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Objective:To explore the ability of the Hammersmith Infant Neurological Examination (HINE) to predict the gross motor development of high-risk infants.Methods:A total of 207 high-risk infants were assessed with the HINE and the Gesell Developmental Schedule (GDS) at the ages of 3, 6, 9 and 12 months. They were then divided into a normal development group and a delayed group according to their gross motor development at 12 months old. The validity of the HINE′s discrimination was quantified retrospectively as the difference in the total HINE score at each follow-up month between the two groups. Spearman coefficients relating the total HINE score with the gross motor development quotient from the GDS were calculated at each follow-up month. The HINE′s total score threshold for predicting gross motor retardation at 12 months was determined from a receiver operating characteristics curve, and the predictive validity, sensitivity and specificity were evaluated by calculating the area under the curve.Results:At each time point the average total HINE score of the delayed group was significantly lower than the normal group′s average. The correlation between the HINE total scores and the GDS gross motor development quotients was strongest at 6 months old, and weakest at 3 months. The threshold total HINE score for predicting gross motor retardation at 12 months old was 60 at 3 months, 67 at 6 months, and then 71. The instrument′s sensitivity and specificity were very good at all four time points.Conclusion:The HINE can usefully predict gross motor retardation in the first year of life for high-risk infants. The critical value of the total score can be used as an auxiliary diagnostic reference for neuromotor development in such infants.
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Objective:To evaluate the clinical value of the General Movements (GMs) in predicting the neurological outcome of high-risk infants with cerebral palsy in the early stage, and to analyze the application of the Peabody Developmental Motor Scale-Gross Motor (PDMS-GM) and Gross Motor Function Measure Scale (GMFM) in the rehabilitation assessment and intervention of high-risk infants with cerebral palsy.Methods:The gross motor function of 64 high-risk infants with cerebral palsy before treatment and after 2 months of treatment in Department of Child Rehabilitation, Zhengzhou Central Hospital Affiliated to Zhengzhou University from January 2017 to December 2019 was evaluated using PDMS-GM and GMFM.The total percentage of PDMS-GM and GMFM before and after treatment, and the monthly relative percentage of PDMS-GM and GMFM were compared.The correlation between PDMS-GM and GMFM original scores in the writhing and fidgety movements period before treatment, and that between PDMS-GM and GMFM original scores before and after treatment were compared.High-risk infants with cerebral palsy were followed up to 1 year old, and their neurological outcome was determined according to the clinical diagnosis and evaluation results.The predictive value of GMs on the outcome of cerebral palsy was evaluated.Results:Compared with that before treatment, the total percentage of PDMS-GM and GMFM in high-risk infants with cerebral palsy increased significantly after treatment [PDMS-GM: (37.250±13.690)% vs.(20.992±10.273)%, t=-15.793, P<0.01; GMFM: (22.672±8.438)% vs.(10.601±7.890)%, t=-16.442, P<0.01]. PDMS-GM original scores in the writhing movements period and fidgety movements period before treatment were highly correlated with those of GMFM (writhing movements period: r=0.922, P<0.01; fidgety movements period: r=0.905, P<0.01). PDMS-GM original score before and after treatment were highly correlated with those of GMFM (before treatment: r=0.901, P<0.01; after treatment: r=0.801, P<0.01). There was no significant difference in the monthly relative percentage of PDMS-GM and GMFM [(97.286±88.330)% vs.(76.885±43.815)%, t=-1.656, P=0.103]. The sensitivity, specificity, positive predictive value and negative predictive value of the writhing movements period to the prediction of cerebral palsy outcome were 90.7%, 82.3%, 23.4%, and 95.8%, respectively, which were 98.3%, 88.1%, 27.6% and 96.8% in the fidgety movements period, respectively.At 1-year-old follow-up, 3 cases of spastic cerebral palsy were found in a high risk with cerebral palsy, and 1 case was cramped synchronized and 2 cases were absence of fidgety movements. Conclusions:Gross motor function of high-risk infants with cerebral palsy was significantly improved after treatment compared with that before treatment, and PDMS-GM and GMFM were consistent in the assessment of gross motor function of high-risk infants with cerebral palsy in the writhing and fidgety movements period before and after treatment.In the early screening of infants at high risk of cerebral palsy, absence of fidgety movements and cramped synchronized maybe predict spastic cerebral palsy more sensitively, and fidgety movements assessment was more sensitive to predict spastic cerebral palsy outcome than writhing movements assessment.
