Skip to main content
SpringerLink
Log in

Psychologisch-sozialmedizinische Versorgung in der Neonatologie

Psychological sociomedical care in neonatology

  • Originalien
  • Published:
Monatsschrift Kinderheilkunde Aims and scope Submit manuscript

Zusammenfassung

Zirka 8,8 % aller Neugeborenen werden vor Vollendung der 37. Schwangerschaftswoche geboren und werden daher als Frühgeborene bezeichnet. Bei ihnen kann die Dauer ihres initialen stationären Aufenthalts Wochen bis Monate betragen. Im Mittelpunkt ihrer Behandlung steht heute die neurologische Entwicklung, die nicht nur aufgrund des unphysiologischen Aufenthalts außerhalb des Mutterleibs beeinträchtigt ist, sondern auch wegen der oftmals behandlungsbedingten Trennung von Mutter und Kind. Moderne Versorgungsansätze umfassen daher sowohl die optimale medizinische Versorgung des Kindes als auch die Begleitung der gesamten Familie. Die Eltern werden zu den Hauptbezugspersonen ihres Kindes und verantworten seine Entwicklung von Anfang an. Hierzu benötigen sie Beratung, Schulung und eine auf ihre Bedürfnisse ausgerichtete Entlassungsplanung. Ausgehend von einem komplexen Versorgungsmodell werden Struktur- und Prozessmerkmale einer psychologisch-sozialmedizinischen Versorgung von Familien frühgeborener und kranker, reif neugeborener Kinder beschrieben.

Abstract

Approximately 8.8 % of all newborn infants are born before 37 weeks of gestational age and are defined as preterm infants. For preterm infants the length of the initial stay in the neonatal intensive care unit (NICU) can last from weeks to months. Nowadays, medical treatment is focused on the neurological development which is affected not only by the physiological extrauterine environment but also by separation of mother and child during NICU treatment. Therefore, new care concepts encompass the optimal medical care of the infant as well as the best support for the whole family. The parents become the primary caregivers of their infant and are responsible for the development from the very beginning. Moreover, they need consultation, training and individualized discharge planning. Characteristics of structure and process of psychological sociomedical care for families of premature and ill, mature newborn children are described by a complex care model.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1

Literatur

  1. Aarnoudse-Moens CS, Weisglas-Kuperus N, Goudoever JB van, Oosterlaan J (2009) Meta-analysis of neurobehavioral outcomes in very preterm and/or very low birth weight children. Pediatrics 124(2):717–728

    Article  PubMed  Google Scholar 

  2. Achenbach TM, Howell CT, Aoki MF et al (1993) 9-year outcome of the Vermont intervention program for low-birth-weight infants. Pediatrics 91(1):45–55

    CAS  PubMed  Google Scholar 

  3. Ahlund S, Clarke P, Hill J et al (200) Post-traumatic stress symptoms in mothers of very low birth weight infants 2–3 years post-partum. Arch Womens Ment Health 12:261–264

    Article  Google Scholar 

  4. Allen EC, Manuel JC, Legault C et al (2004) Perception of child vulnerability among mothers of former premature infants. Pediatrics 113(29):267–273

    Article  PubMed  Google Scholar 

  5. Allen MC, Cristofalo EA, Kim C (2011) Outcomes of preterm infants: morbidity replaces mortality. Clin Perinatol 38(3):441–448

    Article  PubMed  Google Scholar 

  6. Beschluss des Gemeinsamen Bundesausschusses über eine Änderung der „Vereinbarung über Maßnahmen zur Qualitätssicherung der Versorgung von Früh- und Neugeborenen“ vom 20. Juni 2013. BAnz AT 11.11.2013 B3

  7. Brecht CJ, Shaw RJ, St. John NH, McCue Horwitz S (2012) Effectiveness of therapeutic and behavioral interventions for parents of low-birth-weight premature infants: a review. Infant Ment Health J 33(6):651–665

    Article  PubMed Central  PubMed  Google Scholar 

  8. Carter JD, Mulder RT, Bartram AF et al (2005) Infants in a neonatal intensive care unit: parental response. Arch Dis Child Fetal Neonatal Ed 90:109–113

