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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Environmental analysis of neonatal intensive care
The Journal of Nervous and Mental Disease
|March 1, 1982
Summary
Intensive care unit (ICU) environments negatively impact premature infants, reducing vocalizations and parent interaction. Staff providing care also show increased psychological distress, highlighting the need for environmental improvements.
Area of Science:
- Neonatal care
- Developmental psychology
- Clinical psychology
Background:
- Intensive care units (ICUs) present unique environmental challenges for premature infants.
- Understanding the multifaceted experiences of these vulnerable infants is crucial for optimizing care.
Purpose of the Study:
- To investigate the early experiences of premature infants in ICUs, focusing on care patterns, interactions, and environmental influences.
- To examine the psychodynamics of the ICU environment from the perspective of primary care providers.
Main Methods:
- Observational study of premature infants, parents, and staff in two ICUs over 3 weeks.
- Analysis of infant case histories, including medical and environmental data.
- In-depth interviews and psychiatric assessments of primary care providers.
Main Results:
- Infant vocalization decreased significantly with increased days on mechanical ventilation and in the ICU environment.
- Parental time with infants inversely correlated with distance to the hospital; contact ceased for distances over 50 miles.
- Staff-infant contact averaged 6.1 hours daily, with personal attention correlating with care tasks and staff preference for certain infants.
- Primary care providers exhibited higher psychiatric symptomatology than the general population, linked to infant attachment and work experiences.
Conclusions:
- The ICU environment can reinforce initial medical suppressions of infant vocalization.
- Parental presence is significantly limited by geographical distance, impacting infant care and potentially leading to state wardship.
- Staff-infant interactions are influenced by care tasks and staff preference, suggesting differential nurturing.
- The psychological well-being of care providers is significantly affected by the ICU environment and their work with high-risk infants.
- There is a need to expand environmental models to better understand and improve the early experiences of high-risk premature infants.
