A three-center, randomized, controlled trial of individualized developmental care for very low birth weight preterm infants: Medical, neurodevelopmental, parenting, and caregiving effects

被引:211
作者
Als, H
Gilkerson, L
Duffy, FH
McAnulty, GB
Buehler, DM
Vandenberg, K
Sweet, N
Sell, E
Parad, RB
Ringer, SA
Butler, SC
Blickman, JG
Jones, KJ
机构
[1] Harvard Univ, Sch Med, Dept Psychiat, Boston, MA USA
[2] Erickson Inst Early Childhood Dev, Irving B Harris Infant Studies Program, Chicago, IL USA
[3] Harvard Univ, Sch Med, Dept Neurol, Boston, MA 02115 USA
[4] Harvard Univ, Sch Med, Dept Psychiat, Boston, MA 02115 USA
[5] Mills Coll, Dept Educ, Oakland, CA USA
[6] Childrens Hosp Oakland, Div Dev Behav Pediat, Oakland, CA USA
[7] Univ Arizona, Coll Med, Dept Pediat, Tucson, AZ USA
[8] Harvard Univ, Sch Med, Dept Pediat, Boston, MA 02115 USA
[9] UMC Nijmegen, Dept Radiol, Nijmegen, Netherlands
[10] Brandeis Univ, Florence Heller Sch Adv Studies Social Welfare, Boston, MA USA
关键词
individualized developmental care; very low birth weight infants;
D O I
10.1097/00004703-200312000-00001
中图分类号
B84 [心理学]; C [社会科学总论]; Q98 [人类学];
学科分类号
03 ; 0303 ; 030303 ; 04 ; 0402 ;
摘要
Medical, neurodevelopmental, and parenting effects of individualized developmental care were investigated in a three-center, randomized, controlled trial. A total of 92 preterm infants, weighing less than 1250 g and aged less than 28 weeks, participated. Outcome measures included medical, neurodevelopmental and family function. Quality of care was also assessed. Multivariate analysis of variance investigated group, site, and interaction effects; correlation analysis identified individual variable contributions to significant effects. The results consistently favored the experimental groups. The following contributed to the group effects: shorter duration of parenteral feeding, transition to full oral feeding, intensive care, and hospialization; lower incidence of necrotizing enterocolitis; reduced discharge ages and hospital charges; improved weight, length, and head circumferences; enhanced autonomic, motor, state, attention, and self-regulatory functioning; reduced need for facilitation; and lowered family stress and enhanced appreciation of the infant. Quality of care was measurably improved. Very low birth weight infants and their parents, across diverse settings, may benefit from individualized developmental care.
引用
收藏
页码:399 / 408
页数:10
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