METHODOLOGICAL ISSUES IN PRETERM INFANT OUTCOMES

早产儿结局的方法学问题

• 批准号: 2257634
• 负责人: JANA L PRESSLER
• 金额: $ 11.35万
• 依托单位: VANDERBILT UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1993
• 资助国家: 美国
• 起止时间: 1993-09-30 至 1997-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2257634
• 关键词: child behavior; child physical development; disease /disorder prevention /control; epidemiology; health care quality; health care service evaluation; human morbidity; human subject; longitudinal human study; low birth weight infant human; neonatal intensive care; nursing intervention; parent offspring interaction; premature infant human; quality of life; socioeconomics

This study will investigate methodological issues in preterm infant outcomes by applying time series techniques to the analysis of longitudinal data collected in the NICU environment and integrating these single subject results for generalization across individuals. These methodological and analytic techniques will help elucidate the biologic, behavioral, and growth processes of preterm infants and will suggest potential intervention strategies for ameliorating the outcomes of these infants. The five specific aims outlined are to: 1) identify and describe both short- and long-term biobehavioral VLBW and/or VP infant outcomes as they vary over time; 2) describe salient aspects of the NICU micro- environment as they vary over time; 3) investigate the dynamic relationships between biobehavioral VLBW and/or VP infant outcomes and the NICU micro-environment over time; 4) describe the relationships between the characteristics and demographics of VLBW and/or VP infants, parental participation in their infants' care, and infants' biobehavioral outcomes; and 5) interpret the above findings in terms of an eco-technology approach, identifying specific ways in which variations in environmental care might facilitate positive health care outcomes and disease prevention. Sixty-eight preterms whose gestations are equal to or less than 29 wk will be studied from admission until they are 30 wk gestation, or are transferred or discharged. The study variables include gestational age, growth measures, severity of illness, demographics, skin temperature, heart rate, respiratory rate, mean umbilical arterial pressure (for those infants with umbilical arterial lines), oxygen saturation, peripheral blood pressure, behavior as assessed using the Neonatal Individualized Developmental Care and Assessment Program (NIDCAP; Als & Gibes, 1984), pre- and post-NlDCAP salivary cortisol levels, a contextual measurement of the NICU environment, light and sound intensities, sound frequencies, isolette and warmer bed temperatures, and NICU bedspace geography. These variables will be obtained at pre-determined times for each infant. In addition, data pertinent to family visitation will be collected using a daily survey log. At the completion of the study and the infant's hospitalization, the costs of stay during the study period and for the entire hospitalization will be collected from patient accounting. Data will be analyzed using time series analysis to determine how the current NICU environment relates to VLBW and VP infant biologic status, behavior, growth, and parental visitation dynamically. Specific ways, areas, times, and settings, in which variations in treatment might facilitate early problem treatment and/or early problem detection will be suggested and refined using consultation from a neonatologist. The results from this normative research study will be critical for comparing the effects of any changes implemented in neonatal nursing on behalf of optimizing infant growth, development, and well-being in subsequent studies.

这项研究将研究早产婴儿的方法论问题 通过将时间序列技术应用于分析的结果 在NICU环境中收集的纵向数据并整合了这些数据 跨个体概括的单一主题结果。这些 方法和分析技术将有助于阐明生物学， 早产儿的行为和生长过程，会建议 改善这些结果的潜在干预策略 婴儿。概述的五个具体目的是：1）识别和描述 短期和长期生物行为VLBW和/或VP婴儿的结果均为 随着时间的流逝，它们有所不同。 2）描述NICU Micro-的显着方面 环境随着时间的流逝而变化； 3）研究动态 生物行为VLBW与/或VP婴儿结果与 NICU微环境随着时间的流逝； 4）描述 VLBW和/或VP婴儿的特征和人口统计学，父母 参与婴儿的护理和婴儿的生物行为结果； 5）根据生态技术来解释上述发现 方法，确定环境变化的特定方式 护理可能促进积极的医疗保健结果和疾病 预防。六十八名早产，其妊娠等于或更少 从入学到30周的妊娠期，将研究29周 或转移或出院。研究变量包括妊娠 年龄，增长措施，疾病严重程度，人口统计学，皮肤温度， 心率，呼吸频率，平均脐动脉压（对于那些 脐动脉线的婴儿），氧饱和，周围 血压，使用新生儿个性化评估的行为 发展护理和评估计划（NIDCAP； ALS＆GIBES，1984）， 前后NLDCAP唾液皮质醇水平，上下文测量 NICU环境，光线和声音强度，声音频率， 隔离和温暖的床温度和NICU床架地理。这些 每个婴儿的预定时间将获得变量。在 此外，将使用与家庭探视有关的数据 每日调查日志。研究完成和婴儿的 住院，研究期间的住院费用以及 整个住院将从患者会计中收集。数据 将使用时间序列分析来分析以确定电流的方式 NICU环境与VLBW和VP婴儿生物状况，行为， 成长和父母探访。特定的方式，区域，时间， 和设置，在这种情况下，治疗的变化可能会促进 问题治疗和/或早期问题检测将被建议，并且 使用新生儿医生的咨询来精致。从中的结果 规范研究对于比较任何效果至关重要 在新生儿护理中代表优化婴儿实施的变化 在随后的研究中的增长，发展和福祉。