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Ghaedi-Heidari F, Izadi M, Seyedbagheri S, Ahmadi A, Sayadi AR, Sadeghi T. The Effect of Mindfulness on Posttraumatic Growth of Mothers of Premature Infants Admitted to Neonatal Intensive Care Unit. J Clin Psychol Med Settings 2024; 31:19-25. [PMID: 37178339 DOI: 10.1007/s10880-023-09961-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2023] [Indexed: 05/15/2023]
Abstract
The purpose of this study was to determine the effect of Mindfulness-Based Stress Reduction (MBSR) on Posttraumatic Growth (PTG) in mothers of premature infants admitted to the Neonatal Intensive Care Unit (NICU) in Iran. Sixty mothers were selected by convenience sampling and assigned to the intervention and control groups. The intervention group received two MBSR sessions each week over the course of three weeks. The Posttraumatic Growth Inventory (PTGI) was used to collect data before, immediately after, and 1 month after the intervention. Based on repeated measures ANOVA, group-by-time interaction effect was significant and there was a statistically significant difference in the mean PTG scores of mothers in the two groups over time (p = 0.004). MBSR increased PTG in mothers. As a result, it is suggested that this approach be used in psychological support programs for mothers who have premature infants admitted to neonatal intensive care units.
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Affiliation(s)
- Fatemeh Ghaedi-Heidari
- Department of Psychiatric Nursing, Nursing and Midwifery School, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoomeh Izadi
- Student Research Committee, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Seyedhamid Seyedbagheri
- Deptartment of Pediatric Nursing, Nursing and Midwifery School, Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
| | - Atefeh Ahmadi
- Nursing Research Center, Razi Nursing and Midwifery Faculty, Kerman University of Medical Sciences, Kerman, Iran
| | - Ahmadreza-Reza Sayadi
- Social Determinants of Health Research Center, Department of Psychiatric Nursing, School of Nursing and Midwifery, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Tabandeh Sadeghi
- Non-Communicable Diseases Research Center, Department of Pediatric Nursing, Nursing and Midwifery School, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
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Lee CK, Huang XY. Psychological Processes of Postpartum Mothers with Newborns Admitted to the Intensive Care Unit. Asian Nurs Res (Korean Soc Nurs Sci) 2022; 16:9-17. [PMID: 34990888 DOI: 10.1016/j.anr.2021.12.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 12/16/2021] [Accepted: 12/21/2021] [Indexed: 11/30/2022] Open
Abstract
PURPOSE This research aims to explore the psychological processes of postpartum mothers during the admission of their newborns to the intensive care unit. It is hoped that the findings from this study will serve as a reference for clinical medical staff in providing individual and holistic patient care. METHODS Using grounded theory methodology, we collected data through semi-structured, one-to-one in-depth interviews. When data saturation occurred, 12 participants were involved through the constant comparative analysis process. RESULTS The psychological processes consisted of a core category and three main categories. The core category was "worrying about the baby and striving to fulfill maternal responsibilities." The three main categories:" impact on the maternal role", "recognition of the maternal identity", and "exhibition of maternal role". The entire process may be affected by intrinsic and extrinsic factors, such as breast milk supply, skin-to-skin contact opportunities for mother and baby, seriousness of the newborn's health conditions, the support system, and the style of postpartum confinement care. CONCLUSIONS It is recommended that the neonatal intensive care unit should adopt family-centered care, taking an initiative to empathize and care for the mother, assisting skin-to-skin contact for the mother and baby as soon as possible, maintaining established breastfeeding, providing the correct concept of postpartum care, and encouraging participation in support groups. These activities can reduce the impact of the situation on the maternal role and improve maternal identity recognition.
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Affiliation(s)
- Chiu-Kuei Lee
- Department of Nursing, Taipei Medical University Hospital, Taiwan; Doctoral candidate, National Taipei University of Nursing and Health Sciences, Taiwan
| | - Xuan-Yi Huang
- College of Nursing, National Taipei University of Nursing and Health Sciences, Taiwan.
