Individualized Developmental Care Practices of Nurses Working in Neonatal Intensive Care Units: A Qualitative Study

Yıl 2024, Cilt: 11 Sayı: 1, 35 - 45, 28.03.2024

Müjde Çalıkuşu İncekar , Eda Çeçen , Vesile Kantaş Kazmacı , Melek Selalmaz , Nehir Ulu Ogut

https://doi.org/10.31125/hunhemsire.1248470

Öz

Aim: This study aimed to identify and compare neonatal intensive care nurses who received training in individualized developmental care practices with nurses who did not.
Material and Methods: This study was conducted with a qualitative design in the third-level neonatal intensive care units of two tertiary hospitals. Seven nurses from each hospital participated in the study. A semi-structured interview form was used. The interviews were recorded with a voice recorder and then transferred to a computer. Content analysis was used to analyze the interview data.
Results: Seven themes, 14 sub-themes, and 78 codes were created for the nurses who received training, and 7 themes, 13 sub-themes, and 30 codes were created for the nurses who did not receive training. Since the themes of the two groups were common, the results of the two groups were compared and discussed.
Conclusion: It was found that nurses who received training in individualized developmental care approached the newborn and family more holistically, planned, implemented, and evaluated their care more comprehensively than the nurses who did not receive training.

Anahtar Kelimeler

developmental care, neonatal intensive care, newborn, nursing

Destekleyen Kurum

YOKTUR.

Proje Numarası

YOKTUR.

Teşekkür

The researchers thank the nurses who participated in the research.

Yenidoğan Yoğun Bakım Ünitelerinde Çalışan Hemşirelerin Bireyselleştirilmiş Gelişimsel Bakım Uygulamaları: Nitel Bir Çalışma

Öz

Amaç: Bu çalışmanın amacı, bireyselleştirilmiş gelişimsel bakım uygulamalarına yönelik eğitim alan yenidoğan yoğun bakım hemşireleri ile eğitim almayan hemşirelerin bakım uygulamalarını belirlemek ve karşılaştırmaktır.
Gereç ve Yöntem: Bu çalışma, iki üçüncü basamak hastanenin üçüncü düzey Yenidoğan Yoğun Bakım Ünitelerinde nitel tasarımda yapılmıştır. Yarı yapılandırılmış görüşme formu kullanılmıştır. Görüşmeler ses kayıt cihazına ve ardından bilgisayara kaydedilmiştir. Görüşme verilerinin analizinde içerik analizi yöntemi kullanılmıştır.
Bulgular: Eğitim alan hemşireler için yedi tema, 14 alt tema ve 78 kod oluşturulmuştur. Eğitim almayan hemşireler için yedi tema, 13 alt tema ve 30 kod oluşturulmuştur. İki grubun temaları ortak olduğu için iki grubun bulguları karşılaştırıldı ve tartışıldı.
Sonuç: Bireyselleştirilmiş gelişimsel bakım eğitimi alan hemşirelerin, eğitim almayan hemşirelere göre bebek ve aileye daha bütüncül yaklaştığı, bakımı planladığı, uyguladığı ve daha kapsamlı değerlendirdiği belirlendi.

Anahtar Kelimeler

gelişimsel bakım, hemşirelik, yenidoğan, yenidoğan yoğun bakım

Proje Numarası

YOKTUR.