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Objective:To explore the feasibility of establishing a regional network management system to prevent and control the disability in high-risk infants. Methods:From July, 2015 to June, 2016, 1252 type B high-risk infants who born alive and registered in Lianyungang were divided into control group and experimental group by receiving network management system or not. The network high-risk infants management system was used to monitor the growth, diagnosis and early intervention of high-risk infants in the experimental group, while the control group was managed in the conventional way. A comprehensive physical examination and systematic assessment of 940 high-risk infants finally were conducted after two years. Their parents' compliance, developmental state, degree of dysplasia and function of dysplastic child were compared. Results:The compliance of parents was higher in the experimental group than in the control group (χ2 = 44.161,P < 0.001), as well as the outcome when the infants were two years old (χ2 = 204.340,P < 0.001). The younger they were found deviated and intervened, the better the outcome was (χ2 = 42.038,P < 0.001), and the less degree of dysplasia when they were two years old (χ2 = 10.508,P < 0.01). The deviation/abnormality condition was less in the experimental group than in the control group (χ2 = 17.446,P < 0.01). The development of functional area was better in the experimental group than in the control group (|t| > 2.206,P < 0.05), expect body structure (P > 0.05), in the infants with developmental deviation/abnormality. Conclusion:The establishment of network management system for high-risk infants can significantly improve the management compliance of parents and outcome of development of high-risk infants, to prevent disability.
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Objective@#To study the predictive value of general movements(GMs) quality assessment technique(writhing movements)on the motor development outcome of high-risk infants, so as to provide a reference basis for clinical diagnosis and treatment.@*Methods@#A retrospective analysis was made on the high-risk infants who were hospitalized in the Neonatal Department of the Affiliated Hospital of Inner Mongolia Medical University from January 1, 2017 to December 31, 2018, and the GMs quality assessment was finished and followed up to 12-month-old among high-risk infants.The clinical diagnostic criteria for patients with cerebral palsy and Peabody Development Motor Scales-2(PDMS-2)were used to evaluate the motor development outcome of 12-month-old high-risk infants.Furthermore, the predictive value of GMs writhing movements on the motor development outcome of high-risk infants were evaluated.@*Results@#The predictive validity of writhing movements phase[cramped synchronized(CS)+ poor repertoire(PR)]for motor retardation and cerebral palsy in high-risk infants who met the inclusion criteria were as follows: the sensitivity, specificity, positive predictive value, negative predictive value were 94.44%, 23.03%, 11.04%, 97.62% and 100%, 21.88%, 2.60%, 100%, respectively.The predictive sensitivity and negative predictive value of writhing movements PR for motor retardation and cerebral palsy were 92.31%, 100%; 98.18%, 100% respectively.The predictive sensitivity, specificity and negative predictive value of writhing movements CS for motor retardation and cerebral palsy were 100%, 95.81%, 100% and 100%, 95.31% and 100%, respectively.@*Conclusion@#GMs quality assessment(writhing movements)has high reliability in predicting the motor development outcome of high-risk infants, especially cramped-synchronized has significant value in early screening of children with motor retardation and cerebral palsy.
