Stress Response of Preterm Infants to NICU Caregiving

项目总结/摘要 早产与长期的发育迟缓有关，这些发育迟缓可能要到出生后很长时间才明显。 新生儿重症监护室（NICU）住院。研究人员已经研究了被 早产儿和神经发育结果，并发现早产儿的运动， 行为和认知方面的疾病。这些风险增加， 黑人/非洲裔美国婴儿和男婴。常规护理是众所周知的，即使是必要的， 压力源然而，将护理与早产儿的应激反应和睡眠状态联系起来的机制并不完全 明白本研究旨在探讨常规护理对压力与睡眠之影响 早产儿的状态。其具体目的是：确定常规护理干预与 和早产儿的产后应激反应;并确定 常规护理干预对早产儿产后行为状态的影响。次要目的是：检查 应激与睡眠状态之间的关系，探索潜在的调节作用 应激暴露史对日常生活应激反应和行为状态影响 并探讨预处理应激反应和行为的潜在调节作用 阐述了日常工作与应激反应及工作后行为状态的关系。 我们将在所有分析中考虑生物性别和种族的差异。我们提出了一个非实验性的， 对30例胎龄在28-32周之间出生的早产儿进行的描述性、观察性研究。我们将 观察一个护士的工作事件，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压力源量表和来自电子数据库的数据进行测量。 健康记录。将使用唾液皮质醇和皮肤电导反应测量应激反应。 将使用安德森行为状态量表测量睡眠行为。研究结果将增加 了解常规护理干预对老年人应激反应和睡眠行为的影响， 新生儿重症监护室的早产儿这些发现可以导致改进的实践，从而提高 神经发育结果。这项研究符合国家护理研究所的战略， 通过临床护理模式制定预防和健康促进计划。这项研究是一项重要的 在开发有针对性的干预措施以优化早产儿神经发育结局方面迈出了一步 婴儿。培训计划将提供许多正式和非正式的专业发展机会 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 基于申请人作为NICU护士和研究助理的经验，并整合了她的知识， 护理交付、婴幼儿发育和研究方法。

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.