Neonatal abstinence syndrome (NAS) refers to the withdrawal infants exposed to opioids in utero may experience following birth. In recent years, the number of infants born who present with NAS has grown exponentially. This increase in the number of infants with NAS has led to a new population within the caseloads of speech-language pathologists (SLPs) who work in neonatal intensive care units (NICUs). SLPs’ knowledge base and skill set of assessment and treatment of swallowing and feeding disorders in infancy play a vital role in the treatment of infants with NAS in the NICU. A dearth of research exists regarding the specific nature of the feeding problems and skills of infants with NAS and whether SLP intervention for infants with NAS needs to differ from that of other infant NICU populations. Identifying how SLPs can best serve infants with NAS in the NICU is essential to their immediate well-being as well as the development of these infants. The purpose of this survey-based research study was to examine NICU SLPs’ perceptions of infants with NAS, and more specifically, how NAS affects the infants’ feeding skills, structural, and oral-motor characteristics. A questionnaire was developed based on an in-depth literature review to collect information on NAS, caseloads, treatment environment, and respondent demographics. The survey consisted of three sections: NAS (further divided into Assessment, Treatment, and Education), Environmental Description, and Respondent Demographics. The secure web-based questionnaire was distributed through SurveyMonkey™, an online survey platform. Survey research was conducted, and hospital-based speech-language pathologists within the USA acted as respondents. The findings will contribute to establishing a preliminary base of information on this topic. The results are expected to further inform the field as well as current practices in evidenced-based practice care for infants with NAS.

The purpose of this study was to determine the effects of an atypical pattern of early acoustic stimulation on auditory development. Previous human research suggests that the acoustic environment of pre-term human infants in the Neonatal Intensive Care Unit (NICU) negatively affects some aspects of auditory development. Animal research suggests that premature auditory stimulation interrupts auditory development. Because mice are born before their auditory systems are developed, they make an excellent model for research on fetal and postnatal plasticity of the auditory system. The premature auditory state of newborn mice is similar to that of the NICU pre-term infant, albeit, natural for mice C57 mouse pups were exposed to an augmented acoustic environment (AAE) of a nightly 12-hour regiment of 70 dB SPL noise burst, beginning before age 12 days (onset of hearing) and lasting for one month. The prepulse inhibition (PPI) of mice exposed to the AAE was compared to that of non-exposed mice to observe short-term and long-term effects. Results showed that the prepulse inhibition of the AAE exposed mice did not differ significantly from that of the non-exposed mice. However, it is possible that the measurement used, PPI, may not have been appropriate or that the AAE may not have been an appropriate simulation of the NICU environment.

No description available.

