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Family-centered Care Improved Neonatal Medical and Neurobehavioral Outcomes in Preterm Infants: Randomized Controlled
Yen-Ting Yu1, Wu-Shiun Hsieh2, Chyong-Hsin Hsu3
1Y.-T. Yu, PhD, School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.
Insights
Family-centered care improved outcomes for very low birth weight preterm infants in Taiwan, leading to earlier feeding and discharge. Parental involvement significantly enhanced infant neurobehavioral performance and weight gain.
Area of Science:
- Neonatal Medicine
- Developmental Psychology
- Pediatric Care
Background:
- Family-centered care (FCC) models show benefits in Western countries for preterm infants.
- Limited validation of FCC interventions exists in Eastern societies.
- Taiwanese healthcare settings require culturally relevant approaches to infant care.
Purpose of the Study:
- To evaluate the efficacy of a family-centered intervention program (FCIP) compared to usual care (UCP) in Taiwan.
- To assess short-term medical and neurobehavioral outcomes for very low birth weight (VLBW) preterm infants.
- To determine if FCIP improves feeding, growth, and neurodevelopmental trajectories.
Main Methods:
- A multicenter, single-blind, randomized controlled trial was conducted in three Taiwanese medical centers.
- 251 VLBW preterm infants without severe perinatal complications were randomized to FCIP or UCP.
- Infant morbidities, feeding, growth, and neurobehavioral performance were assessed; parental adherence was measured in the FCIP group.
Main Results:
- FCIP infants achieved earlier full enteral feeding and hospital discharge.
- FCIP was associated with greater infant weight gain and improved neurobehavioral performance compared to UCP.
- Higher parental motivation and adherence in FCIP correlated with better infant outcomes.
Conclusions:
- Family-centered care positively impacts short-term medical and neurobehavioral outcomes for VLBW preterm infants in Taiwan.
- Parental adherence and engagement are key mediators of FCIP effectiveness.
- FCC strategies may be beneficial for implementation in Taiwanese neonatal care settings.
Background:
Family-centered care for preterm infants in Western societies has yielded short- to medium-term benefits. However, the intervention effects have rarely been validated in Eastern societies.
Objective:
The aim of this study was to examine whether a family-centered intervention program (FCIP) could improve the short-term medical and neurobehavioral outcomes in preterm infants with very low birth weight (VLBW; a birth weight of <1,500 g) in Taiwan over the outcomes seen with a usual care program (UCP).
Design:
This was a multicenter, single-blind, randomized controlled trial study.
Setting:
Three medical centers in northern and southern Taiwan were the locations for the study.
Participants:
The participants were 251 VLBW preterm infants without severe perinatal complications.
Intervention:
The infants were randomly assigned to receive the FCIP or the UCP during hospitalization.
Measurements:
Infant morbidities, feeding, growth, and neurobehavioral performance were evaluated during the neonatal period. Parental adherence to interventions was measured in the FCIP group.
Results:
The FCIP promoted earlier full enteral feeding (β = -1.1 weeks; 95% CI = -1.9 to -0.2 weeks) and hospital discharge (β = -0.6 week; 95% CI = -1.1 to -0.1 weeks), greater weight gain (β = 3.3 g/d; 95% CI = 0.1 to 6.6 g/d), and better neurobehavioral performance than the UCP (β = 1.2 points; 95% CI = 0.2 to 2.3 points). Furthermore, a higher degree of parental motivation in interventions, goal attainment, and comprehensiveness of home activities was significantly associated with greater effects in infants' neurobehavioral performance and weight gain (r = .20-.31; all Ps < .05).
Limitations:
The findings may not be generalized to preterm infants with severe perinatal diseases and parents with a low level of interest in interventions.
Conclusions:
Family-centered care facilitated short-term medical and neurobehavioral outcomes in VLBW preterm infants in Taiwan; the effects were likely achieved through parental adherence to interventions. The designated strategies may be considered in a future launch of family-centered care in Taiwan.
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