Background:
Survival of very-low-birth-weight infants is improving in neonatology and family-centered-care might contribute to premature infants' clinical outcomes.
Aim:
To evaluate a family-centered care intervention on clinical outcomes of very-low-birth-weight infants.
Methods:
A quasi-experimental study was conducted in a Chinese NICU between June 2016 and June 2017. The intervention included parental education of basic care knowledge and skills followed by active participation in care for at least 4 h a day. A total of 319 very-low-birth-weight infants were recruited by convenience sampling; intervention group
n
= 156 and control group
n
= 163. Primary outcome measures were weight at discharge, length-of-stay, breastfeeding, nasal feeding, total parental nutrition, re-admission, hospital expenses. Secondary outcome measures were infant complications.
Results:
Infants' weight at discharge was higher in the interventions group (2,654 g vs. 2,325 g,
p
< 0.001). Nutritional outcomes improved significantly: breastfeeding rate 139 vs. 91,
p
< 0.001; days of total parental nutrition 25 d vs. 32 d,
p
< 0.001; gastric feeding days 23 d vs. 35 d,
p
< 0.001. Length-of-stay and hospital expenses did not differ between both groups. Improved infants' complications were bronchopulmonary dysplasia (32 vs. 51,
p
= 0.031), retinopathy of prematurity (between groups no/mild and moderate/severe,
p
= 0.003), necrotizing enterocolitis (6 vs. 18,
p
= 0.019), and re-admission rate (21 vs. 38,
p
= 0.023). No differences were observed in intraventricular hemorrhage and nosocomial infections.
Conclusion:
Very-low-birth-weight premature infants might experience improved clinical health outcomes when parents are present and caring from them. Family-centered care is as a beneficial care model for premature infants and should be recognized and implemented by NICUs where parents have currently limited access.
BackgroundMost Neonatal Intensive Care Units (NICUs) in China have restricted visiting policies for parents. This also implicates that parents are not involved in the care of their infant. Family Integrated Care (FIC), empowering parents in direct care delivery and decisions, is becoming the standard in NICUs in many countries and can improve quality-of-life and health outcomes of preterm infants. The aim of this study was to evaluate the impact of a FIC intervention on the clinical outcomes of preterm infants with Bronchopulmonary Dysplasia (BPD).MethodsA pre-post intervention study was conducted at NICUs in two Chinese children’s hospitals. Infants with BPD were included: pre-intervention group (n = 134) from December 2015 to September 2016, post-intervention (FIC) group (n = 115) and their parents from October 2016 to June 2017. NICU nurses were trained between July and September 2016 to deliver the FIC intervention, including parent education and support. Parents had to be present and care for their infant minimal three hours a day. The infants’ outcome measures were length-of-stay, breastfeeding, weight gain, respiratory and oxygen support, and parent hospital expenses.ResultsCompared with control group (n = 134), the FIC group (n = 115) had significantly increased breastfeeding rates (83% versus 71%, p = 0.030), breastfeeding time (31 days versus 19 days, p < 0.001), enteral nutrition time (50 days versus 34 days, p < 0.001), weight gain (29 g/day versus 23 g/day, p = 0.002), and significantly lower respiratory support time (16 days versus 25 days, p < 0.001). Oxygen Exposure Time decreased but not significant (39 days versus 41 days p = 0.393). Parents hospital expenses in local Chinese RMB currency was not significant (84 K versus 88 K, p = 0.391).ConclusionThe results of our study suggests that FIC is feasible in two Chinese NICUs and might improve clinical outcomes of preterm infants with BPD. Further research is needed to include all infants admitted to NICUs and should include parent reported outcome measures. Our study may help other NICUs with limited parental access to implement FIC to enhance parental empowerment and involvement in the care of their infant.
Involving parents in the care of their infant improved clinical outcomes of infants. Family-centered care also contributed to a better understanding of parent's clinical education, decrease stress levels, and increased parental satisfaction. Our study suggests that involving parents in the daily care of their infants is feasible and should be promoted by neonatal ICU clinicians.
Objectives:
To determine the feasibility of a personalized music intervention with mechanically ventilated patients in the PICU.
Design:
Pilot study with a quasi-experimental design.
Setting:
Tertiary children’s hospital in China with a 40-bed PICU.
Patients:
Children, 1 month to 7 years, with mechanical ventilation were recruited and assigned to music group (n = 25) and control group (n = 25).
Interventions:
Children in the music group received their own favorite music and listened for 60 minutes three times a day. The control group receive routine care without music.
Measurements and Main Results:
Primary outcome measure was comfort measured with the COMFORT Behavior scale 5 minutes before and after the music. Secondary outcome measures were physiologic variables; heart rate, respiration, blood pressure, oxygen saturation. Mechanical ventilation time, length of stay, and sedation medication were also collected. Qualitative analysis revealed that nurses had a positive attitude in delivering the interventions and identified improvements for the main trial. Children in the music group had lower COMFORT Behavior scores (15.7 vs 17.6; p = 0.011). Children in the music group had better physiologic outcomes; heart rate (140 vs 144; p = 0.039), respiration rate (40 vs 43; p = 0.036), systolic blood pressure (93 vs 95 mm Hg; p = 0.031), oxygen saturation (96% vs 95%; p < 0.001), diastolic blood pressure was not significantly (52 vs 53 mm Hg; p = 0.11). Children in the music group had a shorter ventilation time (148.7 vs 187.6; p = 0.044) and a shorter length of stay, but not significant (11.2 vs 13.8; p = 0.071). Children in the control group had higher total amount of on-demand midazolam (29 vs 33 mg; p = 0.040).
Conclusions:
Our pilot study indicates that personalized music intervention is feasible and might improve the comfort of children with mechanical ventilation. Further studies are needed to provide conclusive evidence in confirming the effectiveness of music interventions comforting critically ill children in PICUs.
With the quickly rising popularity of smartphone among adolescents over the past decade, studies have begun to investigate the relationship between smartphone addiction and Eysenck's personality traits. Despite numerous studies on this topic, however, findings have been mixed and there is a lack of consensus regarding this relationship. Thus, this meta-analysis aimed to explore the relationship between smartphone addiction and Eysenck's personality traits in Chinese adolescents, as well as its possible moderators. Through literature search and screening, 33 studies were included, comprising 79 independent effect sizes with a total of 17, 737 subjects. A random effects model was selected, and it was found that smartphone addiction was positively associated with psychoticism (r = 0.16, p < 0.001) and neuroticism (r = 0.32, p < 0.001), but not significantly associated with extroversion (r = −0.06, p = 0.079). The moderating effect test showed that sex and year of study publication had significant influences on the relationship between smartphone addiction and psychoticism, and the year of study publication had a significant influence on the relationship between smartphone addiction and neuroticism. This study is the first meta-analysis on the relationship between smartphone addiction and Eysenck's personality traits among adolescents in China, and the results have helped to clarify the controversy of previous studies regarding this relationship.
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