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Objective:To investigate evaluation methods to predict the outcome of nervous system development in high-risk infants. Methods:From March, 2015 to March, 2016, 336 high-risk infants were enrolled. They were assessed by General Movements (GMs) Quality Assessment, 0~1 Years Old 20 Items Neuromotor Assessment and Gesell Developmental Schedules. Results:A total of 236 infants finishied the study. GMs Quality Assessment showed that 203 cases were normal and 33 cases were abnormal in the writhing movements stage; 218 cases were normal and 18 cases were abnormal in the fidgety movemonts stage. 0~1 Years Old 20 Items Neuromotor Assessment showed that 202 cases were normal and 34 cases were abnormal. Gesell Developmental Schedules showed that 12 cases were abnormal. Conclusion:The combination of GMs Quality Assessment, 0~1 Years Old 20 Items Neuromotor Assessment and Gesell Developmental Schedules could better predict the nervous system development of high-risk infants.
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Objective To study the predictive value of general movements( GMs) quality assess-ment technique(writhing movements)on the motor development outcome of high-risk infants,so as to pro-vide a reference basis for clinical diagnosis and treatment. Methods A retrospective analysis was made on the high-risk infants who were hospitalized in the Neonatal Department of the Affiliated Hospital of Inner Mongolia Medical University from January 1,2017 to December 31,2018,and the GMs quality assessment was finished and followed up to 12-month-old among high-risk infants. The clinical diagnostic criteria for patients with cerebral palsy and Peabody Development Motor Scales-2 ( PDMS-2) were used to evaluate the motor development outcome of 12-month-old high-risk infants. Furthermore, the predictive value of GMs writhing movements on the motor development outcome of high-risk infants were evaluated. Results The predictive validity of writhing movements phase[cramped synchronized(CS) +poor repertoire(PR)]for mo-tor retardation and cerebral palsy in high-risk infants who met the inclusion criteria were as follows:the sensi-tivity,specificity, positive predictive value, negative predictive value were 94. 44%, 23. 03%, 11. 04%, 97. 62% and 100%,21. 88%,2. 60%,100%,respectively. The predictive sensitivity and negative predictive value of writhing movements PR for motor retardation and cerebral palsy were 92. 31%,100%;98. 18%, 100% respectively. The predictive sensitivity,specificity and negative predictive value of writhing movements CS for motor retardation and cerebral palsy were 100%,95. 81%,100% and 100%,95. 31% and 100%, respectively. Conclusion GMs quality assessment(writhing movements)has high reliability in predicting the motor development outcome of high-risk infants,especially cramped-synchronized has significant value in ear-ly screening of children with motor retardation and cerebral palsy.
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Objective To explore the effects of rehabilitation starting at different stages on the gross motor function of infants with high risk of cerebral palsy.Methods 214 neonates (117 boys and 97 girls) at least 14 days old and with a neonatal behavioral neurological assessment scale (NBNA) score of less than 35 were randomly divided into four groups.They received 2 to 3 weeks of rehabilitation in the hospital,followed by 4 to 6 weeks of family rehabilitation and then another 2 to 3 weeks of hospital rehabilitation.The three groups started this course of treatment at different times:beginning when the babies were not older than 3 months for group Ⅰ,3 to 6 months for group Ⅱ,6 to 12 months for group Ⅲ and 12 to 24 months for group Ⅳ.In each individual case the rehabilitation in hospital was replaced by family rehabilitation only when the baby's overall development was normal or almost normal.Another 63 infants with high risk of cerebral palsy composed group Ⅴ.They received only the family rehabilitation.The rehabilitation in hospital included taking neurotrophic drugs,receiving physical treatment,hand manipulation,kinesiotherapy,cognitive training,conductive education,and using orthoses.Family rehabilitation was implemented by the parents once or twice a day,for 35 to 45 minutes each time following detailed,individualized exercise plans made up jointly by the rehabilitation doctors and therapists.Moreover,a clinical checkup was required every 1 to 2 months.At 3,6,12 and 24 months old,all of the subjects' gross motor ability was quantified using the gross motor function measure (GMFM) scale.The hospital stays and the number of subjects diagnosed with cerebral palsy and motor retardation were recorded.Results At 3 months old,the average GMFM scores