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- Edéll-Gustfsson, Ulla, et al.
(författare)
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Hindering and buffering factors for parental sleep in neonatal care. : A phenomenographic study
- 2015
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Ingår i: Disability, Chronic Disease and Human Development. - : Nova Science Publishers, Inc.. - 9781634830294
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- BackgroundParents experience many stressful situations when their newborn infant is preterm and/or sick. This affects bonding. By developing more family-centered care units with single-family rooms, parents are given the opportunity to stay and care for their newborn infant(s) twenty-four hours a day. Lack of sleep may affect the new parents’ ability to handle the situation.AimTo explore and describe how parents of preterm and/or sick infants in neonatal care perceive their sleep.Methods This is a phenomenographic study with an inductive, exploratory design. Semi-structured interviews were conducted with twelve parents of infants in neonatal care. Data was analysed to describe variations of the phenomenon.FindingsFour descriptive categories were identified within the phenomenon sleep in parents of preterm and/or sick infants in neonatal care; Impact of stress on sleep, How the environment affects sleep, Keeping the family together improves sleep, and How parents manage and prevent tiredness.ConclusionAnxiety, uncertainty and powerlessness have a negative influence on sleep. This can be decreased by continuous information, guidance, and practical support. Skin-to-skin-care is an important source for recovery, relaxation and sleep, and should be encouraged by the nurse. The parents also mentioned the importance of being together. To have a private place where they could relax and take care of themselves and their newborn infant improved sleep. It was also desirable to involve older siblings in order to decrease feelings of loneliness, sadness and isolation. Improved parental sleep in the neonatal care may help the families to cope with the situation, and facilitate problem-solving, emotional regulation, and the transition to parenthood.
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| 2. |
- Kleberg, Agneta, et al.
(författare)
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Lower stress responses after newborn individualized developmental care and assessment program care during eye screening examinations for retinopathy of prematurity : A randomized study
- 2008
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Ingår i: Pediatrics. - : American Academy of Pediatrics (AAP). - 0031-4005 .- 1098-4275. ; 121:5, s. E1267-E1278
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE. Screening examination for retinopathy of prematurity is distressing and painful. The aim of the present study was to investigate whether a Newborn Individualized Developmental Care and Assessment Program intervention during a retinopathy of prematurity examination results in less adverse behavioral, pain, and stress responses as compared with standard care. METHODS. The first 2 eye examinations in 36 preterm infants were evaluated. The infants were randomly assigned at the first eye examination to receive either Newborn Individualized Developmental Care and Assessment Program care or standard care. At the second examination, crossover of subject assignment was performed. The assessments included behavioral responses, recordings of heart rate, respiration, and oxygenation, pain scores (premature infant pain profile), and salivary cortisol at defined time points up to 4 hours after the eye examination. The nursing support given during the eye examinations (intervention score) were scored using predefined criteria. RESULTS. Altogether, 68 examinations were evaluated. Newborn Individualized Developmental Care and Assessment Program care was associated with better behavioral scores during the examination but there was no difference in heart rate, respiratory rate, oxygenation, or premature infant pain profile score between the 2 care strategies before or after the eye examination. Salivary cortisol increased from baseline to 30 minutes after the eye examination independent of care strategy and decreased significantly between 30 and 60 minutes when infants were subjected to Newborn Individualized Developmental Care and Assessment Program care but not after standard care. During the study period the intervention score for standard care increased and approached the score for Newborn Individualized Developmental Care and Assessment Program care at the later eye examinations. CONCLUSION. A Newborn Individualized Developmental Care and Assessment Program-based intervention during eye examination does not decrease pain responses but results in faster recovery, as measured by lower salivary cortisol 60 minutes after the examination. The differences were seen despite the influence from the Newborn Individualized Developmental Care and Assessment Program intervention on the standard care treatment that occurred during the study period.
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| 3. |
- Mörelius, Eva-lotta, 1965-, et al.
(författare)
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A randomised trial of continuous skin-to-skin contact after preterm birth and the effects on salivary cortisol, parental stress, depression, and breastfeeding
- 2015
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Ingår i: Early Human Development. - : Elsevier BV. - 0378-3782 .- 1872-6232. ; 91:1, s. 63-70
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Tidskriftsartikel (refereegranskat)abstract
- AIM:To evaluate the effects of almost continuous skin-to-skin contact (SSC) on salivary cortisol, parental stress, parental depression, and breastfeeding.STUDY DESIGN:This is a randomised study engaging families of late preterm infants (32-35weeks gestation). Salivary cortisol reactivity was measured in infants during a nappy change at one month corrected age, and in infants and mothers during still-face at four month corrected age. Both parents completed the Swedish Parenthood Stress Questionnaire (SPSQ) at one month and the Edinburgh Postnatal Depression Scale (EPDS) at one and four months. Ainsworth's sensitivity scale was used to control for parental sensitivity.SUBJECTS:Thirty-seven families from two different neonatal care units in Sweden, randomised to either almost continuous SSC or standard care (SC).RESULTS:Infants randomised to SSC had a lower salivary cortisol reactivity at one month (p=0.01). There was a correlation between the mothers' and the preterm infants' salivary cortisol levels at four months in the SSC group (ρ=0.65, p=0.005), but not in the SC group (ρ=0.14, p=0.63). Fathers in SSC scored lower on the SPSQ sub-scale spouse relationship problems compared to fathers in SC (p<0.05).CONCLUSIONS:Almost continuous SSC decreases infants' cortisol reactivity in response to handling, improves the concordance between mothers' and infants' salivary cortisol levels, and decreases fathers' experiences of spouse relationship problems.
