鄭素芳臺灣大學:物理治療學研究所林昱志Lin, Yu-ChihYu-ChihLin2010-05-072018-07-082010-05-072018-07-082009U0001-1708200918585100http://ntur.lib.ntu.edu.tw//handle/246246/181465Purpose: This study was aimed to examine the effectiveness of early intervention for very low birth weight (VLBW, birth weight <1,500 g) preterm infants in mother-infant feeding interaction at 4 and 6 months corrected age. Methods: This study enrolled 62 term infants and 179 VLBW infants that the latter were randomly assigned into usual care program (UCP), clinic-based intervention program (CBIP) and home-based intervention (HBIP) group. Mother-infant dyads feeding activity were examined using the Assessment of Mother Infant Sensitivity- Chinese version (AMIS-C). Infants’ heart rate variability (HRV) was assessed using an electrocardiography at 4 and 6 months corrected age. Results: For interactive behavior, the CBIP group showed significantly higher maternal scores on the AMIS-C than the HBIP at 4 and 6 months corrected age (p = 0.004); whereas, the infant, dyadic and total scores of all groups were comparable. As for the physiological response, all groups showed similar HRV at baseline and during feeding at 6 months corrected age. Furthermore, a higher AMIS-C dyadic and total score on at 4 months were associated with a smaller change in some HRV indices from baseline to feeding at 6 months in all groups (all r=-0.16, p<0.05). A higher AMIS-C maternal and total score on at 6 months was each associated with a smaller change in some HRV indices from baseline to feeding at 6 months (r=-0.20 to -0.16, all p<0.05). Conclusion: VLBW preterm dyads showed comparable interactive behavior and infant’s heart rate variable than term dyads during feeding at 4 and 6 months corrected age. Early intervention delivered at clinic visit was more beneficial than that delivered at home in altering maternal feeding behavior during the follow-up period.Content試委員會審定書......................................І謝..................................................І Іcknowledgments ......................................І І Іart I: Reliability and Responsiveness of the Assessment of Mother-Infant Sensitivity- Chinese version when Used on Preterm and Term Taiwanese Mother-Infant Dyadsbstract..............................................i. Introduction.......................................1.1 Background .......................................1.2 Purposes..........................................2. Methods............................................2.1 Participants......................................2.2 Testing Procedure and Instrument..................3.3 Statistical Analysis..............................5. Results ...........................................6.1 Intra- and Inter-Rater Reliability of AMIS-C .....6.2 Internal Consistency of AMIS-C ...................7.3 Comparison of AMIS-C Individual Section and Total Score between Term and Preterm Dyads .......................8.4 Responsiveness of AMIS-C..........................8. Discussion.........................................8.1 Intra- and Inter-Rater Reliability of the AMIS-C..8.2 Internal Consistency of the AMIS-C................9.3 Responsiveness of the AMIS-C .................... 11.4 Study Limitations and Future Study................12.5 Conclusion .......................................12eferences............................................14able 1. Intra-and inter-rater reliability for the section and total scores of the AMIS-C........................17able 2. Internal consistency of the AMIS-C section and total scores for term and preterm dyads ..............18able 3. Illustration of AMIS-C section and total score for term and preterm dyads................................19art II: Early Intervention for Very Low Birth Weight Preterm Infants: Effects on Interactive Behavior and Heart Rate Variability in Feedingbstract..............................................i. Introduction.......................................1.1 Background .......................................1.2 Purposes and Hypotheses...........................4. Methods............................................5.1 Subjects .........................................5.2 Intervention Modalities ..........................6.2.1 Control Groups .................................6.2.2 Experimental Groups ............................6.3 Testing Procedure and Instrument..................7.4 Measures .........................................7.4.1 Assessment of Mother Infant Sensitivity- Chinese Version...............................................7.4.2 Heart Rate Variability .........................8.5 Statistical Analysis..............................10. Results .......................................... 11.1 Sample Characteristics........................... 11.2 Assessment of Mother Infant Sensitivity- Chinese Version.............................................. 11.3 Infants’ Heart Rate Variability .................12.4 Relations between the AMIS-C scores and infants’ HRV indices...............................................14. Discussion.........................................14.1 Mother-infant interactive behavior during feeding.14.2 Infants’ HRV during feeding......................15.3 Relations of mother-infant interactive behavior with infants’ HRV ........................................17.4 Conclusion .......................................18eferences............................................18able 1. Perinatal and demographic characteristics of term and preterm groups....................................25able 2. A comparison of the infant characteristics and demographic data between those dyads who returned at both ages and those who missed either one age..............27able 3. Illustration of the AMIS-C section and total scores for term and preterm dyads returned at corrected ages 4 and/or 6 months................................29able 4. Illustration of the AMIS-C section and total scores for term and preterm dyads returned at both corrected ages 4 and 6 months.........................30able 5. Illustration of the HRV indices for term and preterm groups at corrected age 6 months..............31able 6. Illustration of change of infants’ HRV from baseline to feeding for term and preterm groups at 6 months CA....................................................32able 7. Relations of the AMIS-C section and total scores at 6 months CA with the change of infants’ HRV indices from baseline to feeding at 6 months CA in all infants (N=155) ..............................................33able 8. Relations of the AMIS-C section and total scores at 6 months CA with the change of infants’ HRV indices from baseline to feeding at 6 months CA in term infants (N=35) ...............................................34able 9. Relations of the AMIS-C section and total scores at 6 months CA with the change of infants’ HRV from baseline to feeding at 6 months CA in preterm infants (N=120) ..............................................35able 10. Relations of the AMIS-C section and total scores at 4 months CA with the change of infants’ HRV from baseline to feeding at 6 months CA in all infants (N=149)...............................................36able 11. Relations of the AMIS-C section and total scores at 4 months CA with the change of infants’ HRV indices from baseline to feeding at 6 months CA in term infants (N=31) ...............................................37able 12. Relations of the AMIS-C section and total scores at 4 months CA with the change of infants’ HRV indices from baseline to feeding at 6 months CA in preterm infants (N=116)...............................................38application/pdf571231 bytesapplication/pdfen-US極低出生體重早產兒早期介入親子互動心跳變異率Mother-infant interactionAssessmentReliabilityResponsivenessVery Low Birth WeightPretermEarly interventionHeart rat variabilityhttp://ntur.lib.ntu.edu.tw/bitstream/246246/181465/1/ntu-98-R96428001-1.pdf