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The Universe of Developmental Care: A New Conceptual Model for Application in the Neonatal Intensive Care Unit

Gibbins, Sharyn RN, PhD1; Hoath, Steven B. MD2; Coughlin, Mary RN, MS3; Gibbins, Alan4; Franck, Linda RN, PhD5

Section Editor(s): SHORT, MARY A. RN, MSN

doi: 10.1097/01.ANC.0000324337.01970.76
Foundations in Newborn Care

Developmental care for high-risk infants is practiced in most neonatal units around the world. Despite its wide acceptance, inconsistency in its definition and application has resulted in criticism regarding its scientific merit. The universe of developmental care model proposed in this article is the first major reformulation of neonatal developmental care theory since Als' synactive theory. Neither the developing brain nor the environment exists in isolation, and therefore are dependent on each other for all caregiving activities. Central to this model is the concept of a shared surface, manifested most obviously by the skin that forms the critical link between the body/organism and environment and becomes the focal point for human interactions. The components of the model and its theoretical underpinnings, its practical application and direction for future clinical practice, education, and research are presented.

1Sunnybrook Health Sciences Centre and The Hospital for Sick Children, Toronto, Ontario, Canada, 2Skin Sciences Institute and the Division of Neonatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, 3Children's Medical Ventures, Norwell, Massachusetts, 4Anglersthree Multimedia, Burlington, Ontario, Canada, and 5Institute of Child Health, University College London, London, England.

Address correspondence to Sharyn Gibbins, RN, PhD, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; sharyn.gibbins@sunnybrook.ca.

© 2008 National Association of Neonatal Nurses