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dc.contributor.advisorKaaresen, Per Ivar
dc.contributor.authorNordhov, Solveig Marianne
dc.date.accessioned2011-11-08T09:10:22Z
dc.date.available2011-11-08T09:10:22Z
dc.date.issued2011-09-23
dc.description.abstractBACKGROUND: Preterm infants are at increased risk of cognitive problems/delay and behavioual problems in the long term. Studies have shown that their mothers are more overprotective, and find it hard to implement a nurturant child rearing practice compared to parents of term infants. To improve the parent-infant interaction and thereby influence infant development in a beneficial different early intervention (EI) strategies have been studied but the results are conflicting OBJECTIVE: To study the effect of an EI program in low birth weight (LBW) children on parental child-rearing attitudes, and cognitive, motor and behaviorual outcomes in pre-school age (2-5 years). METHODS: LBW babies (BW <2000g) were randomized to an intervention (IG) or a control group (CG). In addition a term group (TG) was recruited to provide reference data. The EI program was a modified version of the Mother Infant Transaction Program (MITP). The intervention was implemented by eight specially trained neonatal nurses and consisted of seven daily sessions during the week prior to discharge, followed by four home visits. The unit’s standard discharge procedure was followed in the CG and TG. RESULTS: A total of 146 LBW infants were randomized, and 134 and 131 were assessed at 3 and 5 y, respectively. BW in the IG (n=72) was 1396 (SD 429) g, 1381(436)g in CG (n=74) and 3619 (490) in the TG . Mean GA was 30.2 (3.1) w in IG, 29.9 ( 3.5) w in CG and 39.3 (1.3) in TG. The groups were well balanced in baseline characteristics. At 1 and 2 year, mothers in the intervention group reported significantly more nurturant child- rearing attitudes compared to the control group. Children in the intervention group had 4.5 higher IQ scores at 3 years and this difference increased to 6.4 points at 5 years. Furthermore, children in the intervention group had significantly less behaviour problems reported by parents at 5 years compared with the control group. CONCLUSION: This EI program leads to improved IQ scores and less behaviour problems in the pre-school age in preterm infants. In addition, mothers reveal more nurturant child-rearing attitudes at 1 and 2 years. There were no effect on motor outcome.en
dc.description.doctoraltypeph.d.en
dc.description.popularabstractProsjektet er en utprøving av "Vermontmodellen". Studien omfatter en tiltaksgruppe på 72 barn med fødselsvekt < 2 kg, og en kontroll gruppe på 74 barn. Foreldrene i tiltaksgruppen fikk opplæring av en spesialtrenet sykepleier (1 time daglig) den siste uken før utskrivelse fra sykehuset. I opplæringen ble det lagt vekt på å forstå det for tidlig fødte barnets uttrykksformer, som for eksempel gråt og ansiktsuttrykk. I tillegg fikk de en time til sorgbearbeiding. Etter utskrivelsen fikk familien 4 hjemmebesøk av den samme sykepleieren. en viktig målsetting var å styrke foreldrenes evne til å samhandle med barnet. Kontrollgruppen fikk avdelingens vanlige oppfølging.Ved 3 år hadde barna i tiltaksgruppen 4,5 IQ poeng mer enn kontrollgruppen, og ved 5 år var forskjellen økt til 6,4 IQ poeng. I tillegg hadde barna i tiltaksgruppen betydelig færre atferdsproblemer ved 5 år. Mødrene i tiltaksgruppen hadde mer sensitive holdninger til barneoppdragelse ved 1 og 2 år. Konklusjonen av studien er at dette foreldreopplæringstiltaket har en svært gunstig effekt på IQ og atferd hos for tidlig fødte barn i førskolealder.en
dc.description.sponsorshipHelse Nord, Psykiatrisk Forskningsprogramen
dc.descriptionThe papers of this thesis are not available in Munin: <br/>1. Nordhov SM, Kaaresen PI, Rønning JA, Ulvund SE and Dahl LB.: 'A randomized study of the impact of a sensitizing intervention on the child-rearing attitudes of parents of low birth weight preterm infants', Scandinavian Journal of Psychology (2010), 51(5):385-391. Available at <a href=http://dx.doi.org/10.1111/j.1467-9450.2009.00805.x>http://dx.doi.org/10.1111/j.1467-9450.2009.00805.x</a> <br/>2. Nordhov SM, Rønning JA, Dahl LB, Ulvund SE, Tunby J and Kaaresen PI.: 'Early intervention improves cognitive outcomes for preterm infants : Randomized controlled trial', Pediatrics (2010), 126:e1088-e1094. Available at <a href=http://dx.doi.org/10.1542/peds.2010-0778>http://dx.doi.org/10.1542/peds.2010-0778</a> <br/>3. Nordhov SM, Rønning JA, Ulvund SE, Dahl LB and Kaaresen PI.: 'Early intervention improves behavioural outcomes for preterm infants : Randomized controlled trial' (submitted for publication at Pediatrics)en
dc.identifier.isbn978-82-7589-321-3
dc.identifier.urihttps://hdl.handle.net/10037/3674
dc.identifier.urnURN:NBN:no-uit_munin_3389
dc.language.isoengen
dc.publisherUniversity of Tromsøen
dc.rights.accessRightsopenAccess
dc.subject.courseIDDOKTOR-003en
dc.subjectVDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Pediatri: 760en
dc.subjectVDP::Medical disciplines: 700::Clinical medical disciplines: 750::Pediatrics: 760en
dc.titleA randomised clinical trial on the impact of early intervention on parental child-rearing attitudes and cognitive, motor and behavioral outcomes in preterm infants.en
dc.typeDoctoral thesisen
dc.typeDoktorgradsavhandlingen


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