Aoyama Yusuke, Mori Tomohiro, Nagata Masako, Sato Yoshiaki
Department of Rehabilitation, Nagoya University Hospital, Nagoya, JPN.
Department of Rehabilitation, Nagoya University Graduate School of Medicine, Nagoya, JPN.
Cureus. 2025 Aug 7;17(8):e89567. doi: 10.7759/cureus.89567. eCollection 2025 Aug.
This case report describes the implementation of Family-Centered Care (FCC) and developmental occupational therapy (OT) for an extremely preterm infant born at 22 weeks and one day of gestation, weighing 448 g. The infant experienced multiple complications, including necrotizing enterocolitis, sepsis, intraventricular hemorrhage, and respiratory distress, requiring prolonged intensive care. Due to physiological fragility and immature neurobehavior, a structured rehabilitation approach was introduced, integrating OT and caregiver participation based on FCC principles. The intervention aimed to enhance the infant's self-regulation and support parenting resilience. Self-regulation was evaluated using the Brazelton Neonatal Behavioral Assessment Scale (NBAS), and parental resilience was assessed with the Parenting Resilience Elements Questionnaire (PREQ). The program was divided into three phases aligned with developmental stages and caregiver involvement. NBAS self-regulation scores improved from a median of 1 (low level) to 6 (ordinary level). PREQ scores for both parents also increased, reflecting stronger emotional bonding, better understanding of the infant's cues, and improved confidence in caregiving. Caregivers were gradually engaged in routines such as suckling, bathing, and developmental play. Collaborative role-sharing among occupational therapists, physical therapists, and nursing staff further supported the intervention. This case highlights how early FCC and developmental OT may promote neurodevelopment and psychological adaptation in families of extremely preterm infants.
本病例报告描述了对一名孕22周零1天出生、体重448克的极早产儿实施以家庭为中心的护理(FCC)和发育性职业治疗(OT)的情况。该婴儿经历了多种并发症,包括坏死性小肠结肠炎、败血症、脑室内出血和呼吸窘迫,需要长期重症监护。由于生理脆弱和神经行为不成熟,引入了一种结构化康复方法,基于FCC原则整合职业治疗和照顾者参与。干预旨在增强婴儿的自我调节能力并支持养育韧性。使用布雷泽尔顿新生儿行为评估量表(NBAS)评估自我调节能力,并用养育韧性要素问卷(PREQ)评估父母的韧性。该项目分为三个阶段,与发育阶段和照顾者参与度相匹配。NBAS自我调节得分从中位数1(低水平)提高到6(普通水平)。父母双方的PREQ得分也有所提高,反映出更强的情感联结、对婴儿线索的更好理解以及照顾婴儿的信心增强。照顾者逐渐参与到诸如哺乳、洗澡和发育性游戏等日常活动中。职业治疗师、物理治疗师和护理人员之间的协作角色分担进一步支持了干预。本病例突出了早期FCC和发育性OT如何促进极早产儿家庭中的神经发育和心理适应。