Bakgrund: Varje år föds det 15 miljoner prematura barn i världen. Prematura barn behöver vårdas på en neonatalavdelning, tills de är friska nog att lämna avdelningen. I familjecentrerad omvårdnad betraktas familjen som en helhet. Familjecentrering är ett relativt nytt forskningsområde, med perspektiv från både föräldrar och vårdpersonal. Tidigare forskning inom familjecentrerad omvårdnad på en neonatalavdelning visar på positiva effekter hos både förälder och barn. Syfte: Syftet var att belysa föräldrars upplevelse av familjecentrerad omvårdnad på en neonatalavdelning. Metod: Studien var en litteraturöversikt som inkluderade 15 vetenskapliga artiklar på engelska som var publicerade mellan år 2010 och 2020. Både kvalitativa och kvantitativa artiklar inkluderades i studien. Databassökningen skedde i databaserna CINAHL och PubMed och artiklarna analyserades i enlighet med Kristenssons (2014) integrerade analys. Resultat: Resultatet visade att många föräldrar upplever tiden på neonatalavdelningen som en känslomässig berg- och dalbana. Många föräldrar längtade efter närhet med deras barn, oftast var hindret till närhet en rädsla för att barnets hälsa skulle försämras. Vägledning visade sig ge föräldrarna modet att delta i omvårdanden med deras barn, och även möjlighet till att knyta an till barnet. Sjuksköterskan var ett stort stöd enligt föräldrarna, även bara att vara i närheten gav familjen en möjlighet till att slappna av. Slutsats: Föräldrar som får ett prematurt barn överväldigas av många olika känslor. Vårdpersonalen på neonatalavdelningen bidrar till stöd och vägledning. Upplevelser som var återkommande hos föräldrarna var att deras stress minskade när de fick vara med sitt barn samt vara delaktig i vården. Som sjuksköterska är kunskap om hur man ska stötta och bemöta föräldrar i denna sårbara situation betydelsefull för att kunna möjliggöra en så bra och individanpassad vård som möjligt. / Background: Every year 15 million premature children are born. Premature children are in need of care in a neonatal intensive care unit, until they are strong enough to be discharged. In family centered care (FCC) the family is viewed as an ensemble. FCC is a relatively new research area, with perspectives both from parents and health personnel. Research has shown that FCC had positive effects on both parents and child in a neonatal intensive care unit (NICU). Aim: The aim was to describe parent’s experiences of FCC in NICU.  Method: The study was a literature review that included 15 scientific articles in English, which were published between the years 2010 and 2020. Both qualitative and quantitative articles were included. The database search was made in CINAHL and PubMed and the articles were analysed according to Kristensson’s (2014) integrated analysis. Results: The results showed that many parents experience the time in NICU as an emotional roller-coaster. Many parents long for a physical contact with their child, often the fear of the child's health is an obstacle. Guidance showed that parents had the courage to participate in their child's care and got the opportunity of getting an emotional connection. The nurse was a big support for the parents, to be nearby gave the family the opportunity to relax more. Conclusions: Parents that give birth to a premature child gets overwhelmed with different feelings. The health personnel in the NICU contributes to support and guidance. Experiences that was repetitive were that parents stress decreased when they were able to be with their child and to participate in the care of their child. As a nurse knowledge of how you are going to support and meet parents in this vulnerable situation is significant to make it possible for a good and an individualized care.

Bakgrund: Det är känt att nyfödda barn och prematurer som vårdas på neonatal intensivvårdsavdelning känner smärta. Det kan vara en utmaning att identifiera smärta hos de barnen trots användning av olika smärtskalor. Föräldrarna har en viktig roll i vården av barnet, inklusive smärtskattning och smärtlindring, ur ett familjecentrerat vårdperspektiv. Syfte: Att beskriva föräldrars upplevelser om deras barns smärta, som vårdas inom neonatal intensivvård. Metod: Kvalitativ litteraturstudie med systematisk ansats. Resultat: 12 artiklar analyserades. Föräldrars upplevelser om deras barns smärta inom neonatal intensivvård handlar om föräldrarnas behov, föräldrarnas roll samt föräldrarnas känslor. Föräldrarnas känslor påverkas negativt av deras barns smärta. Det är viktigt för föräldrarna att få vara närvarande och delaktiga under smärtprocedurer. Föräldrarna har ett stort behov av kommunikation och information angående barns smärta. Dessutom är ett gott bemötande och en stödjande miljö betydande för att underlätta för föräldrarnas delaktighet och för lindring av deras stress och lidande under barnets smärtprocedur. Slutsats: Familjecentrerad vård är ett stöd för föräldrar att vara delaktig i barnets vård, särskilt under smärtprocedurer. Anpassning av stöd till föräldrar är viktigt för att utveckla deras föräldraroll när de vårdar ett sjukt nyfött barn. Det behövs empirisk forskning i Sverige om föräldrars upplevelser om deras barns smärta inom neonatal intensivvård. / Background: It is known that newborns and premature babies in the neonatal intensive care unit can feel pain. It can be challenging to identify pain in these children despite the use of different pain scales. Parents have an important role in the care of the child, including pain assessment and pain management, from a family-centered care perspective.  Aim of the study: To describe parents' experiences of their child’s pain, who ́s being cared for in a neonatal intensive care unit.  Method: Qualitative literature study with a systematic approach.  Results: 12 articles were analyzed. Parents' experiences of their child's pain in neonatal intensive care are about parents' needs, parents' roles, and parents' feelings. Parents' emotions are negatively affected by their child's pain. It is important for parents to be present and involved during painful procedures. Parents have a strong need for communication and information regarding their child's pain. In addition, a good response and a supportive environment are significant in facilitating parents' involvement and in alleviating their stress and suffering during the child's pain procedure.  Conclusion: Family-centered care is a support for parents to be involved in their child's care, especially during painful procedures. Adapting support to parents is important to develop their parental role when caring for a sick newborn child. There is a need for empirical research in Sweden on parents' experiences of their child's pain in neonatal intensive care.

