Department of Nursing, Far East University, 76-32 Daehak-gil, Gamgok-myeon, Eumseong-gun, Chungbuk, 27601, Republic of Korea.
Department of Nursing, Daegu Haany University, Daegu, Republic of Korea.
Syst Rev. 2020 Mar 21;9(1):61. doi: 10.1186/s13643-020-01331-8.
Attachment in the parent-infant dyads is fundamental for growth and development of children born prematurely. However, the natural process of attachment is interrupted just after preterm birth, and emotional and physical detachment, limited social interaction, and a traumatic, technologically heavy environment in a neonatal intensive care unit (NICU) may result in impaired attachment or bonding. To our knowledge, few studies have evaluated the effectiveness of interventions aimed at enhancing attachment, bonding, and relationships between parents and their preterm infants during the infant's hospitalization in the NICU. This study aims to perform a comprehensive systematic review and a meta-analysis survey of the effects of attachment- and relationship-based interventions in the NICU.
A comprehensive literature review will be conducted in the following databases: MEDLINE, CINAHL, PubMed, EMBASE (OVID), Scopus, PsycINFO (OVID), Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science. Selected studies will be published in English, in the last 20 years, from 1999 onwards. All studies of randomized controlled trials (e.g., parallel groups, cluster) will be included. We will consider studies evaluating attachment- and relationship-based interventions (e.g., skin-to-skin contact, parental involvement in infant care) versus a comparator (standard of care). The primary outcome will be maternal attachment. Secondary outcomes will include infants' growth and development, family health, and parenting experience. Data extraction from eligible studies will be conducted independently by two experts who will compare their data. The Cochrane risk of bias tool will be applied to the selected studies. If data permits, we will conduct random effects meta-analysis where appropriate. Subgroup and additional analyses will be conducted to explore the potential sources of heterogeneity considering gender of parents, infants' sex, and gestational age. Data synthesis will be carried out using the RevMan 5.3 software. Publication bias will be assessed with the graphical funnel plot method and the Egger test. The quality of the evidence will be rated using the methods of the Grades of Recommendation Assessment, Development and Evaluation (GRADE) Working Group.
The results of this systematic review will discuss the types of attachment- or relationship-based interventions that are effective for facilitating family health outcomes and the babies' growth and development and will contribute to establishing new evidence in neonatal and family-centered care by providing scientific guidance for clinical practice and further research.
PROSPERO CRD42019145834.
母婴依恋关系是早产儿生长发育的基础。然而，早产出生后母婴依恋的自然过程就被打断了，情感和身体上的分离、有限的社会互动以及新生儿重症监护病房（NICU）中创伤性的、技术密集型的环境可能导致母婴依恋或亲子关系受损。据我们所知，很少有研究评估旨在增强母婴依恋、亲子关系以及父母与早产儿关系的干预措施的有效性，这些干预措施是在婴儿住院期间在 NICU 中进行的。本研究旨在对 NICU 中基于依恋和关系的干预措施的效果进行全面的系统评价和荟萃分析调查。
将在以下数据库中进行全面的文献综述：MEDLINE、CINAHL、PubMed、EMBASE（OVID）、Scopus、PsycINFO（OVID）、Cochrane 系统评价数据库、Cochrane 对照试验中心注册库（CENTRAL）和 Web of Science。选定的研究将以英文发表，在过去 20 年中，从 1999 年开始。所有随机对照试验（例如，平行组、聚类）的研究都将被纳入。我们将考虑评估基于依恋和关系的干预措施（例如，皮肤接触、父母参与婴儿护理）与对照（标准护理）的研究。主要结局将是母婴依恋。次要结局将包括婴儿的生长发育、家庭健康和育儿经验。两名专家将独立从合格研究中提取数据，并比较其数据。将应用 Cochrane 偏倚风险工具对选定的研究进行评估。如果数据允许，我们将在适当情况下进行随机效应荟萃分析。将进行亚组和额外分析，以考虑父母的性别、婴儿的性别和胎龄，探索潜在的异质性来源。数据综合将使用 RevMan 5.3 软件进行。将使用图形漏斗图法和 Egger 检验评估发表偏倚。证据质量将使用推荐评估、制定和评价（GRADE）工作组的方法进行评级。
本系统评价的结果将讨论促进家庭健康结果和婴儿生长发育的基于依恋或关系的干预措施的类型，并通过为临床实践和进一步研究提供科学指导，为新生儿和以家庭为中心的护理建立新的证据。
PROSPERO CRD42019145834。
