Résumés
Abstract
Introduction: Sensitive mother-infant interactions are important predictors of long-term mother-infant relationship, which is one factor having a positive impact on infant development. Considering preterm infants’ immaturity, mother-infant interactions and maternal sensitivity may not develop optimally. A systematic review showed that current evidence on the effectiveness of parent-infant interventions promoting parental sensitivity in the neonatal intensive care unit (NICU) is of low to very low quality.
Objective: The objective of this paper is to report the development process of a novel nursing intervention, using a theory and evidence-based approach, to enhance maternal sensitivity and preterm infant neurodevelopment in the NICU.
Methods: The Medical Research Council’s guidance to develop and evaluate complex health interventions, that is an evidence and theory-based approach, was used for this study. Thus, based on the MRC framework, three main steps were conducted: 1- Identifying existing empirical evidence; 2- Identifying and developing theory; 3- Modeling processes and outcomes.
Results: We developed a guided participation intervention for mothers to participate in their preterm infant’s care and positioning (‘GP_Posit’). ‘GP_Posit’ is based upon the Attachment theory, the Guided Participation theory as well as the Synactive theory of development.
Conclusion: This novel intervention is being tested in a pilot randomized controlled trial (NCT03677752).
Keywords:
- nursing science,
- mother-infant interactions,
- maternal sensitivity,
- prematurity,
- neuro-development,
- theory
Résumé
Introduction : La relation mère-enfant, dont les interactions empreintes de sensibilité maternelle en sont l’un des principaux prédicteurs, figure parmi les facteurs pouvant améliorer le développement des nouveau-nés prématurés. En raison de l’immaturité des nouveau-nés prématurés, les interactions mère-enfant précoces et la sensibilité maternelle sont à risque de se développer de façon sous-optimale. Les résultats d’une revue systématique ont montré que les données actuelles sur l’efficacité des interventions parent-enfant favorisant la sensibilité parentale dès l’hospitalisation à l’unité de soins intensifs néonatals (USIN) sont de faible à très faible qualité.
Objectif : L’objectif de cet article est de rapporter le processus de développement d’une nouvelle intervention infirmière, en utilisant une approche basée sur la théorie et les données empiriques, pour améliorer la sensibilité maternelle et le développement neurologique des nouveau-nés prématurés à l’USIN.
Méthodes : Les lignes directrices du Medical Research Council pour le développement et l’évaluation d’interventions complexes en santé ont été utilisées. Ainsi, trois principales étapes ont été suivies : 1- Identification des preuves empiriques existantes ; 2- Identification et développement théorique ; 3- Modélisation des processus et des résultats.
Résultats : Nous avons développé une intervention de participation guidée pour que les mères participent aux soins et au positionnement de leur nouveau-né prématuré : GP_Posit (ou Guided Participation of mothers to the Positioning of their preterm infant). GP_Posit est basée sur la théorie de l’attachement, la théorie de la participation guidée ainsi que la théorie synactive du développement.
Conclusion : Cette intervention est mise à l’essai dans un essai contrôlé randomisé pilote (NCT03677752).
Mots-clés :
- sciences infirmières,
- interactions mère-enfant,
- sensibilité maternelle,
- prématurité,
- neuro-développement,
- théorie
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