DOI
https://doi.org/10.25772/XS2F-AV48
Author ORCID Identifier
0009-0005-2672-487X
Defense Date
2023
Document Type
Dissertation
Degree Name
Doctor of Philosophy
Department
Health Related Sciences
First Advisor
Audrey Kane
Second Advisor
Stacey Reynolds
Third Advisor
Sarah Marrs
Fourth Advisor
Bobbi Pineda
Fifth Advisor
Elizabeth Rogers
Abstract
Medical advances have significantly increased the survival rates of preterm infants at lower gestational ages. However, infants born at lower gestational ages have an increased risk for developmental disabilities and oral feeding difficulties. A stay in the neonatal intensive care unit (NICU) is very costly and inadequate oral feeding is the most common barrier to discharge for premature infants. Infants can receive dysphagia therapy services during their NICU stay that focuses on the development of oral feeding and swallowing skills. However, literature to this date has mainly focused on the impact of therapy services for premature infants after NICU discharge.
The purpose of this dissertation is to describe the scope of dysphagia therapy for preterm infants in a Level IV NICU and to determine the association between infant characteristics, dysphagia therapy utilization, and feeding outcomes. This study uses a correlational retrospective study design to analyze secondary data extracted from the electronic medical record for all eligible infants who were born at less than 37 weeks of gestation, with a history of admission to a Level IV NICU between January 2017 and December 2019. Variables for this study were selected using Gelberg’s Behavioral Model for Vulnerable Populations by examining how preterm infant characteristics impact dysphagia therapy service utilization, which ultimately impact their feeding outcomes.
The results showed that mainly need factors, such as gestational age, birthweight, and medical complexity, were associated with receipt of dysphagia therapy referral, referral type, number of treatment sessions, and postmenstrual age (PMA) at independent oral feeding. Regression analysis showed that when controlling for infant characteristics, the receipt of dysphagia therapy was associated with higher PMA at independent oral feeding. This is likely due to infants who received dysphagia therapy referrals having higher medical complexities.
Findings from this study contributes to understanding of the provision of dysphagia therapy, which could lead to earlier identification of populations that are at higher risk for delayed achievement of independent oral feeding and the creation of protocols for the referral process for those infants. More research is needed to further understand and address factors that impact neonatal feeding outcomes and length of stay to ultimately decrease healthcare costs.
Rights
© The Author
Is Part Of
VCU University Archives
Is Part Of
VCU Theses and Dissertations
Date of Submission
11-28-2023