[Integrated psychological parental assistance in the neonatal intensive care unit: concepts and first experiences]. / Integrative psychologische Elternbetreuung auf der neonatologischen Intensivstation: Konzept und erste Erfahrungen.

BACKGROUND AND HYPOTHESIS: Psychosocial support programs have been established in view of the burden caused to parents having their newborn admitted to the neonatal intensive care unit (NICU). Due to limited resources, preventive programs can only be offered to parents who are identified by the staff to be at risk. Based on the results of a parent questionnaire, the University Children's Hospital Vienna has developed a standardized concept of integrated psychological support. The program and first results are presented. PATIENTS AND METHODS: The psychological support is offered to parents of newborns admitted to the neonatal intensive care unit. The aim of the support is to avoid later psychosocial problems for child and parents. In an interdisciplinary collaboration, the psychologist facilitates parent-child bonding, family development and coping with the baby's illness. The standardized psychological support consists of a consultation at the beginning and end of the hospital stay. Parents are offered optional psychological support or intensive assistance. RESULTS: Parents from 152 patients received the standardized basic psychological support. The majority of the parents took advantage of the additional optional assistance. Because of external transfers (42.1 %) or infant death (18.4 %), only 39.5 % of the parents could be accompanied until discharge. CONCLUSIONS: A standardized psychological model provides parents with the psychological support as one important part of the overall concept of neonatal treatment. Additionally, the medical and nursing staff were sensitized to psychological factors. An effective psychosocial prevention requires psychological support as an essential part of intensive neonatal care.

Outcome of very-low-birth-weight infants at 1 and 2 years of age. The importance of early identification of neurodevelopmental deficits.

The developmental and neurologic outcome of very-low-birth-weight infants (n=76) at 1 and 2 years, corrected for postconceptional age, and variables predicting outcome were assessed. At 1 year 24% of tile children were neurologically normal and at 2 years 61%. Developmental status was evaluated by use of the Griffiths Developmental Scales. The rate of cognitively normal children remained constant (58% at 1 year and 59% at 2 years) indicating that developmental status at 1 year was predictive for the second year. This early period is important, therefore, for the identification of developmental deficits and for establishing early, adequate interventions.