家庭综合护理（FICare）：对 18 个月时行为结果的积极影响。
Family Integrated Care (FICare): Positive impact on behavioural outcomes at 18 months.
机构信息
Sunnybrook Health Sciences Centre, Department of Newborn and Developmental Paediatrics, 2075 Bayview Avenue, M4-234, Toronto, ON M4N 3M5, Canada; University of Toronto, Department of Paediatrics, 27 King's College Cir, Toronto, ON M5S 3H7, Canada.
University of British Columbia, Department of Pediatrics and BC Children's Research Institute, 4500 Oak Street, Vancouver, BC V6H 3N1, Canada; BC Women's Hospital, 4500 Oak St, Vancouver, BC V6H 3N4, Canada.
出版信息
Early Hum Dev. 2020 Dec;151:105196. doi: 10.1016/j.earlhumdev.2020.105196. Epub 2020 Sep 19.
BACKGROUND
Children born very preterm demonstrate behavioural challenges due to clinical factors, exposure to the high stress environment of intensive care, and separation from parents during neonatal hospitalization at a critical stage in development. Family Integrated Care (FICare) significantly reduced parent stress and anxiety, and improved neonatal outcomes.
AIMS
To examine the impact of FICare on behavioural outcomes at 18-21 months corrected age (CA), and assess possible mediation through parenting or infant growth.
STUDY DESIGN AND METHODS
A prospective cohort study enrolling infants under 33 weeks gestation and parents from the FICare cluster randomized controlled trial. Primary outcome was behaviour assessed by the Infant Toddler Social Emotional Assessment (ITSEA). Parent child variables were measured with the Nursing Child Assessment Satellite Training (NCAST), Parenting Stress Index (PSI) and infant growth.
RESULTS
Subjects included 123 FICare infants and 62 standard care controls evaluated at 18-21 months CA. FICare infants demonstrated lower ITSEA Dysregulation, indicating better self-regulation skills, compared with the control group (T-score 41.7 vs 46.6, p < 0.01). At 12 months CA, the NCAST Child subtotal score was higher and the PSI-Child Domain score was lower in FICare infants than non-FICare infants. The PSI-Child domain was identified as a possible mediator of FICare on child behaviour (mediation effect 1.28, -2.96-0.02, p = 0.044).
CONCLUSION
FICare in the NICU has a sustained effect on child behaviour, improving self-regulation at 18-21 months CA.
背景
由于临床因素、在重症监护环境中面临的高度压力、以及新生儿住院期间与父母分离等原因，极早早产儿表现出行为挑战。家庭综合护理（FICare）显著降低了父母的压力和焦虑，并改善了新生儿的结局。
目的
研究 FICare 对 18-21 个月校正年龄（CA）时行为结果的影响，并评估通过育儿或婴儿生长进行可能的中介作用。
研究设计和方法
一项前瞻性队列研究纳入了来自 FICare 群组随机对照试验的妊娠不足 33 周的婴儿及其父母。主要结局是通过婴儿幼儿社交情感评估（ITSEA）评估行为。使用护理婴儿评估卫星培训（NCAST）、父母压力指数（PSI）和婴儿生长来测量母婴变量。
结果
共纳入 123 名 FICare 婴儿和 62 名标准护理对照组，在 18-21 个月 CA 时进行评估。与对照组相比，FICare 婴儿的 ITSEA 失调评分较低，表明其自我调节技能更好（T 评分 41.7 对 46.6，p<0.01）。在 12 个月 CA 时，FICare 婴儿的 NCAST 儿童总分较高，PSI-儿童域评分较低。PSI-儿童域被确定为 FICare 对儿童行为的可能中介（中介效应 1.28，-2.96-0.02，p=0.044）。
结论
NICU 中的 FICare 对儿童行为有持续的影响，可改善 18-21 个月 CA 时的自我调节。
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