of the groups were 5.00± 1.89 for group Ⅰ,6.80± 1.55 for group Ⅱ,8.44±1.26 for group Ⅲ,11.10±1.72 for group Ⅳ and 12.70±1.64 for group Ⅴ,the controls.All of the intergroup differences were significant.At 6 months old the average GMFM scores of groups Ⅰ to Ⅳ were not significantly different,but all were significantly lower than the group Ⅳ average.At 12 months old the average GMFM scores of groups Ⅰ,Ⅱ and Ⅴ were significantly higher than the group Ⅲl and Ⅳ averages.At 24 months old the groups' average scores decreased consistently from Ⅰ to Ⅴ,with significant differences between one group and the next.Group Ⅲ had the longest hospital stays,followed by groups Ⅰ,Ⅱ and Ⅳ.Those inter-group differences were significant except for between groups Ⅰ and Ⅱ.The incidence of cerebral palsy in groups Ⅰ and Ⅱ (38.10％ and 29.79％) was significantly higher than in group Ⅲ (21.62％),Ⅳ (12.00％) or Ⅴ (3.17％).Moreover,the incidence of motor retardation in groups Ⅰ and Ⅱ (7.14％ and 10.64％) was also significantly lower than in group Ⅲ(56.76％),Ⅳ (68.00％) or Ⅴ (36.51％),but the differences between groups Ⅰ and Ⅱ and between groups Ⅲ and Ⅳ were not significant.The incidence of excellent gross motor performance ratings at 24mo decreased significantly from group Ⅰ to group Ⅴ,with all of the inter-group differences significant.Conclusion Early and formal rehabilitation is of great importance for infants with a high risk of cerebral palsy.The earlier formal rehabilitation starts,the better is its effect.
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Objective To explore the effects of rehabilitation starting at different stages on the gross motor function of infants with high risk of cerebral palsy.Methods 214 neonates (117 boys and 97 girls) at least 14 days old and with a neonatal behavioral neurological assessment scale (NBNA) score of less than 35 were randomly divided into four groups.They received 2 to 3 weeks of rehabilitation in the hospital,followed by 4 to 6 weeks of family rehabilitation and then another 2 to 3 weeks of hospital rehabilitation.The three groups started this course of treatment at different times:beginning when the babies were not older than 3 months for group Ⅰ,3 to 6 months for group Ⅱ,6 to 12 months for group Ⅲ and 12 to 24 months for group Ⅳ.In each individual case the rehabilitation in hospital was replaced by family rehabilitation only when the baby's overall development was normal or almost normal.Another 63 infants with high risk of cerebral palsy composed group Ⅴ.They received only the family rehabilitation.The rehabilitation in hospital included taking neurotrophic drugs,receiving physical treatment,hand manipulation,kinesiotherapy,cognitive training,conductive education,and using orthoses.Family rehabilitation was implemented by the parents once or twice a day,for 35 to 45 minutes each time following detailed,individualized exercise plans made up jointly by the rehabilitation doctors and therapists.Moreover,a clinical checkup was required every 1 to 2 months.At 3,6,12 and 24 months old,all of the subjects' gross motor ability was quantified using the gross motor function measure (GMFM) scale.The hospital stays and the number of subjects diagnosed with cerebral palsy and motor retardation were recorded.Results At 3 months old,the average GMFM scores of the groups were 5.00± 1.89 for group Ⅰ,6.80± 1.55 for group Ⅱ,8.44±1.26 for group Ⅲ,11.10±1.72 for group Ⅳ and 12.70±1.64 for group Ⅴ,the controls.All of the intergroup differences were significant.At 6 months old the average GMFM scores of groups Ⅰ to Ⅳ were not significantly different,but all were significantly lower than the group Ⅳ average.At 12 months old the average GMFM scores of groups Ⅰ,Ⅱ and Ⅴ were significantly higher than the group Ⅲl and Ⅳ averages.At 24 months old the groups' average scores decreased consistently from Ⅰ to Ⅴ,with significant differences between one group and the next.Group Ⅲ had the longest hospital stays,followed by groups Ⅰ,Ⅱ and Ⅳ.Those inter-group differences were significant except for between groups Ⅰ and Ⅱ.The incidence of cerebral palsy in groups Ⅰ and Ⅱ (38.10％ and 29.79％) was significantly higher than in group Ⅲ (21.62％),Ⅳ (12.00％) or Ⅴ (3.17％).Moreover,the incidence of motor retardation in groups Ⅰ and Ⅱ (7.14％ and 10.64％) was also significantly lower than in group Ⅲ(56.76％),Ⅳ (68.00％) or Ⅴ (36.51％),but the differences between groups Ⅰ and Ⅱ and between groups Ⅲ and Ⅳ were not significant.The incidence of excellent gross motor performance ratings at 24mo decreased significantly from group Ⅰ to group Ⅴ,with all of the inter-group differences significant.Conclusion Early and formal rehabilitation is of great importance for infants with a high risk of cerebral palsy.The earlier formal rehabilitation starts,the better is its effect.
