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Care of preterm infants: programs of research and their relationship to developmental science
Diane Holditch-Davis1, Beth Perry Black
1School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Insights
This review highlights nursing research on preterm infant care, finding strengths in clinical relevance but a need for more developmental science integration. Future studies should incorporate developmental perspectives for comprehensive preterm infant care research.
Area of Science:
- Nursing Research
- Developmental Science
- Neonatal Care
Background:
- Current nursing research programs focus on preterm infant care.
- A program of research was defined by at least five publications since 1990, with the researcher as first author on at least three.
- Studies included infants from birth through childhood, excluding research on parenting or other infant populations.
Purpose of the Study:
- To examine topics in current nursing research on preterm infant care.
- To determine the extent to which this research is informed by developmental science.
- To identify areas for expansion in preterm infant care research.
Main Methods:
- A review of current nursing research programs on preterm infant care.
- Identification of 17 nurse researchers with active programs.
- Categorization of research themes: NICU environment responses, pain management, infant stimulation, and infant behavior/development.
Main Results:
- Research programs covered infant responses to the NICU, pain management, stimulation, and behavior/development.
- Strengths included interdisciplinary focus and clinical relevance.
- Limited use of developmental science (3 researchers) and appropriate statistics for longitudinal data analysis.
- Ecological context factors like gender, ethnicity, and culture were rarely examined.
Conclusions:
- Nursing research on preterm infant care has strengths but needs greater emphasis on critically ill infants.
- Incorporating a developmental science perspective is crucial for future research.
- Expanded research should examine individual infant responses and broader ecological contexts.
Abstract:
The purpose of this review was to examine the topics covered in current programs of nursing research on the care of the preterm infant and to determine the extent to which this research is informed by developmental science. A researcher was considered to have a current program of research if he or she had at least five publications published since 1990 and was the first author on at least three of them. The infants in a study could be any age from birth throughout childhood; studies focusing on parenting, nursing, or other populations of infants were not included. Seventeen nurse researchers had current programs of research in this area. These programs had four themes. Those of Becker, Evans, Pridham, Shiao, and Zahr focused on infant responses to the neonatal intensive care unit (NICU) environment and treatments. Franck, Johnston, and Stevens focused on pain management. Harrison, Ludington-Hoe, and White-Traut's research focused on infant stimulation. Holditch-Davis, McCain, McGrath, Medoff-Cooper, Schraeder, and Youngblut studied infant behavior and development. These research programs had many strengths, including strong interdisciplinary focus and clinical relevance. However, additional emphasis is needed on the care of the critically ill infant. Also, despite the fact that the preterm infant's neurological system develops rapidly over the first year, only three of these researchers used a developmental science perspective. Only research on infant behavior and development focused on the developmental changes that the infants were experiencing. Most of the studies were longitudinal, but many did not use statistics appropriate for identifying stability and change over time. The response of individual infants and the broader ecological context as evidenced by factors such as gender, ethnic group, culture, and intergenerational effects were rarely examined. Thus research on the care of preterm infants could be expanded if the developmental science perspective formed the basis of more studies.