    Article  Google Scholar 

  9. Eichner JM, Johnson BH (2012) Patient- and family-centered care and the pediatrician’s role. Committee on hospital care and institute for patient-and-family-centered care. Pediatrics 129(2):394–405

    Article  Google Scholar 

  10. Gerhold M, Laucht M, Texdorf C et al (2002) Early mother-infant interaction as a precursor to childhood social withdrawal. Child Psychiatry Hum Dev 32(4):277–293

    Article  PubMed  Google Scholar 

  11. Gray PH, Edwards DM, O’Callaghan MJ, Cuskelly M (2012) Parenting stress in mothers of preterm infants during early infancy. Early Hum Dev 88(1):45–49

    Article  PubMed  Google Scholar 

  12. Jotzo M, Reichert J (2013) Psychoneonatologie – Ein Epilog. In: Reichert J, Rüdiger M (Hrsg) Psychologie in der Neonatologie – Psychologisch-sozialmedizinische Versorgung von Familien Frühgeborener. Hogrefe, Göttingen, S 266–276

  13. Keller M, Felderhoff-Müser U, Lagercrantz H et al (2010) Policy benchmarking report on neonatal health and social policies in 13 European countries. Acta Paediatr 99:1624–1629

    Article  PubMed  Google Scholar 

  14. Lester BM, Miller RJ, Hawes K et al (2011) Infant neurobehavioral development. Semin Perinatol 35(1):8–19

    Article  PubMed Central  PubMed  Google Scholar 

  15. Mehler K, Wendrich D, Kissgen R et al (2011) Mothers seeing their VLBW infants within 3 h after birth are more likely to establish a secure attachment behavior: evidence of a sensitive period with preterm infants? J Perinatol 31(6):404–410

    Article  CAS  PubMed  Google Scholar 

  16. Melnyk BM, Feinstein NF, Alpert-Gillis L et al (2006) Reducing premature infants‘ length of stay and improving parents‘ mental health outcomes with the Creating Opportunities for Parent Empowerment (COPE) neonatal intensive care unit program: a randomized, controlled trial. Pediatrics 118(5):1414–1427

    Article  Google Scholar 

  17. Milgrom J, Newnham C, Anderson PJ et al (2010) Early sensitivity training for parents of preterm infants: impact on the developing brain. Pediatr Res 67:330–335

    Article  PubMed  Google Scholar 

  18. Montirosso R, Borgatti R, Trojan S et al (2010) A comparison of dyadic interactions and coping with still-face in healthy preterm and full-term infants. Br J Dev Psychol 28(2):347–368

    Article  PubMed  Google Scholar 

  19. Moore T, Hennessy EM, Myles J et al (2012) Neurological and developmental outcome in extremely preterm children born in England in 1995 and 2006: the EPICure studies. BMJ 345:e7961

    Article  PubMed Central  PubMed  Google Scholar 

  20. Natürliche Bevölkerungsbewegung. https://www.destatis.de/DE/ZahlenFakten/GesellschaftStaat/Bevoelkerung/Geburten/Tabellen/GeboreneGestorbene.html. Zugegriffen: 11. Feb. 2014

  21. Newnham CA, Milgrom J, Skouteris H (2009) Effectiveness of a modified Mother-Infant Transaction Program on outcomes for preterm infants from 3 to 24 months of age. Infant Behav Dev 32:17–26

    Article  PubMed  Google Scholar 

  22. Papousek H, Papousek M (1995) Intuitive parenting. In: Bornstein MH (Hrsg) Handbook of parenting. Ecology and biology of parenting, Bd II. Erlbaum Associates, Mawhaw, S 117–136

  23. Poehlmann J, Miller AJ, Bolt D et al (2009) Predictors of depressive symptom trajectories in mothers of preterm or low birth weight infants. J Fam Psychol 23(5):690–704

    Article  PubMed Central  PubMed  Google Scholar 

  24. Reichert J, Rüdiger M (2012) Psychologisch-sozialmedizinische Versorgung von Eltern Frühgeborener. Ligatur, Stuttgart

  25. Reichert J (2004) Kinderverhaltenstherapie und klassische Grundpositionen. In: Hoppe F, Reichert J (Hrsg) Verhaltenstherapie in der Frühförderung. Hogrefe, Göttingen, S 223–244

