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Biomedical subjects

D Brooten

Publications and source records attributed to D Brooten.

36 records · Page 2Linked to original sources
PubMed1986

A randomized clinical trial of early hospital discharge and home follow-up of very-low-birth-weight infants.

To determine the safety, efficacy, and cost savings of early hospital discharge of very-low-birth-weight infants (less than or equal to 1500 g), we randomly assigned infants to one of two groups. Infants in the control group (n = 40) were discharged according to routine nursery criteria, which included a weight of about 2200 g. Those in the early-discharge group (n = 39) were discharged before they reached this weight if they met a standard set of conditions. For families of infants in the early-discharge group, instruction, counseling, home visits, and daily on-call availability of a hospital-based nurse specialist for 18 months were provided. Infants in the early-discharge group were discharged a mean of 11 days earlier, weighed 200 g less, and were two weeks younger at discharge than control infants. The mean hospital charge for the early-discharge group was 27 percent less than that for the control group ($47,520 vs. $64,940; P less than 0.01), and the mean physician's charge was 22 percent less ($5,933 vs. $7,649; P less than 0.01). The mean cost of the home follow-up care in the early-discharge group was $576, yielding a net saving of $18,560 for each infant. The two groups did not differ in the numbers of rehospitalizations and acute care visits, or in measures of physical and mental growth. We conclude that early discharge of very-low-birth-weight infants, with follow-up care in the home by a nurse specialist, is safe and cost effective.

Body Weight↗
PubMed1986

A computerized system for measuring the effect of nursing care activities on the clinical indices of energy expenditure.

A computerized system for measuring clinical indices of energy expenditure (heart rate, temperature and activity) was pilot tested on three low-birth-weight infants over a period of 24 hours. The mean heart rate was 163 beats/min and the following mean temperatures were recorded: heel, 34.7 degrees C; abdominal skin, 35.1 degrees C; incubator wall, 29 degrees C; and air, 25.5 degrees C. Activity, determined as the number of baseline crossings of the processed signal from a pressure mattress, was calculated to be 8-9 crossings/min. When compared with an established activity scale based on behavioral observation, a correlation of 0.84 was found. The system described is valid, reliable and interferes minimally with normal nursing activities.

Computers↗
PubMedDate not supplied

Breast-milk jaundice.

The syndrome of breast-milk jaundice, which often results in cessation of breastfeeding, maternal anxiety, and guilt, may be increasing. Research to date on pregnanediol, increased lipase, and free fatty acids as the causes of breast milk jaundice is reviewed. Variations in current treatment are presented and nursing measures supportive of parents and continued breastfeeding are provided.

Anxiety↗
PubMedDate not supplied

Clinical specialist pre- and postdischarge teaching of parents of very low birth weight infants.

This study examined the pre- and postdischarge teaching needed by parents of very low birth weight infants (less than or equal to 1,500 g). The sample consisted of 36 families observed from the births of their infants to 18 months' postdischarge. Content analyses yielded five major teaching categories of infant, mother, family, home, and resources. Major predischarge teaching included feeding, recognition of infections, and growth and development. Major postdischarge teaching included feeding, current health problems, growth and development, and managing within the health-care system.

Child Development↗
PubMedDate not supplied

Postdischarge services for low-birth-weight infants.

Efforts to improve infant mortality and morbidity should focus on preventing low birth weight and improving infant care. Although preventing low birth weight is the ultimate goal, nurses also must improve the care of infants who are born with low birth weights. This article examines postdischarge care for these infants and the nurse's role in providing follow-up services. Nurses have unique opportunities to influence infant well-being directly through continued contact with families and through interventions that support infant caregivers. However, continued research is needed to provide nurses with information about how follow-up for low-birth-weight infants can be best provided.

Aftercare↗
PubMedDate not supplied

Anxiety and depression in mothers of low birthweight and very low birthweight infants: birth through 5 months.

The purpose of this study was to compare two common psychologic stress responses, anxiety and depression, in 27 mothers of very low birthweight (VLBW; less than or equal to 1500 grams) preterm infants and 35 mothers of low birthweight (LBW; 1501-2500 grams) preterm infants from the time of the infant's birth until the infants reached 5 months adjusted gestational age. There were significant differences in the patterns of anxiety and depression experienced by mothers of LBW and VLBW infants over time. Mothers of VLBW infants had higher anxiety and depression until 2 months adjusted gestational age while mothers of LBW infants had higher anxiety and depression at 3 and 4 months. Nursing interventions designed to decrease stress during the first postpartal week and to counsel mothers about patterns of anxiety and depression they may experience over time may be useful.

