Sudden infant death syndrome: Parents' perceptions and responses to the loss of their infant

Sudden Infant Death Syndrome (SIDS) is the number one killer of infants under one year of age. Families are left in a state of crisis after a baby dies of SIDS. Thus, crisis counseling has been offered routinely to SIDS parents in King County, Washington. The purpose of this retrospective study was to assess whether mothers differed significantly from fathers in their perception of the situation, their feelings experienced and expressed, their approaches to problem solving, and the support they received. Differences in reactions between single and married parents were also studied. The 48% return rate produced a sample of 54 parents, 37 mothers and 17 fathers, who had lost their infant to SIDS. Statistically significant differences were found between mothers and fathers, as well as between single and married parents, in their view of the SIDS event, their problem solving approaches, and support systems. The results provide useful information for nurses in counseling SIDS parents and in working with families during and after subsequent pregnancies.     

Office care of the premature infant

The family physician should follow the small premature infant in the neonatal intensive care center and review the baby's problems and risk factors. In the office, special attention is required in monitoring the infant. Proper hospital and office care greatly improve the prognosis.     

Outpatient care of the premature infant

An increasing number of infants in the United States are born prematurely, with current statistics estimating about 13 percent of all births. Although survival rates and outcomes for premature infants have dramatically improved in recent decades, morbidity and mortality are still significant. Infants born prematurely are at increased risk of growth problems, developmental delays, and complex medical problems. To account for prematurity, growth and development monitoring should be done according to adjusted age (age in months from term due date). Premature infants should gain 20 to 30 g (0.71 to 1.06 oz) per day after discharge from the hospital. Growth parameters may be improved in the short term with the use of enriched preterm formula or breast milk fortifier. Each well-child examination should include developmental surveillance so that early intervention can be initiated if a developmental delay is diagnosed. Routine vaccination should proceed according to chronologic age with minor exceptions, and respiratory syncytial virus immune globulin is indicated in preterm infants who meet the criteria.     

Exploring the loss and disenfranchised grief of animal care workers

Abstract

This article explores the psychological distress of Animal Care Workers (ACWs), and the disenfranchisement of this distress through mixed methods study conducted as an online survey. In all, 139 participants responded about their experiences as an ACW, related psychological distress, and the systemic disenfranchisement of distress. Findings indicate that nearly half of ACWs experienced symptoms of depression in the previous month. Over 66% indicated it was difficult to cope. Limited support often resulted in a disenfranchized loss. Implications suggest ACW distress and disenfranchisement related to animals they serve is similar to that of individuals who lose animal companions.     

Parents' experiences of midwife-managed care following the loss of a baby in a previous pregnancy

AIMS OF THE STUDY: This article reports on research that explored the impact of the Special Delivery Service, a midwife-managed intervention, developed as an addition to routine care to support and educate high-risk pregnant women and their partners subsequent to the death of a baby in a previous pregnancy. BACKGROUND: Approximately 40,000 families suffer the trauma of a neonatal death* annually in the USA, while statistics for Canada and Australia give similar numbers relative to population. Since many more babies die than those accounted for in these statistics, through stillbirth, miscarriage and Sudden Infant Death Syndrome, more than the above-cited 2% of childbearing couples will face the trauma of the loss of a baby. RATIONALE: The resultant threat that this situation may pose to the health of the mother has been extensively documented in the literature. However, despite the recent growth in knowledge about the impact of perinatal loss and bereavement, few interventions are specifically designed to support Australian and Canadian women and their partners during a pregnancy following the loss of a baby. METHODOLOGY: This phenomenological study explored women's and their partners' experiences of grief and loss and the support offered to them through the Special Delivery Service programme. RESULTS & DISCUSSION: In the face of funding and organizational changes to both the Australian and Canadian health care systems that have eliminated or reduced some services, this research reinforced the need for individualized, compassionate midwifery care and the urgent need for genuinely empathic and supportive health care services for these women and their partners. It also emphasized the need for couples to be informed and supported so that gender differences in grieving do not become a divisive element in the relationship. CONCLUSIONS: The findings have implications for both nurses and midwives in their practice in countries where optimum care of this vulnerable population is not routinely available. The research supports midwife-managed models of care to ensure women and their families are appropriately supported in crisis. The findings provide insight also into the diverse grief response among couples and the difficulties experienced in a pregnancy following the loss of a baby.     

Applying the synactive theory of development to the care of a premature infant with sucking problems

Sucking problems in an infant born prematurely at 24 weeks and 5 days were identified through systematic behavioral observation and family assessment. Reasons underlying the infant's sucking problems included poor sucking and swallowing skills due to an immature nervous system, a chaotic care environment and ecology, and unimplemented sucking and feeding care procedures. Due to the paucity of domestic diagrams related to oral-sucking training for premature babies, in addition to reviewing the literature and establishing a sucking training program to help the infant establish a regular sucking pattern, we also applied the synactive theory of development and improved the hospital feeding environment and ecology to reduce environmental factors that could affect sucking care such as ambient light and noise and feeding schedules. We observed implied infant sucking pattern actions such as restlessness, mouth shakes, and irritation and provided the mother with an appropriate feeding schedule. We helped foster parent-child attachment and enhanced the mother's post-discharge caring confidence. Home visits were also conducted after discharge to assess the home care environment and give instant consultation, providing holistic health care with sustained quality of care.     

