Als Heidelise, McAnulty Gloria B
Department of Psychiatry, Harvard Medical School, and Neurobehavioral Infant and Child Studies, Department of Psychiatry (Psychology) Children's Hospital Boston.
Curr Womens Health Rev. 2011 Aug;7(3):288-301. doi: 10.2174/157340411796355216.
State-of-the-art Newborn Intensive Care Units (NICUs), instrumental in the survival of high-risk and ever-earlier-born preterm infants, often have costly human repercussions. The developmental sequelae of newborn intensive care are largely misunderstood. Developed countries eager to export their technologies must also transfer the knowledge-base that encompasses all high-risk and preterm infants' personhood as well as the neuro-essential importance of their parents. Without such understanding, the best medical care, while assuring survival jeopardizes infants' long-term potential and deprives parents of their critical role. Exchanging the womb for the NICU environment at a time of rapid brain growth compromises preterm infants' early development, which results in long-term physical and mental health problems and developmental disabilities. The Newborn Individualized Developmental Care and Assessment Program (NIDCAP) aims to prevent the iatrogenic sequelae of intensive care and to maintain the intimate connection between parent and infant, one expression of which is Kangaroo Mother Care. NIDCAP embeds the infant in the natural parent niche, avoids over-stimulation, stress, pain, and isolation while it supports self-regulation, competence, and goal orientation. Research demonstrates that NIDCAP improves brain development, functional competence, health, and life quality. It is cost effective, humane, and ethical, and promises to become the standard for all NICU care.
先进的新生儿重症监护病房(NICU)对高危及出生孕周越来越小的早产儿的存活至关重要,但往往会带来高昂的人力成本。新生儿重症监护的发育后遗症在很大程度上被误解了。急于输出其技术的发达国家还必须传授相关知识,这些知识涵盖所有高危和早产儿的人格,以及其父母在神经方面的重要作用。如果没有这种理解,最好的医疗护理在确保婴儿存活的同时,会危及婴儿的长期潜力,并剥夺父母的关键角色。在大脑快速发育时期,将子宫环境换成NICU环境会损害早产儿的早期发育,从而导致长期的身心健康问题和发育障碍。新生儿个体化发育护理与评估项目(NIDCAP)旨在预防重症监护的医源性后遗症,并维持母婴之间的亲密联系,袋鼠式护理就是其中一种表现形式。NIDCAP将婴儿置于自然的亲子关系中,避免过度刺激、压力、疼痛和隔离,同时支持自我调节、能力发展和目标导向。研究表明,NIDCAP能改善大脑发育、功能能力、健康状况和生活质量。它具有成本效益、人道且符合伦理,有望成为所有NICU护理的标准。