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Journal Article 2004; 25(Suppl 1): 103-109 PubMed PMID: 15735592 Citation  Keywords:  Caregivers:psychology, Counseling, Humans, Infant, Newborn, Infant, Premature, Intensive Care Units, Neonatal, Parents:psychology, Physician's Role, Psychological Techniques,.   

: Counselling psychology appears to be neglecting the importance and merits of working with the client population associated with the preterm neonate within the Neonatal Intensive Care Unit (NICU). Throughout, the benefits of such a move are highlighted with particular emphasis on how counselling psychologists are uniquely qualified for this role. Specialist knowledge required to provide clients with the greatest therapeutic gains illustrates the pertinent issues, with proposals for clinical practice put forward. NHS Trusts nationwide are encouraged to recruit this ready-made professional into the Department for the psychological health of parents and caregivers engaged in caring for the preterm neonate....

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Journal Article 2004; 25(Suppl 1): 95-102 PubMed PMID: 15735591 Citation  Keywords:  Analysis of Variance, Breast Feeding, Female, Hospitalization, Humans, Infant, Newborn, Infant, Premature, Mothers:psychology, Parenting:psychology, Self Efficacy,.   

: Breastfeeding is a complex task for many mothers but may be particularly difficult when coping with the birth of a preterm. In the following article the task of breastfeeding a preterm neonate is identified as one facet of the parenting process and the many problems encountered when breastfeeding are highlighted. Research is presented which investigates whether breastfeeding a preterm neonate mediates mothers' Perceived Parenting Self-Efficacy (PMP S-E) whilst in hospital. The findings from this study suggest that not only do mothers who are breastfeeding their preterm neonate have a lower self-efficacy than non-breastfeeding mothers, but they also require further support in all aspects of parenting. The authors discuss these results in terms of self-efficacy theory and suggest that they may have implications for Neonatal Health Psychologists practice particularly with regard to the facilitation of breastfeeding within the neonatal unit....

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Journal Article 2004; 25(Suppl 1): 87-93 PubMed PMID: 15735590 Citation  Keywords:  Family Nursing, Humans, Infant Care, Infant, Newborn, Infant, Premature, Models, Nursing, Self Care,.   

: The increased technology of neonatal intensive care has meant that babies born at increasingly lower gestational age are surviving to be discharged home. A family centred approach in neonatal care supports the move toward patient or parent empowerment, which is vital, if babies are to be fully integrated into the family unit. Nurses are essential to the success of this process as they have the most direct and prolonged contact with both family and their baby. Critical care areas such as Neonatal Units (NNU) can be adjusted to support a more family focused philosophy. In Wolverhampton Orems 'Self-Care Model' of self care has been adapted to the family as the self care unit and simple adjustments to the area such as Quiet Times supports families feeling of well being and control....

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Journal Article 2004; 25(Suppl 1): 79-85 PubMed PMID: 15735589 Citation  Keywords:  Child Development, Female, Humans, Infant, Newborn, Infant, Premature, Learning, Maternal Behavior, Mother-Child Relations, Mothers:psychology, Social Identification, Social Support, Stress, Psychological:psychology,.   

: This article draws together thoughts derived from an experienced clinical psychologist's practice, with parents of ill and premature infants in the context of a psychological service for children and parents in a paediatric and maternity teaching hospital. Parents were those referred by attendant neonatologists in intensive neonatal care who observed acute distress. Referral was usually some weeks after birth and help continued until after discharge, in some instances after the death of the infant. The particular approach adopted was that of offering parents a therapeutic contact which, allowed them talk over these thoughts and feelings for which they had little other skilled listening environment. Parents chose the opportunity of a safe, calm and confidential contact to explore deep feelings and draw on their own strengths and an understanding of their own vulnerabilities. The novel insights derived and the clinical material presented were used to develop an understanding of the issues a support service should address. Key aims are described and should be incorporated to restore and enhance personal strengths and the mother child relationship hence contributing to positive outcome in infant development. Reference is made to the importance of understanding how women achieve soothed states and restoration of empowerment when birth presents extra challenge....

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Journal Article 2004; 25(Suppl 1): 67-77 PubMed PMID: 15735588 Citation  Keywords:  Blood Gas Monitoring, Transcutaneous, Child Development, Conditioning (Psychology), Extremities:physiology, Female, Gastrointestinal Contents:chemistry, Handling (Psychology), Heart:physiology, Humans, Hydrogen-Ion Concentration, Infant Behavior, Infant C.   

