The Universe of Developmental Care

Abstract

Developmental care for high-risk infants is practiced in most neonatal units around the world. Despite its wide acceptance, inconsistency in its definition and application has resulted in criticism regarding its scientific merit. The universe of developmental care model proposed in this article is the first major reformulation of neonatal developmental care theory since Als' synactive theory. Neither the developing brain nor the environment exists in isolation, and therefore are dependent on each other for all caregiving activities. Central to this model is the concept of a shared surface, manifested most obviously by the skin that forms the critical link between the body/organism and environment and becomes the focal point for human interactions. The components of the model and its theoretical underpinnings, its practical application and direction for future clinical practice, education, and research are presented.

Maternal voice and short‐term outcomes in preterm infants

“…For example, increased family involvement in conjunction with developmental care is encouraged and has been shown to positively influence short-term outcomes in preterm infants (Als et al, 2003; Melnyk et al, 2006; Zeskind & Iacino, 1984). The amount of parental touching and talking to their infants’, however, is varied depending upon the infant's individual response and developmental age (Butler & Als, 2008; Gibbins, Hoath, Coughlin, Gibbins, & Frank, 2008). …”

Core measures for developmentally supportive care in neonatal intensive care units: theory, precedence and practice

“…In an attempt to extend Als’ Synactive Theory as a theoretical foundation for developmental care, the Universe of Developmental Care model (UDC; Gibbins et al 2008) was proposed to create a practical heuristic framework highlighting developmental care practices in a patient- and family-centric context. The model focused the caregiver’s attention to the interface linking the body/organism and the environment, specifically referred to as the shared care surface (Figure 1).…”

Developmentally Supportive Care in Congenital Heart Disease: A Concept Analysis

“…Als' Syntactive Theory of Development was expanded by Gibbons and colleagues as the Universe of Developmental Care (UDC) model, to include the idea of a "shared care surface," or context where the infant and the environment directly and dynamically interact; it is this confluence where nursing care is delivered (Gibbins, Hoath, Coughlin, Gibbins, & Franck, 2008). The UDC model defines developmental care as a patient and family-centered process in which caregivers interact with the infant and the NICU environment at the level of the shared care surface to implement an individualized plan of care (Gibbins et al, 2008). Core measures of DSC include protected sleep, pain and stress assessment and management, developmental activities of daily living, family-centered care, and the healing environment (Coughlin, Gibbins, & Hoath, 2009).…”

“…Developmentally supportive care is individualized to meet the unique needs of the patient (Als, 1998;Gibbins et al, 2008;Paul & Roth, 2011). Developmentally supportive care for the infant or child with CHD is adapted to meet individual needs at a point in time, but also evolves to meet changing needs throughout the continuum of health and illness experienced.…”

“…Developmentally supportive care is also family-centered (Altimier & Phillips, 2013;Coughlin et al, 2009;Gibbins et al, 2008;Torowicz et al, 2012). Family-Centered Care is the pediatric nursing care model adopted and endorsed by the American Nurses Association and the Society of Pediatric Nursing (American Nurses Association, 2008;Harrison, 2010).…”