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      Atenção humanizada ao recém-nascido de baixo-peso. Método Canguru e cuidado centrado na família: correspondências e especificidades Translated title: Humanized care for low birth weight newborns. The Kangaroo care Method and family-centered care: correspondence and specificities

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          Abstract

          Este artigo apresenta a Atenção Humanizada ao Recém-Nascido de Baixo-Peso - Método Canguru - como uma diretriz clínica na assistência neonatal, e busca traçar um paralelo com outro importante componente do cuidado infantil descrito na literatura internacional: o cuidado centrado na família. O artigo propõe que a Atenção Humanizada ao Recém-Nascido de Baixo-Peso - Método Canguru seja vista como uma boa prática e seja considerada também no campo das tecnologias em saúde.

          Translated abstract

          The main purpose of this paper is to introduce the Human Attention of Low Birth Weight-Kangaroo Care as clinical guidelines in neonatal intensive care. It will also try to link this clinical guideline and another component of neonatal infant care: the Family-Centered Care. Based on this relationship, this paper proposes that Human Attention of Low Birth Weight-Kangaroo Care should be catalogued as a Potentially Better Practices and also, considered as a Health Care Technology.

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          Early experience alters brain function and structure.

          Gloria B McAnulty, Petra Hüppi, Michael J. Rivkin … (2004)
          To investigate the effects of early experience on brain function and structure. A randomized clinical trial tested the neurodevelopmental effectiveness of the Newborn Individualized Developmental Care and Assessment Program (NIDCAP). Thirty preterm infants, 28 to 33 weeks' gestational age (GA) at birth and free of known developmental risk factors, participated in the trial. NIDCAP was initiated within 72 hours of intensive care unit admission and continued to the age of 2 weeks, corrected for prematurity. Control (14) and experimental (16) infants were assessed at 2 weeks' and 9 months' corrected age on health status, growth, and neurobehavior, and at 2 weeks' corrected age additionally on electroencephalogram spectral coherence, magnetic resonance diffusion tensor imaging, and measurements of transverse relaxation time. The groups were medically and demographically comparable before as well as after the treatment. However, the experimental group showed significantly better neurobehavioral functioning, increased coherence between frontal and a broad spectrum of mainly occipital brain regions, and higher relative anisotropy in left internal capsule, with a trend for right internal capsule and frontal white matter. Transverse relaxation time showed no difference. Behavioral function was improved also at 9 months' corrected age. The relationship among the 3 neurodevelopmental domains was significant. The results indicated consistently better function and more mature fiber structure for experimental infants compared with their controls. This is the first in vivo evidence of enhanced brain function and structure due to the NIDCAP. The study demonstrates that quality of experience before term may influence brain development significantly.
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            The principles for family-centered neonatal care.

            Lee Harrison (1993)
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              The Vermont Oxford Network: evidence-based quality improvement for neonatology.

              Jeffrey Horbar (1998)
              The Vermont Oxford Network is a voluntary collaborative group of health professionals committed to improving the effectiveness and efficiency of medical care for newborn infants and their families through a coordinated program of research, education, and quality-improvement projects. In support of these activities, the Network maintains a clinical database of information about very low birth weight infants that now has more than 300 participating neonatal intensive care units (NICUs). We anticipate that these NICUs will submit data for 25 000 infants with birth weights of 401 to 1500 g born in 1998. The research program of the Network includes outcomes research and randomized clinical trials. The goal of Network outcomes research is to identify and explain the variations in clinical practice and patient outcomes that are apparent among NICUs. Network trials are designed to answer practical questions of importance to practitioners and families using pragmatic designs that can be integrated into the daily practice of neonatology. Quality improvement is a major focus of the Network. Members receive confidential quarterly and annual reports based on the Network database that document their performance and compare practices and outcomes at their unit with those at other units within the Network. These reports are intended to assist the members in identifying opportunities for improvement and to help them monitor the success of their improvement efforts. Although information is necessary for improvement to occur, it is not sufficient to foster lasting improvement by itself. Information must be translated into action. The Network is sponsoring an ongoing program of quality initiatives designed to provide members with the knowledge, skills, tools, and resources needed to foster action for improvement. The Network's first formal quality-improvement project, the NIC/Q Project, brought together 10 NICUs to apply the methods of collaborative improvement and benchmarking to neonatal intensive care. Building on the lessons learned in that initial project, the Network now is conducting the Vermont Oxford Network Evidence-Based Quality Improvement Collaborative for Neonatology, known as NIC/Q 2000. This 2-year collaborative will assist multidisciplinary teams from the 34 participating NICUs to develop four key habits for improvement: the habit for change, the habit for practice as a process, the habit for collaborative learning, and the habit for evidence-based practice. During the collaborative, participants will contribute to a knowledge bank of clinical, organizational, and operational change ideas for improving neonatal care. The coordinated program of research, education, and quality improvement described in this article is only possible because of the voluntary efforts of the members. The Network will continue to support these efforts by developing and providing improved tools and resources for the practice of evidence-based neonatology.neonatology, very low birth weight, database, network, quality improvement, evidence-based medicine, randomization, trials, outcomes, mortality, length of stay.
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                Author and article information

                Contributors
                Marcia de Abreu e Silva Hennig: Role: ND
                Maria Auxiliadora de Souza Mendes Gomes: Role: ND
                Denise Streit Morsch: Role: ND
                Journal
                Journal ID (publisher): physis
                Title: Physis: Revista de Saúde Coletiva
                Abbreviated Title: Physis
                Publisher: IMS-UERJ (Rio de Janeiro )
                ISSN: 1809-4481
                Publication date (Print): 2010
                Volume: 20
                Issue: 3
                Pages: 835-852
                Affiliations
                [1 ] PMERJ
                [2 ] Fundação Oswaldo Cruz Brazil
                [3 ] Fundação Oswaldo Cruz Brazil
                Article
                Publisher ID: S0103-73312010000300008
                DOI: 10.1590/S0103-73312010000300008
                SO-VID: ccab1aa4-0737-43fb-ac45-79d5ad8ed4fa
                License:

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=0103-7331&lng=en
                Categories
                Subject: PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

                ScienceOpen disciplines: Public health
                Keywords: Kangaroo Mother Care,family-centered care,low birth weight,clinical guidelines,health technologies,potentially better practices,Método Canguru,Cuidado Centrado na Família,recém-nascido de baixo-peso,diretrizes clínicas,tecnologias em saúde,boas práticas
                Data availability:
                ScienceOpen disciplines: Public health
                Keywords: Kangaroo Mother Care, family-centered care, low birth weight, clinical guidelines, health technologies, potentially better practices, Método Canguru, Cuidado Centrado na Família, recém-nascido de baixo-peso, diretrizes clínicas, tecnologias em saúde, boas práticas

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