Trauma-informed care in the newborn intensive care unit: promoting safety, security and connectedness
| Autor: | M R Sanders, S L Hall |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Cortisol secretion
Pediatrics medicine.medical_specialty Unconscious mind Social connectedness media_common.quotation_subject Mothers Developmental psychology law.invention 03 medical and health sciences 0302 clinical medicine Pregnancy law Intensive Care Units Neonatal 030225 pediatrics Intensive care Adaptation Psychological medicine Humans 030212 general & internal medicine Parent-Child Relations media_common business.industry Infant Newborn Obstetrics and Gynecology Intensive care unit Kangaroo-Mother Care Method Feeling Polyvagal Theory State-of-the-Art Pediatrics Perinatology and Child Health Intensive Care Neonatal Female business Stress Psychological Dyad |
| Zdroj: | Journal of Perinatology |
| ISSN: | 1476-5543 0743-8346 |
| DOI: | 10.1038/jp.2017.124 |
| Popis: | Both babies and their parents may experience a stay in the newborn intensive care unit (NICU) as a traumatic or a 'toxic stress,' which can lead to dysregulation of the hypothalamic-pituitary-adrenal axis and ultimately to poorly controlled cortisol secretion. Toxic stresses in childhood or adverse childhood experiences (ACEs) are strongly linked to poor health outcomes across the lifespan and trauma-informed care is an approach to caregiving based on the recognition of this relationship. Practitioners of trauma-informed care seek to understand clients' or patients' behaviors in light of previous traumas they have experienced, including ACEs. Practitioners also provide supportive care that enhances the client's or patient's feelings of safety and security, to prevent their re-traumatization in a current situation that may potentially overwhelm their coping skills. This review will apply the principles of trauma-informed care, within the framework of the Polyvagal Theory as described by Porges, to care for the NICU baby, the baby's family and their professional caregivers, emphasizing the importance of social connectedness among all. The Polyvagal Theory explains how one's unconscious awareness of safety, danger or life threat (neuroception) is linked through the autonomic nervous system to their behavioral responses. A phylogenetic hierarchy of behaviors evolved over time, leveraging the mammalian ventral or 'smart' vagal nucleus into a repertoire of responses promoting mother-baby co-regulation and the sense of safety and security that supports health and well-being for both members of the dyad. Fostering social connectedness that is mutual and reciprocal among parents, their baby and the NICU staff creates a critical buffer to mitigate stress and improve outcomes of both baby and parents. Using techniques of trauma-informed care, as explained by the Polyvagal Theory, with both babies and their parents in the NICU setting will help to cement a secure relationship between the parent-infant dyad, redirecting the developmental trajectory toward long-term health and well-being of the baby and all family members. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink