Development and Design of a Nursing Intervention Following a Theory and Evidence-Based Approach to Promote Maternal Sensitivity and Preterm Infant Neurodevelopment in the NICU

Abstract

Background: Maternal sensitivity is an important predictor of long-term mother-infant attachment and infant development. Considering the behavioral specificities of preterm infants that may impede the development of maternal sensitivity, it is essential to promote these outcomes soon after a preterm birth. A systematic review showed that current evidence on the effectiveness of parent-infant intervention promoting parental sensitivity in the neonatal intensive care unit (NICU) is of low to very low quality. The aim of this project was to develop and design a novel nursing intervention to enhance maternal sensitivity and preterm infant neurodevelopment in the NICU. Methods: The Medical Research Council’s guidance to develop and evaluate complex health interventions, that is an evidence and theory-based approach, was used for this study. Thus, based on the MRC framework, three main steps were conducted: 1- Identifying existing empirical evidence; 2- Identifying and developing theory; 3- Modeling processes and outcomes.Results: We developed a guided participation intervention for mothers to participate in their preterm infant’s care and positioning (GP_Posit). GP_Posit is based upon the Attachment theory, the Guided participation theory as well as the Synactive theory of development. Conclusion: This novel intervention is being tested in a pilot randomized controlled trial (NCT03677752).