress overall, with a mean score of 167.56 (21.3). Conclusion About three-quarters of the parents experienced high overall stress levels. Also, factors that were found to affect parents' stress levels included premature infants connected to mechanical ventilators, previous neonatal death, parents living far from hospitals, infants delivered through cesarean section, insufficient income, and prolonged hospitalization beyond 5 days.
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Affiliation(s)
- Abdelaziz Hendy
- Pediatric Nursing, Faculty of Nursing, Ain Shams University, Cairo, Egypt
| | - Salma El-sayed
- Pediatric Nursing, Faculty of Nursing, Ain Shams University, Cairo, Egypt
| | - Salma Bakry
- Psychiatric Mental Health Nursing, Ain Shams University, Cairo, Egypt
| | - Shimmaa M Mohammed
- Pediatric Nursing, Faculty of Nursing, Zagazig University, Zagazig, Egypt
- Department of Nursing, College of Applied Medical Sciences, University of Bisha, Bisha, Saudi Arabia
| | - Hossam Mohamed
- General Secretariat of Mental Health and Addiction Treatment, Cairo, Egypt
| | | | - Rym Hassani
- Department of Biology, University College Al-Darb, Jazan University, Jazan, Saudi Arabia
| | | | - Salwa Sayed
- Technical Health Institute, General Authority for Health Insurance, Benha, Egypt
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Spagnoli J, Dhanireddy R, Gannon E, Chilakala S. Effect of cue-based feeding on time to nipple feed and time to discharge in very low birth weight infants. Sci Rep 2023; 13:9509. [PMID: 37308556 DOI: 10.1038/s41598-023-36634-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 06/07/2023] [Indexed: 06/14/2023] Open
Abstract
The objective of this study is to evaluate the effectiveness of a cue-based feeding protocol in improving time to nipple feed and time to discharge in very low birth weight infants in a Level III Neonatal Intensive Care Unit. Demographic, feeding, and discharge data were recorded and compared between the two cohorts. The pre-protocol cohort included infants born from August 2013 through April 2016 and the post-protocol cohort included infants born from January 2017 through December 2019. 272 infants were included in the pre-protocol cohort and 314 infants in the post-protocol cohort. Both cohorts were statistically comparable in gestational age, gender, race, birthweight, prenatal care, antenatal steroid use, and rates of maternal diabetes. There were statistically significant differences between the pre- versus post-protocol cohorts in median post-menstrual age (PMA) in days at first nipple feed (PO) (240 vs 238, p = 0.025), PMA in days at full PO (250 vs 247, p = 0.015), and length of stay in days (55 vs 48, p = 0.0113). Comparing each year in the post-protocol cohort, for each outcome measure, a similar trend was noted in 2017 and 2018, but not in 2019. In conclusion, the cue-based feeding protocol was associated with a decrease in the time to first PO, time to full nipple feeds, and the length of stay in very-low-birthweight infants.
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Affiliation(s)
- Jonathan Spagnoli
- Department of Pediatrics, Division of Neonatology, The University of Tennessee Health Science Center, 201 Rout Center for Women and Newborns, 853 Jefferson Avenue, Memphis, TN, 38103, USA
| | - Ramasubbareddy Dhanireddy
- Department of Pediatrics, Division of Neonatology, The University of Tennessee Health Science Center, 201 Rout Center for Women and Newborns, 853 Jefferson Avenue, Memphis, TN, 38103, USA
- Regional One Health Rout Center for Women and Newborns, Memphis, TN, USA
| | - Emily Gannon
- Department of Pediatrics, Division of Neonatology, The University of Tennessee Health Science Center, 201 Rout Center for Women and Newborns, 853 Jefferson Avenue, Memphis, TN, 38103, USA
| | - Sandeep Chilakala
- Department of Pediatrics, Division of Neonatology, The University of Tennessee Health Science Center, 201 Rout Center for Women and Newborns, 853 Jefferson Avenue, Memphis, TN, 38103, USA.
- Regional One Health Rout Center for Women and Newborns, Memphis, TN, USA.