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| 4. |
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| 5. |
- Mörelius, Eva-Lotta, et al.
(författare)
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Salivary cortisol and administration of concentrated oral glucose in newborn infants: improved detection limit and smaller sample volumes without glucose interference
- 2004
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Ingår i: Scandinavian Journal of Clinical and Laboratory Investigation. - : Informa UK Limited. - 0036-5513 .- 1502-7686. ; 64:2, s. 113-118
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Tidskriftsartikel (refereegranskat)abstract
- Newborn infants are subject to repetitive painful and stressful events during neonatal intensive care. When the baby attempts to cope with a stressful situation the hypothalamus-pituitary-adrenal axis is activated, releasing cortisol. The free cortisol response is optimally measured in saliva and saliva samples can be taken easily and without pain. However, saliva is very scarce in infants and saliva stimulants can interfere with analytical methods. Nowadays, sweet solutions are frequently administered to neonates prior to a disturbing procedure in order to reduce pain. The possible interference of sweet solutions with the measurement of salivary cortisol has not yet been documented. The aims of the present study were to further improve the detection limit of the radioimmunoassay used for cortisol analysis and to determine the degree of interference of high concentrations of glucose with the analytical method. By decreasing incubation temperature and prolonging the incubation time it was possible to improve the detection limit of the radio immunoassay (RIA) to 0.5 nmol/L at the same time as the sample volume was decreased to 10 μL saliva. Saliva was collected from full-term and preterm babies and was sufficient for analysis in 113 out of 116 (97%) samples. Glucose in the concentrations and amounts commonly used for pain relief did not interfere with the RIA method. In conclusion, it is feasible to collect microlitre volumes of saliva and analyse even very low concentrations of cortisol in newborns. It is also possible to offer the baby oral glucose prior to a painful procedure and still reliably measure salivary cortisol.
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| 6. |
- Teder, Marie, 1947-
(författare)
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Evaluation of a family-based behavioural intervention programme for children with obesity
- 2013
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background and aims: Impaired eating habits and reduced physical activity have become associated with obesity in children in the last three decades. Parents have a responsibility to be good models for their children regarding lifestyle patterns and habits. The aim of this thesis was to evaluate a family-based behavioural intervention programme (FBIP) for children with obesity designed for use in paediatric outpatient care. The specific aims were to investigate the clinical outcomes and programme adherence and to examine the children’s lifestyle habits according to their own and their parents’ reports, the agreement between these reports, and the correlations to change in z-BMI (standardized body mass index) from baseline to 12 months after the FBIP.Subjects and methods: This thesis is based on a prospective single-group before/after design. Twenty-six children, 14 boys and 12 girls aged 8.3–12.0 years, and their parents attended 25 group sessions, in 3 child and 3 parental groups, during a 2-year FBIP. The treatment manual, Group treatment for children with Overweight and Obesity and their Parents and the semistructured interview called MORSE, a Swedish term for Food and Activity, Social and Emotional adaptation, emphasizes cognitive and behavioural guidelines and the focus is to change eating and physical activity habits and to maintain the new changes.Results: The results showed that the children decreased their z-BMI from a mean of 3.3 (0.7 SD) at baseline to 2.9 (0.7 SD) 1 year after the completion of the programme. There was a significant decrease in z-BMI in boys from a mean of 3.5 (0.6 SD) at baseline to 3.0 (0.7 SD) (p = 0.001) at follow-up 12 months after completion of the programme; the z-BMI in the girls decreased from a mean of 3.0 (0.6 SD) at baseline to 2.7 (0.8 SD) (p = 0.155) at follow-up. The children’s waist/height ratio (the waist circumference in centimetres) divided by the height (in centimetres) showed no significant decrease over the same period. The biomedical markers of blood glucose metabolism and lipid status remained within the normal range at the 1-year follow-up after program completion compared with baseline. The rate of family adherence to the programme was high. The reports from the children and the parents regarding the children’s lifestyle habits showed a significant increase regarding the level of physical activity after the FBIP (24 months) compared with baseline. Agreement between the children and their parents improved after the FBIP (24 months) compared with baseline, regarding whether the children felt hungry most of the time and the children’s levels of physical and sedentary activity. Changes in the child or parental analyses of lifestyle were not significantly associated with reduced weight 1 year after the end of the FBIP.Conclusions: A 2-year FBIP against childhood obesity implemented in a paediatric outpatient setting can be seen as a potential model for children and their parents. It is important to offer interventions to children with obesity although this FBIP needs to be confirmed with larger populations in a randomized controlled trial.
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