The purpose of this study is to explore the differences in physiologic and financial outcomes among neonates delivered at 26, 28, 30, 32 and 34 gestational weeks. The Rosswurm-Larrabee model was selected as the theoretical framework for this research study. Prior to this study, an extensive review of the relevant literature failed to discover studies that encompass physiologic and financial outcomes at gestational-age specific groups. A descriptive, comparative design was utilized to determine physiologic and financial outcome among the five groups. A systematic retrospective chart review was used to select the sample from premature deliveries that occurred from January 1, 1999 to December 31, 1999 at a tertiary hospital in a metropolitan area in the Southeastern United States. The data analysis indicated a significant statistical difference in the financial outcomes among the groups. Additionally, there was a significant statistical difference in the majority of the physiologic outcomes including, respiratory distress, hyperbilirubinemia, necrotizing enterocolitis, sepsis, retinopathy, patent ductus arteriosus, intrauterine growth retardation, Apgar Scores at 1 and 5 minutes, and birth weight. Recommendations were made for further studies utilizing a larger, more diverse sample. In addition, a longitudinal study that encompasses long-term outcomes of neonates would be beneficial since many effects of prematurity are no evident until certain developmental milestones are or not achieved. A qualitative research study on how to better prepare parents for parenthood and to what extent the additional responsibilities and expectations might compromise the families parenting abilities was also recommended. Furthermore, the development of additional studies that focus on the use of critical pathways and outcomes should also be investigated. The devastating effects of prematurity on families and society provides the nurse with the unique opportunity for education and intervention with caring strategies. This research presents baseline data from which our society stands to benefit.

Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / Judgment methodology was employed to provide a qualitative description of mother/child interaction during infant play. Videoclips of 40 9-month-old infants in a free play situation with their mothers were rated by a panel of 10 judges using a series of 9 point Likert scales. Thirteen qualitative items, grouped into the five different areas of communication, coordination, engagement, affect, and overall quality of interaction, were rated from low or absent (0) to consistently high (8). Each mother/child dyad was assessed on two different segments. The reliability of the scales for assessing the mother/child interaction (mean ratings of 10 judges) ranged from .65 (mismatch) to .81 (mutual responsiveness) with an overall mean effective reliability of .77. There was a high intercorrelation among individual variables and overall quality of the interaction suggesting that no one of the rated qualities was more predictive of the overall mother/child interaction. Differences found in the rated quality of mother/child interaction between the two segments raise questions regarding the validity of conclusions about the overall quality of interaction based on a single short segment. Results are discussed in terms of the psychometric features of the scales and in terms of the mother/child interactional patterns. Suggestions for revising the methodology and the assessment tool are made to improve reliability and validity. More studies are necessary to validate the usefulness of the judgment methodology as an alternative approach to studying the quality of mother/child interaction. / 2999-01-01

Thesis (D.N.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / This study examined the effect that maternal post partum depressive affect had on an infant's affective development at three months of age. A sample of 26 mother-infant pairs, 13 with maternal depressive symptomatology and 13 with no depressive symptomatology were compared for differences in infant affective regulation and affective responses during an age appropriate stressful interaction - the still-face interaction. The implications of this data and the potential complexity of the relationship between maternal depressive affect and infant coping behavior are discussed. Recommendations for further propective research are proposed. [TRUNCATED] / 2999-01-01

