Reducing stress in the neonatal intensive care unit:an occupational therapy approach to preterm infant massage
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Kunisch, Julie A.
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Preterm infants and their parents in the neonatal intensive care unit (NICU) are a growing client population for occupational therapists. The NICU environment of care can be over stimulating and cause high amounts of stress for preterm infants and their parents. Evidence-based literature supports preterm infant massage to decrease stress for preterm infants and improve overall neurobehavioral development. Evidenced-based literature also supports decreased stress for parents that perform preterm infant massage with their child as well as improved confidence of parental skills and infant-parent attachment. Despite these benefits, infant massage is practiced in less than half of the NICUs in the United States (Field, Diego & Hernandez-Reif, 2010). This may be related to the underlying mechanisms not being well understood and/or cost effectiveness considerations. This doctoral project (1) identifies evidenced-based literature to support the benefits of preterm infant massage for both the infant and the parent, (2) investigates evidence and best practice in designing a preterm infant massage parent education program in the NICU that supports the infant-parent dyad, (3) provides an overview of best practice for implementing a preterm infant massage parent education program in the NlCU, (4) describes a detailed evaluation plan and dissemination of the results including estimated budgets for implementation and dissemination. This project's target audiences are medical directors, directors of occupational therapy departments, neonatal occupational therapists, neonatologists, other health care staff in the NICU, and parents of preterm infants in the NICU. This project will be presented to the medical director of a Level IV NlCU and the director of occupational therapy at University of Rochester Medical Center-Golisano Children's Hospital for consideration of implementation. This project contributes to three areas of occupational therapy: (1) addressing best practice for implementing a preterm infant massage program in the NlCU to reduce stress levels for infants and parents, (2) providing more evidenced-based practice with a growing occupational therapy population of preterm infants and their parents, and (3) building a more diverse occupational therapy profession.
Thesis (Ph.D.)--Boston University