Improving Outcomes of LBW Premature Infants and Parents

描述：虽然低出生体重儿(LBW)早产儿的死亡率 在过去的几年里，婴儿的发病率急剧下降 由于消极的认知、神经发育和 行为后遗症。研究表明，LBW早产儿的父母 经历多种持续的压力，导致短期和长期的 消极的应对结果，如焦虑和抑郁，以及 不正常的育儿模式。在拟议的研究中，我们将在我们的 先前的工作和先前的研究支持了 对住院儿童母亲的教育行为干预 儿童和LBW早产儿。在这一独特的贡献中， 研究包括：(A)开发一种理论驱动的、可复制的 易于转化为临床实践并广泛应用的干预措施 传播；(B)评价我们对父亲的干预/重大意义 (C)预期成本效益分析；及 (D)在NICU住院早期、在父母之前开始的干预 养成对婴儿的负面看法，并建立 无效的亲子互动。这个多站点的主要目的是 研究的目的是评估一种理论上驱动的、可重现的效果 干预(COPE=为父母赋权创造机会) 父母/重要他人应对压力的过程和结果 LBW早产儿和婴儿发育结局。次要目标是 为：(A)探讨母亲和父亲的应对过程和结果 共同促进低出生体重早产儿的结局；(B)确定 COPE方案的成本效益；和(C)探讨哪些因素不利于 干预计划的效果(例如，气质、家庭结构、 SES)。将对240名母亲和240名母亲进行两组实验 NTCU中LBW早产儿的父亲/重要其他人。衡量标准 过程和结果变量，包括父母的信仰，焦虑， 抑郁、亲子互动和婴儿发育结果将 在住院期间进行评估，最高可达婴儿的2岁矫正 年龄。最近一项有42个母婴双亲支持的先导研究的结果 进行这项全面的临床试验，在接受了 与那些接受比较计划的人相比，COPE计划有更多的积极因素 应对结果和他们的婴儿得分显著高于(14分) 贝利婴幼儿发育量表的智力发育指数 6个月矫正年龄。

DESCRIPTION: Although the mortality rate of low-birth-weight (LBW) premature infants has declined dramatically over the past several years, morbidity remains high as the result of negative cognitive, neurodevelopmental, and behavioral sequelae. Studies indicate that parents of LBW premature infants experience multiple ongoing stressors that result in short- and long-term negative coping outcomes, such as anxiety and depression, as well as dysfunctional parenting patterns. In the proposed study, we will build upon our prior work and previous studies that have supported the positive benefits of educational-behavioral interventions with mothers of hospitalized young children and LBW premature infants. Among the unique contributions of this study include: (a) development of a theoretically-driven, reproducible intervention that can be easily translated into clinical practice and widely disseminated; (b) evaluation of our intervention with fathers/significant others as well as mothers; (c) a prospective cost-effectiveness analysis; and (d) an intervention that begins early in the NICU stay, prior to parents developing negative perceptions of their infants and the establishment of ineffective parent-infant interactions. The primary aim of this multi-site study is to evaluate the effects of a theoretically driven, reproducible intervention (COPE = creating Opportunities for Parent Empowerment) on the process and outcomes of mothers and fathers/significant others' coping with a LBW premature infant and infant developmental outcomes. The secondary aims are to: (a) explore how the coping process and outcomes of mothers and fathers together contribute to the outcomes of LBW premature infants; (b) determine the cost-effectiveness of the COPE program; and (c) explore what factors moderate the effects of the intervention program (e.g. temperament, family structure, SES). A two-group experiment will be used with 240 mothers and 240 fathers/significant others of LBW premature infants in the NTCU. Measures of both process and outcome variables, including parental beliefs, anxiety, depression, parent-infant interaction, and infant developmental outcomes will be assessed during hospitalization and up to the infants' 2-year corrected ages. Findings from a recent pilot study with 42 mother-infant dyads support undertaking this full-scale clinical trial in that mothers who received the COPE program, versus those who received a comparison program, had more positive coping outcomes and their infants scored significantly (14 points) higher on the Mental Development Index of the Bayley Scales of Infant Development at 6-months corrected age.