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Commentary on: “Factors Associated With Developmental Concern and Intent to Access Therapy Following Discharge From the NICU”

Lovelace-Chandler, Venita PT, PhD, PCS; Chitwood, Carla PT, DPT, PCS

Pediatric Physical Therapy: April 2013 - Volume 25 - Issue 1 - p 70
doi: 10.1097/PEP.0b013e31827a83ba
Clinical Bottom Line

University of North Texas Health Science Center, Ft Worth, Texas

Cook Children's Medical Center, Ft Worth, Texas

The authors declare no conflicts of interest.

“How should I apply this information?”

The authors' findings reinforce the importance of gathering such information as family demographics and maternal status during a history and initial evaluation and using the information for decision making. The instruments used in the study to assess maternal emotional status serve as examples for clinicians wishing to include assessment of maternal depression in the evaluation process. The authors' discussion of the factors associated with developmental concerns, particularly maternal depression, provides insights that may assist therapists in providing family-centered care.

Higher levels of maternal education were associated with increased intent to access services. The surprising finding that infant factors of medical severity and brain injury were not associated with developmental concern or intent to access therapy should assist therapists in identifying new strategies for meeting caregiver needs in the neonatal intensive care unit (NICU) and following discharge. Increased infant stress signs were associated with developmental concern, perhaps suggesting that the immediate needs of the caregiver and the infant must be addressed before planning for the future

“What should I be mindful about in applying this information?”

The authors shared limitations of their study, including that mothers may have thought that they should answer with a positive intent to access services. A recent article presented an administrative case related to instituting parent education practices in the NICU.1 The authors used evaluation of the existing services and evidence from the literature to develop 3 strategies to enhance parent education on development. Although that case did not provide evidence that the 3 strategies were effective, the case provides an example to examine practice. In addition, current best practice trends involve fathers as caregivers in the NICU. The mother should not be considered as the only party responsible for follow-up care, and physical therapists need to be faithful to the concept of family-centered care.

Venita Lovelace-Chandler, PT, PhD, PCS

University of North Texas Health Science Center, Ft Worth, Texas

Carla Chitwood, PT, DPT, PCS

Cook Children's Medical Center, Ft Worth, Texas

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1. Dusing S, Van Drew C, Brown S. Instituting parent education practices in the neonatal intensive care unit: an administrative case report of practice evaluation and statewide action. Phys Ther. 2012;92:967–975.
© 2013 Lippincott Williams & Wilkins, Inc.