ABSTRACT

Introduction

Despite medical advances, preterm birth and neonatal intensive care (NICU) hospitalization are demanding and pose risks for infants and parents. Various music therapy (MT) models have suggested parental singing to promote healthy bonding and development in premature infants, but evidence on long-term effects is lacking.

Method

We present the theoretical framework and intervention protocol of a resource-oriented MT approach for premature infants and their caregivers used in the international LongSTEP trial (ClinicalTrials.gov NCT03564184). We illustrate how guiding principles manifest in MT sessions, describe frames for phases of intervention, discuss prerequisites and present hypothesized mechanisms of change.

Results

The LongSTEP MT approach is resource-oriented, emphasizes parental voice and parent-infant mutual regulation, builds on family-centered care principles, and is relevant in the NICU and beyond. Essential elements include: observation and dialogue on infant and parent needs; voice as the main musical source, with parental voice as the most prominent; active parental participation; modification of music in response to infant states and cues; and integration of the family’s culture and music preferences. The music therapist facilitates and supports interaction between parents and infant. Parents learn how to adapt principles in relation to infant development across NICU hospitalization and post-discharge phases.

Discussion

The LongSTEP approach is feasible in culturally diverse countries where consistent parental presence is available, but requires tailoring to local circumstances and culture, particularly in the post-discharge phase. The emphasis on parent-led infant-directed singing places a higher demand on parents than other MT approaches, and requires sufficient psychosocial and musical support for parents.

中文翻译：

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LongSTEP 方法：使用父母驱动的婴儿导向歌唱作为资源导向音乐疗法的理论框架和干预方案

摘要

介绍

尽管医学取得了进步，但早产和新生儿重症监护 (NICU) 住院治疗要求很高，并对婴儿和父母构成风险。各种音乐疗法 (MT) 模型表明，父母唱歌可以促进早产儿的健康结合和发育，但缺乏长期影响的证据。

方法

我们介绍了国际 LongSTEP 试验 (ClinicalTrials.gov NCT03564184) 中使用的早产儿及其护理人员的资源导向 MT 方法的理论框架和干预方案。我们说明指导原则如何在 MT 会议中体现，描述干预阶段的框架，讨论先决条件并提出假设的变革机制。

结果

LongSTEP MT 方法以资源为导向，强调父母的声音和父母与婴儿的相互调节，建立在以家庭为中心的护理原则之上，并适用于 NICU 及其他地区。基本要素包括：对婴儿和父母需求的观察和对话；声音为主要音乐来源，以父母的声音最为突出；父母积极参与；根据婴儿状态和提示修改音乐；并融合了家庭的文化和音乐偏好。音乐治疗师促进和支持父母与婴儿之间的互动。父母学习如何在 NICU 住院和出院后阶段调整与婴儿发育相关的原则。

讨论

LongSTEP 方法在文化多元的国家是可行的，因为这些国家有父母始终在场，但需要根据当地情况和文化进行调整，特别是在出院后阶段。与其他 MT 方法相比，强调以父母为主导的婴儿导向唱歌对父母的要求更高，并且需要为父母提供足够的社会心理和音乐支持。