Date Presented 03/28/20
Preterm birth leads to delayed maternal identity, which is linked with poor infant outcomes and decreased infant participation in activities of daily living. It is vital that OTs address maternal role competence during the NICU stay to facilitate positive outcomes for infants and their caregivers. This research reviews the strength of occupation-based, caregiver-centered interventions in the NICU that can be utilized to promote caregiver role competence.
Primary Author and Speaker: Rebecca Schuck
Additional Authors and Speakers: Molly Kessler, Carly Rosenthal, Devon Stobbe, Rebecca Sinko
PURPOSE: According to previous research, preterm birth leads to delayed maternal identity which is linked with poor infant outcomes and decreased infant participation in activities of daily living (Reid, 2000; Pizur-Barnekow & Erickson, 2011). Caregiver education is a common mode of intervention used by occupational therapists (OTs) in the Neonatal Intensive Care Unit (NICU) to address these challenges (Craig, Carroll, Ludwig & Sturdivant, 2018). OTs are well-positioned to facilitate co-occupations between infants and their caregivers in the NICU, strengthening the relationship and confidence in parenting roles (Craig, Carroll, Ludwig & Sturdivant, 2018). OTs can facilitate realistic and transformative expectations of infant occupational performance, which is often in conflict with parental expectations (Craig, Carroll, Ludwig, & Sturdivant, 2018). The purpose of this presentation is to review the strength of occupation-based caregiver-centered interventions in the NICU to promote caregiver role competence.
METHODS/DESIGN: A systematic process was used to search and locate literature through three databases: PubMed, CINHAL, and Scopus. Inclusion criteria were articles focused on interventions delivered in the NICU for caregivers that were within the scope of OT practice, with outcomes measured within one year of the NICU stay. The exclusion criteria were systematic, scoping and literature reviews, clinical protocols and pilot studies, articles without interventions, and assessment focused studies. Revised Critical Review Forms were used to appraise each included article. Thematic analysis was used to analyze reviews.
RESULTS: Two themes were found. The first theme was the method of educational delivery, with sub-themes of didactic methods, continued care, and active participation. Didactic delivery and continued care methods increased knowledge, while continued care and active participation improved maternal mental health. The second theme was the content of education, with sub-themes of relaxation techniques, caregiver-infant communication, and foundational knowledge. These content areas increased mental health and other role competency outcomes.
CONCLUSION: These themes suggest that both the content and the method of caregiver education are important factors in caregiver NICU education. It is important for OTs in the NICU to prioritize caregiver training, embedding relaxation techniques and foundational knowledge into the training, and to prioritize follow-up care. This information will allow practitioners to ground their caregiver education in the NICU in evidence-based practice.
References
Craig, J., Carroll, S., Ludwig, S., & Sturdivant, C. (2018). Occupational therapy’s role in the neonatal intensive care unit. American Journal of Occupational Therapy,72(Supplement_2). doi:10.5014/ajot.2018.72s204
Pizur-Barnekow, K., & Erickson, S. (2011). Perinatal posttraumatic stress disorder: Implications for occupational therapy in early intervention practice. Mental Health Special Interest Section Quarterly / American Occupational Therapy Association, 27(2). doi:10.1080/0164212X.2011.566165.
Reid, T. (2000). Maternal identity in preterm birth. Journal of Child Health Care: for Professionals Working with Children in the Hospital and Community, 4(1), 23–29. doi:10.1177/136749350000400104.