: This article provides a synopsis of a series of studies exploring the effects of TAC-TIC (Touching And Caressing-Tender In Caring) therapy with premature infants. Study 1 looked at the short and long-term effects and found enhanced mental development in the stroked infants at 15 months. In study 2 the physiological effects of an abbreviated version of TAC-TIC with high-risk ventilated infants were examined and it was concluded that TAC-TIC exerted no harm to these vulnerable infants. The behavioural reactions of a sample of premature and low birthweight infants to TAC-TIC and parental responses to administering it were explored in study 3. The infants were found to respond predominantly with arm and leg movements to TAC-TIC while fathers and mothers reported enjoying performing TAC-TIC and elicited a similar pattern and frequency of behavioural reactions. In study 4 the question of whether TAC-TIC benefits preterm infant learning and/or sucking behaviour was investigated. The conclusion reached was that TAC-TIC may potentially benefit cognitive performance within the neonatal period and that this may be an early indicator of long-term cognitive gains reported by previous studies. Using a matched subjects design, study 5 explored the impact of TAC-TIC upon the digestive system by analysing gastric aspirates before and after TAC-TIC and a control period of time. It was concluded that TAC-TIC appeared to induce a more suitable stomach environment for digestion....

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Case Reports 2004; 25(Suppl 1): 57-65 PubMed PMID: 15735587 Citation  Keywords:  Awareness, Female, Humans, Infant Behavior, Infant, Low Birth Weight, Infant, Newborn, Infant, Premature, Movement, Neonatal Screening, Neurologic Examination, Orientation, Twins,.   

: This chapter covers the purposes for which a neurological examination of a neonate may be performed. A brief description is given, of assessments currently in use. More extensive information is provided on the elements of the Neurobehavioral Assessment of the Preterm Infant (NAPI), an assessment which has been used extensively by this author and others (see references at www-med.stanford.edu/school/pediatrics/NAPI/index). Medical and environmental factors that impact on the neurobehavioral performance of an infant are outlined. Two detailed case studies give insight to the complexity of the initial hospital stay of extremely low birth weight infants of short gestational age. The results of NAPIs for each of these cases are explained and the relation to long term outcome at 18 months is presented....

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Journal Article 2004; 25(Suppl 1): 49-55 PubMed PMID: 15735586 Citation  Keywords:  Empathy, Humans, Infant, Newborn, Intensive Care Units, Neonatal, Neonatology:methods, Pain:diagnosis, Pain Management, Palliative Care:methods, Terminal Care,.   

: Research has shown that even extremely premature babies are sufficiently developed, anatomically and physiologically, to be capable of experiencing and responding to pain. All newborn infants and especially those who require intensive care in the first days of life are exposed to some painful procedures. Part of the neonatologist's role is the detection and management of pain in these infants. Difficult challenges come with this role. All medications carry known or potential adverse effects and limited research has been done in this vulnerable population. The benefits and risks of all available pain-relieving measures should be balanced when planning management. Compassion is no excuse for a high incidence of undesirable or dangerous side effects. We must proceed with great care....

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Journal Article 2004; 25(Suppl 1): 43-47 PubMed PMID: 15735585 Citation  Keywords:  Female, Humans, Infant, Newborn, Pregnancy, Premature Birth:epidemiology, Risk Factors,.   

: Preterm birth is a major clinical problem, accounting for 47% of all neonatal deaths. The preterm delivery rate in UK is approximately 7%, and rates of preterm birth are steadily increasing. The diagnosis of preterm labour is difficult and most interventions to halt labour are unsuccessful. Despite this, the lack of good data hinders high quality research. The West Midlands has the highest perinatal mortality in the UK and a Perinatal Institute was set up in 2000 to address this, and aid improvements in care. Survival rates amongst preterm infants have changed dramatically over the last decade, with 88% survival for 2728 weeks, and 21% for > or =24 weeks (depending on birth weight). Risk factors include lower social class, less education, single marital status, low income, younger maternal age, low body weight, ethnicity, smoking, poor housing along with medical factors such as induction, premature rupture of membranes, infection, multiple pregnancy intrauterine death, fetal and uterine abnormalities and chorioamnionitis. Data from further detailed, robust studies are required to facilitate a comprehensive understanding of risk factors and their relationship with each other. Only then will it be possible to influence the adverse outcomes described....

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