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Objective To explore the hearing screening, and the change and outcome of hearing impairment of high risk infants. Meth-ods From March, 2015 to March, 2016, 336 high risk infants were screened with otoacoustic emissions (OAE), auditory brainstem response (ABR) and brainstem auditory evoked-potential (BAEP) 0-1, 3, 6, 12 months after born, respectively. Results Among the 336 high risk in-fants, 29 failed the examinations within the 1st month, 37 cases failed in the 3rd month, 27 cases recovered in the 9th month, and 7 cases re-covered in the 12th month, 3 cases were finally diagnosed as deafness (0.89%). Conclusion OAE, ABR combining with BAEP examination may obtain comprehensive diagnosis of hearing impairment for high risk infants, continuous listening comprehension monitoring can effec-tively dynamically observe the hearing impairment, changes and outcome of high risk infants.
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One of the challenge of pediatricians at follow -up for high risk babies is how to identify early in-fants who is at risk of neurodevelopment disability and timely intervention,another is to find infants who will not have a neurodevelopment sequel in order to avoid unnecessary excessive intervention as soon as possible.Accurate diagnosis can be achieved through comprehensive analysis by combined with the basic knowledge,neuroimaging and follow -up of neonatal brain injury.
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Objective: This cross-sectional comparative study tried to assess the hearing status of the high risk infants by Brainstem Evoked Response Audiometry (BERA) and compare with that of the normal infants. Material & Methods: BERA was done on 127 infants of 6 to18 months age of which 87 were high risk. All were given monaural acoustic stimulation using Cz-M1/M2 Montage. Waves I, III and V were analysed for absolute & interpeak latencies (in ms) & also for amplitudes (in µv) & their ratio. All the parameters were compared at 70 dB stimulus at p<0.05 significance. Results were analysed by Statistical Package for Social Sciences (SPSS) software, version 14.0. Results: There was no significant difference of mean age and sex between the two group. In the study froup, mean values of all the Absolute and Inter-Peak Latencies of both ears were significantly higher and mean Amplitudes of waves I and V of both ears were significantly smaller than that of the Control group. Conclusion: The study found evidence of persistent injury to the various parts of the auditory pathway even as the high risk infants grew up.
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Early physical therapy intervention is important in improving the long-term outcome of the infants with high-risk of cerebral palsy. The early intervention programs that included child and parents were reported to affect the motor development of the high-risk infants. The approaches of early physical therapy included Vojta approach, Bobath approach and Doman-Delecato approach, etc. The Vojta approach has been regarded as advantages in early intervention. However, there are fewer studies on the effect of special motor training programs on motor development in high-risk infants.
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@#This paper summarized the criteria and the detection of high-risk infants with cerebral palsy, the modes, approaches, effect of operation of early intervention, to explore the suitable method of early intervention for the domestic high-risk children with cerebral palsy.
