Stress Response of Preterm Infants to NICU Caregiving

项目摘要/摘要 早产与长期发育迟缓有关，这种情况可能要到很久以后才会显现出来。 新生儿重症监护病房(NICU)住院。研究人员已经研究了存在的潜在影响 出生的早产儿和神经发育结果发现早产儿有更多的运动， 与其术语对应的术语相比，行为和认知方面的病态。这些风险在以下方面增加 黑人/非裔美国婴儿和男性婴儿。常规护理是众所周知的，尽管是必要的， 压力源。然而，将护理与早产儿的压力反应和睡眠状态联系起来的机制并不完全 明白了。本研究的目的是检验常规护理对压力和睡眠的影响。 早产儿的状态。具体目标是：确定常规护理与护理之间的关系 和早产儿护理后应激反应；并确定两者之间的关系 常规护理对早产儿照料后行为状态的影响次要目标是：检查 护理前后压力与睡眠状态的关系；探讨潜在的调节作用 应激暴露史对常规照护对应激反应和行为状态的影响 后续护理；并探索护理前应激反应和行为的潜在调节作用 常规照护与压力反应及照护后行为状态的关系。 我们将在所有分析中考虑生物性别和种族的差异。我们提出了一个非试验性的， 30例28-32周出生早产儿的描述性观察性研究。我们会 观察一个护士护理事件，记录压力暴露、压力反应和行为状态。 压力暴露将使用新生儿应激源量表和来自电子设备的数据进行测量 健康记录。应激反应将使用唾液皮质醇和皮肤电导反应来测量。 睡眠行为将使用安德森行为状态量表进行测量。研究结果将会增加 常规护理对住院患者应激反应及睡眠行为影响的研究 NICU中的早产儿。这些发现可以改善照看实践，从而改善 神经发育结果。这项研究与国家护理研究所的战略一致 通过解决临床护理模式来计划预防和促进健康。这项研究是一个重要的 制定有针对性的干预措施以优化早产儿的神经发育结果 婴儿。培训计划将提供许多正式和非正式的职业发展机会。 同时为独立研究人员的成功职业生涯奠定坚实的基础。本研究 以申请者作为NICU护士和研究助理的经验为基础，并整合她在 护理提供、婴幼儿发展和研究方法。

PROJECT SUMMARY/ABSTRACT Being born preterm is associated with long-term developmental delays that may not be apparent until well after Neonatal Intensive Care Unit (NICU) hospitalization. Researchers have examined the potential effects of being born preterm and neurodevelopmental outcomes and found that preterm infants have increased motor, behavioral, and cognitive morbidities when compared to their term counterparts. These risks are increased for Black/African American infants and male infants. Routine nursing care is a known, even though necessary, stressor. However, mechanisms linking care to stress responses and sleep states in preterm infants is not fully understood. The purpose of this study is to examine the effects of routine nursing care on stress and sleep states in preterm infants. The specific aims are to: determine the relationship between routine nurse caregiving and the post-caregiving stress response among preterm infants; and determine the relationship between routine nurse caregiving on preterm infants’ post-caregiving behavior state. Secondary aims are to: examine the relationships among stress and sleep states pre- and post-caregiving; explore the potential moderating effect of history of stress exposure on effects of routine caregiving on stress response and behavior states following care; and explore the potential moderating effect of pre-caregiving stress response and behavior state on the relationship between routine caregiving and stress response and behavior state post-caregiving. We will consider differences in biological sex and race in all analyses. We propose a non-experimental, descriptive, observational study of 30 preterm infants born between 28-32 weeks gestational age. We will observe one nurse caregiving event, recording stress exposures, stress responses, and behavior states. Stress exposures will be measured using the Neonatal Infant Stressor Scale and data from the electronic health record. Stress responses will be measured using salivary cortisol and skin conductance response. Sleep behaviors will be measured using the Anderson Behavioral State Scale. The study findings will increase our understanding of the effects of routine nurse caregiving on the stress response and sleep behaviors in preterm infants in the NICU. These findings can lead to improved caregiving practices, thus, improving neurodevelopmental outcomes. This study aligns with the National Institute of Nursing Research’s strategic plan for prevention and health promotion by addressing a clinical model of care. The research is an important step in the development of targeted interventions to optimize neurodevelopmental outcomes for preterm infants. The training plan will provide numerous formal and informal opportunities for professional development while allowing building a solid foundation for a successful career as an independent researcher. This study builds on the applicant’s experiences as a NICU nurse and research assistant and integrates her knowledge of nursing care delivery, infant and child development, and research methods.