In effort to conduct comparative study on the caregiving environment of Neonatal Intensive Care Unit(NICU) in both U.
S and Korea, this study was been conducted first in the U.
S.
PURPOSE: The purpose of this study is to identify the physical environment and direct caregiving practices to lowbirth weight infants in NICU in the US. It also aims to examine the NICU outcome status and behavioral reponses of lowbirth weight infants.
METHODS: A study design using descriptive and inferential statistics was been conducted through an observational, field method. A sample of 15 preterm infants admitted to NICU were recruited for the study. The subjects were those with birth weight between 1,000 gm to 1,500 gm, born at the gestation period of 27 to 33 weeks, and without any chromosomal or maternal illness. Thirty minutes observation(three times of ten minutes of continuous observation) of the infant's behavior and physiological status, and an four-hour observation of the physical environment and direct care giving procedures were been conducted on the 3rd and 10th day after birth, and on the day of discharge from the NICU or at 34weeks postconception.
The data to be collected were in four areas: the demographic characteristics of the infants, the physical environment and care giving procedures, the frequency of the infant's designated behavior and physiological response, and NICU outcome variables. A descriptive analysis and Kruskal-Wallis, Pearson r were been applied according to variable characteristics.
RESULTS: 1. Mother's mean age was 29.47. The sample consisted of 6 males and 9 females.
Mean gestational ages were 29.17 weeks. Man birth weight was 1236.33g. Mean Apgar scores at one minute were 6.6, and 7.8 at five minutes.
2. The location for the incubator was in the distance from the light, X-ray screens and nursing station, in proximity to side-lamp, telephone and faucet on the third day after birth. The location for the incubator was in the distance from the light and radio on the tenth day and in proximity to nursing station on the day of discharge from the NICU or at 34weeks postconception.
3. Nesting was the most applying aids to the infants. And foot roll, shielding and plastic frame were frequently using by nurse for facilitating well modulated restful posture.
4. There were statistically significant changes in the patterns of physical environment included locating the infant's incubator and bedding, specificaids to self regulation on the 3rd and 10th day after birth, and on the day discharge from the NICU or at 34weeks postconception.
5. Statistically significant changes were not appeared in the patterns of direct caregiving procedure to the infants included stress inducing or reducing manipulations on the 3rd and 10th day after birth, and on the day of discharge form the NICU or at 34weeks postconception.
6. The stress response of the infants in NICU were significantly reduced as the infants grow older.
7. There were not statistically significant correlation between the physical environment. and the stress responses of the infants in NICU.
8. The were statistically significant correlation between the direct caregiving procedure to the infants and the stress response of the infants in NICU in the second and third observation on the day three.
9. Average weight gain per day from birth to discharge was 38.73g, number of days in the hospital was 42.60, number of days before bottle feeding was 3.6. Postconception age starting bottle feeding was 31+5 weeks. Number of days on mechanical ventilator was average 7.64, 11.42 was an average number of days of oxygen need.
CONCLUSION: It, thus, appears that to minimize the senso-rymotor stimulation for the low birthweight preterm infant in NICU, manipulation of care giving practices to the babies whatever the stress inducing or reducing procedures, have to be limited in the immediate early stage after birth. And it needed to be reexamine to identify the appropriate and specific physical environment and the patterns of direct caregiving to the low birthweight preterm infant as the infants grow older in NICU.
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