published_or_final_version / Public Health / Master / Master of Public Health

Uncertainty is recognized as a significant perceptual variable in the experience of illness. The purpose of this study was to gain an understanding of how parents of ill infants cope with the uncertainty inherent in illness-related events and situations. A conceptual framework of coping with uncertainty was proposed and tested. The four constructs in the model and their measures were perceived uncertainty (Mishel's Parents' Perceptions of Uncertainty Scale), cognitive appraisal (Lazarus and Folkman's Appraisal Questionnaire), coping efforts (Lazarus and Folkman's Ways of Coping Checklist) and cognitive schema (Mishel's Parents' Perceptions of Uncertainty Scale and grounded theory methodology). Methodological triangulation was used. A quantitative, longitudinal, descriptive correlational design examined the model. A qualitative study using grounded theory methodology explored the forming and using of a cognitive schema. A convenience sample of 37 parents of critically ill neonates participated in the quantitative study with 15 of those also participating in the qualitative study. Self report questionnaires measured model variables. Interviews comprised the grounded theory approach. Descriptive and correlational statistics characterized model variables and their relationships. Constant comparative analysis identified processes central to forming and using a cognitive schema. From the descriptive results, parents perceived high levels of uncertainty when measured at approximately 2.5 days following the ill infant's birth. Appraisal of uncertainty as harmful to well-bring was correlated with perceived ambiguity (r =.63) and complexity (r =.36). The coping efforts of self-blame (r =.53) and wishful thinking (r =.44) were related to the harm appraisal. Significant decreases in perceived ambiguity and lack of information were demonstrated when uncertainty was measured again at approximately eight days following birth. From the grounded theory methodology, three processes central to cognitive schema were identified (forming, framing, using) were discovered and conceptualized. When uncertainty was perceived, parents actively sought information in forming a schema. With sufficient information, information was categorized to frame an explanation of illness experiences. With framing, schema was created and used by the parents. Methodological triangulation accounted for consistencies and inconsistencies across quantitative and qualitative results. The model of coping with uncertainty was supported through triangulation.

No description available.

The purpose of this study was to assess if preterm infants receiving an intervention of intermittent human tactile contact would demonstrate clinical improvement over infants who did not receive the intervention. A quasi-experimental design was used with 26 infants between 28 and 32 weeks gestation. Hands were placed on the infants' heads and lower backs for a total of 36 minutes of tactile contact a day for 10 days. Findings indicated a significant gain in mean body weight for both groups between Day 0 and Day 10. Also, there was a significant decrease in mean hematocrit in the control group between Day 0 and Day 10. On Day 10, experimental infants had a significantly higher mean number of apneic and bradycardic episodes than control infants. There were no significant mean differences between the groups for body weight, body temperature stability, oxygen variance, or hematocrit. Data suggest that gentle human touch may be correlated with desireable outcomes. Further research is necessary.

This study investigates (1) whether infants in a day-care setting exhibit sexual preferences in the choice of a playmate, and (2) whether males exhibit more overt acts in play than do females. Eight male and eight female infants, attending a day-care center, paired by age (ages twelve to twenty-four months), were selected as subjects. Each of the sixteen children was observed for a ten-minute period on four separate days, over a two-week period, a total of forty minutes' observation time per child. No significant differences were found between male and female infants involving the preference of the sex of a playmate, or between male and female overt behaviors.

Thesis (Ph.D.)--University of Delaware, 2006. / Principal faculty advisor: James C. Galloway, Dept. of Physical Therapy. Includes bibliographical references.

The purpose of this study was to determine the efficacy of the Behavioral Pediatrics Feeding Assessment Scale (BPFAS) in identifying children at risk for feeding difficulties when given to parents by interview versus without assistance. Thirty subjects from Emory Developmental Progress Clinic (Emory DPC) participated in the study and were randomized to receive the BPFAS either by interview or without assistance. Mean BPFAS scores were compared by survey administration method and nutrition referral status for the total cohort as well as by age (1.5 year) and weight status (<25th percentile, 25-75th percentile, >75th percentile) using the t-test. The association between survey administration method as well as nutrition referral status and referral score category (84) was determined using the Chi-square test, as was the relationship between nutrition referral status and the response to each BPFAS question. No difference in mean BPFAS score or referral score category by survey administration method was found in the total cohort. However, a higher BPFAS score was observed for children >1.5 years of age who were referred for nutrition intervention vs. not referred (95.33 vs. 62.5, respectively; p=0.004). There was also a significant association between the number of patients referred for nutrition intervention vs. not referred and referral score (11 vs. 19, respectively; p=0.041). There was no association between responses to individual BPFAS questions and nutrition referral status. In conclusion, evaluation of other feeding assessment surveys or the in-house development of a screening tool may be better alternatives for the Emory DPC.