Effects of maternal voice on pain and mother-Infant bonding in premature infants in Taiwan: A randomized controlled trial.

PURPOSE: This study aimed to examine the effectiveness of maternal voice in alleviating premature infants' pain during the heel sticks and facilitating mother-infant bonding during hospitalization. DESIGN AND METHODS: A randomized controlled trial with a parallel group design was conducted in which 64 premature infant-mother dyads were randomly assigned to an intervention group or a control group. Voice recordings of the mother reading a children's book were created and subsequently played for the infant during a heel stick procedure once daily for 3 consecutive days. The primary outcomes were heart rate, respiratory rate, oxygen saturation, and pain response assessed using the Neonatal Infants Pain Scale before, during, and after the procedure. The secondary outcome was mother-infant bonding evaluated using the Mother-Infant Bonding Inventory on the seventh postnatal day. Data were analyzed using generalized estimation equations. RESULTS: The two groups did not significantly differ in length of gestation, sex, weight, or other demographic characteristics. At 1 min after the procedure, the intervention group had a lower heart rate (p < 0.001) and Neonatal Infants Pain Scale score (p < 0.001) than the control group did. CONCLUSIONS: The maternal voice intervention slowed the heart rate and alleviated the pain response of the hospitalized premature infants. PRACTICE IMPLICATIONS: This intervention has clinical potential to provide mothers with an opportunity to care for their infants and infants with an opportunity to be soothed during health care, thus enhancing the infant-mother connection. The clinical trial registration number is NCT04158206.

[Nursing Experience Using Art Therapy With Parents Facing the Death of a Newborn].

When a newborn requires immediate hospitalization due to a potentially life-threatening situation, parents face a sudden and significant increase in stress. This situation and the potential loss of their child will bring great grief and loss to the parents, which may lead to conditions that foster dysfunctional family dynamics. This article describes the author's experience providing hospice care to a dying infant with a group B streptococcus infection in the neonatal intensive care unit. The author served as the primary care nurse from April 5th to July 6th, 2019. Data were collected during direct care provision, observations, and interactions with parents, while overall systemic assessments were used in analysis to establish that the health problems of the case were: (1) existing infection: related to group B streptococcus; (2) ineffective tissue perfusion: insufficient perfusion of multiple organs, including brain, heart, lung, and kidney, due to sepsis infection; and (3) caregiver grief: facing the death of a newborn. Nursing care provided to the patient included maintaining individualized physical functions and retaining physical integrity during the end-of-life period. The nursing care provided to the parents included the use of art therapy to encourage them to express their inner emotions through the writing of memoirs and diaries and their participation in companionship. This intervention was designed to help the parents transition from the grief of denying the collapse to the fact that their baby had died. As Taiwanese culture typically avoids discussions of death, the nursing experience described in this article may provide a reference for caring for similar patients. This article highlights the beauty of nursing through art therapy, demonstrates the achievement of whole-person and family-centered nursing, shows how the case was successfully helped through the crisis, and illustrates how normal family functions may be maintained.

[Enhancing Maternal-Infant Attachment in a Neonatal Intensive Care Unit During the Pandemic Prevention Period].

BACKGROUND & PROBLEMS: Parent-infant attachment is affected by parent-infant interaction. The limitations on related visitations during the COVID-19 pandemic suspended the opportunity to engage in kangaroo care (skin-to-skin contact) activities. These changes impacted parent-infant attachment in the neonatal intensive care unit. After investigation, the score of premature infant-parent attachment was found to be only 64.6 points during the period in which visitation limitations were in effect. PURPOSE: To enhance maternal-premature infant attachment during the pandemic period by 10% (from an average score of 64.6 to 71.1). RESOLUTION: This project involved nurses playing audio files provided by mothers to their premature infants, and recording a video and taking pictures of the infants during this process. This project used a cloud platform as bidirectional pipelines. Furthermore, emotional support and caring information were provided to the mothers via expressive arts therapy and phone interviews. RESULTS: After the intervention, the premature infant-parent attachment score rose to 74.4 from the pre-intervention score of 64.6. CONCLUSIONS: During pandemic control periods, traditional modes of care aimed at building infant-parent attachment are not applicable. The intervention project used was found to be an effective alternative approach to increasing maternal-premature infant attachment. Breaking the restrictions of time and place, this project applies family-centered care, and may provide a reference for developing software, hardware, and communication equipment for other care units related to newborns.

[Improving the Completeness of Facilitated Tucking for Preterm Infants in the Neonatal Intensive Care Unit].

BACKGROUND & PROBLEMS: Facilitated tucking (containment) is a strategy that has been demonstrated to improve insufficient muscle tone, reduce procedural pain, and stabilize vital signs in premature infants. PURPOSE: The aim of this study was to improve the accuracy and implementation rate of nursing staffs` facilitated tucking. METHODS: Formulate and standardize nursing care to reduce the burden on nursing staff and make staff implementation consistent. Decomposition diagrams of the production steps were posted in patient units, on-the-job education courses were held, and a short video was used to provide care guidelines to nursing staff. RESULTS: Compared to pretest levels, the rate of facilitated tucking implementation in the early, middle, and late invasive medical treatment periods, respectively, increased from 0% to 53.5%, 1.2% to 50%, and 6% to 48.8%, while the accuracy rate of facilitated tucking cognition increased from 61.1% to 91.9%. CONCLUSIONS: This project effectively promoted the standardization of facilitated tucking in our hospital, provided preterm infants with better care and neurological development, and improved mother-infant attachment.

[Improving the provision of nesting and positioning for premature infants by nurses in neonatal intensive care units].

BACKGROUND & PROBLEMS: Nesting and positioning is a common nursing skill used in the developmental care of premature infants. This skill maintains premature infants in a comfortable position, facilitates the monitoring of stable vital signs, and enables spontaneous motor activity for normal neuromuscular and skeletal joint function. PURPOSE: This project was designed to improve nursing staff cognition and skills regarding nesting and positioning for premature infants in the NICU. RESOLUTIONS: Strategies used in this project were: develop an infant position assessment tool; record a demonstration video about nesting and positioning skills to provide learning efficacy among the nursing staff; and modify an education program for new nurses. RESULTS: After implementation, nurse cognition regarding premature infant nesting and positioning increased from 58.3% to 92.3%. The rate of correct technique use similarly rose from 63.3% to 91.4%. CONCLUSIONS: This is a valid intervention for improving the correctness of nesting and positioning in nursing care. This project standardized education in terms of nesting and positioning practice goals and enhanced quality care for premature infants.