Design and Sample: The effectiveness of the intervention was evaluated using a multi-site, randomized clinical trial. 164 healthy full-term infants with excessive unexplained irritability (between the ages of 2 to 6 weeks) were randomized to intervention or control group (n =121). A third group (n = 43) of infants were enrolled in a post-test only group.

Variables and Method: The 4 week REST Routine, consisted of regulation, entrainment, structure and touch for the infants; and reassurance, empathy, support and time-out for the parents. The four outcome measures were: 1) amount of unexplained infant crying, 2) level of parenting stress 3) quality of maternal-infant interaction and 4) infant sleep patterns. The home-based intervention was delivered by trained advanced practice nurses during weekly visits. A separate trained evaluation team obtained measurements at specified intervals during and following the intervention program.

Findings: Infants in the REST Routine group cried 1.7 hours per day as compared to 3 hours in the control group (p = .02). Statistically significant differences were found in the amount of parenting stress. No group differences in maternal-infant interaction or infant sleep were found, however some of the NCAST Feeding Scale items and sleep analysis revealed a modification in parent interaction patterns and infant sleep patterns.

Conclusions and Implications: The findings support the emerging view of unexplained irritability as a behavioral pattern that is responsive to environmental modification and structured, cue-based care. Clinical recommendations for intervening with these families and options for program modification will be discussed. Distance-based networking and opportunities for mentoring of students, faculty, and clinical colleagues were unique aspects of this multi-site study that will also be presented.

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Back to 15th International Nursing Research Congress
Sigma Theta Tau International
July 22-24, 2004