Kaynakça

• Weber A, Harrison TM. Reducing toxic stress in the neonatal intensive care unit to improve infant outcomes. Nurs Outlook. 2019;67(2):169-89.
• Coughlin M. Trauma-informed, neuroprotective care for hospitalized newborns and infants. Infant. 2017;13:176-9.
• D’Agata AL, Young EE, Cong X, Grasso DJ, McGrath JM. Infant medical trauma in the neonatal intensive care unit (IMTN). Adv Neonatal Care. 2016;16(4):289-97.
• Weber AM, Harrison TM, Steward DK. Schore's regulation theory: maternal-infant interaction in the NICU as a mechanism for reducing the effects of allostatic load on neurodevelopment in premature infants. Biol Res Nurs. 2012;14(4):375-86.
• Coughlin M, Gibbins S, Hoath S. Core measures for developmentally supportive care in neonatal intensive care units: Theory, precedence, and practice. J Adv Nurs. 2009;65(10):2239-48.
• Gardner SL, Goldson E, Hernandez JA. The Neonate and the environment impact on development. S.L. Gardner, B.S. Carter, M. Enzman Hines, J.A. Hernandez (Eds.). Merenstein & Gardner's Handbook of Neonatal İntensive Care. Yayın yeri: St Louis, Missouri, Elsevier; 2016.pp. 262-314.
• Haumont D. NIDCAP and developmental care. Journal of Pediatric and Neonatal Individualized Medicine. 2014;3:e030240.
• VandenBerg KA. Individualized developmental care for high-risk newborns in the NICU: A practice guideline. Early Hum Dev. 2007;83(7):433-42.
• Als H. Toward a synactive theory of development: promise for the assessment and support of infant individuality. Infant Ment Health J. 1982;3:229-2-43.
• Als H, Duffy FH, McAnulty G, Butler SC, Lightbody L, Kosta S, et al. NIDCAP improves brain function and structure in preterm infants with severe intrauterine growth restriction. J Perinatol. 2012;32(10):797-803.
• Als H. Newborn Individualized Developmental Care and Assessment Program (NIDCAP): New frontier for neonatal and perinatal medicine. J Neonatal-Perinatal Med. 2009;2:135-47.
• Smith K, Buehler D, Hedlund R, Kosta S, Als H. NIDCAP nursery certification program (NNCP): A guide to preparation, application and implementation of NIDCAP nursery certification. Boston, MA: NIDCAP Federation International. 2011;1-23.
• Macho P, Zukowsky K. Individualized developmental care in the NICU. Adv Neonatal Care. 2017;17(3):162-74.
• Griffiths N, Spence K, Loughran-Fowlds A. Westrup B. Individualized developmental care for babies and parents in the NICU: Evidence-based best practice guideline recommendations. Early Hum Dev. 2019;139:104840.
• Lizarondo L. Evidence Summary. Developmental Care: Preterm or Ill Neonates. The Joanna Briggs Institute EBP Database. 2016 [Erişim Tarihi 1 Aralık 2020]. Erişim adresi: https://jbi.global/sites/default/files/2020-06/23872%20Moral%20Distress%20Critical%20Care.pdf
• Tokan F, Geçgil E. Prematüre Bebeklerde Bireyselleştirilmiş Gelişimsel Bakım Kapsamında Toplu Bakım Verme Kavramı. Genel Sağlık Bilimleri Dergisi. 2019;1:64-77.
• Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. International J Qual Health Care. 2007;19(6):349-57.
• Gunawan J. Ensuring trustworthiness in qualitative research. Belitung Nurs J. 2015;1:10-1.
• Graneheim UH, Lindgren BM, Lundman B. Methodological challenges in qualitative content analysis: A discussion paper. Nurse Educ Today. 2017;56:29-34.
• Skene C, Gerrish K, Price F, Pilling E, Bayliss P, Gillespie S. Developing family-centred care in a neonatal intensive care unit: An action research study. Intensive Crit Care Nurs. 2019;50:54-62.
