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.

项目概要/摘要 早产与长期发育迟缓有关，这种迟缓可能要到出生后很久才会显现出来。 研究人员检查了新生儿重症监护病房 (NICU) 住院的潜在影响。 早产儿和神经发育结果，发现早产儿的运动能力有所增强， 与术语对相比，这些风险会增加。 黑人/非裔美国婴儿和男婴的常规护理是众所周知的，尽管是必要的。 然而，将护理与早产儿压力反应和睡眠状态联系起来的机制并不完全。 这项研究的目的是检查常规护理对压力和睡眠的影响。 早产儿状态的具体目标是： 确定常规护士护理之间的关系。 以及早产儿护理后的应激反应，并确定两者之间的关系； 常规护士护理对早产儿护理后行为状态的次要目的是：检查。 护理前后压力和睡眠状态之间的关系探索潜在的调节作用； 压力暴露史对日常护理对压力反应和行为状态的影响 后续护理；并探索护理前应激反应和行为的潜在调节作用 说明日常护理与应激反应和护理后行为状态之间的关系。 我们将在所有分析中考虑生物性别和种族的差异，我们提出一种非实验性的、 我们将对 30 名胎龄在 28-32 周之间的早产儿进行描述性观察性研究。 观察一名护士护理事件，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婴儿压力量表和电子压力表中的数据进行测量 健康记录将使用唾液皮质醇和皮肤电导反应来测量压力反应。 睡眠行为将使用安德森行为状态量表进行测量，研究结果将会增加。 我们对常规护士护理对压力反应和睡眠行为影响的理解 这些发现可以改善新生儿重症监护室中的早产儿的护理实践，从而改善病情。 这项研究符合国家护理研究所的战略。 通过解决临床护理模式来制定预防和健康促进计划是一项重要的研究。 制定有针对性的干预措施以优化早产儿的神经发育结果 培训计划将为婴儿提供大量正式和非正式的职业发展机会。 同时为作为一名独立研究人员的成功职业生涯奠定坚实的基础。 以申请人作为新生儿重症监护室护士和研究助理的经验为基础，并整合了她的知识 护理服务、婴儿和儿童发展以及研究方法。