Family-centered Care Improved Neonatal Medical and Neurobehavioral Outcomes in Preterm Infants: Randomized Controlled Trial


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Abstract

BackgroundFamily-centered care for preterm infants in Western societies has yielded short- to medium-term benefits. However, the intervention effects have rarely been validated in Eastern societies.ObjectiveThe aim of this study was to examine whether a family-centered intervention program (FCIP) could improve the short-term medical and neurobehavioral outcomes in preterm infants with very low birth weight (VLBW; a birth weight of <1,500 g) in Taiwan over the outcomes seen with a usual care program (UCP).DesignThis was a multicenter, single-blind, randomized controlled trial study.SettingThree medical centers in northern and southern Taiwan were the locations for the study.ParticipantsThe participants were 251 VLBW preterm infants without severe perinatal complications.InterventionThe infants were randomly assigned to receive the FCIP or the UCP during hospitalization.MeasurementsInfant morbidities, feeding, growth, and neurobehavioral performance were evaluated during the neonatal period. Parental adherence to interventions was measured in the FCIP group.ResultsThe FCIP promoted earlier full enteral feeding (β = -1.1 weeks; 95% CI = -1.9 to -0.2 weeks) and hospital discharge (β = -0.6 week; 95% CI = -1.1 to -0.1 weeks), greater weight gain (β = 3.3 g/d; 95% CI = 0.1 to 6.6 g/d), and better neurobehavioral performance than the UCP (β = 1.2 points; 95% CI = 0.2 to 2.3 points). Furthermore, a higher degree of parental motivation in interventions, goal attainment, and comprehensiveness of home activities was significantly associated with greater effects in infants’ neurobehavioral performance and weight gain (r = .20-.31; all Ps < .05).LimitationsThe findings may not be generalized to preterm infants with severe perinatal diseases and parents with a low level of interest in interventions.ConclusionsFamily-centered care facilitated short-term medical and neurobehavioral outcomes in VLBW preterm infants in Taiwan; the effects were likely achieved through parental adherence to interventions. The designated strategies may be considered in a future launch of family-centered care in Taiwan.

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