The purpose of this study was to describe maternal coping effort. The sample was composed of 30 mothers of infants hospitalized in the neonatal intensive care unit. Descriptive and correlational statistics were used to determine maternal coping effort and the maternal factors that may be associated with coping effort. Results of the study showed that a majority of the mothers exerted a great amount of effort to cope with situations encountered in the NICU. Maternal age, marital status, gravidity and parity, mode of delivery and ethnicity did not prove to associate significantly with coping effort. The results of this study are significant to nursing practice in the confirmation of the high degree of maternal coping associated with the hospitalization of an infant in the NICU.

Class of 2012 Abstract / Specific Aims: The objective of this study is to evaluate and compare clinical outcomes and economic impact involved with the use of beractant (B) compared to poractant (P) for the treatment of respiratory distress syndrome (RDS) in premature neonates admitted to a neonatal intensive care unit. Methods: Patients were included if they were less than 35 weeks gestational age at birth, survived at least 48 hours, and admitted to the neonatal intensive care unit and treated with P or B for RDS. The primary outcome of this study is the change in the fraction of inspired oxygen (FiO2) over the first 48 hours after surfactant administration. Secondary outcomes were the change in oxygen saturation, time spent on mechanical ventilation and continuous positive airway pressure (CPAP), complication occurrence and mortality of the neonates. Main Results: There were a total of 40 neonates whose charts were reviewed (n= 13 and n=27 in the P and B groups respectively). The mean gestational age of the neonates were 29.2+/-2.9 and 28.8+/-2.9 weeks in the P and B groups respectively. The FiO2 was found to not be lower between the P and B groups (35.5+/-22.2 and 42.4+/-24.2, respectively; p=0.379), as well as the O2 saturation (94.6+/-4.6 and 92.3+/-6.1; p=0.194). Significance was also not found for the other clinical or economic outcomes assessed in this study. Conclusions: There was not a significant difference between poractant and beractant in FiO2, O2 saturation, or in the other clinical outcomes evaluated in this study.

Background: Care of premature infants is challenging for health care professionals. When the preterm infant is separated from its mother the parent-child interaction is impeded. In the last few decades, there has been increasing interest in the effectiveness of massage as an intervention to counter the negative physiological, clinical and behavioral consequences of prematurity and the neonatal intensive care unit environment. Aims: To establish the effectiveness of moderate pressure massage from evidence in the literature and to then explore the cultural, organisational and contextual factors that may act as facilitators and/or barriers for its future implementation in Lebanon. Methods: This thesis utilizes a two-step approach. Two literature reviews were undertaken to establish recent evidence on moderate pressure massage. A qualitative exploratory investigation was adopted as no articles were found that elucidated the contextual barriers and facilitators for massage implementation in the neonatal intensive care unit. The normalization process theory was used as a sensitizing framework to understand implementation issues and address the observed difficulties in implementing new interventions in clinical settings. This study was also concerned with context and culture as moderate pressure massage is not practiced in the Lebanese neonatal intensive care units. A purposive sample of Lebanese health care professionals and parents were recruited from three university hospitals with data generated through focus group discussions and observational notes. Framework analysis was used for the analysis and interpretation of the findings. The study drew on the principles and practice of ethnographic approaches. Findings: The findings from the two literature reviews only revealed randomized control trials that observed mostly the short-term physiological and psychological effects of moderate pressure massage. There were no studies that examined the organizational and contextual issues that need to be understood before any trial could be designed in the neonatal intensive care unit setting. The evidence from this review suggested there is a need to explore the views of health care professionals and parents on the practice of massage in the neonatal intensive care units to provide insight into the subsequent design of an intervention study that would be culturally sensitive, appropriate, and acceptable in practice. The findings from the qualitative study then revealed that despite the participants’ interest in implementing massage intervention, parents’ participation in the neonatal intensive care unit is almost absent except for breastfeeding. Participants in both groups, parents and health care professionals, highlighted the parents’ fear and anxiety. In general, nurses are in charge and parents are passive observers. Transportation difficulties, unavailability of helpful staff, and fear were reported as major barriers to parent-implemented infant moderate pressure massage; health care professionals highlighted staff attitude and resistance, workload and time constraints. Communication, gradual implementation, encouragement and support were identified by parents as potential facilitators. In comparison, having extra staff and a protocol for teaching nurses, training parents and openness to innovation were the main potential facilitators of implementation identified by health care professionals. Conclusion: This study helped to reveal the potential challenges of applying such a complex intervention as moderate pressure massage by the parents in the neonatal intensive care unit. Adopting infant massage in the Lebanese neonatal intensive care unit without preparation of health care professionals and parents would be premature. Good communication between parents and health care providers is a key element to facilitate early bonding and parent-infant interaction. Missing the opportunity to involve parents in neonatal intensive care unit care puts the family in a difficult situation to adapt to the new challenges after discharge. The findings of this study will advance current knowledge in understanding the factors that determine applicability, acceptability and feasibility of massage implementation in the neonatal intensive care unit setting. It will also assist and inform the design of future randomized control trials. The noramalization process theory was a valuable lens to guide the process of inquiry and to make sense of the emergent findings from this exploratory qualitative study.

