Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA.
Department of Pediatrics, Keck School of Medicine, Los Angeles, CA, USA.
BMC Pediatr. 2021 Mar 22;21(1):137. doi: 10.1186/s12887-021-02594-3.
To maximize the benefit of parent-directed, positive sensory exposures in the NICU, a structured sensory-based program titled the Supporting and Enhancing NICU Sensory Experiences (SENSE) program was developed that includes specific doses and targeted timing of evidence-based sensory exposures.
The Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework was used to systematically evaluate the SENSE program as an implementation strategy. One-hundred preterm infants ≤32 weeks gestation were studied (61 receiving the SENSE program and 39 standard-of-care). Parent education time and infant sensory exposures were tracked, and parents completed a questionnaire that probed their perceptions about the SENSE program.
One-hundered thirty-one families were recruited, and 100 (76%) enrolled. The SENSE program was initiated at an average postmenstrual age of 29.8 (±2.4) weeks; 4.9 (±5.6) days after birth. The average number of education sessions with families was 4.8 (±3.7) amounting to 72.3 (±37.4) total minutes over hospitalization. The total time of logged tactile and auditory exposures among SENSE recipients over the length of hospitalization was a median (IQ range) of 9325 (5295-15,694) minutes over an average of 10.1 (±7.6) weeks of hospitalization. There were differences in the proportion of tactile and auditory exposure targets received by the infant among those receiving the SENSE program compared to standard-of-care (91% compared to 48%; p < 0.0001). Ninety-five percent of infants tolerated the SENSE program as defined, with 5% of infants requiring intermittent adaptations or the interventions being stopped for a period that typically lasted 1-2 weeks. Earlier parent education was related to more parent participation in SENSE program interventions (p = 0.04). Eighty-five percent of participants receiving the SENSE program had most of the sensory interventions completed by parents, as opposed to the medical or sensory support team. Seventy-two percent of infants had at least 100% of the auditory and tactile doses conducted over the length of stay. Parents reported acceptability.
The SENSE program had good reach, was effective and acceptable with minimal cost, was adopted, and had good fidelity. Insights from implementation of the SENSE program (within a research study) informed future strategies to aid maintenance during dissemination.
为了使父母主导的积极感觉暴露在新生儿重症监护病房（NICU）中最大程度地受益，开发了一种名为支持和增强新生儿感觉体验（SENSE）的结构化基于感觉的计划，其中包括基于证据的感觉暴露的特定剂量和针对性时间。
使用扩展、有效性、采用、实施和维持（RE-AIM）框架系统地评估 SENSE 计划作为实施策略。研究了 100 名≤32 周龄的早产儿（61 名接受 SENSE 计划，39 名接受标准护理）。跟踪了父母的教育时间和婴儿的感觉暴露情况，父母完成了一份调查问卷，以探究他们对 SENSE 计划的看法。
共招募了 131 个家庭，其中 100 个（76%）家庭入组。SENSE 计划在平均胎龄 29.8（±2.4）周时开始；在出生后 4.9（±5.6）天。平均每个家庭接受 4.8（±3.7）次教育，住院期间共进行了 72.3（±37.4）分钟的教育。在住院期间，SENSE 接受者记录的触觉和听觉暴露总时间中位数（IQR 范围）为 9325（5295-15694）分钟，平均住院时间为 10.1（±7.6）周。与标准护理相比，接受 SENSE 计划的婴儿接受触觉和听觉暴露目标的比例存在差异（91%对比 48%；p<0.0001）。95%的婴儿可以耐受 SENSE 计划，定义为有 5%的婴儿需要间歇性调整或干预暂停 1-2 周。较早的家长教育与家长更多地参与 SENSE 计划干预相关（p=0.04）。85%的接受 SENSE 计划的参与者中，大部分的感觉干预由父母完成，而不是医疗或感觉支持团队。72%的婴儿在住院期间至少完成了 100%的听觉和触觉剂量。父母报告接受度。
SENSE 计划的覆盖率高、有效且可接受，成本低、采用率高、保真度高。从 SENSE 计划的实施（在研究中）中获得的见解为将来在传播过程中帮助维持提供了策略。
