Very preterm infants hospitalized in the neonatal intensive care unit (NICU) experience alterations in sensory experiences. Defining types, timing and frequency of sensory-based interventions that optimize outcomes can inform environmental modifications. The objective of this study was to conduct an integrative review on sensory-based interventions used with very preterm infants in the NICU to improve infant and parent outcomes.
The data sources include MEDLINE, CINAHL, Cochrane Library and Google Scholar. Studies were identified that used sensory-based interventions in the NICU with preterm infants born ⩽32 weeks gestation, were published in a peer-reviewed journal between 1995 and 2015, and measured outcomes related to infant and parent outcomes. Studies were extracted from electronic databases and hand-searched from identified reference lists.
Eighty-eight articles were identified (31 tactile, 12 auditory, 3 visual, 2 kinesthetic, 2 gustatory/olfactory and 37 multimodal). There was evidence to support the use of kangaroo care, music and language exposure, and multimodal interventions starting at 25 to 28 weeks postmenstrual age. These interventions were related to better infant development and lower maternal stress, but not all findings were consistent. Limitations included lack of consistent outcome measures, study quality and gaps in the literature.
Most research identified interventions that were done for short periods of time. It is unclear what the potential is for improving outcomes if positive sensory exposures occur consistently throughout NICU hospitalization. Until more research defines appropriate sensory-based interventions to use with infants born very preterm in the NICU, information from this review can be combined with expert opinion and parent/family values to determine best practice.
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The project was supported by the University Research Strategic Alliance, the Comprehensive Opportunities for Rehabilitation Researchers (K12 HD055931) and the Gordon and Betty Moore Foundation. Research reported in this publication was supported by the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health under Award Number U54 HD087011 and the Intellectual and Developmental Disabilities Research Center at Washington University. We would like to thank Jessica Roussin, Michael Wallendorf, Mary Bocox, Liana Merz, Geneva Wilson and Jake Gilliland. We also wish to thank Brad Schlaggar, Carolyn Baum, Graham Colditz, Mary Politi, Elizabeth Kruvand and F Sessions Cole. We would also like to thank Katie Ross, Kelsey Dewey, Felicia Foci, Polly Durant, Justin Ryckman, Rachel Harris, Elizabeth Heiny, Gabby Blenden, Lisa Shabosky, Bailey Hall, Anna Annecca and Sarah Wolf.
RGP conceived of the original idea to do an integrative review to inform a clinical practice guideline on sensory-based interventions in the NICU. She was involved with data synthesis, and wrote the first draft of the manuscript. She oversaw all parts of the project and approved the final version of the manuscript submitted. RG and AH conducted the literature review and identified articles appropriate for the integrative review. They were involved in identifying the articles, assessing each for quality and wrote the first draft of the evidence table. They critically reviewed the manuscript’s content and approved the final version of the manuscript submitted. LCR assisted with the analysis processes, reviewed and revised the manuscript, and approved the final manuscript as submitted, and was also responsible for reporting the studies in the evidence table and ensured the accuracy of the evidence table. SO assisted with the analysis processes, reviewed and revised the manuscript, and approved the final manuscript as submitted, and made the PMA tables that demonstrate the PMA at which interventions have been investigated. JS was involved in idea conception, study design, data synthesis and ensured accuracy of the studies reported. She oversaw all parts of the project. She provided intellectual content to the manuscript and approved the final version that was submitted.
The authors declare no conflict of interest.
Supplementary Information accompanies the paper on the Journal of Perinatology website
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Pineda, R., Guth, R., Herring, A. et al. Enhancing sensory experiences for very preterm infants in the NICU: an integrative review. J Perinatol 37, 323–332 (2017). https://doi.org/10.1038/jp.2016.179
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