Improving Outcomes of LBW Premature Infants and Parents

描述：尽管早产儿低出生体重（LBW）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， 行为后遗症研究表明，低体重早产儿的父母 经历多种持续的压力源，导致短期和长期的 消极的应对结果，如焦虑和抑郁，以及 不正常的养育模式在拟议的研究中，我们将建立在我们的 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）发展一种理论驱动、可重复的 可以很容易地转化为临床实践和广泛的干预 （B）评估我们对父亲的干预/重要 （c）预期成本效益分析;以及 (d)在新生儿重症监护室早期开始的干预， 发展对婴儿的负面看法， 无效的亲子互动。这个多站点的主要目标 这项研究是为了评估理论驱动的，可重复的 干预（科普=创造赋予父母权力的机会） 母亲和父亲/重要他人应对的过程和结果 低出生体重早产儿与婴儿发育结局次要目标是 （a）探讨母亲和父亲的应对过程和结果如何 共同影响LBW早产儿的结局;（B）确定 COPE计划的成本效益;以及（c）探讨哪些因素会影响COPE计划的成本效益;以及（c）探讨哪些因素会影响COPE计划的成本效益 干预计划的影响（例如气质，家庭结构， SES）。一个两组实验将使用240名母亲和240名 NTCU中低体重早产儿的父亲/重要他人。措施 过程和结果变量，包括父母的信仰，焦虑， 抑郁症、亲子互动和婴儿发育结果将 在住院期间和婴儿2岁前进行评估 年龄最近一项针对42对母婴的试点研究结果支持 在那些接受了 科普项目，与那些接受比较项目的人相比， 应对结果和他们的婴儿得分显着（14分）高， 贝利婴儿发展量表的智力发展指数， 6-月校正年龄。

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.