Bakgrund Tidigt föräldraskap redan på neonatalvårdsavdelning med aktivt deltagande och hud-mothudkontakt påvisar positiva effekter hos det prematura barnet och främjar en sund anknytning. För att främja deltagande behövs ett respektfullt samarbete mellan sjuksköterska och familj enligt familjecentrerad vård (FCC). Syfte Syftet var att sammanställa tidigare forskning för att beskriva föräldrars upplevelser av delaktighet i omvårdnaden av prematura barn. Metod Litteraturstudien inkluderade 15 studier med kvalitativ design och utformades som en strukturerad litteraturstudie. Datainsamlingen utfördes i databaserna PubMed och CINAHL. Inför inklusion lästes artiklarna av båda författarna och kvalitetsgranskades enligt Fribergs granskningsfrågor för kvalitativa studier. Dataanalys utfördes strukturerat utifrån Fribergs fyra steg för att analysera och sammanställa resultatet. Resultat Två kategorier med respektive sex underkategorier identifierades där främjande respektive hindrande faktorer av föräldrars upplevelser av delaktighet speglas. Att vara närvarande i omvårdnaden samt hud-mot-hudkontakt med barnet fick föräldrarna att känna sig delaktiga. Stöd och vägledning från vårdpersonal hade stor betydelse och upplevdes underlättade för föräldrarna. Det fanns känslomässiga hinder för anknytningen samt svårigheter med miljöns utformning. Slutsats Delaktigheten i omvårdnaden var viktigt för att gynna amningen, stärka föräldrarollen samt öka självförtroendet och kan uppnås med implementering av FFC. / Background Early parenthood already in the neonatal care unit with active participation and skin-to-skin contact demonstrates positive effects in the premature baby and promotes a healthy bonding. To promote participation, a respectful collaboration between nurse and family is needed according to family-centered care (FCC). Aim The aim of this study was to compile previous research to describe parents' experiences of participation in the care of premature infants. Method The literature review included 15 studies with qualitative design and was designed as a structured literature review. The data collection was performed in the databases PubMed and CINAHL. Prior to inclusion, the articles were read by both authors and quality reviewed according to Friberg's review questions for qualitative studies. Data analysis was performed in a structured way based on Friberg's four steps to analyze and set the results. Results Two categories with six subcategories were identified where promoting and barrier factors of parents' experiences of participation are reflected. Being present in the care and skin-to-skin contact with the child made the parents feel involved. Support and guidance from healthcare professionals was of great importance and was perceived as easier for the parents. There were emotional barriers to the connection as well as difficulties with the design of the environment. Conclusions Participation in nursing was important to promote breastfeeding, strengthen the parental role and increase self-confidence and can be achieved with the implementation of FCC.

