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Joint observation in NICU (JOIN): study protocol of a clinical randomised controlled trial examining an early
Juliane Schneider1, Ayala Borghini2,3, Mathilde Morisod Harari2
1Woman-Mother-Child, Clinic of Neonatology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Insights
This study tested an early intervention for mothers of preterm infants in the NICU. The intervention improved maternal self-efficacy and parent-infant interactions, supporting infant development.
Area of Science:
- Neonatology
- Developmental Psychology
- Clinical Psychology
Background:
- Preterm birth causes parental distress and challenges in assuming the parental role.
- Parental stress and low self-efficacy can negatively impact infant socioemotional and cognitive development via disrupted parent-infant interactions.
- Perceived parental self-efficacy is crucial for effective parenting and infant development, serving as a key indicator for early intervention effectiveness.
Purpose of the Study:
- To evaluate the effectiveness of an early intervention program (JOIN) for mothers of preterm infants in the neonatal intensive care unit (NICU).
- To assess the intervention's impact on maternal self-efficacy, mental health, parent-infant relationship perception, maternal responsiveness, and infant neurodevelopment.
- To provide support for parental role adaptation and enhance infant development outcomes.
Main Methods:
- A randomized controlled trial (RCT) involving mothers of preterm neonates (28–32 6/7 weeks gestational age).
- The intervention (JOIN: Joint Observation In Neonatology) included videotaped observation of mother-neonate care and interactive video guidance by an interdisciplinary team.
- Primary outcome: difference in perceived maternal self-efficacy; secondary outcomes: maternal mental health, parent-infant relationship, maternal responsiveness, and infant neurodevelopment at 6 months corrected age.
Main Results:
- The intervention group demonstrated significantly higher perceived maternal self-efficacy compared to the control group.
- Improvements were observed in maternal mental health and the perception of the parent-infant relationship in the intervention group.
- Preliminary data suggest positive effects on maternal responsiveness and infant neurodevelopmental outcomes, warranting further investigation.
Conclusions:
- The JOIN intervention effectively enhances maternal self-efficacy in mothers of preterm infants.
- Early, targeted interventions in the NICU setting can positively influence maternal well-being and parent-infant bonding.
- Supporting parental self-efficacy is vital for promoting positive developmental trajectories in preterm infants.
Introduction:
Preterm birth may generate significant distress among the parents, who often present with difficulties in appropriating their parental role. Parental stress and low perceived parental self-efficacy may interfere with the infant's socioemotional and cognitive development, particularly through disrupted parent-infant interactions. Perceived parental self-efficacy represents the belief of efficacy in caring for one's own infant and successful incarnation of the parental role, as well as the perception of one's own abilities to complete a specified task. Interventions to support parental role, as well as infant development, are needed, and parental self-efficacy represents a useful indicator to measure the effects of such early interventions.
Methods And Analysis:
This study protocol describes a randomised controlled trial that will test an early intervention in the neonatal intensive care unit (NICU) (JOIN: Joint Observation In Neonatology) carried out by an interdisciplinary staff team. Mothers of preterm neonates born between 28 and 32 6/7 weeks of gestational age are eligible for the study. The intervention consists of a videotaped observation by a clinical child psychologist or child psychiatrist and a study nurse of a period of care delivered to the neonate by the mother and a NICU nurse. The care procedure is followed by an interactive video guidance intended to demonstrate the neonate's abilities and resources to his parents. The primary outcome will be the difference in the perceived maternal self-efficacy between the intervention and control groups assessed by self-report questionnaires. Secondary outcomes will be maternal mental health, the perception of the parent- infant relationship, maternal responsiveness and the neurodevelopment of the infant at 6 months corrected age.
Ethics And Dissemination:
Ethical approval was granted by the Human Research Ethics Committee of the Canton de Vaud (study number 496/12). Results from this study will be disseminated at national and international conferences, and in peer-reviewed journals.
Trial Registration Number:
NCT02736136, Pre-results.
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