  26. Rüdiger M (2013) Frühgeburt: Von der medizinischen Behandlung des Kindes zur Begleitung seiner Familie. In: Reichert J, Rüdiger M (Hrsg) Psychologie in der Neonatologie – Psychologisch-sozialmedizinische Versorgung von Familien Frühgeborener. Hogrefe, Göttingen, S 29–38

  27. Spittle A, Orton J, Anderson P et al (2012) Early developmental intervention programmes post-hospital discharge to prevent motor and cognitive impairments in preterm infants. Cochrane Database Syst Rev 12:CD005495. doi:10.1002/14651858.CD005495.pub3

    PubMed  Google Scholar 

  28. Statistisches Bundesamt (2012) Gesundheit. Fallpauschalenbezogene Krankenhausstatistik (DRG-Statistik). Diagnosen, Prozeduren, Fallpauschalen und Case Mix der vollstationären Patientinnen und Patienten in Krankenhäusern 2011. Fachserie 12 Reihe 6.4. Statistisches Bundesamt, Wiesbaden

  29. Symington AJ, Pinelli J (2006) Developmental care for promoting development and preventing morbidity in preterm infants. Cochrane Database Syst Rev 2:CD001814. doi:10.1002/14651858.CD001814.pub2

    PubMed  Google Scholar 

  30. Vanderveen JA, Bassler D, Robertson CMT, Kirpalani H (2009) Early interventions involving parents to improve neurodevelopmental outcomes of premature infants: a meta-analysis. J Perinatol 29:343–351

    Article  CAS  PubMed  Google Scholar 

  31. Wense A von der, Bindt C (2013) Risikofaktor Frühgeburt – Entwicklungsrisiken erkennen und behandeln. Beltz, Weinheim

  32. Vonderlin E, Noecker-Ribaupierre M, Wilken M (2010) Supportive interventions in newborn. German newborn intensive care units. Monatsschr Kinderheilkd 158(1):42–47

    Article  Google Scholar 

  33. Voss W, Jungmann T, Wachtendorf M, Neubauer AP (2012) Long-term cognitive outcomes of extremely low-birth-weight infants: the influence of the maternal educational background. Acta Paediatr 101:569–573

    Article  CAS  PubMed  Google Scholar 

  34. Wolke D (2008) Prenatal and early biological risk, genes and human development. Int J Psychol 43(3–4):717

  35. Wolke D (2006) Psychological development of extremely preterm (< 26 weeks) and not so preterm (27–35 weeks) children – the big picture. Early Hum Dev 82(9):612–613

    Google Scholar 

Download references

Einhaltung ethischer Richtlinien

Interessenkonflikt. J. Reichert, S. Eulerich-Gyamerah, Ch. Poets, A. Kribs, B. Roth, T. Kühn, R. Rossi, C. Bindt, A. von der Wense und M. Rüdiger geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

Author information

Authors and Affiliations

  1. Universitätsklinikum Carl Gustav Carus, Fetscherstr. 74, 01307, Dresden, Deutschland

    J. Reichert &  M. Rüdiger

  2. Universitätsklinikum Tübingen, Tübingen, Deutschland

    S. Eulerich-Gyamerah & C. Poets

  3. Universitätsklinikum Köln, Köln, Deutschland

    A. Kribs & B. Roth

  4. Vivantes Klinikum Berlin-Neukölln, Berlin, Deutschland

    T. Kühn & R. Rossi

  5. AKK Altonaer Kinderkrankenhaus gGmbH, Hamburg, Deutschland

    C. Bindt & A. von der Wense

Authors
  1. J. Reichert
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S. Eulerich-Gyamerah
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. C. Poets
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A. Kribs
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. B. Roth
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. T. Kühn
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. R. Rossi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. C. Bindt
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. A. von der Wense
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. M. Rüdiger
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M. Rüdiger.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Reichert, J., Eulerich-Gyamerah, S., Poets, C. et al. Psychologisch-sozialmedizinische Versorgung in der Neonatologie. Monatsschr Kinderheilkd 162, 1010–1017 (2014). https://doi.org/10.1007/s00112-014-3219-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00112-014-3219-1

Schlüsselwörter

Keywords

Search

Navigation