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Mosayebi Z, Sagheb S, Mirzendedel M, Movahedian AH. Serum Vitamin D Deficiency in NICU Hospitalized Neonates and Its Association With Neonatal Outcomes. J Family Reprod Health 2021; 15:99-105. [PMID: 34721598 PMCID: PMC8520660 DOI: 10.18502/jfrh.v15i2.6450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective: Vitamin D deficiency is a major health problem in all age groups. In the present study, we aimed to determine the prevalence of vitamin D deficiency in neonates hospitalized in an intensive care unit (NICU) and its association with clinical neonatal outcomes. Materials and methods: A prospective cross-sectional study was carried out on all neonates hospitalized in the NICU of Children's Medical Center over a period of one year (January–December 2018). Immediately on admission, a serum sample for vitamin D measurement was obtained with another routine blood sampling. Demographic and clinical data including sex, gestational age, the season of birth, serum levels of vitamin D and calcium, the causes of hospitalization, age at admission and neonatal outcomes including length of hospital stay and mortality during hospitalization were assessed. Results: One hundred neonates entered the study. Vitamin D deficiency and insufficiency were present in 95% of neonates. There was a significant association between vitamin D status and birth during winter (p=0.014); hypocalcemia (p=0.025) and older age at NICU admission (p<0.001). The mean value of vitamin D in term neonates was significantly lower than in preterm neonates (p=0.031). There were no correlations between length of hospital stay and neonatal mortality rate with vitamin D status (p=0.876). Conclusion: Vitamin D deficiency and insufficiency were highly prevalent among NICU patients. Maternal vitamin D supplementation during pregnancy may prevent or reduce the risk of low levels of vitamin D in neonates.
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Affiliation(s)
- Ziba Mosayebi
- Maternal, Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Setareh Sagheb
- Department of Neonatology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahsa Mirzendedel
- Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
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Chatziioannidis I, Iliodromiti Z, Boutsikou T, Pouliakis A, Giougi E, Sokou R, Vidalis T, Xanthos T, Marina C, Iacovidou N. Physicians' attitudes in relation to end-of-life decisions in Neonatal Intensive Care Units: a national multicenter survey. BMC Med Ethics 2020; 21:121. [PMID: 33225943 PMCID: PMC7681959 DOI: 10.1186/s12910-020-00555-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 10/27/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND End-of-life decisions for neonates with adverse prognosis are controversial and raise ethical and legal issues. In Greece, data on physicians' profiles, motivation, values and attitudes underlying such decisions and the correlation with their background are scarce. The aim was to investigate neonatologists' attitudes in Neonatal Intensive Care Units and correlate them with self-reported practices of end-of-life decisions and with their background data. METHODS A structured questionnaire was distributed to all 28 Neonatal Intensive Care Units in Greece. One hundred and sixty two out of 260 eligible physicians answered anonymously the questionnaire (response rate 66%). Demographic and professional characteristics, self-reported practices and opinions were included in the questionnaire, along with a questionnaire of 12 items measuring physicians' attitude and views ranging from value of life to quality of life approach (scale 1-5). RESULTS Continuation of treatment in neonates with adverse prognosis without adding further therapeutic interventions was the most commonly reported EoL practice, when compared to withdrawal of mechanical ventilation. Physicians with a high attitude score (indicative of value of quality-of-life) were more likely to limit, while those with a low score (indicative of value of sanctity-of-life) were more likely for continuation of intensive care. Physicians' educational level (p:0.097), involvement in research (p:0.093), religion (p:0.024) and position on the existing legal framework (p < 0.001) were factors that affected the attitude score. CONCLUSIONS Physicians presented with varying end-of-life practices. Limiting interventions in neonates with poor prognosis was strongly related to their attitudes. The most important predictors for physicians' attitudes were religiousness and belief for Greek legal system reform.