Thesis (Ph. D.)--University of Chicago, Dept. of Anthropology, June 1999. / Includes bibliographical references. Also available on the Internet.

Thesis (Ph. D.)--University of Texas at Austin, 1999. / Vita. Includes bibliographical references (leaves 131-169). Available also in a digital version from Dissertation Abstracts.

The admission of an infant to the Neonatal Intensive Care Unit (NICU) has the potential to produce significant stress for the mothers of these infants. Researchers suggest that this may contribute to difficulties with coping following discharge. Past research on this topic has been primarily focused on Caucasian women. Approximately 9% of the U.S. population is of Mexican heritage; therefore, this population is significantly underrepresented in the existing literature. For this reason, the purpose of this grounded theory study was to identify the basic social processes used by English-speaking mothers of Mexican heritage who have experienced the admission of an infant to the NICU. Maximum variation sampling was utilized to recruit 15 English-speaking mothers of Mexican heritage who were at least 18 years of age and had experienced the admission of an infant to the NICU. The women were recruited from various locations in San Antonio, Texas. Data collection was conducted through audio-taped, semi-structured individual interviews and transcribed field notes. Data analysis consisted of constant comparison, open coding of data, and theoretical coding. This investigation resulted in the substantive theory making sure my baby is cared for by being there for my baby. The process began with the unexpected event of having an infant in the NICU and played out in the context of opposing forces: trying to be the mother or making meaningful connections. The mothers developed strategies for managing this situation by balancing responsibilities, leaving part of me with my baby, and watching over. The process concluded with one of two consequences: bringing my baby home or losing my baby. The theory that emerged from this study offers insight for researchers, nurse educators, and neonatal nurses who provide care for English-speaking, Mexican-heritage mothers and their infants as well as for the care of all NICU mothers and their infants. / text

Infants born prior to 37 weeks gestation are at risk for countless medical problems and developmental delays. In order to help minimize these delays and improve the child’s potential, the Individuals with Disabilities Education Act, Part C, funds Early Intervention (EI) Services. These services may include speech, physical therapy, occupational therapy, or developmental therapy, among others. Purpose and Objective: While numerous studies show the benefits of EI therapies, little is known about barriers to EI participation, what the parents of these children who participate in EI think, or how to improve EI services. This study attempts to answer these questions. Methods: Surveys regarding EI were posted to three preemie parent organizations social media pages, and 140 surveys were returned. These surveys were analyzed for both quantitative and qualitative answers. Qualitative answers were coded and themes were garnered. Results: A total of 148 participants took the survey, and 76% had children that had participated or currently participate in EI. Of the parents who answered their child did not attend EI, most state there was no EI services near them, their child did not qualify, or the EI services were of poor quality. Of the EI parent surveys, most parents (73%) were happy with their child’s EI and their child’s progress, and would recommend EI to others. Most children had EI therapy at least weekly, and were referred to EI prior to leaving the NICU. Parents felt as though their child benefitted in nearly all domains. In addition to the benefits to their child, EI parents also felt as though therapy helped decrease their stress level, gave them a benchmark to measure their child’s progress and connected them with other professionals for their child. Some parents also provided recommendations to improve EI: decrease eligibility requirements, improve communication with parents, provide continuity of care, and create a bridge program for children three and up until they reach school age. Conclusions: With these suggestions, providers can help improve current EI services. Primary care providers should ensure children who are at risk for delays are referred, and EI services should improve communication with parents and enhance continuity of care.

This essay presents a Wittgensteinian analysis of the rationales, beliefs, and contributing factors that supported the denial of neonatal pain until the late 80's. It provides an historical review of the denial of neonatal pain and describes the main events leading to its recognition. It explores the link between enduring erroneous conceptions and scientific assumptions about the nature of pain, and the denial of neonatal pain. Wittgenstein's work on the origin of pain-language in the natural tendency of human beings to exhibit pain-behaviour and to react to the pain manifestation of others by engaging in meaningful activities provides the background for this investigation of neonatal pain. The lack of training in pain assessment techniques and the unique pain manifestation of sick and premature infants is considered. The impact of Neonatology's driving concepts and the overreaching scientifical approach of medicine is also discussed. Finally, it is recognized that individual, scientific, and sociopolitical forces have influenced neonatal pain research and clinical practice. The essay concludes with a reflection on the consequence of privileging the biological function over the experiential dimension of life for sick infants presently in the N.I.C.U but also for the quality of their long-lasting memories.

Thesis (PhD. (Nursing Science) - Faculty of Health Sciences))--University of Pretoria, 2008. / Includes bibliographical references.

Thesis (Ph. D.)--University of Notre Dame, 2009. / Thesis directed by Maura A. Ryan for the Department of Theology. "April 2009." Includes bibliographical references (leaves 250-259).