Date of Award

2024

Document Type

Scholarly Project

Degree Name

Doctor of Occupational Therapy (OTD)

Department

Occupational Therapy

First Advisor

Wanda Lauer

Second Advisor

Jodie Storhaug

Abstract

Background Neonatal abstinence syndrome (NAS) is a condition that happens in newborn babies who were exposed to illicit substances or opiates while in the womb. The baby becomes dependent on the substances and will experience withdrawal symptoms after birth. Between 2010 and 2017, NAS births increased by 131%. Approximately 6.6% of pregnant women admitted to using prescription opioids, of which 21.2% acknowledged misuse. A significant portion (31.9%) of these women reported not receiving information on the potential effects of opioid use on their unborn baby. Infants exposed to opioids in utero are at higher risk of Neonatal Intensive Care Unit (NICU) stays due to preterm delivery. Parents of infants with NAS often experience heightened stress. Reducing stress and supporting the mental health of parents is crucial for supporting overall wellbeing and competency in caregiving. In addition to mental health struggles, caregivers feel judged and alienated in the NICU setting which hinders their ability to care for their infant effectively. Lack of information and education on their infant's condition exacerbates feelings of isolation and makes caregiving feel overwhelming. Overall, the literature revealed gaps in occupation-based care, which emphasizes the need for education, psychological support, and personalized intervention plans for parents and caregivers of infants diagnosed with NAS.

Project Description The purpose of the product is to create an evidence and occupation based resource guide to address the gaps identified in the literature. Identified gaps for parents and caregivers of infants diagnosed with NAS include lack of education, lack of support, and feelings of alienation. The product is a resource guide titled Bridges to Bright Beginnings; A Resource Guide for Caregivers of Infants Diagnosed with NAS. The Bridges to Bright Beginnings resource guide was created for parents and caregivers of infants with NAS in the NICU. The guide includes pictures and easy to understand written information about their infant with NAS, how to support them, and supports that are in place after discharge from the NICU. There is a QR code present that will enable caregivers to have fast and convenient access to the guide. The goal of the resource guide developed for parents and caregivers of infants diagnosed with NAS is to increase their involvement in caregiving and overall wellbeing. The guide aims to increase competency in caregiving by reducing feelings of alienation and increasing understanding of how to care for the infant. By educating parents, the resource guide will optimize confidence and engagement in caregiving occupations.

Discussion Bridges to Bright Beginnings aims to increase caregivers' engagement in caring for their infant, reduce feelings of alienation, and improve understanding of NAS care in the NICU (Cleveland & Gill, 2013; Hames et al., 2021; Oostlander, et al., 2019). The resource guide can be used to assist occupational therapists in providing personalized and occupation based care to families in the NICU with a baby diagnosed with NAS. The guide will be implemented at Altru Hospital in Grand Forks, ND. The guide will be implemented by occupational therapists or by other members of the interdisciplinary care team if the occupational therapists are unable due to scheduling conflicts with parents. Even though the guide was created for one specific NICU, the information is generalizable to any NICU. The guide is backed by evidence and is occupation centered. Additionally, it uses current research and incorporates principles of adult learning theory (Bastable et al., 2020). The PEO model was also used throughout the product development process to understand and enhance involvement in caregiving activities.

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