Yenidoğan Bütünleştirici Gelişimsel Bakım Modeli: Nöroprotektif Aile Merkezli Gelişimsel Bakım için Yedi Temel Ölçüm

Yıl 2019, Cilt: 2 Sayı: 3, 170 - 180, 31.12.2019

Fatma Taş Arslan Sevinç Akkoyun

Öz

Prematüre
bebeklerin gelişimsel sorunları daha iyi anlamak için yenidoğanın nörolojik
sisteminin gelişimini izlemek önemlidir. Nöroproteksiyon, nöron hasarını geri
döndüren ya da daha ileri hasar oluşmasını önleyen ajanların uygulanması
demektir. Nöroprotektif stratejiler ise gelişmekte olan beynin desteklenmesi
veya nöronal hücre ölümünü azaltan ve işlevselliği için yeni bağlantılar ve
yollar geliştirerek iyileşmesini sağlayan bir nöron hasarı sonrası beynin eski
fonksiyonuna dönmesini kolaylaştırmak için kullanılan müdahalelerdir. Yenidoğan
Bütünleştirici Gelişim Bakım Modeli, nöroprotektif müdahaleleri optimal
sinaptik sinir bağlantılarını, normal nörolojik, fiziksel ve duygusal gelişimi
desteklemek ve engelleri önlemek için stratejiler kullanmaktadır. Yenidoğan
Bütünleştirici Gelişimsel Bakım Modeli prematüre bebeklerin nöroprotektif aile
merkezli gelişimsel bakımı için yedi temel ölçümü tanımlayan bir modeldir. Yedi
temel ölçüm: iyileşme ortamı, ailelerle ortaklık sağlamak, pozisyon ve bakım
sağlamak, uykuyu korumak stres ve ağrıyı en aza indirmek, cildi korumak ve en
iyi beslenmeyi sağlamaktır. Yenidoğan yoğun bakım ünitesindeki (YYBÜ) prematüre
bebeklerin bakımı için kanguru bakımı temel olup, bütün temel ölçümler içinde
yer almaktadır. Yenidoğan Bütünleştirici Gelişimsel Bakım Modeli dünyadaki pek
çok YYBÜ’nde klinik pratiğine danışmanlık eden bir sistemdir. Her temel ölçüm
için standartlar geliştirilmiş ve tanımlanmıştır. Bu derlemenin amacı,
Yenidoğan Bütünleştirici Gelişimsel Bakım Modelinin prematüre bebeklerin
nöroprotektif aile merkezli gelişimsel bakımı için yedi temel ölçümünün
bileşenleri ve uygulamaları hakkında bilgi vermektir.

Anahtar Kelimeler

gelişimsel bakım, hemşire, model, nöroprotektif, YYBÜ

The Neonatal Integrative Developmental Care Model: Seven Core Measures for Neuroprotective Family-Centered Developmental Care

Öz

It
is important to monitor the development of the neonatal neurological system in
order to better understand the developmental problems of premature infants.
Neuroprotection, means agents implementation that reverse neuronal damage or
prevent further damage. Neuroprotection or neuronal protection signifies the
application of agents which revert a part of neuronal damage or prevent the
formation of worse damages. Neuroprotective strategies are interventions used
for facilitating the developing brain or reverting its functions after a neuron
damage which decreases the neuronal cell death and provides recovery by
developing new connections and ways for its functionality. The Neonatal
Integrative Developmental Care Model utilizes neuroprotective interventions as
strategies to support optimal synaptic neural connections, promote normal
neurological, physical, and emotional development, and prevent disabilities.
The Neonatal Integrative Developmental Care Model is a model that defines seven
core measures for neuroprotective family-centered developmental care of
premature infants. The seven neuroprotective core measures: healing environment, partnering with
families, ositioning & handling, safeguarding sleep, minimizing stress and
pain, protecting skin, and optimizing nutrition. Skin to Skin Contact (SSC) is
considered the foundation for care of premature infants in the NICU and all
core measurements in located. The Neonatal Integrative Developmental Care Model
is a system that consulting clinical practice in many NICUs around the world.
Standards have been developed and defined for each core measures criterion. The purpose of this
review is to provide information on the components and applications of the
seven basic measures of the Neonatal Integrative Developmental Care Model for
neuroprotective family-centered developmental care of premature infants.

Anahtar Kelimeler

developmental care, model, neuroprotective, NICU, nurse

Kaynakça

• Als, H. (2004). Individualized developmental care for preterm infants. Encyclopedia on Early Childhood Development, 6, 1-7.
• Altimier, L. (2011). Mother and child integrative developmental care model: a simple approach to a complex population. Newborn & Infant Nursing Reviews, 11,105-8.
• Altimier L, Phillips R. (2013). The neonatal integrative developmental care model: seven neuroprotective core measures for family centered care. Newborn & Infant Nursing Reviews, 13, 9-22.
• Altimier, L. (2015). Compassionate family care framework: A new collaborative compassionate care model for NICU families and caregivers. Newborn & Infant Nursing Reviews, 15, 33-41.
• Altimier L, Phillips R. (2016). The neonatal integrative developmental care model: Advanced clinical applications of the seven core measures for neuroprotective family-centered developmental care. Newborn & Infant Nursing Reviews, 16, 230-244.
• Bartocci M, Serra G, Papiendieck G, Winberg J, Mustica T, Lagercantz H. (2000). Cerebral cortex response in newborn infants after exposure to the smell of detergent used in NICU: a near infrared spectroscopy study. Pediatric Research, 47, 388.
• Belfort MB, Anderson P, Nowak VA, Lee KJ, Molesworth C, Thompson DK et al. (2016).
• Breast milk feeding, brain development, and neurocognitive outcomes: a 7-year longitudinal study in infants born at less than 30 weeks' gestation. The Journal of Pediatrics, 177,133-139.
• Bergman, N. (2013). Neonatal stomach volume and physiology suggest feeding at 1-h intervals. Acta Paediatrica, 102, 773-777.
• Bonnier, C. (2008). Evaluation of early stimulation programs for enhancing brain development. Acta Paediatrica, 97, 853-858.
• Cone SK, Short S, Gutcher G. (2010). From “baby barn” to the “single family room designed NICU”: a report of staff perceptions one year post occupancy. Newborn & Infant Nursing Reviews, 10, 7-103.
• Comaru T, Miura E. (2009). Postural support improves distress and pain during diaper change in preterm infants. Journal of Perinatology, 29, 504-7.
• DSÖ (2018). Preterm birth. Erişim tarihi: 25.09.2018, https://www.who.int/news-room/fact-sheets/detail/preterm-birth.
• DSÖ (2012). Born too soon: the global action report on preterm birth. Erişim tarihi: 25.09.2018, https://www.who.int/pmnch/media/news/2012/201204_borntoosoon-report.pdf.
• Erickson C, Kattelmann K, Remington J, Ren C, Helseth CC, Stevens DC. (2011). Traditional open-bay versus single-family room neonatal intensive care unit: a comparison of selected nutrition outcomes. Research and Reports in Neonatology, 1,15-20.
• Fegram L. (2006). Nurses asmoral practitioners encountering parents in the neonatal intensive care unit. Nursing Ethics, 12,52-64.
• Gardner S, Goldson E. (2002). The neonate and the environment. 5th ed. Mosby.
• Goubet N, Strasbaugh K, Chesney J. (2007). Familiarity breeds content? Soothing effect of a familiar odor on full-term newborns. Journal of Developmental Behavioral Pediatrics, 28,189-94.
• Graven, S. (2006). Sleep and brain development. Clinics in Perinatology, 33,693-706.
• Graven S, Browne JV. (2008). Sensory development in the fetus, neonate, and infant: introductions and overview. Newborn & Infant Nursing Reviews, 8, 169-72.
• Maureen Hack, EA, Youngstrom LA, Schluchter H, Taylor G, Flannery D, Klein N et al. (2004). Behavioral outcomes and evidence of psychopathology among very low birth weight infants at age 20 years. Pediatrics, 114, 932-940.
• Jacobs S, Sokol J, Ohlsson A. (2002). The newborn individualized developmental care and assessment program is not supported by meta-analyses of the data. The Journal of Pediatrics, 140,699-706.
• Johnson SB, Riley AW, Granger DA, Riis J. (2013). The science of early life toxic stress for pediatric practice and advocacy. Pediatrics, 131, 319-327. Karakoç Tarı A, Çiğdem Z. (2008). Preterm bebeklerde biberonla beslenmeye geçiş sırasında uygulanan geleneksel ve gelişimsel bakım yönteminin karşılaştırılması. Maltepe Üniversitesi Hemşirelik Bilim ve Sanatı Dergisi, 1,3-12.
