ABSTRACT
The use of 53 different technologies was studied in 82 patients in a neonatal intensive care unit. Using a coefficient of similarity based on the utilization pattern of these technologies, it was possible to identify five clusters of patients that can be correlated with the primary diagnostic groups and such other variables as birth weight (BW), gestational age, length of stay (LOS), and weight gain. Four interdependent models were identified by multiple regression analysis. The number of different therapeutic technologies applied to these patients can be explained (r = 0.67) by their Apgar scores, gestational age, and an index of severity of illness based on the diagnostic group. The number of different diagnostic technologies used is directly related to the number of therapies delivered (r = 0.63) and, jointly with BW, determines LOS (r = 0.73). Finally, weight gain is explained by LOS and BW (r = 0.65).
Subject(s)
Intensive Care Units, Neonatal/methods , Technology Assessment, Biomedical/methods , Cluster Analysis , Data Collection , Developing Countries , Intensive Care Units, Neonatal/statistics & numerical data , Models, Statistical , Regression AnalysisABSTRACT
As technology and medical care have improved, increasing numbers of critically ill neonatal patients are surviving the immediate neonatal period. The hectic environment of the neonatal intensive care unit often makes it difficult for personnel to attend adequately to the needs of the dying infant and his family. Accordingly, the option of home death for such infants has been offered in our neonatal intensive care unit. Experience is described for six infants who were managed in this manner.
Subject(s)
Abnormalities, Multiple/nursing , Death , Home Nursing , Terminal Care/methods , Euthanasia, Passive/psychology , Hospital-Patient Relations , Humans , Infant , Infant, Newborn , Intensive Care Units, Neonatal/methods , MaleABSTRACT
This prospective longitudinal study was designed to evaluate the effects of a multidisciplinary infant development program (IDP) on the mental and physical development of low birth weight infants (less than 1,800 g). Infants in the neonatal intensive care were randomly assigned to the IDP or to traditional care (control group). IDP infants received developmental interventions in the hospital and at home through the first 2 years of life. Counseling and parenting education were provided to their parents during this same period. The control group received all the postnatal care and referrals customarily given in traditional care. Both IDP and control infants were enrolled in an independent follow-up program, which used the Bayley Scales of Infant Development in a blind evaluation design. The IDP group had a significantly lower incidence of developmental delay (P less than .05) and scored significantly higher than the control group (P less than .05) on mean mental and physical indices at 12 and 24 months of adjusted age.
Subject(s)
Developmental Disabilities/prevention & control , Infant, Low Birth Weight/growth & development , Infant, Premature/growth & development , Intensive Care Units, Neonatal/methods , Counseling , House Calls , Humans , Infant, Newborn , Longitudinal Studies , Patient Care Team , Prospective Studies , Statistics as TopicABSTRACT
The prolonged and total separation of a premature infant from its parents in a Neonatal Intensive Care Unit is an additional element of anxiety in a family already upset by the premature birth itself. However, while encouraging parents to participate in the care of their child lessens some problems, it also tends to create others. The environment of intensive care and continuous contact with the nursing of the infant may give rise to distress, and parental reactions may interfere with the running of the department. We report some results from 60 semistructured interviews between a clinical psychologist and 30 couples whose preterm infants had spent at least 10 days in the Neonatal Intensive Care Unit (NICU) of the 2nd School of Medicine of Naples. For more than 4 years we have encouraged parents to take care of their infants, to touch them, change them and feed them. The results of our study appear to suggest that allowing parents unrestricted access to the Unit stimulates paternal interest in the child.