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Jiang L, Ma J, Li F, Qin N. Association between incubator standards and newborn nosocomial infection with machine-learning prediction. Transl Pediatr 2023; 12:655-662. [PMID: 37181021 PMCID: PMC10167382 DOI: 10.21037/tp-23-171] [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: 02/15/2023] [Accepted: 04/13/2023] [Indexed: 05/16/2023] Open
Abstract
Background Newborns have a high incidence of nosocomial infection (NI). We conducted a logistic regression to analyze different incubator standards and other risk factors for newborn NI, which could better help clinical choice of incubator standard. Methods Newborns with complete necessary clinical data were included. We collected the demographic and incubator data of 76 patients (40 uninfected and 36 infected) at the Heping Hospital Affiliated to Changzhi Medical College. An analysis of variance, Pearson correlation matrix analysis, and logistic regression analysis were conducted to explore the different incubator standards and other risk factors for neonatal hospital infections. In addition, 4 machine-learning algorithms were used to predict neonatal hospital infections. Results We found differences in the gestational age, incubator type, paternal age, and maternal age between the 2 groups. The correlation analysis only revealed a correlation between paternal age and maternal age. The logistic regression showed that gestational age [odds ratio (OR)= 0.77574, 95% confidence interval (CI): 0.583513-0.996354] and the new standard incubator (OR =0.011639, 95% CI: 0.000958-0.067897) may be protective factors for infant infection during hospitalization. Among the extreme gradient boosting (XGBoost), random forest (RF), support vector machine (SVM), and decision tree (DT) algorithms, XGBoost had the best performance in terms of accuracy, sensitivity, specificity, and precision. Conclusions We found early gestational age and incubator standards may be risk factors for the NIs of newborns, which might help clinicians to improve the health and safety standards for incubators. XGBoost can be used to predict newborn NIs.
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Affiliation(s)
- Lingxia Jiang
- Department of Pediatrics, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, China
| | - Jun Ma
- Department of Pediatrics, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, China
| | - Fang Li
- Department of Pediatrics, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, China
| | - Na Qin
- Department of Pediatrics, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, China
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Astuti DD, Rustina Y, Wanda D. Oral feeding skills in premature infants: A concept analysis. BELITUNG NURSING JOURNAL 2022; 8:280-286. [PMID: 37546503 PMCID: PMC10401373 DOI: 10.33546/bnj.2107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 04/28/2022] [Accepted: 07/07/2022] [Indexed: 08/08/2023] Open
Abstract
Background The delay in developing oral feeding skills becomes a problem experienced by premature infants. One of the reasons for the delay may be related to inconsistent definitions of oral feeding skills, which can cause discrepancies in the provision of nursing care. Objective This study aimed to clarify the concept of oral feeding skills in premature infants. Methods The Walker and Avant concept analysis method was used. A literature search was also conducted from five databases: CINAHL, PubMed, ProQuest, EMBASE, and Google Scholar, to find articles between January 2020 and December 2022. Results The literature search obtained 20 articles on oral feeding skills from various disciplines. Five attributes were developed from the concept analysis, including (1) coordination ability to suck, swallow, and breathe, (2) the ability to regulate oral-motor functions, (3) the ability to regulate sensory functions, (4) the ability to maintain the stability of physiology function, and (5) the ability to regulate feeding behavior. Antecedents to oral feeding skills include immaturity of the nervous system, gestational age, feeding intolerance, increased length of stay and cost of care, increased rehospitalization, stress on parents, and increased morbidity and mortality. Consequences include optimization of growth and development, reduction of length of stay and cost of hospitalization, increased bonding attachment, increased self-efficacy of parents in caring for premature infants, and improvement of the quality of life of premature infants. Conclusion The concept analysis provides five comprehensive attributes and their antecedents and consequences. However, this concept can be used to provide nursing care to premature infants, assess the criteria for discharge, and optimize nutrition for the growth and development of premature infants.
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Affiliation(s)
- Dyah Dwi Astuti
- Postgraduate Program, Faculty of Nursing, Universitas Indonesia, Depok 16424, Indonesia
- Department of Pediatric Nursing, Poltekkes Kemenkes Surakarta, Letjend Sutoyo, Mojosongo, Surakarta 57127, Indonesia
| | - Yeni Rustina
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Indonesia, Depok 16424, Indonesia
| | - Dessie Wanda
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Indonesia, Depok 16424, Indonesia
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