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Esta pesquisa tem como objeto de estudo as representações sociais e as práticas de seguimento do recém-nascido de alto risco. Trata-se de um estudo descritivo, com abordagem qualitativa, que objetivou analisar as representações sociais e as práticas de seguimento de recém-nascidos de alto risco, em programas de follow-up no município do Rio de Janeiro. Definiram-se como objetivos específicos: descrever as representações sociais dos profissionais sobre o recém-nascido de alto risco; descrever as atividades e os procedimentos adotados pelos programas de seguimento do recém-nascido de alto risco; caracterizar as ações desenvolvidas pela equipe multidisciplinar que atua no seguimento do recém-nascido de alto risco; discutir a atuação das enfermeiras no seguimento do recém-nascido de alto risco, no contexto da equipe multidisciplinar. A orientação teórico-metodológica adotada foi a da Teoria das Representações Sociais, concebida por Moscovici, que considera as representações como teorias do senso comum, construídas para explicar aspectos da vida cotidiana. Esta pesquisa contou com a participação de 23 profissionais de três equipes multidisciplinares, que realizam o acompanhamento ambulatorial das crianças egressas da Unidade de Terapia Intensiva Neonatal, com os quais foram realizadas entrevistas estruturadas. A análise das entrevistas foi realizada através da técnica de análise de conteúdo. O resultado da análise revelou 8 categorias que são as seguintes: a percepção da criança de risco; objetivos e significado do follow-up; a percepção do funcionamento do follow-up; a atividade educativa no follow-up; atitudes e sentimentos maternos e familiares diante do follow-up; perfil da clientela e a possibilidade do acompanhamento; o trabalho interdisciplinar no follow-up e a participação da enfermeira no follow-up...
The objective of this research has is to study the social representations and follow-up practices on high-risk newborns. It is a descriptive essay, with qualitative approach, which aimed at the analysis of social representations and follow-up practices on high-risk infants on follow-up programs in Rio de Janeiro, RJ, Brazil. Specific objectives are defined as follows: to describe the social representations of the high-risk newborn by the nursing professionals; to describe the activities and procedures adopted on the follow-up programs on the high-risk new-born; to point out the specific qualities of the actions developed by the multidisciplinary team involved in the follow-up of the high-risk newborn; to discuss the nurses' performance on the follow-up of the high-risk newborn in the context of a multidisciplinary team. The theoretical framework was built upon the theory of Social Representations conceived by Moscovici, who considers the representations as common sense theories conceived to explain aspects of our daily life. This research counted on 23 professionals on three multidisciplinary teams who carry out the follow-ups on ambulatory infant egresses from the Neonatal Intensive Therapy Unit. Structured interviews with those professionals were analyzed under the light of content-analysis techniques. Results of the analysis revealed 8 categories as follows: perception of the high-risk infant; objectives and significance of the follow-up; perception of the follow-up work; pedagogical activity on the follow-up; maternal attitudes and feelings in the face of the follow-up; client profile and the possibility of the follow-up; interdisciplinary work on the follow-up and nurses' participation on the follow-up...
Subject(s)
Humans , Infant, Newborn , Neonatal Nursing/methods , Patient Care Team , Monitoring, Physiologic/nursing , Social Perception , Brazil , Qualitative Research , Nursing TheoryABSTRACT
Agrowing number of premature infants including those with extremely low birth weight (birth weight <1,000g) are surviving in recent years with advances in neonatal intensive care. The infant follow-up program is a service that provides a continuum of care to high-risk infants who have increased risk for major and minor neuro-developmental impairments after they have been discharged from the hospital's intensive care unit. The goals of the outpatient clinic include the followup of the growth and development, identification of medical, neurological, developmental or psychological abnormalities, referral and consultation services as needed, and the enhancement of infant-parental bonding. All high-risk premature infants who are at risk for developmental delays should be evaluated with the Bayley Scales of Infant Development at corrected 7~8, 18, and 24 months and appropriate developmental assessment tools later in life to identify problems and to make appropriate referrals for early interventional therapies such as physical, occupational, speech, hearing, feeding and play group.
