Title

An investigation of parent and infant occupational performance in the neonatal intensive care unit

Location

New River Room A

Start Time

3-10-2015 2:30 PM

End Time

3-10-2015 4:00 PM

Session Type

Theoretical Paper

Abstract

An Investigation of Parent and Infant Occupational Performance in the Neonatal Intensive Care Unit

The earliest of occupational therapy interventions often commence in the Neonatal Intensive Care Unit (NICU), where mothers and fathers begin learning how to parent in unexpected surroundings and with unexpected complications. Worry about the infant’s health, the unfamiliar setting, technology, medicine, and constant monitoring can interrupt normal family functioning and bonding. It is within this hyper-technical and complex environment that occupational therapists have the unique opportunity to harness the power of occupation and to support parents’ engagement in their infant’s care in order to achieve positive family outcomes (Altimier & Phillips, 2013). Family life in the NICU exists; however, it may look and feel very different from parents’ expectations and dreams.

Recognition of the existence of NICU-based family life is fueling recommendations for a shift in neonatal occupational therapy practice. Although there will always be a need for specialized medical care and technology, occupational therapy has the opportunity to introduce and support family occupations in the NICU. In an effort to bridge the gap between the infant’s medical fragility and emerging family life, neonatal occupational therapists look beyond the infant’s person factors to address interrupted family engagement and participation, which in turn may affect family health and well-being.

This shift in thinking about infants as occupational beings and active participants in their environment coincides with the profession’s transformation back to a “discipline focused on occupation” (Polatajko, 1994, p. 591). However, a limitation of occupation-based practice may be the lack of clarity surrounding what infant and family occupations exist in NICU. Without clear definitions of these constructs, occupational therapists may not recognize or value them as part of practice. While recommendations for neonatal occupational therapists’ skill level, knowledge base, and practice have been established (AOTA, 2006), there is paucity of literature describing parent and infant occupations in the NICU. Thus, the innovative purpose of this presentation is twofold: to both inform and transform neonatal occupational therapy practice.

First, in an effort to inform, a qualitative research project was undertaken to provide occupational therapists, multidisciplinary NICU professionals, family members, and other stakeholders with rich definitions of parent occupations, infant occupations, and parent-infant co-occupations experienced in the NICU. Using a phenomenological approach, examples of occupations and themes emerged from inductive analysis of parent interviews conducted in a Level III NICU. Second, in order to transform practice and encourage a shift from a biomedical, sensory, or purely environmental view of the NICU infant toward one that assesses the infant and family in concert, this project employed a strong occupational focus and outlined the process guiding occupational therapist and client interaction in the NICU. The interactional process was framed using the Person-Environment-Occupation-Performance (PEOP) Model (Baum, Christiansen, & Bass, 2015) and the Person-Environment-Occupation-Performance (PEOP) Occupational Therapy Process (Bass, Baum, & Christiansen, 2015) as theoretical foundations for neonatal practice.

keywords: neonatal, infant, occupation

References

Altimier, L, & Phillips, R.M. (2013). The neonatal integrative developmental care model: Seven neuroprotective core measures for family-centered developmental care. Newborn & Infant Nursing Reviews, 13, 9-22). http://dx/doi.org/10.1053/j.nainr.2012.12.002

American Occupational Therapy Association [AOTA]. (2006). Specialized knowledge and skills for occupational therapy practice in the Neonatal Intensive Care Unit. The American Journal of Occupational Therapy, 60, 659-668.

Bass, J.D., Baum, C.M., Christiansen, C.H. (2015). Interventions and outcomes of OT: PEOP Occupational Therapy Process. In C.H. Christiansen, C.M. Baum, & J.D. Bass (Eds.). Occupational therapy: Performance, participation, and well-being (4th ed.) (pp.57-79). Thorofare, NJ: Slack, Incorporated.

Baum, C.M., Christiansen, C.H., & Bass, J.D. (2015). The Person-Environment-Occupation-Performance (PEOP) Model. In C.H.Christiansen, C.M. Baum, & J.D. Bass (Eds.), Occupational therapy: Performance, participation, and well-being (4th ed.) (pp.49-56). Thorofare, NJ: Slack Incorporated.

Polatajko, H.J. (1994). Dreams, dilemmas, and decisions for occupational therapy practice in a new millennium: A Canadian perspective. The American Journal of Occupational Therapy, 48, 590-594.

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Oct 3rd, 2:30 PM Oct 3rd, 4:00 PM

An investigation of parent and infant occupational performance in the neonatal intensive care unit

New River Room A

An Investigation of Parent and Infant Occupational Performance in the Neonatal Intensive Care Unit

The earliest of occupational therapy interventions often commence in the Neonatal Intensive Care Unit (NICU), where mothers and fathers begin learning how to parent in unexpected surroundings and with unexpected complications. Worry about the infant’s health, the unfamiliar setting, technology, medicine, and constant monitoring can interrupt normal family functioning and bonding. It is within this hyper-technical and complex environment that occupational therapists have the unique opportunity to harness the power of occupation and to support parents’ engagement in their infant’s care in order to achieve positive family outcomes (Altimier & Phillips, 2013). Family life in the NICU exists; however, it may look and feel very different from parents’ expectations and dreams.

Recognition of the existence of NICU-based family life is fueling recommendations for a shift in neonatal occupational therapy practice. Although there will always be a need for specialized medical care and technology, occupational therapy has the opportunity to introduce and support family occupations in the NICU. In an effort to bridge the gap between the infant’s medical fragility and emerging family life, neonatal occupational therapists look beyond the infant’s person factors to address interrupted family engagement and participation, which in turn may affect family health and well-being.

This shift in thinking about infants as occupational beings and active participants in their environment coincides with the profession’s transformation back to a “discipline focused on occupation” (Polatajko, 1994, p. 591). However, a limitation of occupation-based practice may be the lack of clarity surrounding what infant and family occupations exist in NICU. Without clear definitions of these constructs, occupational therapists may not recognize or value them as part of practice. While recommendations for neonatal occupational therapists’ skill level, knowledge base, and practice have been established (AOTA, 2006), there is paucity of literature describing parent and infant occupations in the NICU. Thus, the innovative purpose of this presentation is twofold: to both inform and transform neonatal occupational therapy practice.

First, in an effort to inform, a qualitative research project was undertaken to provide occupational therapists, multidisciplinary NICU professionals, family members, and other stakeholders with rich definitions of parent occupations, infant occupations, and parent-infant co-occupations experienced in the NICU. Using a phenomenological approach, examples of occupations and themes emerged from inductive analysis of parent interviews conducted in a Level III NICU. Second, in order to transform practice and encourage a shift from a biomedical, sensory, or purely environmental view of the NICU infant toward one that assesses the infant and family in concert, this project employed a strong occupational focus and outlined the process guiding occupational therapist and client interaction in the NICU. The interactional process was framed using the Person-Environment-Occupation-Performance (PEOP) Model (Baum, Christiansen, & Bass, 2015) and the Person-Environment-Occupation-Performance (PEOP) Occupational Therapy Process (Bass, Baum, & Christiansen, 2015) as theoretical foundations for neonatal practice.

keywords: neonatal, infant, occupation