Preterm Infant Follow‐up Project: A Multi‐Site Field Experiment of Hospital and Home Intervention Programs for Mothers and Preterm Infants

Abstract

This study was designed as a multi-site field experiment to test the efficacy of hospital and home visit interventions to improve interaction between mothers and preterm infants. Hospital intervention consisted of State Modulation (SM) treatment, which focused on teaching mothers to read the behavioral cues and modulate the states of consciousness of preterm infants during feedings. Home visit intervention was a field-tested program, Nursing Systems for Effective Parenting-Preterm (NSTEP-P), implemented during the first five months after the infant's hospital discharge. A hospital program on car seats (CS) and standard public health nursing home visits (PHN) served as comparison treatments. The sample consisted of 327 mothers and their preterm infants who were less than 36 weeks of gestational age at hospital discharge. Mothers were randomly assigned to intervention groups on the basis of their education. High education (HE) was > or = 13 years of education, while low education (LE) was < or = 12 years of education. HE mothers were only assigned to hospital programs, while LE mothers were assigned to combinations of hospital and home visit programs. Evaluations were conducted at 40 weeks conceptual age (expected date of birth), at 46 weeks conceptual age (1.5-months-corrected age), and 60 weeks conceptual age (5-months-corrected age). Comparisons were made within each educational group. For HE groups, SM infants gave significantly more clear cues during observations of feeding interactions at 1.5-months-corrected age and teaching interactions at 5-months-corrected age than infants in the CS group. During the teaching interaction, well-educated SM mothers provided significantly more social-emotional and cognitive stimulation than CS mothers. For LE groups, infants in the SM group combined with either PHN or NSTEP-P exhibited significantly more responsive behavior during feeding observations than those infants in the CS/PHN group at 1.5-months-corrected age. LE mothers in the SM/NSTEP-P group demonstrated more sensitivity and more stimulation during teaching interactions at 5-months-corrected age than mothers in the SM/PHN or CS/PHN groups. Findings suggest that State Modulation treatment is effective in influencing positive social interaction of infants regardless of the level of maternal education. State modulation treatment combined with NSTEP-P is most effective in improving the social interaction between preterm infants and mothers with limited formal education. Such treatment-specific programs suggest avenues for providing cost-effective care that complements the changing transactional needs of mothers and preterm infants.

Positive Mental Health: A Turn of the Century Perspective

“…Other nurse scientists have studied the promotion of psychosocial processes from a life span developmental perspective. For example, healthy childhood development has been examined in relation to psychosocial risk and protective processes such as social support, the parent-infant attachment process, and parenting competencies (Barnard, 1999;Kang, Barnard, Hammond, & Oshio, 1995). Another nursing prevention research area is the study of stress and the effects on physical and mental functioning, such as the daily challenges of coping with a chronic health condition or developmental disability (Magyary & Brandt, 1996;Ryan-Wenger, 1994;Shands, Lewis, & Zahlis, 2000;Woods & Lewis, 1994).…”

Assistência de enfermagem a crianças prematuras: uma revisão da literatura sobre o seguimento

“…O período pós-alta também é considerado estressante e tem sido proposto apoio e auxílio às famílias destas crianças, como continuidade da assistência, através de serviços de enfermagem comunitária (Ahmann, 1994, De Pompei et ai., 1994, Zahr, 1994, Kang et ai. , 1995, McCarlon et aI., 1995, McLoughlin, 1995, Zel/e, 1995.…”

“…As experiências dos serviços de saúde apontadas enfatizam intervenções das equipes de saúde com as crianças e os pais realizadas no hospital, outras combinam assistência hospitalar e domiciliar e algumas retratam o trabalho entre cllnicas especializadas e assistência domiciliar (Zahr, 1994, Kang et aI., 1995, McLoughlin, 1995, Zelle, 1995.…”

Relationship between neurobehaviours of Chinese neonates and early mother–infant interaction

“…Both scales have been used in diverse ethnic groups (Boffman et al, 1997;Gaffney et al, 2002;Keefer et al, 1982;MacDonald-Clark et al, 1994;Seideman et al, 1992;Woodson et al, 1989), but the NCATS has not been used in China. The scales have been used in research assessment and as clinical tools to enhance parenting skills and knowledge (Beeghly et al, 1995;Das Eiden & Reifman, 1996;Kang et al, 1995;Koniak-Griffin et al, 1992). The NBAS was designed to describe the full range of the infant's behavioural repertoire, and has a theoretical construct that positive competencies can compensate for the deficits in the infant's neurological system.…”