Adult↗
PubMedDate not supplied

The HOME scale: the influence of socioeconomic status on the evaluation of the home environment.

Caldwell's Home Observation for Measurement of the Environment (HOME) was developed to provide specific and sensitive information about the home and maternal environment as a stimulus to infant learning and development. The use of the HOME scale was examined in a sample of 118 middle- and lower-income mothers and their low-birth-weight (LBW) or very-low-birth-weight (VLBW) infants. The analysis of data demonstrated limited variability in the HOME scale total scores within each income group, and income alone was found to account for 41% of the variance in the sample. These findings raise questions about the effectiveness of the HOME scale in making useful discriminations about family functioning within an income group.

Adult↗
PubMedDate not supplied

Institutional yield on research: a case study.

This University of Pennsylvania School of Nursing study on the early discharge of very low birthweight infants led to a care model that saves over $18,000 per infant. The benefits to the institution as a whole, however, have been far greater. They include enhanced faculty and student recruitment as well as $700,000 in indirect cost recovery.

Cost-Benefit Analysis↗
PubMedDate not supplied

Serial neurobehavioral assessments in preterm infants.

The purpose of this study was to compare serial neurobehavioral assessments in a sample of preterm infants with intraventricular hemorrhage (IVH) to those of a group of unaffected preterm infants. Of the 30 infants included in the study, 5 infants had a grade III or IV/VI intraventricular hemorrhage. Infants with IVH demonstrated more abnormalities in mental status and a cluster of abnormal neurologic findings (persistent ankle clonus, tremulousness, and brisk deep tendon reflexes). Of the 30 infants, 20 infants were included in a brain metabolism study. Infants who had experienced an IVH had significantly different brain metabolism findings, as measured by nuclear magnetic resonance spectroscopy (NMR). There was a significant correlation between one measure of brain metabolism (PCr/PI) and the neurobehavioral assessment rating for infants with IVH.

Brain↗
PubMedDate not supplied

Concerns of mothers of low birthweight infants.

To provide more comprehensive follow-up care for low birthweight infants, it is important for nurses to know what concerns mothers of these low birthweight infants commonly experience and how concerns change over time. This descriptive, longitudinal study followed 65 mothers of low birthweight infants from birth until the infant was 6 months adjusted gestational age. Most concerns were raised the week following birth (109) and after infant discharge (72), although from 40 weeks (62) to 6 months (40), the number of concerns raised were fairly consistent. The largest category of concerns was health related (253).

Female↗
PubMedDate not supplied

Very low birth-weight infants: parental visiting and telephoning during initial infant hospitalization.

The purposes of this study were to examine visiting and telephoning patterns of families of very low birth-weight (VLBW) infants during their initial hospitalization and to identify factors related to visiting and telephoning. The sample of 65 VLBW infants (less than or equal to 1,500 gm) and their families was followed for 6 weeks in the special care nurseries. Mothers were the primary visitors, with the typical mother visiting the nursery twice per week. Fathers and other family members made most of their visits in the first few weeks with minimal involvement thereafter. During a typical week the number of telephone calls to the nursery from mothers ranged from one to three. Fathers and other family members made minimal calls. Significantly fewer visits were made by families in which the mother was unmarried, the mother was younger, Medicaid was the type of insurance, annual income was less than $10,000, and private transportation was unavailable. There were no significant relationships between total number of telephone calls made and maternal demographic variables.

Adolescent↗
PubMedDate not supplied

Anxiety, depression, and hostility in mothers of preterm infants.

Anxiety, depression, and hostility in 47 mothers of high-risk preterm infants were tested at the time of infant discharge and when the infant was 9 months old. Mothers of these high-risk preterms were significantly more anxious and depressed before their infant was discharged than when the infant was 9 months old. Before infant discharge, multiparas were significantly more depressed than primiparas. Additionally, mothers whose infants remained in the hospital longer than the mean of 51 days were significantly less depressed at infant discharge than were mothers whose infants had shorter hospital stays. Maternal anxiety, depression, and hostility did not differ based on marital status, maternal education, socioeconomic status, or maternal age at the time of infant discharge or when the infant was 9 months old.

Adult↗