Stress Response of Preterm Infants to NICU Caregiving

早产儿对 NICU 护理的应激反应

• 批准号: 10682923
• 负责人: Nicole Cistone
• 金额: $ 4.05万
• 依托单位: OHIO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-05-01 至 2024-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10682923
• 关键词: Address; Affect; African American; Area; Behavior; Behavioral; Black race; Brain; Care given by nurses; Caring; Child Development; Circadian Rhythms; Clinical; Cognitive; Development; Developmental Delay Disorders; Diagnosis; Disparity; Distress; Electronic Health Record; Energy Metabolism; Event; Exposure to; Face; Foundations; Galvanic Skin Response; Gestational Age; Grant; Health; Health Promotion; Hormonal; Hospitalization; Hour; Hydrocortisone; Hypothalamic structure; Infant; Infant Behavior; Interruption; Intervention; Knowledge acquisition; Life; Link; Measures; Modeling; Morbidity - disease rate; Motor; National Institute of Nursing Research; Neonatal; Neonatal Intensive Care; Neonatal Intensive Care Units; Nociception; Nurses; Observational Study; Outcome; Pain; Personal Satisfaction; Physiological; Pituitary-Adrenal System; Play; Premature Infant; Prevention; Race; Recording of previous events; Research; Research Assistant; Research Methodology; Research Personnel; Risk; Risk Factors; Role; Salivary; Schedule; Severity of illness; Sleep; Sleep disturbances; Solid; Stimulus; Strategic Planning; Stress; Synapses; System; Tactile; Training; adverse outcome; biological adaptation to stress; biological sex; care delivery; care giving burden; career; caregiving; critical period; design; electronic health data; experience; forging; health equity; health inequalities; improved; knowledge integration; male; negative affect; neurodevelopment; neurophysiology; neurosensory; pre-doctoral; prevent; psychologic; response; routine care; sex; skills; sleep behavior; stress state; stressor

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.

项目摘要/摘要 出生的早产与长期发育延迟有关，直到之后才可能显而易见 新生儿重症监护病房（NICU）住院。研究人员检查了存在的潜在影响 天生的早产和神经发育结果，发现早产儿的运动增加了， 与术语对应物相比，行为和认知病变。这些风险增加了 黑人/非洲裔美国婴儿和男性婴儿。常规护士护理还是已知的，尽管有必要 压力源。但是，将护理与压力反应和睡眠状态联系起来的机制尚未完全 理解齿。这项研究的目的是检查常规护理护理对压力和睡眠的影响 在早产儿中的状态。具体目的是：确定常规护士护理之间的关系 早产儿的照顾后压力反应；并确定 在早产儿的后期行为状态下，常规护士护理。次要目的是：检查 压力和睡眠状态之间的关系前后；探索潜在的调节 压力暴露史对常规护理对压力反应和行为状态的影响 谨慎；并探索护理前压力反应和行为的潜在调节作用 陈述了常规护理与压力反应与行为状态后的关系之间的关系。 在所有分析中，我们将考虑生物性和种族的差异。我们提出了一个非实验性的 描述性的，观察性的研究对30位28-32周胎龄之间出生的早产儿。我们将 观察一个护士护理事件，记录压力暴露，压力反应和行为状态。 应力暴露将使用新生儿婴儿应力量表和电子的数据测量 健康记录。应力反应将使用唾液皮质醇和皮肤电导反应来测量。 睡眠行为将使用安德森行为状态尺度来衡量。研究结果将增加 我们对常规护士护理对压力反应和睡眠行为的影响的理解 NICU的早产婴儿。这些发现可以改善照顾实践，从而改善 神经发育结果。这项研究与国家护理研究所的战略保持一致 通过解决临床护理模型来预防和健康促进计划。这项研究很重要 一步发展有针对性的干预措施，以优化早产的神经发育结果 婴儿。培训计划将为专业发展提供许多正式和非正式的机会 同时允许为成功的独立研究人员建立稳固的基础。这项研究 建立在申请人担任NICU护士和研究助理的经历，并将她的知识融为一体 护理护理，婴儿和儿童发展以及研究方法。