Subject(s)
Child , Humans , Infant , Infant, Newborn , Ambulatory Care Facilities , Child Development , Continuity of Patient Care , Follow-Up Studies , Growth and Development , Hearing , Infant, Low Birth Weight , Infant, Premature , Intensive Care Units , Intensive Care, Neonatal , Referral and Consultation , Weights and MeasuresABSTRACT
PURPOSE: To investigate the degree and sources of stress which fathers of infants in NICU experience. METHOD: Eighty-five fathers of NICU infants at 5 university hospitals in Seoul volunteered to complete the Parental Stressor Scale for NICU (PSS: NICU) from September 1, to October 15, 2002. RESULTS: Total perceived stress was 3.50+/-0.76. The highest score were in Parental Role Alteration (3.76+/-0.83) and Appearance and Behavior (3.65+/-1.04). The total perceived stress score (PSS), correlated significantly with method (t=3.50, p=.01), and route (F=5.30, p=.00) of feeding. Light & Sound correlated significantly with birth weight (F=3.39, p=.02), medical diagnosis(F=2.30, p=.03), plan of operation(t=2.50, p=.01), operation (t=3.80, p=.02), method (F=4.90, p=.003), and route (F=4.70, p=.00) of feeding. Infant Appearance and Behavior correlated significantly with birth weight (F=5.12, p=.01), plan of operation (t=2.50, p=.01), method (F=3.50, p=.01), and route (F=7.80, p=.00) of feeding. Parental Role Alteration correlated significantly with care of incubator (t=-.68, p=.03), method of feeding (F=2.80, p=.04) and education level of father (F=3.00, p=.05). CONCLUSION: Father with NICU infants were concerned mostly with parental role alteration and infant appearance. Nursing intervention should include fathers of NICU infants.
Subject(s)
Humans , Infant , Infant, Newborn , Birth Weight , Education , Fathers , Hospitals, University , Incubators , Intensive Care, Neonatal , Nursing , Parents , Seoul , Child HealthABSTRACT
PURPOSE: The quasi-experimental study was conducted to investigate the effects of the integrated NICU hospitalization education on maternal attachment, maternal self-esteem, and EPDS in the 26 mothers of high-risk infants(HRI). METHOD: The subjects were divided into the experimental group to received the integrated NICU hospitalization education included the enforced direct education of NICU and HRI to the mothers using a booklet and the provision of the neomaternal exposure as soon as possible after delivery. The control group received the routine education of the NICU hospitalization, mostly including the admission process and the NICU rules delivering to the husband. The research variables were maternal attachment, maternal self-esteem, and EPDS. RESULTS: The results showed the increases in these variables after the integrated education in experimental group compared to the control group. CONCLUSION: It supports the benefits of the early direct NICU education and the neomaternal exposures on maternal adaptation process in the mothers of HRI.
Subject(s)
Female , Humans , Infant , Depression, Postpartum , Education , Hospitalization , Mothers , Pamphlets , Postpartum Period , Spouses , Child HealthABSTRACT
OBJECTIVE: Maturation of the acoustic and visual pathways in brainstem can be reflected by the brainstem auditory evoked potential(BAEP) and visual evoked potential(VEP) response studies. The purpose of this study was to evaluate the high-risk infants by the BAEP and VEP studies as a screening test for Their brainstem maturities. METHOD: The BAEP and VEP studies were used as a screening test in 142 high-risk infants with 31 to 42 weeks of conceptional age. Further follow-up data were obtained within 1 year in the same infants who showed the abnormal findings in BAEP and VEP at an initial screening test. RESULTS: On an initial BAEP and VEP study, the proportion of the abnormal findings was significantly higher among infants with below 36weeks(53.8%, 28.2%) of conceptional age than above 36 weeks(27.2%, 3.9%). At the follow-up study, 3 of 21 infants with no responses in BAEP and 1 of 6 infants with no responses in VEP on an initial test showed the persistent abnormal findings. However, normal configurations of BAEP and VEP were observed in infants with prolonged latencies or with distorted waveforms of BAEP and VEP at the first examination. CONCLUSIONS: These results suggest that the BAEP and VEP studies on the useful screening tests in infants above 36weeks of conceptional age. Because of the risk of persistent abnormal results, infants with no responses on an initial screening test need a follow-up study.