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Affiliation(s)
- Ilias Chatziioannidis
- 2nd Neonatal Department and Neonatal Intensive Care Unit, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloníki, Greece.
| | - Zoi Iliodromiti
- Neonatal Department, School of Medicine, Aretaieio Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Theodora Boutsikou
- Neonatal Department, School of Medicine, Aretaieio Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Abraham Pouliakis
- 2nd Department of Pathology, School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Rozeta Sokou
- Neonatal Department, School of Medicine, Aretaieio Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Takis Vidalis
- Hellenic National Bioethics Commission, Athens, Greece
| | | | - Cuttini Marina
- Clinical Care and Management Innovation Research Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Nicoletta Iacovidou
- Neonatal Department, School of Medicine, Aretaieio Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Demtse AG, Pfister RE, Nigussie AK, McClure EM, Ferede YG, Tazu Bonger Z, Mekasha A, Demisse AG, Gidi NW, Metaferia G, Worku B, Goldenberg RL, Muhe LM. Hypothermia in Preterm Newborns: Impact on Survival. Glob Pediatr Health 2020; 7:2333794X20957655. [PMID: 32974416 PMCID: PMC7493265 DOI: 10.1177/2333794x20957655] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 08/13/2020] [Accepted: 08/17/2020] [Indexed: 01/21/2023] Open
Abstract
Background. Globally, prematurity is the leading cause of neonatal mortality, and hypothermia is one of its contributing factors. The goal of this study was to determine the association between hypothermia and mortality. Methods. A prospective, multi-center, descriptive clinical study was conducted in 5 hospitals in Ethiopia. Axillary temperatures were taken at the time of admission to the newborn intensive care units (NICU) and followed during the NICU stay. Results. A total of 3852 premature neonates (<37 weeks) were admitted to the NICUs from July 2016 to May 2018. Of these infants, 1109 (28.8%) died and 2991 (79.6%) had hypothermia. Hypothermia was associated with perinatal asphyxia (89.5%), RDS (86.2%), and resuscitation at birth (82.7%). Admission temperatures in preterm newborns were inversely associated with mortality and morbidity. Conclusion. Hypothermia at admission is associated with neonatal mortality in premature neonates in Ethiopia. RDS and perinatal asphyxia were the main factors associated with hypothermia. The very high prevalence and association with mortality warrants quality improvement interventions.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Gesit Metaferia
- St Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Bogale Worku
- Ethiopian Pediatric Society, Addis Ababa, Ethiopia
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Sultan AM, Seliem WA. Identifying Risk Factors for Healthcare-Associated Infections Caused by Carbapenem-Resistant Acinetobacter baumannii in a Neonatal Intensive Care Unit. Sultan Qaboos Univ Med J 2018; 18:e75-e80. [PMID: 29666685 DOI: 10.18295/squmj.2018.18.01.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 12/24/2017] [Accepted: 01/11/2018] [Indexed: 11/16/2022] Open
Abstract
Objectives Acinetobacter baumannii is a causative pathogen of various healthcare-associated infections (HAIs) and is particularly prevalent in high-risk hospital settings. This study aimed to determine risk factors associated with HAIs caused by carbapenem-resistant A. baumannii (CRAB) in a neonatal intensive care unit (NICU). Methods This prospective study was performed between January 2013 and June 2014 among NICU patients at the Mansoura University Children's Hospital, Mansoura, Egypt. Neonates who developed HAIs due to CRAB were assigned to a case group, while those infected with carbapenem-sensitive A. baumannii (CSAB) were assigned to a control group. Results Among the 124 neonates who developed A. baumannii-caused HAIs during the study period, 91 (73.4%) were caused by CRAB and 33 (26.6%) were caused by CSAB. Prematurity, premature rupture of the membranes (PROM), a previous stay in another hospital, prolonged NICU stay, the presence of invasive devices, previous exposure to carbapenems or aminoglycosides and prolonged antibiotic therapy before infection were significantly associated with CRAB-caused HAIs. A multivariate logistic regression analysis identified prematurity (adjusted odds ratio [aOR] = 25.3; P <0.01), mechanical ventilation (aOR = 18.9; P <0.01) and the previous use of carbapenems (aOR = 124.7; P <0.01) or aminoglycosides (aOR = 22.6; P = 0.04) to be independent risk factors for CRAB infections. Conclusion Various risk factors were significantly associated with CRAB-caused HAIs among the studied NICU patients.
