NIDCAP-newborn individualised developmental care and assessment program : Evaluering av intervensjonsmetode for pleie av premature

Abstract

Abstract BACKGROUND: Our aim is to review the effectiveness of NIDCAP and its influence on the ward. METHODS: Searches were made in May 2006, January 2007 and August 2007 by using keywords like “NIDCAP”, “Developmental care”, (Ohlsson A)AND(developmental care), Westrup B, Als H and (Fleisher BE)AND(Individualized developmental care) of mainly PubMed and The Cochrane Library. RESULTS: 19 studies were included. Results concerning short-term medical outcomes showed conflicting results. Three studies reported cost savings of NIDCAP compared with conventional care. Neurodevelopmental outcome was improved at 2 weeks, 1, 3, 6, 9 months and 42 weeks post-Expected Date of Confinement (EDC). One study found no significant evidence of improved neurodevelopmental outcome at 36weeks, 4, 12 and 24 months post-EDC. Significant differences in brain function and structure were found at 2 weeks and 9 months post-EDC. No studies have clearly demonstrated a significant benefit of NIDCAP on long-term neurodevelopmental outcome. Qualitative studies reported more closeness between the mother and her infant, but also more anxiety among mothers in the NIDCAP-group. The staff was in general positive about NIDCAP, especially the nursing staff. However, NIDCAP was also reported to be time-consuming and might worsen environmental conditions. The nursing staff also felt loss of control and that their competence was being questioned. CONCLUSIONS: There is insufficient evidence on the effectiveness of NIDCAP to improve medical and neurodevelopmental outcomes. More studies are needed to investigate long-term neurodevelopmental outcome and cost-effectiveness.