• Dykes F, Thomson G, Gardner C, Hall Moran V, Flacking R. Perceptions of European medical staff on the facilitators and barriers to physical closeness between parents and infant in neonatal units. Acta Paediatr. 2016;105(9):1039-46.
• Flacking R, Lehtonen L, Thomson G, Axelin A, Ahlqvist S, Moran VH, et al. Closeness and separation in neonatal intensive care. Acta Paediatr. 2012;101(10):1032-7.
• Sutton PS, Darmstadt GL. Preterm birth and neurodevelopment: a review of outcomes and recommendations for early identification and cost-effective interventions. J Trop Pediatr. 2013;59(4):258-65.
• Buil A, Sankey C, Caeymaex L, Apter G, Gratier M, Devouche E. Fostering mother-very preterm infant communication during skin-to-skin contact through a modified positioning. Early Hum Dev. 2020;141:104939.
• Coşkun D, Günay U. The Effects of Kangaroo Care Applied by Turkish Mothers who Have Premature Babies and Cannot Breastfeed on Their Stress Levels and Amount of Milk Production. J Pediatr Nurs. 2020;50:e26-e32.
• Vittner D, McGrath J, Robinson J, Lawhon G, Cusson R, Eisenfeld L, et al. Increase in oxytocin from skin-to-skin contact enhances development of parent-infant relationship. Biol Res Nurs. 2018;20(1):54-62.
• Boundy EO, Dastjerdi R, Spiegelman D, Fawzi WW, Missmer SA, Lieberman E, et al. Kangaroo mother care and neonatal outcomes: A meta-analysis. Pediatrics. 2016;137(1):e20152238.
• Stevens B, Yamada J, Ohlsson A. Sucrose for analgesia in newborn infants undergoing painful procedures. Cochrane Database Syst. Rev. 2013;(3):CD001069.
• Harris J, Ramelet AS, van Dijk M, Pokorna P, Wielenga J, Tume L, et al. Clinical recommendations for pain, sedation, withdrawal and delirium assessment in critically ill infants and children: An ESPNIC position statement for healthcare professionals. Intensive Care Med. 2016;42(6):972-86.
• De Clifford-Faugere G, Lavallée A, Khadra C, Ballard A, Colson S, Aita M. Systematic review and meta-analysis of olfactive stimulation interventions to manage procedural pain in preterm and full-term neonates. Int J Nurs Stud. 2020;110:103697.
• Usta C, Tanyeri-Bayraktar B, Bayraktar S. Pain Control with Lavender Oil in Premature Infants: A Double-Blind Randomized Controlled Study. J Altern Complement Med. 2021;27(2):136-41.
• Erkut Z, Yildiz S. The effect of swaddling on pain, vital signs, and crying duration during heel lance in newborns. Pain Manag Nurs. 2017;18(5):328-36.
• Dur Ş, Çağlar S, Yıldız NU, Doğan P, Güney Varal İ. The effect of yakson and gentle human touch methods on pain and physiological parameters in preterm infants during heel lancing. Intensive Crit Care Nurs. 2020;61:102886.
• Rivas-Fernandez M, Roqué I Figuls M, Diez-Izquierdo A, Escribano J, Balaguer A. Infant position in neonates receiving mechanical ventilation. Cochrane Database of Syst Rev. 2016;11(11):CD003668.
• Lubbe W, Van der Walt CSJ, Klopper HC. Integrative literature review defining evidence-based neurodevelopmental supportive Care of the Preterm Infant. J Perinat Neonatal Nurs. 2012;26(3):251-9.
• Çakıcı M, Mutlu B. Effect of Body Position on Cardiorespiratory Stabilization and Comfort in Preterm Infants on Continuous Positive Airway Pressure. J Pediatr Nurs. 2020;54:e1-e8.
• Çağlayan S, Gözen D. Effect of Supine and Prone Flexion Positions on Heart Rate, Oxygen Saturation, and Pain Score of Preterm Infants. Erciyes Medical Journal. 2020;43(1):26-30.
• Spilker A, Hill C, Rosenblum R. The effectiveness of a standardised positioning tool and bedside education on the developmental positioning proficiency of NICU nurses. Intensive Crit Care Nurs. 2016;35:10-5.
• Morag I, Ohlsson A. Cycled light in the intensive care unit for preterm and low birth weight infants. Cochrane Database Syst Rev. 2016;2016(8):CD006982.
• White RD, Smith JA, Shepley MM. Recommended standards for newborn ICU design, 8th edition. Committee to establish recommended standards for newborn ICU design. J Perinatol. 2013;33:S2-16.
• Servel AC, Rideau ABN. Single-family rooms for neonatal intensive care units impacts on preterm newborns, families, and health-care staff. A systematic literature review. Arch Pediatr. 2016;23(9):921-6.
• Wang D, Aubertin C, Barrowman N, Moreau K, Dunn S, Harrold J. Reduction of noise in the neonatal intensive care unit using sound-activated noise meters. Arch Dis Child Fetal Neonatal Ed. 2014;99(6):F515-6.
• Filippa M, Panza C, Ferrari F, Frassoldati R, Kuhn P, Balduzzi S, et al. Systematic review of maternal voice interventions demonstrates increased stability in preterm infants. Acta Paediatr. 2017;106(8):1220-9.
• Braid S, Bernstein J. Improved cognitive development in preterm infants with shared book Reading. Neonatal Netw. 2015(1);34:10-7.
• Kanbur BN, Balci S. Impact of the odors of vanilla extract and breast milk on the frequency of apnea in preterm neonates. Jpn J Nurs Sci. 2020;17(1):e12271.
• Salam RA, Darmstadt GL, Bhutta ZA. Effect of emollient therapy on clinical outcomes in preterm neonates in Pakistan: A randomised controlled trial. Arch Dis Child Fetal Neonatal Ed. 2015;100(3):F210-5.
• Caglar S, Yildiz GK, Bakoglu I, Salihoglu O. The Effect of Sunflower Seed and Almond Oil on Preterm Infant Skin: A Randomized Controlled Trial. Adv Skin Wound Care. 2020;33(8):1-6.
• Levesque V, Johnson K, McKenzie A, Nykipilo A, Taylor B, Joynt C. Implementing a Skin-to-Skin Care and Parent Touch Initiative in a Tertiary Cardiac and Surgical Neonatal Intensive Care Unit. Adv Neonatal Care. 2021;21(2):E24-34.
• Manzotti A, Cerritelli F, Esteves JE, Lista G, Lombardi E, La Rocca S, et al. Dynamic touch reduces physiological arousal in preterm infants: A role for c-tactile afferents?. Dev Cogn Neurosci. 2019;39:100703.
• Abdeyazdan Z, Mohammadian-Ghahfarokhi M, Ghazavi Z, Mohammadizadeh M. Effects of nesting and swaddling on the sleep duration of premature infants hospitalized in neonatal intensive care units. Iran J Nurs Midwifery Res. 2016;21(5):552-6.
• Donnellan D, Moore Z, Patton D, O'Connor T, Nugent L. The effect of thermoregulation quality improvement initiatives on the admission temperature of premature/very low birth?weight infants in neonatal intensive care units: A systematic review. J Spec Pediatr Nurs. 2020;25(2):e12286.
• Ostadi M, Jokar F, Armanian AM, Namnabati M, Kazemi Y, Poorjavad M. The Effects of Swallowing Exercise and Non-Nutritive Sucking Exercise on Oral Feeding readiness in Preterm Infants: A Randomized Controlled Trial. Int J Pediatr Otorhinolaryngol. 2021;142:110602.
• Dur Ş, Gözen D. Non-nutritive sucking before oral feeding of preterm infants in Turkey: A randomized controlled study. Journal of Pediatric Nursing. 2021;58:e37-43.
• Valizadeh L, Avazeh M, Bagher Hosseini M, Asghari Jafarabad M. Comparison of clustered care with three and four procedures on physiological responses of preterm infants: Randomized crossover clinical trial. Jf Caring Sci. 2014;3(1):1-10.
• Van den Hoogen A, Teunis CJ, Shellhaas RA, Pillen S, Benders M, Dudink J. How to improve sleep in a neonatal intensive care unit: A systematic review. Early Hum Dev. 2017;113:78-96.
• Park J. Sleep Promotion for Preterm Infants in the NICU. Nurs Womens Health. 2020;24(1):24-35.