• Lickliter, R. (2011). The integrated development of sensory organization. Clinics in Perinatology, 38,591-603.
• Liu W, Laudert S, Perkins B, MacMillan-York E, Martin S, Graven S. (2007). The development of potentially better practices to support the neurodevelopment of infants in the NICU. Journal of Perinatology, 27,48-74.
• Ludington-Hoe, S. (2010). Kangaroo Care Is Developmental Care. In: McGrath CKJ, ed. Developmental Care of Newborns and Infants: A Guide for Health Professionals. Glenview, IL: National Association of Neonatal Nurses, p. 349-8.
• Maquet P, Smith C, Stickgold R. (2003). Sleep and Brain Plasticity. New York: Oxford University Press.
• McGrath, J. (2005). Single-room design in the NICU: making it work for you. Journal of Perinatal & Neonatal Nursing, 19, 210-211.
• McGrath JM, Cone S, Samra HA. (2011). Neuroprotection in the preterm infant: further understanding of the short- and long-term.
• Moon C. (2011). The role of early auditory development in attachment and communication. Clinics in Perinatology, 38,657-669.
• Phillips, R. (2013). The sacred hour: uninterrupted skin-to-skin contact immediately after birth. Newborn & Infant Nursing Reviews, 13,67-72.
• Picheansathian W, Woragidpoonpol P, Baosoung C. (2009). Positioning of preterm infants for optimal physiologic development: a systematic review. Joanna Briggs Institute Library of Systematic Reviews, 7, 224-259.
• Potts NL, Mandleco B. (2012). Pediatric Nursing Caring for Children and Their Families.
• Rattaz C, Goubet N, Bullinger A. (2005). The calming effect of a familiar odor on full-term newborns. Journal of Developmental and Behavioral Pediatrics, 26,86-92.
• Rees S, Harding R, Walker D. (2011). The biological basis of injury and neuroprotection in the fetal and neonatal brain. International Journal of Developmental Neuroscience, 29, 551-563.
• Resmî Gazete. (2017). Yenidoğan yoğun bakım servislerinin asgari donanım, personel ve hizmet standartları. 22/03/2017 tarih ve 30015 sayılı. SB 2019. https://hsgm.saglik.gov.tr/depo/birimler/ cocuk_ergen_db/dokumanlar/istatistikler/premature.pdf
• Shahheidari M, Homer C. (2012). Impact of the design of neonatal intensive care units on neonates, staff, and families: a systematic literature review. Journal of Perinatal & Neonatal Nursing, 26, 260-266.
• Tandberg BS, Sandtro HP, Vardal M, Ronnestad A. (2013). Parents of preterm evaluation of stress and nursing support. Journal of Neonatal Nursing, 19, 6, 317-26.
• Twohig A, Reulbach U, Figuerdo R, McCarthy A, McNicholas F, Molloy EJ. (2016). Supportıng preterm infant attachment and socioemotional development in the neonatal intensive care unit: staff perceptions. Infant Mental Health Journal, 37, 2, 160-71.
• Uludağ A, Ünlüoğlu İ. (2012). Yenidoğan yoğun bakım ünitesinde izlenen bebeklerin annelerinde stres oluşturan faktörler; stresle başa çıkmada birinci basamağın rolünün belirlenmesi. Konuralp Tıp Dergisi, 4, 3, 19-26.
• Vanderbilt D, Gleason M. (2012). Mental health concerns of the premature infant through the lifespan. Child Adolesc Psychiatr Clin N Am, 19:211.
• Visscher MO, Adam R, Brink S, Odio M. (2015). Newborn infant skin: physiology, development, and care. Clinics in Dermatology, 33,3,271-280.
• Visscher, M. (2014). A practical method for rapid measurement of skin condition. Newborn & Infant Nursing Reviews, 14,147-152.
• Wachman EM, Lahav A. (2011). The effects of noise on preterm infants in the NICU. Archives of Disease in Childhood Fetal and Neonatal Edition, 96,305-309.
• Walker SM. (2014). Neonatal pain. Pediatr Anesth, 24,39-48.
• White, R. (2012). Recommended standards for newborn ICU design. www.nd.edu/ nicudes. White R, Smith J, Shepley M. (2013). Recommended standards for newborn ICU design, eighth edition. Journal of Perinatology, 33, 2-16.
• Yolande N, Roslyn B. (2012). Neonatal assessments for the preterm infant up to 4 months corrected age: A systematic review. Developmental Medicine & Child Neurology, 54, 129-139.
• Zwicker JG, Grunau RE, Adams E, Chau V, Brant R, Poskitt KJ et al. (2013). Score for neonatal acute physiology-II and neonatal pain predict corticospinal tract development in premature newborns. Pediatric Neurology, 123-9.