早产合并剥脱性皮炎患儿的护理

报告1例早产合并剥脱性皮炎患儿的护理.主要内容包括:皮肤护理,眼部护理,保护静脉和穿刺后护理,严密观察病情,全身营养支持,保护性隔离和对怠儿家长的心理疏导等.经过14d的精心治疗与护理,惠儿治愈出院.     

1例B族链球菌感染早产儿的围生期护理

总结1例B族链球菌（group B streptococcus,GBS）感染早产儿的围生期护理经验。护理要点：孕期筛查、产时预防性使用抗生素,降低早发型GBS感染发生率;启动高危预警,警惕早发型GBS感染;早期识别晚发型GBS感染症状,提高治疗、抢救成功率;加强基础护理,预防呼吸机相关并发症;开展个性化母乳喂养指导,避免GBS感染复发;提供针对性的健康教育,提高患儿家长对GBS感染的认知。经过40 d积极治疗与精心护理,患儿痊愈出院,随访至纠正月龄6个月,患儿疾病未复发,生长发育良好。     

Parents' support and satisfaction with their child's postoperative care

It is recognized that parents' presence during their child's hospitalization is of benefit to the parents and the child. However, the level of parental involvement in their child's care may be influenced by many factors, such as the amount of support nurses provide for parents. This article reports on two themes from the findings of a larger study on parental involvement in children's postoperative pain management - parental support and parents' satisfaction with their child's postoperative pain management. The aim of the larger study was to explore both nurses' and parents' perceptions of parental involvement in their child's postoperative pain management. The methods used were both qualitative and quantitative. The qualitative method of phenomenology was used to guide 20 nurse and 20 parent interviews. Quantitative methods involved surveying the nurses and parents on their perceptions of how supportive the nurses were towards the parents. The charts of 20 children were reviewed for pain-related data. This article reports on the issues of parent support from the results of the survey, and on satisfaction relating to their child's postoperative pain management from the parent interviews. The findings demonstrated that nurses perceived that parents were receiving more support from them than that which parents felt they were receiving. Parents were more satisfied with their child's pain management and children received more analgesia when they were cared for by a lower grade nurse.     

Current approaches to correcting blood loss in obstetric care

The paper considers current approaches to the strategy and tactics of infusion-transfusion therapy (ITT) in the development of obstetric bleedings. The results of treatment were analyzed in 124 patients in whom pregnancy or labor had been complicated by hemorrhage. Various ITT options are presented depending on the volume of blood loss and physiological background. The ITT programs applied are based on the combined used of colloid and crystalloid solutions and hypertonic sodium chloride solution. With increased blood loss volume, artificial colloids are gradually excluded from an ITT program in the following order: dextrans, hydroxyethyl starch, and gelatin derivatives. Subsequently, priority is given to natural colloids. Blood components were transfused if strictly indicated. The studies have indicated that the baseline blood circulation of patients with physiological and severe gestosis-complicated pregnancy should be taken into account during ITT for acute obstetric blood loss. The differential approach to ITT and its pattern and type depend on the quantity of lost blood, that should be calculated as percentage with reference to the volume of circulating blood of a pregnant woman rather than relied on its total volume. The pathophysiologically substantiated approach to ITT for acute obstetric blood loss with the physiological background being kept in mind makes it possible to stabilize the parameters of blood circulation, volemic and colloid-osmotic homeostasis, thereby reducing the incidence of postoperative complications.     

Primary care of the premature infant discharged from the neonatal intensive care unit

Premature infants require varying degrees of newborn intensive care and have a wide range of physical and developmental outcomes. Subsequent ambulatory care for these infants is often complex. Although tertiary hospitals often provide multidisciplinary follow-up clinics, the pediatric nurse practitioner (PNP) responsible for primary care has a unique opportunity to influence the lives of these special babies and their families. While the basic principles of well child care and health maintenance apply to this special population, there are several inherent challenges. The transition from neonatal intensive care unit (NICU) to home can be stressful for families. Infants born prematurely often have unpredictable behavior and present with cues that are vague and unclear to caregivers. Growth must be monitored adjusting for prematurity, and nutrition must be tailored to the physical and developmental level of the infant. Assessments of development, vision, and hearing must also be adjusted for prematurity. Fortunately, the majority of premature infants discharged from the NICU thrive and develop normally. However, some will experience medical problems and developmental delay. Knowledge of complications common to premature infants will be helpful to the PNP providing primary care. These include difficulties of growth and feeding, gastroesophageal reflux, apnea and bradycardia, chronic lung disease, fine and gross motor abnormalities, and other learning problems. Providing care to the NICU graduate is one of the challenges faced by PNPs in primary care, but one that is both rewarding and enjoyable.