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Co-bedding twins in a neonatal intensive care unit : a descriptive case study

University of British Columbia

Co-bedding twins in the NICU is evolving as a practice which attempts to replicate and capitalize upon the infants' unique prenatal environment and experience. The purpose of this descriptive case study was to explore the relatively unknown phenomenon of co-bedding to generate rich, descriptive, contextual knowledge in order to develop context specific family-centered care interventions. The study focused on the behaviours during co-bedding of one set of twins, born at 30 weeks gestation, and the family's and the consistent nurse's perceptions of the co-bedding experience. Four behavioural observations were conducted on each infant using the Neonatal Individualized Developmental Care and Assessment Program (NIDCAP) naturalistic behavioural observations (Als, 1995). The picture of co-regulation that emerged from the descriptions of the infants' behaviours, and the parents' and nurse's perceptions was one of holding onto, touching, reaching towards, responding to each other's stress behaviours, calming each other, and crying when separated. Co-regulation, in this study, was characterized by infants who were calmer and more settled, fell asleep more easily, slept for longer periods, woke together, and whose biorhythms, sleepwake cycles, and body temperatures became increasingly more synchronous. The development of a mutuality in circadian rhythm between the infants, as well as their close physical proximity to each other, assisted the parents in caring for their infants both in a NICU and at home, and facilitated nursing care in the NICU. Co-bedding is a developmentally supportive, family-centered care strategy for twins that may contribute to physiological stability, thereby enhancing shortterm and longterm neurological and developmental outcomes both in and beyond the NICU, while capitalizing on the unique experience of twinship.

Thesis/Dissertation

application/pdf

2009-06-26

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http://hdl.handle.net/2429/9725

Nursing

University of British Columbia

UBCV

DSpace