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Affiliation(s)
- Amira M Sultan
- Department of Medical Microbiology & Immunology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Wael A Seliem
- Department of Pediatrics, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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Jesus VR, Oliveira PMN, Azevedo VMGO. Effects of hammock positioning in behavioral status, vital signs, and pain in preterms: a case series study. Braz J Phys Ther 2018; 22:304-9. [PMID: 29598896 DOI: 10.1016/j.bjpt.2018.03.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 02/26/2018] [Accepted: 03/02/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The hammock positioning within the incubators simulates the intrauterine environment, however, there is little evidence of its benefits and possible risks. OBJECTIVES The aim of this study was to assess the effects of hammock positioning on behavioral status, vital signs, and pain in very low birth weight preterm newborns. METHODS This is a quasi-experimental/case series study in which premature infants (<1500g) were positioned in supine for one hour in a hammock. The preterm newborns were assessed 10min before, during (2, 20, 40, and 60min), and 10min after hammock positioning with the Brazelton Neonatal Behavioral Assessment Scale, vital signs and pain by the Neonatal Facial Coding System. RESULTS 28 preterm infants between 28 and 36 weeks of gestational age were evaluated. Regarding the behavioral state, the preterm newborns progressively evolved to light or deep sleep during hammock positioning. There was a statistically significant reduction of the heart and respiratory rate from 2 to 60th minute in a hammock, which was maintained after the positioning. The oxygen saturation remained within normal values. No changes in pain scores were observed. CONCLUSION The hammock positioning can be considered a safe method of positioning that can be used to reduce the stress levels in very low birth weight preterm newborns. We did not observe worsening in either pain or vital signs.
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de Magalhães-Barbosa MC, Prata-Barbosa A, Robaina JR, Raymundo CE, Lima-Setta F, Antonio José Ledo Alves da Cunha. Prevalence of microcephaly in eight south-eastern and midwestern Brazilian neonatal intensive care units: 2011-2015. Arch Dis Child 2017; 102:728-734. [PMID: 28302630 DOI: 10.1136/archdischild-2016-311541] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 02/05/2017] [Accepted: 02/10/2017] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To describe the prevalence of microcephaly in infants admitted to the neonatal intensive care units (NICUs) in eight private hospitals in south-eastern and midwestern Brazil, from 2011 to 2015. DESIGN Observational, cross-sectional study in a cohort of neonates. SETTING Eight private NICUs situated in the cities of Rio de Janeiro (RJ), São Paulo (SP) and Federal District of Brasilia (FDB). PATIENTS Neonates up to 7 days of age and >23 weeks of gestational age. MAIN OUTCOME MEASURES Primary outcomes were the annual prevalence of microcephaly and severe microcephaly, both overall and in subgroups according to gestational age, type of microcephaly (proportional or disproportional) and the NICU's location in RJ, SP or FDB. RESULTS In this cohort of 8275 neonates admitted to eight private NICUs, the overall prevalence of microcephaly was 5.6% (95% CI 5.1% to 6.1%) and severe microcephaly, 1.5% (95% CI 1.2% to 1.7%). There was no annual variation in these overall estimates (p=0.48 and p=0.99, respectively), nor in the studied subgroups. Microcephaly prevalence was higher in extremely premature and term newborns (7.7% and 7.2%; p<0.001, respectively). Disproportional microcephaly was much more common than proportional microcephaly (prevalence 5.0% vs 0.6%; p<0.001). CONCLUSIONS The prevalence of microcephaly showed little variation from 2011 to 2015 in these south-eastern and midwestern Brazilian NICUs, suggesting that the impact of the Zika epidemic in neonates that occurred mainly in the north-eastern region in 2015 did not yet affect the infants of those regions during the studied period. These prevalence results can serve as a reference for comparisons with any future Zika outbreaks in the same or similar populations from these regions.
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Affiliation(s)
| | - Arnaldo Prata-Barbosa
- Instituto D'Or de Pesquisa e Ensino (IDOR), Rio de Janeiro, Rio de Janeiro, Brazil.,Instituto de Puericultura e Pediatria Martagão Gesteira-Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | - Fernanda Lima-Setta
- Instituto D'Or de Pesquisa e Ensino (IDOR), Rio de Janeiro, Rio de Janeiro, Brazil.,Instituto Fernandes Figueira da Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
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Baptista MI, Nona J, Ferreira M, Sampaio I, Abrantes M, Tomé MT, Neto MT, Barroso R, Serelha M, Virella D. Invasive fungal infection in neonatal intensive care units: a multicenter survey. J Chemother 2017; 28:37-43. [PMID: 25365503 DOI: 10.1179/1973947814y.0000000222] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
This study assesses the epidemiology of invasive fungal infection (IFI) in Portuguese Neonatal Intensive Care Units (NICUs) and compares the effectiveness and safety of antifungal therapies. A survey concerning the period 2005-2010 was carried out in NICUs of Greater Lisbon. Among 10 473 admitted neonates, 44 cases were identified, 29 among extreme low birth weight neonates (65.9%). Cumulative incidence rate was 0.42% (95%CI 0.309-0.559). A central vascular catheter was present before IFI in all cases. Candida albicans and Candida parapsilosis were the most frequent isolates. The initial antifungic was fluconazole in 22 cases and liposomal amphotericin B (L-AmB) in 18. Therapy was switched in 10 patients on fluconazole and 3 on L-AmB. Case fatality rate was 11.4% (95%CI 4.39-23.91). No serious adverse drugs reactions (SADRs) or clinical side effects were observed. The knowledge of the local epidemiology helps to identify adequate prophylactic and treatment strategies.
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Affiliation(s)
- Monica Isabel Baptista
- a Neonatology Department, Maternidade Dr. Alfredo da Costa , Centro Hospitalar Lisboa Central , Portugal
| | - José Nona
- a Neonatology Department, Maternidade Dr. Alfredo da Costa , Centro Hospitalar Lisboa Central , Portugal
| | - Marta Ferreira
- b Neonatology Department , Hospital Fernando da Fonseca , Lisbon , Portugal
| | - Isabel Sampaio
- c Neonatology Department , Hospital de Santa Maria , Centro Hospitalar Lisboa Norte , Portugal
| | - Margarida Abrantes
- c Neonatology Department , Hospital de Santa Maria , Centro Hospitalar Lisboa Norte , Portugal
| | - Maria Teresa Tomé
- a Neonatology Department, Maternidade Dr. Alfredo da Costa , Centro Hospitalar Lisboa Central , Portugal
| | - Maria Teresa Neto
- d Neonatology Department , Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central , Portugal
| | - Rosalina Barroso
- b Neonatology Department , Hospital Fernando da Fonseca , Lisbon , Portugal
| | - Micaella Serelha
- d Neonatology Department , Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central , Portugal
| | - Daniel Virella
- e Epidemiology and Statistics Office of the Research Unit of Centro Hospitalar de Lisboa Central , Portugal
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Capan M, Hoover S, Jackson EV, Paul D, Locke R. Time Series Analysis for Forecasting Hospital Census: Application to the Neonatal Intensive Care Unit. Appl Clin Inform 2016; 7:275-89. [PMID: 27437040 DOI: 10.4338/aci-2015-09-ra-0127] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 02/14/2016] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Accurate prediction of future patient census in hospital units is essential for patient safety, health outcomes, and resource planning. Forecasting census in the Neonatal Intensive Care Unit (NICU) is particularly challenging due to limited ability to control the census and clinical trajectories. The fixed average census approach, using average census from previous year, is a forecasting alternative used in clinical practice, but has limitations due to census variations. OBJECTIVE Our objectives are to: (i) analyze the daily NICU census at a single health care facility and develop census forecasting models, (ii) explore models with and without patient data characteristics obtained at the time of admission, and (iii) evaluate accuracy of the models compared with the fixed average census approach. METHODS We used five years of retrospective daily NICU census data for model development (January 2008 - December 2012, N=1827 observations) and one year of data for validation (January - December 2013, N=365 observations). Best-fitting models of ARIMA and linear regression were applied to various 7-day prediction periods and compared using error statistics. RESULTS The census showed a slightly increasing linear trend. Best fitting models included a non-seasonal model, ARIMA(1,0,0), seasonal ARIMA models, ARIMA(1,0,0)x(1,1,2)7 and ARIMA(2,1,4)x(1,1,2)14, as well as a seasonal linear regression model. Proposed forecasting models resulted on average in 36.49% improvement in forecasting accuracy compared with the fixed average census approach. CONCLUSIONS Time series models provide higher prediction accuracy under different census conditions compared with the fixed average census approach. Presented methodology is easily applicable in clinical practice, can be generalized to other care settings, support short- and long-term census forecasting, and inform staff resource planning.
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Affiliation(s)
- Muge Capan
- Christiana Care Health System, Value Institute , Newark, DE
| | - Stephen Hoover
- Christiana Care Health System, Value Institute , Newark, DE
| | - Eric V Jackson
- Christiana Care Health System, Value Institute , Newark, DE
| | - David Paul
- Christiana Care Health System, Division of Neonatology , Newark, DE
| | - Robert Locke
- Christiana Care Health System, Division of Neonatology , Newark, DE
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Ramezani T, Hadian Shirazi Z, Sabet Sarvestani R, Moattari M. Family-centered care in neonatal intensive care unit: a concept analysis. Int J Community Based Nurs Midwifery 2014; 2:268-78. [PMID: 25349870 PMCID: PMC4201206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Revised: 06/21/2014] [Accepted: 06/22/2014] [Indexed: 11/02/2022]
Abstract
BACKGROUND The concept of family- centered care in neonatal intensive care unit has changed drastically in protracted years and has been used in various contexts differently. Since we require clarity in our understanding, we aimed to analyze this concept. METHODS This study was done on the basis of developmental approach of Rodgers's concept analysis. We reviewed the existing literature in Science direct, PubMed, Google Scholar, Scopus, and Iran Medex databases from 1980 to 2012. The keywords were family-centered care, family-oriented care, and neonatal intensive care unit. After all, 59 out of 244 English and Persian articles and books (more than 20%) were selected. RESULTS The attributes of family-centered care in neonatal intensive care unit were recognized as care taking of family (assessment of family and its needs, providing family needs), equal family participation (participation in care planning, decision making, and providing care from routine to special ones), collaboration (inter-professional collaboration with family, family involvement in regulating and implementing care plans), regarding family's respect and dignity (importance of families' differences, recognizing families' tendencies), and knowledge transformation (information sharing between healthcare workers and family, complete information sharing according to family learning style). Besides, the recognized antecedents were professional and management-organizational factors. Finally, the consequences included benefits related to neonate, family, and organization. CONCLUSION The findings revealed that family centered-care was a comprehensive and holistic caring approach in neonatal intensive care. Therefore, it is highly recommended to change the current care approach and philosophy and provide facilities for conducting family-centered care in neonatal intensive care unit.
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Affiliation(s)
- Tahereh Ramezani
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | | | - Marzieh Moattari
- Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
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Aymar CLGD, Lima LSD, Santos CMRD, Moreno EAC, Coutinho SB. Pain assessment and management in the NICU: analysis of an educational intervention for health professionals. J Pediatr (Rio J) 2014; 90:308-15. [PMID: 24560962 DOI: 10.1016/j.jped.2013.09.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Revised: 09/17/2013] [Accepted: 09/17/2013] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVE to study the perception of a Neonatal Intensive Care team on pain assessment and management before and after an educational intervention created and implemented in the unit. METHODS intervention study developed as action research, in three phases. In Phase 1, a quantitative study was performed to identify how professionals perceive pain management in the unit. In Phase 2, an educational intervention was carried out, using the Operational Group (OG), which defined strategies to be adopted to seek improvements in pain assessment and management. In Phase 3, the initial questionnaire was reapplied to assess professionals' perceptions about the subject after the intervention. All professionals directly working in newborn care were included. RESULTS the perception of professionals about pain management and assessment in the unit showed a statistically significant difference between the two phases of research, highlighting the increase in frequency of reference for evaluation and use of some method of pain relief procedures for most analyzed procedures. Participation in training (one of the strategies defined by the operational group) was reported by 86.4% of the professionals. They reported the use of scales for pain assessment, established by the protocol adopted in the service after the intervention, with a frequency of 94.4%. Changes in pain assessment and management were perceived by 79.6% of the participants. CONCLUSION the professionals involved in the educational intervention observed changes in pain management in the unit and related them to the strategies defined and implemented by the OG.
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Affiliation(s)
| | - Luciane S de Lima
- Department of Nursing, Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil
| | | | | | - Sônia B Coutinho
- Maternal-Child Departament, Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil
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Kapoor K, Jajoo M, Dabas V. Predictors of mortality in out born neonates with acute renal failure; an experience of a single center. Iran J Pediatr 2013; 23:321-6. [PMID: 23795256 PMCID: PMC3684478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/15/2012] [Accepted: 03/15/2013] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To evaluate the incidence, etiology, outcome, and predictors of mortality in neonates with Acute Renal Failure (ARF) in an out born Neonatal Intensive Care Unit (NICU) of India. METHODS A retrospective analysis of case records of out born neonates, who had ARF at admission or developed ARF during NICU stay, from January to December 2011 (one year) was done. FINDINGS Out of the total 456 neonates admitted during the study period, 44 (9.6%) neonates with ARF (32 males, 12 females) were studied. Their mean gestational age, weight, and age at admission was 34.7±3.9 weeks, 2100±630 grams, and 2.1±6.3 respectively. Causes of ARF were pre-renal in 22 (50%), intrinsic renal failure in 16 (36.3%), and post-renal in six (13.6%). Oliguria was present in 29 neonates. Neonatal sepsis was the commonest cause of ARF, followed by perinatal asphyxia, respiratory distress syndrome, and genitourinary anomalies. ARF was present at admission in 37 neonates. The mortality rate was 15.9% (7/44). Thirty-seven (84%) were discharged with complete recovery of renal functions and followed for six months. Shock, oliguria, need for mechanical ventilation, and presence of disseminated intravascular coagulopathy (DIC) emerged as predictors of mortality in neonates with ARF. CONCLUSION The incidence and mortality rate of neonatal ARF were 9.6% and 15.9% respectively in our out born NICU. Neonatal sepsis was the commonest cause of ARF followed by perinatal asphyxia. Shock, oliguria, need for mechanical ventilation, and presence of DIC were associated with poor outcome.
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Affiliation(s)
- Kapil Kapoor
- Corresponding Author:Address: Department of Pediatrics, Maulana Azad Medical College and Associated Chacha Nehru Bal Chikitsalaya, Delhi, India. E-mail:
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Valizadeh L, Zamanzadeh V, Akbarbegloo M, Sayadi L. Importance and Availability of Nursing Support for Mothers in NICU: A Comparison of Opinions of Iranian Mothers and Nurses. Iran J Pediatr 2012; 22:191-6. [PMID: 23056885 PMCID: PMC3446074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/25/2010] [Revised: 12/16/2011] [Accepted: 02/05/2012] [Indexed: 12/03/2022]
Abstract
OBJECTIVE The current study was conducted to compare the opinions of mothers and nurses on the importance and availability of nursing support for parents with premature infants hospitalized in NICU. There is no overall picture of the nursing support for parents with hospitalized premature infants in Iran. Nurses, providing care in NICU, must view parent as an essential partner in care. But what is the situation? Assessing the viewpoints of both parents and nurses regarding the importance and availability of nursing support can elucidate this situation. METHODS A comparative descriptive design was used. The population consisted of all mothers with hospitalized premature newborns in NICU (n=300) and all NICU nurses (n=32) in three teaching hospitals in Tabriz (Iran), in 2007. Data was collected through the NPST questionnaire. Data analysis was done with SPSS. FINDINGS Mann-Whitney test showed that there were significant differences between nurses and mothers on four subscales of nursing support. Generally, mothers scored every subscale lower than nurses who cared for them and their children. On the other hand, it could be said that NICU nurses claimed more importance for the subscales and rated the provided support higher in comparison with mothers who did not think so. CONCLUSION The opinions of the nurses and mothers toward the availability and importance of the nursing supports in NICU were different. This study provides nurses with concrete information in order to better understand parents' need for support and try to meet their expectations, resulting in improved nursing care in neonatal intensive care units.
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Affiliation(s)
- Leila Valizadeh
- Corresponding Author:Address: Tabriz University of medical sciences, Department of child health nursing, school of nursing and midwifery. E-mail:
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Tu WJ, He J, Li Y. Correlation between Hypoglycemia and Positive Rate of Inborn Error of Metabolism in Neonatal Intensive Care Unit. Iran J Pediatr 2012; 22:113-6. [PMID: 23056869 PMCID: PMC3448226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2010] [Revised: 05/01/2011] [Accepted: 05/19/2011] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To investigate the correlation between hypoglycemia and positive rate of inborn error of metabolism (IEM) in neonatal intensive care unit. METHODS 160 patients from a neonatal intensive care unit were enrolled. Blood glucose was measured by Roche Modular chemistry. The dry blood on filter papers, collected from 160 patients, was tested by tandem mass spectrometry to detect 35 inborn errors of metabolism. Clinical follow-up of all the patients was at least in an interval of 12 months. The mean observation period was 13.5 months per child. FINDINGS Based on the ROC curve, the optimal cut-off value of hypoglycemia as an indicator for screening for IEMs was projected to be 2.8 mmol/L, which yielded a sensitivity of 71.4% and a specificity of 76.5%. The patients were divided into two groups: hypoglycemia group (48 cases) and the control group (112 cases). 5(10.4%) of the 48 patients in the hypoglycemia group were positive, while only 2(1.8%) of the 112 patients in the control group were positive. The difference of the positive rate in the screening for IEMs between the two groups was significant (χ(2)=4.10, P<0.05); the relative risk (RR) was 5.83 (95% CI: 1.06-32.12). CONCLUSION The risk of patients with hypoglycemia suffering from IEMs was significantly higher than that of the non-hypoglycemia patients in NICU, based on cut-off value of 2.8mmol/L.
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Affiliation(s)
- Wen-jun Tu
- Department of Clinical laboratory, China Rehabilitation Research Center, Beijing, China,Corresponding Author:Address: No.10, Jiao men North Road, Fengtai District, Beijing 100068, P.R.China. E-mail:
| | - Jian He
- Center for Clinical Laboratory Development, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Ying Li
- Department of Pediatrics, Beijing Haidian Maternal & Child Health Hospital, Beijing, China
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