Newborn and infant nursing reviews : NAINR最新文献

Pregnancy is a time of profound physical and psychological change. It marks the transition to parenthood and the beginning of the infant-parent attachment, which is critical for the infant's future mental health. We describe obstetric practices that utilize an integrated infant mental health approach. Integrated infant mental health models in prenatal care emphasize the importance of the maternal fetal relationship, both from a medical as well as a relational perspective. Professionals using an infant mental health informed approach during the course of obstetric care have an opportunity for promotion of the relationship between the mother and her baby and, if needed, can intervene at the earliest possible time, minimizing the psychological vulnerability of the prenatal period.

Premature and medically fragile infants demonstrate greater risk for regulatory challenges than healthy newborns, and primary caregivers of fragile babies experience heightened stress. Post-discharge from neonatal intensive care units (NICUs), babies are frequently referred to early intervention (EI) community-based services. However, EI providers may lack skills to meet the needs of fragile infants and families. This paper describes a training program for EI professionals to recognize infants' subtle changes in regulatory behaviors. The program emphasizes a developmental care model with a focus on infant mental health to support infants and families. After receiving training, providers were able to better support primary caregivers' responses to their infants' behaviors and subsequently, decrease caregiver stress. After 6 months, caregivers' skill, confidence, and closeness with their infants increased, while stress levels decreased. Implications for embedding infant mental health concepts into EI are explored and the role of infant mental health specialists in EI is discussed.

Successful mental health support in the neonatal intensive care unit and post-hospitalization relies on policies and systems that are aligned with infant mental health principles and practice. This article explores important considerations essential to promoting effective and competent care including a focus on building trauma-informed settings, the training of nursing and ancillary staff, and the reflective support necessary to help cope with the experience and stress of caring for very ill infants and their families. The types of evidence-based infant mental health treatments and interventions are discussed and the ways in which these treatments are financed are highlighted.

This article contains a perspective on the evolution of the neonatal intensive care unit (NICU) by a psychologist, who became the father of a premature baby in 1980. The perspective offered describes: a) parent support groups, b) research on emotional distress in NICU parents, c) the evolution of the NICU into neonatal intensive parenting units, d) fathers in the NICU, and e) psychologists in the NICU.

Infant mental health is an emerging evidence based field that enhances infant parent relationships and provides opportunities for early infant regulation that optimizes later social and emotional development. Infant mental health in intensive care settings is an approach that emphasizes the importance of helping manage stressful events for infants, parents, and staff, and supports early relationship development using reflective practice. Educational and experiential preparation for multidisciplinary IMH providers specific to work in infant intensive care is described.

This study explored factors influencing the implementation of environmental design guidelines to facilitate neurodevelopmental supportive care in neonatal intensive care units in a South African public hospital and recommended implementation strategies. A qualitative design, explorative, descriptive and contextual in nature was used, utilizing the Model of Synactive Organization of Behavioral Development as a guiding framework. Data collection was conducted during four focus group interviews with 20 professional nurses working in a neonatal intensive care unit (NICU). Thematic analyses were done using Tesch's eight-step approach. Three themes emerged: current practices regarding the best practice guidelines, reasons for not implementing best practice guidelines and recommendations to implement best practice guidelines. Available best practice guidelines were not implemented due to shortages of staff, poor maintenance plans, financial constraints and lack of resources. These aspects need to be addressed for best practice guidelines to be implemented and sustained to enhance preterm infants' neurodevelopmental outcomes.

This article examines common parental responses to the experience of having a medically fragile infant in the intensive care unit, which are compounded by parental mental health issues, and may result in a disrupted parent-preterm infant attachment. The importance of an interdisciplinary team with a strong infant mental health approach is described.

The Neonatal Integrative Developmental Care Model, which outlines seven core measures for neuroprotective family-centered developmental care of premature infants, is a framework that guides clinical practice in many neonatal intensive care units (NICUs) around the globe. The seven neuroprotective core measures are depicted as overlapping petals of a lotus as the 1) healing environment, 2) partnering with families, 3) positioning & handling, 4) safeguarding sleep, 5) minimizing stress and pain, 6) protecting skin, and 7) optimizing nutrition. Skin to Skin Contact (SSC) is considered the foundation for care of infants in the NICU and its importance as the “normal environment” and the ideal place of care is described. The mother/child dyad is the center of the lotus surrounded closely by symbols representing various aspects of the healing environment, highlighting the physical, extra-uterine environment in which the infant now lives, the significance of the developing infant's sensory system, and the influence of people (patient, family, and staff) who help to create a healing environment for hospitalized infants and their families. The Neonatal Integrative Developmental Care Model utilizes neuroprotective interventions as strategies to support optimal synaptic neural connections, promote normal neurological, physical, and emotional development and prevent disabilities.

Modern neonatal intensive care arose from, and will forever depend upon, technology. There are increasing pressures to leverage new technologies to make care safer, more efficient and cost-effective. Changes in the delivery room will bring better monitoring and data display for the resuscitation team. Sensing and monitoring advances will be used in the NICU, measuring a wider range of physiologic parameters. Better integration of technologies with the EMR will be the basis for decision support and predictive analytics. Communication will be improved between the EMR, NICU staff and parents of newborns. Advances in conventional, CT, MRI and ultrasound imaging of neonates will aid in our diagnostic efforts. Ventilators are getting smarter, with wider ranges of support options and monitoring, in parallel with improvements in non-invasive respiratory support. New technologies can be used to evaluate and support neurodevelopment and to optimize nutrition. Laboratory testing can be done more rapidly, with smaller sample size and reduced costs, bringing more testing to the bedside. All these new technologies should optimize the NICU physical environment, improving the experience for patients, their families and hospital staff.