Malpica Rios J.C.1,2, Hernandez Alvarez E.D.1, Junco Romero J.P.1, Quijano Cuellar M.1,2
1National University of Colombia, Human Movement Department, Bogota, Colombia, 2Hospital Universitario de la Samaritana, Neonatal ICU, Bogota, Colombia
Background: Prematurity is the cause of perinatal morbidity and mortality; it is also considered a high risk factor of impairment and disability, not only due to system immaturity but also due to stress during the stay in the intensive care unit. Therefore, various strategies have been designed to counteract the high stress levels; one of which is the Newborn Individualized Developmental Care and Assessment Program (NIDCAP). The premature population is more likely to show deterioration in motor development; this is why it is important to provide adequate care from the NICU in order to promote motor development sequence according to age. That is, a timely physiotherapy intervention provides significant benefits for motor development.
Purpose: Determine the behavior of the signs of stress and self-regulation of pre-term infant, at the application of two physiotherapy interventions in the NICU of the Hospital Universitario de la Samaritana(HUS).
Methods: Thirty infants were selected and randomized into two groups: NIDCAP+HUS physiotherapy protocol and HUS physiotherapy protocol , where the vital, stress and self-regulation signs were the variables analyzed. For the response variables, a multiple factor analysis was used. In addition, a cluster analysis was performed.
Results: Behavior of Vital Signs: We found that for the Respiratory Rate variable, the group and day effect is significant. As for the remaining variables, they did not have statistical significance that would determine that these variables are of great importance to assess stress or self-regulation of the neonate.
Behavior of Signs of Stress and Self-Regulation: We conclude that the relationship between the signs of stress and self-regulation was reversed, that is, that with greater signs of stress in the neonate, the appearance of signs of self-regulation becomes more difficult or almost nil. The close-up of the factor map is performed, where three clusters are evident. Cluster 1 comprises the observations with a high presence of signs of self-regulation; Cluster 2 contains the average observations of both groups of signs; and Cluster 3 shows all observations showing highly frequent signs of stress. The HUS group has the largest number of participants and for a longer time in Clusters 2 and 3. Meanwhile, the behavior of the NIDCAP+HUS group is different because infants tend to remain in Cluster 1, which refers to a high level of self-regulation. The modeling noted that the possibility of showing a sign of stress (except yawns) decreases when it belongs to the NIDCAP group. Otherwise, to belong to the NIDCAP group involves increasing the possibility of having signs of self-regulation.
Conclusion(s): We found that the NIDCAP method helps in reducing signs of stress caused by environmental factors and manipulations around the care of newborns in the NICU and it also facilitates the preterm newborn to achieve higher self-regulation signs.
Implications: The use of strategies such as those within the NIDCAP could represent a reduction of future levels of disability, this being a high cost condition for the system, society, family and the person. In addition, these strategies do not represent more investment compared with the benefit they provide.
Funding acknowledgements: Economic support of the National University of Colombia System of the Hermes research proyect number 27865.
Topic: Paediatrics
Ethics approval: This research was approved by the Hospital Universitario de la Samaritana ethics committee (Record No. 13 of December 18, 2014)
All authors, affiliations and abstracts have been published as submitted.
