Parent-infant interaction in the NICU: Challenges in measurement.

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Date: July 2022
From: Early Human Development(Vol. 170)
Publisher: Elsevier B.V.
Document Type: Report
Length: 506 words

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Keywords Premature infant; Human development; Parents; Interactions Highlights * Tools that assess parent-infant interaction are not designed for the NICU context. * Positive parent-infant interactions in the NICU may be labeled as negative on standard measures. * There are medical and social factors known to be related to parent-infant interaction. * These medical and social factors were not related to a standard measure of interaction in NICU. * Enhanced education in the NICU related to lower scores on a standardized measure of interaction. Abstract Background Parent-infant interaction is poorly understood among high-risk dyads in NICU settings. No parent-infant interaction measures are specifically designed for preterm infants within the NICU nor account for the education NICU parents receive to tailor their interactions based on the infant's cues. Aim To improve our understanding of a measure of parent-infant interaction in the NICU, we investigated relationships between parent-infant interaction scores on the Nursing Child Assessment Feeding Scale (NCAFS) and 1) socio-demographic and medical factors, 2) parent mental health and confidence, and 3) enhanced parental education (delivered as part of the Supporting and Enhancing NICU Sensory Experiences program) on tailoring interactions based on the infant's cues. Method Twenty-six preterm infants (born [less than or equal to]32 weeks) had a video recorded oral feeding conducted by a parent in the NICU when the infant was 34--48 weeks postmenstrual age. A certified evaluator scored parent-infant interaction from the videos using the NCAFS. Results Seventeen (65 %) parent-infant dyads scored below the 10th percentile on the total NCAFS score. Despite it being well-understood that parent-infant interaction is related to sociodemographic factors and parental mental health, there were no relationships between these factors and NCAFS scores in this study. Dyads who received enhanced parent education (n = 15) had lower NCAFS scores than dyads receiving usual care (n = 11) (p = 0.01). Conclusion It remains unclear if the standard measure of parent-infant interaction, NCAFS, captured positive and negative interactions in context of assessment of a high-risk dyad within the NICU setting. The utility of the NCAFS with preterm infants in the NICU was not supported by this study. Author Affiliation: (a) University of Southern California, Chan Division of Occupational Science and Occupational Therapy, 1540 Alcazar St, Los Angeles, CA 90089, United States of America (b) Self-employed, Ridgeway, CO 81432, United States of America (c) Department of Quality, Safety, and Practice Excellence, St. Louis Children's Hospital, St Louis, MO, United States of America (d) Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, United States of America (e) Gehr Family Center for Health Systems Science and Innovation, University of Southern California, Los Angeles, CA, United States of America (f) Center for the Changing Family, University of Southern California, Los Angeles, CA, United States of America * Corresponding author at: 1540 Alcazar St, Room: CHP 222R, Los Angeles, CA 90089, United States of America. Article History: Received 30 September 2021; Revised 4 May 2022; Accepted 11 June 2022 Byline: M. Richter (a), K. Fehringer (b), J. Smith (c), R. Pineda [] (a,d,e,f,*)

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Gale Document Number: GALE|A708648578