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Commentary on “Effects of Instruction on Parent Competency During Infant Handling in a Neonatal Intensive Care Unit”

D'Amore, Maria, PT, PCS; Gonya, Jenn, PhD

Pediatric Physical Therapy: January 2019 - Volume 31 - Issue 1 - p 50
doi: 10.1097/PEP.0000000000000565

Nationwide Children's Hospital Columbus, Ohio

The authors declare no conflicts of interest.

“How should I apply this information?”

The neonatal intensive care unit (NICU) environment is challenging for parent-infant interaction experiences. Promoting family-centered developmental care and parental efficacy in the NICU is important to infants’ neurodevelopmental outcomes. Parents benefit from support in learning how to respond to their infants’ cues and how to provide developmentally appropriate handling. It is unclear how to best educate parents in these important interactions.

This study explores 3 commonly used instructional methods for teaching parents procedural motor tasks: direct, video, and written-pictorial. Direct and video instructions were most effective in parent performance of positioning and handling of their preterm infants in comparison to written-pictorial only. Neonatal therapists should consider the possible advantages of allocating time and resources toward direct or video instruction when providing developmental education to parents, as well as matching instructional strategies to parent education level.

“What should I be mindful of when applying this information?”

This study limited the parent education to a one-time instructional session with evidence that the effect of instruction was not sustained at follow-up, nor were long-term effects measured. This finding is not surprising, given that parents in the NICU are under stress, which often limits their learning efficiency. This raises a further question as to whether continual, repetitive instruction throughout an infant's hospitalization might support long-term carryover of parents’ perceived effectiveness of the instruction, in turn, promoting parental efficacy.

The aim of the study was to promote improved parent-infant interaction by increasing parent competence in infant handling; however, this was not specifically investigated. Further research on the impact of the positioning and handling technique instruction on parent-infant interaction may provide more meaningful data for the clinician.

Maria D'Amore, PT, PCS

Jenn Gonya, PhD

Nationwide Children's Hospital

Columbus, Ohio

Copyright © 2019 Academy of Pediatric Physical Therapy of the American Physical Therapy Association