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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Maternal and infant predictors of attendance at Neonatal Follow-Up programmes
M Ballantyne1, B Stevens, A Guttmann
1School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
Insights
Maternal factors like single parenting, worry, and distance impact attendance at Neonatal Follow-Up (NFU) programmes. Higher maternal stress increases NFU attendance for high-risk infants.
Area of Science:
- Neonatal care
- Public health
- Developmental pediatrics
Background:
- Neonatal Follow-Up (NFU) programmes support high-risk infants and families.
- Attendance rates for NFU programmes can be as low as 30%.
Purpose of the Study:
- To identify maternal and infant factors predicting attendance at Neonatal Follow-Up programmes.
- To understand barriers and facilitators to NFU programme engagement.
Main Methods:
- Prospective, two-phase, multi-site descriptive cohort study.
- Utilized Andersen's Behavioural Model of Health Services Use.
- Collected data from 357 mothers pre-NICU discharge and tracked attendance over 12 months.
Main Results:
- Single mothers, those with higher worry about substance use, and those living farther from NFU were less likely to attend.
- Increased maternal stress during NICU hospitalization predicted higher NFU attendance.
- No infant-related factors predicted NFU attendance.
Conclusions:
- Mothers at risk of non-attendance need better identification and support.
- Targeted interventions can improve engagement with NFU programmes.
- Enhanced engagement promotes better outcomes for high-risk infants.
Background:
Neonatal Follow-Up (NFU) programmes provide health services for families of infants at high risk of developmental problems following difficult or extremely premature birth: yet, up to 30% of families do not attend these programmes with their infants.
Methods:
The study objective was to determine maternal and infant factors that predicted attendance at NFU programmes. Utilizing Andersen's Behavioural Model of Health Services Use, a prospective two-phase multi-site descriptive cohort study was conducted in three Canadian Neonatal Intensive Care Units (NICU) that refer to two affiliated NFU programmes. In Phase 1, 357 mothers completed standardized questionnaires that addressed maternal and infant factors, prior to their infants' NICU discharge. In Phase 2, attendance at NFU was followed at three time points over a 12-month period. Factors of interest included predisposing factors (e.g. demographic characteristics and social context); enabling factors (e.g. social support, travel distance, and income); and infant illness severity (i.e. needs factors). Multivariate logistic regression was used to estimate the odds ratio for each independent factor.
Results:
Mothers parenting alone, experiencing higher levels of worry about maternal alcohol or drug use, or at greater distances from NFU were less likely to attend. Mothers experiencing higher maternal stress at the time of the infant's NICU hospitalization were more likely to attend NFU. No infant factors were predictive of NFU attendance.
Conclusions:
Mothers at risk of not attending NFU programmes with their infants require better identification, triage, referral and additional support to promote engagement with NFU programmes and improved quality of life for their high-risk infants.
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