Multisensory interventions to improve neurodevelopmental outcomes of preterm infants hospitalized in the neonatal intensive care unit

多感官干预可改善新生儿重症监护病房住院早产儿的神经发育结局

• 批准号: 10443363
• 负责人: Amit Mohan Mathur
• 金额: $ 68.29万
• 依托单位: UNIVERSITY OF SOUTHERN CALIFORNIA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-07-01 至 2027-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10443363
• 关键词: 2 year old; Address; Age; Attention; Auditory; Behavioral; Biological Markers; Birth; Brain; Caring; Cerebrum; Complex; Cues; Development; Dose; Electroencephalography; Emotional; Enrollment; Environment; Environmental Exposure; Equilibrium; Evidence based intervention; Exposure to; Family; Future; Goals; Health; Hospitalization; Hospitals; Hour; Human; Infant; Intervention; Knowledge; Language; Life; Masks; Massage; Measures; Medical; Mental Health; Monitor; Music; Neonatal Intensive Care Units; Newborn Infant; Outcome; Pain; Parent-Child Relations; Parents; Pathway interactions; Pattern; Personal Satisfaction; Pregnancy; Premature Infant; Process; Public Health; Publishing; Randomized; Reporting; Research; Risk; Sampling; Sensory; Sensory Thresholds; Skin; Skin Care; Standardization; Stimulus; Structure; Tactile; Testing; Time; Toddler; Touch sensation; Veins; Work; base; early experience; evidence base; experience; high risk infant; improved; improved outcome; infant outcome; intervention program; language outcome; multisensory; neonatal brain; neurodevelopment; premature; primary outcome; procedural pain; programs; sensory mechanism; sensory stimulus; social; standard of care; therapy design; tool; volunteer

Project Summary The long-term goal of this project is to improve the health and well-being of preterm infants and their parents. Very preterm infants necessitate medical care in the neonatal intensive care unit (NICU) at birth and can be hospitalized for their first several months of life, where they are exposed to repetitive, painful stimuli, are separated from their parents, and often do not receive positive, timed sensory exposures that are similar to what they would have received if not born early. In addition, parents often do not know when and how to engage with their infant in the NICU. However, early positive sensory experiences are important, as they enhance brain development during an important period of time and can be used as a tool to help parents participate during NICU hospitalization and establish early parent-child relationships to optimize development. Although there is evidence to support positive multisensory interventions in the NICU, these interventions are often applied in an inconsistent manner, reducing their benefit. Through a rigorous and scientific process, we have developed a structured multisensory intervention program, titled Supporting and Enhancing NICU Sensory Experiences (SENSE), which includes specific doses and targeted timing of evidence-based interventions such as massage, auditory exposure, rocking, holding, and skin-to-skin care. The interventions are based on the infant’s developmental stage and are adapted based on the infant’s medical status and behavioral cues. The multisensory interventions are designed to be conducted during each day of NICU hospitalization by the parents, who are educated and supported to provide them. A sensory support team fills in gaps when parents are unable to reach the targeted amount of sensory exposures each day. The proposed work aims to determine the effect of multisensory interventions on parent mental health, parent-child interaction, brain activity (amplitude integrated electroencephalography), and infant developmental outcomes through age 2 years, with specific attention to language outcome. Two-hundred fifteen parent-infant dyads of preterm infants born ≤ 32 weeks gestation and admitted to a Level IV NICU will be enrolled within 1 week of birth. Infants will be randomized to either the SENSE multisensory program or to the standard of care during the NICU stay. The SENSE program combines structured, easy-to-conduct, multisensory interventions with parent engagement to optimize outcomes in the complex medical environment of the NICU. Standardized assessments of parent mental health, infant neurodevelopment, and parent-child interaction will be conducted prior to NICU discharge and at 6 months, 1 year, and 2 years, adjusted for prematurity. Differences between groups will be investigated. Brain activity during NICU stay, including in the presence and absence of different sensory exposures, will also be investigated. The expected outcome is that the SENSE multisensory program will have a positive effect on improving outcomes. Importantly, the SENSE program has been implemented with ease in >250 hospitals in the US and abroad, so there is great potential for broad and long-term impact.

项目摘要 该项目的长期目标是改善早产儿及其父母的健康和福祉。 婴儿在出生时在新生儿重症监护病房（NICU）中必要的医疗服务非常早就可以 住院的头几个月，他们暴露于重复，痛苦的刺激 与父母分开，通常不会收到与 如果没有早点出生，他们会收到什么。此外，父母通常不知道何时以及如何 在NICU中与婴儿互动。但是，早期积极的感觉经历很重要，因为 在重要的时期内增强大脑发育，可以用作帮助父母的工具 参加NICU住院期间，建立早期的亲子关系以优化发展。 尽管有证据支持NICU中的肯定多感官干预措施，但这些干预措施是 通常以不一致的方式应用，降低其利益。通过严格而科学的过程，我们 已经制定了一个结构化的多感官干预计划，标题为支持和增强NICU 感官体验（感官），包括基于证据的特定剂量和针对性的时间 诸如按摩，听觉暴露，摇摆，握持和皮肤护理等干预措施。干预措施 基于婴儿的发育阶段，并根据婴儿的医疗状况和 行为提示。多感觉干预措施设计为在NICU的每一天进行 父母的住院，受过教育和支持以提供他们的住院。感官支持团队填补 在父母无法每天无法达到目标曝光量时的空白。提议 工作旨在确定多感觉干预对父母心理健康的影响 相互作用，大脑活动（振幅综合脑电图）和婴儿发育结果 到2岁，特别关注语言结果。两百五十五个父母 早产婴儿≤32周的妊娠妊娠并进入IV级NICU，将在1周内1周内 出生。婴儿将被随机分配到感官多感官程序或在期间的护理标准 NICU留下来。感官程序将结构化的，易于指导的多感官干预与 父母参与度以优化NICU复杂的医疗环境中的结果。标准化 将对父母心理健康，婴儿神经发育和亲子互动的评估进行评估 在NICU出院之前，在6个月，1年和2年的时间为早产。之间的差异 小组将被调查。 NICU停留期间的大脑活动，包括在存在和没有不同的情况下 感官暴露也将进行研究。预期的结果是感官多感官程序 将对改善结果产生积极影响。重要的是，Sense计划已实施 在美国和国外> 250家医院的范围内，可以轻松进行广泛和长期影响的巨大潜力。