Amsterdam UMC, location University of Amsterdam, Department of Rehabilitation Medicine, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; Amsterdam Reproduction & Development Research Institute, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Tafelbergweg 51, 1105 BD Amsterdam, the Netherlands.
Amsterdam UMC, location University of Amsterdam, Department of Rehabilitation Medicine, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; Amsterdam Reproduction & Development Research Institute, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands.
Early Hum Dev. 2024 Nov;198:106124. doi: 10.1016/j.earlhumdev.2024.106124. Epub 2024 Sep 18.
Moderate preterm (MP) birth is associated with an increased risk of developmental problems. However, post-discharge support for this group is scarce. The aim of this study was to evaluate the feasibility of a post-discharge parenting program (TOP program) for MP infants. Three feasibility dimensions were evaluated (1) recruitment capability and compliance, (2) intervention acceptability, and (3) limited efficacy testing.
A group of MP infants with a gestational age (GA) between 32-34 weeks and their parents received six home visits by a TOP interventionist until 6 months corrected age (CA). A pre-posttest intervention design with quantitative and qualitative measures was used. Recruitment capability and compliance, acceptability, and satisfaction with the intervention were evaluated using a questionnaire, checklists, interviews, and a focus group. Infant socio-emotional development, parental distress, self-efficacy, and reflective functioning were measured with questionnaires. Observation measurements were used for infant motor development and parental sensitivity.
Thirty-two families completed the six home visits. The satisfaction rate (scale 0-10) was remarkably high (Mean 9.4, range: 8-10). Parents reported that the program was suitable, enhanced their understanding of their infants' developmental needs, and increased their self-efficacy. The infants showed age-appropriate motor and socio-emotional development post-intervention. Parental self-efficacy, reflective functioning, and sensitivity improved from pre to post intervention, with small to large effect sizes.
The study demonstrated high compliance, acceptability, and satisfaction with the TOP program for MP infants with promising infant and parent outcomes. This study contributes to the preparatory work prior to a larger scale evaluation and dissemination.
中度早产儿(MP)出生与发育问题风险增加有关。然而,针对该群体的出院后支持却很少。本研究旨在评估针对 MP 婴儿的出院后育儿计划(TOP 计划)的可行性。评估了三个可行性维度:(1)招募能力和依从性,(2)干预的可接受性,以及(3)有限的疗效测试。
一组 32-34 周妊娠龄(GA)的 MP 婴儿及其父母接受了六位 TOP 干预者的六次家访,直到 6 个月校正年龄(CA)。使用预前后测干预设计,结合定量和定性措施。使用问卷、检查表、访谈和焦点小组评估了招募能力和依从性、可接受性以及对干预的满意度。使用问卷评估婴儿的社会情感发育、父母的困扰、自我效能和反思功能。观察测量用于婴儿的运动发育和父母的敏感性。
32 个家庭完成了六次家访。满意度评分(0-10 分制)非常高(平均 9.4 分,范围 8-10 分)。父母报告说该计划是合适的,增强了他们对婴儿发育需求的理解,并提高了他们的自我效能感。干预后,婴儿表现出与年龄相适应的运动和社会情感发育。干预后,父母的自我效能感、反思功能和敏感性均得到改善,具有从小到中等的效果量。
该研究表明,对于 MP 婴儿,TOP 计划具有较高的依从性、可接受性和满意度,且婴儿和父母的预后均有希望。这项研究为更大规模的评估和传播之前的筹备工作做出了贡献。