Preterm birth disrupts the development of the brain and other critical organs of the infant body. Since the brain is one of the last organs to finish developing during pregnancy, the risk for substantial neurological deficits increases as the gestational age decreases. One way to combat these deficits is to reconnect the preterm infant with the mother via skin-to-skin contact, also known as kangaroo care (KC). This intimate touch helps to replicate aspects of the environment that the preterm infant experienced in utero. The purpose of this literature review was to analyze the current literature to better understand the effects that KC may have on facilitating neurodevelopment of preterm infants in Neonatal Intensive Care Units (NICUs). Emphasis was placed on neurophysiologic functioning, autonomic functioning, and neurobehavioral functioning. A database search of CINAHL Plus with Full Text, PsycINFO, MEDLINE, Cochrane Central Register of Controlled Trials, and Health Source: Nursing/Academic Edition was conducted, and a total of six articles were reviewed based on their relevance and application towards this thesis. KC is a low-cost, relatively easy intervention to initiate that can have positive impacts on many aspects of preterm infant growth and maturation. There is limited research regarding the use of KC as an intervention to support neurodevelopment, especially with regards to long-term effects. Existing research supports the use of KC as an intervention to facilitate neurodevelopment in preterm infants in the NICU.

The purpose of this study was to conduct an integrated review of the literature examining the use of non-pharmacologic pain management strategies in premature neonates and to explore the relationship between health outcomes and time to discharge from the neonatal intensive care unit (NICU). Non-pharmacologic pain management strategies include human touch, facilitated tucking, non-nutritive sucking, and kangaroo care. A systematic review of the literature was conducted from multiple online databases. Peer reviewed, English-language articles containing the keywords ‘pain management’, ‘neonatal intensive care unit’, and ‘non-pharmacologic’ were included for synthesis. Exclusion criteria included articles with a focus on infants not admitted to the NICU and infants with a gestational age greater than 37 weeks. Results revealed positive outcomes when alternative pain-relieving methods, rather than drug therapy, were used in the NICU. A majority of articles suggest facilitated tucking is very successful in lowering a preterm infant’s pain. However, facilitated tucking alone was significantly less effective in relieving procedural pain compared to facilitated tucking in combination with oral sucrose administration. Kangaroo care and gentle human touch also proved to reduce physiologic and behavioral signs of pain in neonates. The literature reveled an overall positive outcome when non-pharmacologic pain interventions are used in the NICU, with some behavioral interventions showing better efficacy than others at relieving neonatal pain. None of the reviewed articles explored the relationship between reduced length of stay and parameters assessing health outcomes based on pain control in neonates. The literature indicated nurses play a significant role in the use of pain-relieving methods in neonatal populations. Implications for future research that focuses on successful behavioral based pain management strategies that assists in refining neonatal pain relief would be of great benefit to improving health outcomes related to infant survival after discharge from the NICU.

No description available.

Admission of an infant into the neonatal intensive care unit (NICU) is an experience that has been associated with a variety of both positive and negative health outcomes for parent and child. While both the setting name and the admitted population alludes to a sole focus on the affected infant, what often remains underrecognized is the impact on the ones who care for the newborn long before and longer after their NICU stay. Given the recency and unprecedented impact of the COVID-19 pandemic, very little research has examined the impact of COVID-19-specific stress on the experience of parents of infants requiring a NICU stay in the midst of the ongoing pandemic. As such, the current study aimed to gather electronic survey data from caregivers (both biological and non-biological) of infants across the United States admitted to a NICU on or after March 1, 2020. Major factors addressed in the survey included anticipation of the NICU, COVID-19-specific stress, NICU-specific stress, global health outcomes (physical, mental, and social health), parental bonding, and parental self-efficacy. It was hypothesized that (1) COVID-specific stress and would be associated with suboptimal NICU experiences; (2) COVID-specific stress would be associated with worse parental health (physical, mental, and social) and parent-child relational health (bonding, self-efficacy) outcomes; (3) NICU stress and parental health would serve as mechanisms through which COVID-specific stress impacts parental-relational outcomes; (4) These associations would vary depending on whether or not a caregiver was anticipating that their infant would need to go to the NICU. Hypotheses were partially supported such that COVID stress was associated with increased NICU stress and poorer caregiver physical and social health. Unique patterns were found depending on facets of caregiver health. Clinical implications and future directions are discussed.