Date of Award

12-2020

Document Type

Open Access Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Nursing

First Advisor

Teri Aronowitz

Second Advisor

Ling Shi

Third Advisor

Michele DeGrazia

Abstract

Bronchopulmonary dysplasia (BPD) is a pulmonary disease that affects infants born < 32 weeks gestational age. Despite improved survival among preterm infants, the incidence and severity of BPD has not improved, rather the features and severity of BPD have evolved (Abman et al., 2017). BPD is a disease that has significant impact on the outcomes of preterm infants, including poor pulmonary and neurodevelopmental outcomes (Abman et al., 2017). Since its identification in 1967, and many iterations to its defining criteria, healthcare practitioners are unable to accurately predict infants’ risk of developing BPD. Further, there is significant family, social, and economic impacts from BPD. This dissertation research examined risk factors for BPD, as identified in a mid-range theory developed from a systematic review of the literature. This mid-range theory is framed using the Neuman Systems Model (NSM) (2011). The research utilized a secondary analysis of data from a database including a cohort of infants born at < 32 weeks’ gestation (n=455) treated at Boston Children’s Hospital. Findings from this research demonstrated that multiple intrapersonal risk factors are associated with development of BPD and the grades of BPD severity including gestational age, birth weight, surfactant administration, necrotizing enterocolitis, infections, mechanical ventilation duration, and patent ductus arteriosus. This research adds to the current body of research by demonstrating specific risks associated with BPD. Findings of this research could be used to identify maternal infant dyads that would benefit from early therapy(s) to reduce BPD risk.

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