120 Effectiveness of interventions on parental sensitivity, infant neurodevelopment and parental stress in the NICU: Results from a systematic review & meta-analysis
Notice bibliographique
Résumé
Parental sensitivity is the parent’s ability to recognize and interpret their infant’s cues, and identify and apply an appropriate response quickly. Sensitivity is central to the parent-infant relationship and predicts long-term attachment which also influences the child’s neurodevelopment. Parents of preterm infants are not less sensitive than parents of term infants but preterm infants may need more sensitive parenting. Moreover, increased parental stress in the NICU negatively influences parental sensitivity. Prior to NICU discharge, passive and active interventions, the former being interventions where parents receive information and the latter where parents participate in an aspect of their infant’s care, have been evalauated. Yet, no systematic review has examined the effect of both passive and active interventions as different types of interventions and their respective effects on sensitivity, nor have they examined their effects on neurodevelopment and parental stress. The primary objective of this systematic review is to examine the characteristics of passive and active interventions designed to enhance parental sensitivity. The secondary objective of this systematic review and meta-analysis is to examine the effectiveness of early interventions for parents of preterm infants on parental sensitivity, parental stress and preterm infant neurodevelopment, compared to standard care. We adhere to the protocol which has previously been published and registered in the PROSPERO database (registration number: CRD42016047083). Eight databases have been searched. To be included, studies had to be randomized controlled trials (RCT) of early interventions for parents of preterm infants implemented in NICUs with parental sensitivity as a primary outcome and infant neurodevelopment as secondary outcome. Parental stress was added as a secondary outcome retrospectively because it was measured in many of the included RCTs. Intervention caracteristics were qualitatively summerized. Because more than one study was available, a meta-analysis was conducted for the parental sensitivity outcome and for the parental stress outcome using a random effects model. The literature search resulted in 7403 references. Following the study selection process, 24 papers accounting for eighteen studies published from 1988 to 2017 were included in the systematic review. These studies reported on fifteen different interventions. Interventions are often composed of an educational component where parents are taught their preterm infant’s cues. Parental participation in care using guided participation is also common and seems beneficial to promote sensitivity in the NICU. Only four interventions included fathers. Parents had a passive role in five interventions and had an active role in 14 interventions. Active parental participation included participation in kangaroo care, stimulation of their infant’s senses and participation in their infant’s care. The meta-analysis shows that passive interventions have an overall small but significant effect on parental sensitivity. Active interventions show no significant effect on this outcome. Both active and passive interventions also show no significant effect on parental stress. Infant neurodevelopment could not be considered in the meta-analysis because of insufficient data. This is the first systematic review examining the effectiveness of interventions promoting sensitivity of parents of preterm infants in the NICU. Regardless of the meta-analysis results, this systematic review will guide clinical practice for the implementation of interventions in NICUs to enhance parental sensitivity, optimize neurodevelopment of preterm infants, and lower parental stress. Results also guide research and the development of intervenions to further enhance sensitivity in the NICU.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,010 | 0,038 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,001 |
| Méta-épidémiologie (sens large) | 0,017 | 0,029 |
| Bibliométrie | 0,005 | 0,006 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,003 | 0,002 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,005 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».