Premature Infants Born to Adolescent Mothers: Health Care Utilization After Initial Discharge

Ray, Kristin N.; Escobar, Gabriel J.; Lorch, Scott A.

doi:10.1016/j.acap.2010.07.005

Cited by 25 publications

(19 citation statements)

References 28 publications

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“…Similar to our findings, frequent non-health supervision pediatric visits by premature infants have been documented by others. 18,37,38 The AAP has a policy statement addressing community readiness when discharging high-risk infants. 53 Educating families about the role of health supervision visits…”

Section: Discussionmentioning

confidence: 99%

“…The number of eligible months varied for each patient and was calculated by using the time from the first to the last visit in our database. Chronic illness was identified if any of the following complications of preterm birth associated with increased health care use 37,38 or other chronic conditions were noted: bronchopulmonary dysplasia, necrotizing enterocolitis, intraventricular hemorrhage, asthma, seizures, short bowel syndrome, ventriculo-peritoneal shunt, colostomy, ileostomy, gastrostomy, tracheostomy, or supplemental oxygen.…”

Section: Confounding Variable Definitionsmentioning

confidence: 99%

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Preterm Infant Attendance at Health Supervision Visits

et al. 2015

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OBJECTIVES: To assess the adherence of premature infants with the American Academy of Pediatrics health supervision visit schedule, factors affecting adherence, and the association of adherence with preventive care. METHODS:Retrospective cohort of all infants #35 weeks' gestation, born 2005 to 2009, receiving care at a 30-site primary care network for at least 24 months (n = 1854). Adherence was defined as having a health supervision visit within each expected time period during the first 18 months of life. Logistic regression identified sociodemographic and medical factors associated with nonadherence and risk-adjusted association between nonadherence and outcomes.RESULTS: Only 43% received all expected health supervision visits. Those with Medicaid insurance (adjusted odds ratio [AOR] 0.46, 95% confidence interval [CI] 0.35-0.60), a visit without insurance (AOR 0.46, 95% CI 0.32-0.67), chronic illness (AOR 0.7, 95% CI 0.51-0.97), and black race (AOR 0.7, 95% CI 0.50-0.98) were less adherent, whereas provider continuity of care (AOR 2.89, 95% CI 1.92-4.37) and lower birth weight (AOR 1.67, 95% CI 1.02-2.73) increased adherence. Infants ,100% adherent were less likely to be up to date with immunizations and receive recommended preventive care. In nearly half of missed visit windows, no health supervision visit was scheduled.CONCLUSIONS: Fewer than half of premature infants were fully adherent with the preventive health schedule with associated gaps in health monitoring and immunization delays. These data suggest the importance of health supervision visits and the need to explore scheduling facilitators for those at risk for nonadherence. WHAT'S KNOWN ON THIS SUBJECT:Premature infants are at risk for medical and neurodevelopmental sequelae. Close monitoring is an important role for primary care providers. Premature infants have high use of health care services; however, little is known about the role of health supervision visits. WHAT THIS STUDY ADDS:This study explores the utilization and value of health supervision visits for premature infants. Fewer than half were found to be fully adherent to the health supervision visit schedule, resulting in preventive care gaps and immunization delays.

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Section: Discussionmentioning

confidence: 99%

Section: Confounding Variable Definitionsmentioning

confidence: 99%

Preterm Infant Attendance at Health Supervision Visits

et al. 2015

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“…4 The first 2 weeks at home after a NICU stay represents the time most likely for rehospitalizations; up to 30% of the preterm infants readmit within 3 months of discharge; and up to 50% visit emergency departments. 2,3,5,6 Preterm infants also use primary care and special services more often than term infants do. Wade and colleagues 6 found that preterm infants experienced 20 to 29 visits to pediatric offices during the first year after NICU discharge; Leijon and colleagues 7 reported that 74.4% of the preterm infants used specialist services during the first year of life compared with 26.3% of term infants after NICU discharge.…”

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confidence: 97%

Transition From Hospital to Home for Parents of Preterm Infants

Boykova

Kenner

2012

Journal of Perinatal &Amp; Neonatal Nursing

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Research on the phenomenon of transition spans several decades. This article discusses the transition from hospital to home and the challenges parents of preterm infants experience during a neonatal intensive care unit stay and after discharge. The article explores the link between parental problems and rehospitalizations and the need for accurate measures of transitional concerns. An example of a theoretical model and instrument is described.

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“…However, there are a number of studies from other countries revealed that higher anxiety among mothers during the discharge process, especially when the mothers had no proper coping skills and social support system (Gigante et al, 2004;Nicolson et al, 2013;Ray, Escobar, and Lorch, 2010). The stress that occurs while in the hospital is likely due to the NICU situation, and stress may continue as the infant is being prepared of discharge from perinatology ward, the mother may feel unprepared to care for the infant at home.…”

Section: Introductionmentioning

confidence: 99%

Mothers’ Coping Strategies in Preparing for the Discharge of Low Birth Weight Infants from a Perinatology Ward

2017

Aust. J. Basic & Appl. Sci.

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Background: Low birth weight infants are born weighing less than 2500 grams. The chance of life increases with the advancement of technology through intensive care in the perinatology ward. High medical needs during infant care, duration of care, and lack of knowledge about the condition of the infant are factors that causes stress on mothers to bring the infant home. Mother may feel incompetence in caring for the infant at home. Greater stress occurs among mothers who are lack of proper coping skills. Objective: This study aimed to appraise mothers' coping strategies for dealing with stress related to the discharge preparations of a low birth weight (LBW) infant. Sixty mothers of LBW infants hospitalized in a perinatology ward participated in this descriptive-correlational study. They were selected using a convenience sampling method. Data were collected using a structured questionnaire of the Stress and Coping Strategies Scale, and the questionnaire was tested for validity and reliability (Cronbach's alpha: 0.72). Descriptive and inferential statistics, including the Pearson's correlation test, were applied to analyze the data using SPSS. Results: Most mothers (86%) used coping strategies focused on emotions, and 78% reported using ones that focus on solving problems. There was a significant correlation among the infant's length of hospitalization (p. 0.024) and history of hyperbilirubinemia (p. 0.007) with a mother's coping strategy. We also found a strong significant correlation between mothers' stress and coping strategies (r. −0.641; p. < 0.001). Conclusion: This study indicate that stress scores are significantly associated with coping strategies: the higher the score, the lower the mother's coping ability. Developing a maternal coping strategy that focuses on problem solving will increase mother's confidence in preparing for the discharge of LBW infants from perinatology ward and able to care for the baby at home. We recommend that nurses help mothers develop coping strategies with a focus on problem solving through family involvement and educational care for LBW infants.

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Premature Infants Born to Adolescent Mothers: Health Care Utilization After Initial Discharge

Cited by 25 publications

References 28 publications

Preterm Infant Attendance at Health Supervision Visits

Preterm Infant Attendance at Health Supervision Visits

Transition From Hospital to Home for Parents of Preterm Infants

Mothers’ Coping Strategies in Preparing for the Discharge of Low Birth Weight Infants from a Perinatology Ward

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