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McKay K, O’Nions E, Wayland S, Ferguson D, Kennedy E. Fears, Reassurance, and Milestones: A Twitter Analysis around World Prematurity Day during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010807. [PMID: 34682550 PMCID: PMC8535517 DOI: 10.3390/ijerph182010807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 10/05/2021] [Accepted: 10/12/2021] [Indexed: 12/02/2022]
Abstract
Preterm birth (birth <37 completed weeks’ gestation) is common, affecting 10.6% of live births globally (nearly 15 million babies per year). Having a new baby admitted to a neonatal unit often triggers stress and anxiety for parents. This paper seeks to explore experiences of preterm birth via Twitter. The intermingling of COVID-19 restrictions and World Prematurity Day allows for an understanding of both the additional stresses incurred as a consequence of the pandemic and the more “everyday” experiences in the NICU and beyond. The content analysis of the data included 3161 tweets. Three themes were identified: 1. COVID-19 was not the only trauma; 2. Raising awareness, especially World Prematurity Day; and, 3. Baby milestones. These themes highlight the multi-level challenges faced by parents of premature babies and the healthcare professionals involved in their care. The COVID-19 pandemic and the consequent restrictions imposed on parents’ contact with their babies have resulted in immense emotional strain for families. The reported COVID-19 pandemic “baby blind spot” appears to particularly impact this group of babies. Improved understanding of the lived experiences of preterm babies and their families should inform greater awareness and improved support.
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Affiliation(s)
- Kathy McKay
- Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Liverpool L69 3GL, UK
- Research and Development Unit, Tavistock and Portman NHS Foundation Trust, London NW3 5BA, UK;
- Correspondence:
| | - Elizabeth O’Nions
- Research Department of Clinical, Educational & Health Psychology, University of College London, London WC1E 6BT, UK;
| | - Sarah Wayland
- School of Health, University of New England, Armidale 2350, Australia;
| | - David Ferguson
- Formerly, Faculty of Transdisciplinary Innovation, University of Technology Sydney, Sydney 2007, Australia;
| | - Eilis Kennedy
- Research and Development Unit, Tavistock and Portman NHS Foundation Trust, London NW3 5BA, UK;
- Research Department of Clinical, Educational & Health Psychology, University of College London, London WC1E 6BT, UK;
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MacSween K, Fraser C, Clinton T, Clements D, Patel N, McKechnie L. Neonatal healthcare workers' perceptions of the impact of the COVID-19 pandemic. Acta Paediatr 2021; 110:2814-2816. [PMID: 34143498 PMCID: PMC8444642 DOI: 10.1111/apa.15994] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/27/2021] [Accepted: 06/17/2021] [Indexed: 11/29/2022]
Affiliation(s)
| | - Caroline Fraser
- Leeds Children's Hospital Leeds Centre for Newborn CareLeedsUK
| | | | - Dawn Clements
- Leeds Children's Hospital Leeds Centre for Newborn CareLeedsUK
| | | | - Liz McKechnie
- Leeds Children's Hospital Leeds Centre for Newborn CareLeedsUK
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Manuela F, Barcos-Munoz F, Monaci MG, Lordier L, Camejo MP, De Almeida JS, Grandjean D, Hüppi PS, Borradori-Tolsa C. Maternal Stress, Depression, and Attachment in the Neonatal Intensive Care Unit Before and During the COVID Pandemic: An Exploratory Study. Front Psychol 2021; 12:734640. [PMID: 34659049 PMCID: PMC8517514 DOI: 10.3389/fpsyg.2021.734640] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 09/03/2021] [Indexed: 11/13/2022] Open
Abstract
The main aim of the present study was to investigate the effects of the COVID-19 pandemic on the mothers' postnatal depression, stress, and attachment during their stay in the Neonatal Intensive Care Unit (NICU). Twenty mothers of very premature infants born before 32weeks of gestational age were recruited at the Geneva University Hospital between January 2018 and February 2020 before the COVID-19 pandemic started. Mothers were screened for postnatal depression after their preterm infant's birth (Edinburgh Postnatal Depression Scale, EPDS), then for stress (Parental Stressor Scale: Neonatal Intensive Care Unit, PSS:NICU), and attachment (Maternal Postnatal Attachment Scale, MPAS) at infant's term-equivalent age. Data were compared with 14 mothers recruited between November 2020 and June 2021 during the COVID-19 pandemic. No significant differences were found in the scores for depression, stress, and attachment between the two groups. However, a non-statistically significant trend showed a general increase of depression symptoms in mothers during the COVID-19 pandemic, which significantly correlated to the attachment and stress scores. Moreover, the PSS:NICU Sights and Sounds score was significantly positively correlated with EPDS scores and negatively with the MPAS score only in the During-COVID group. To conclude, we discussed a possible dampened effect of the several protective family-based actions that have been adopted in the Geneva University Hospital during the health crisis, and we discussed the most appropriate interventions to support parents in this traumatic period during the COVID-19 pandemic.
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Affiliation(s)
- Filippa Manuela
- Division of Development and Growth, Department of Pediatrics, Obstetrics and Gynaecology, University of Geneva, Geneva, Switzerland
- Neuroscience of Emotion and Affective Dynamics Lab, Swiss Center for Affective Sciences, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
- Department of Human and Social Sciences, University of Valle d’Aosta, Aosta, Italy
| | - Francisca Barcos-Munoz
- Division of Pediatric Intensive Care and Neonatology, Department of Women, Children and Adolescents, University Hospital of Geneva, Geneva, Switzerland
| | - Maria Grazia Monaci
- Department of Human and Social Sciences, University of Valle d’Aosta, Aosta, Italy
| | - Lara Lordier
- Division of Development and Growth, Department of Pediatrics, Obstetrics and Gynaecology, University of Geneva, Geneva, Switzerland
| | - Maricé Pereira Camejo
- Division of Pediatric Intensive Care and Neonatology, Department of Women, Children and Adolescents, University Hospital of Geneva, Geneva, Switzerland
| | - Joana Sa De Almeida
- Division of Development and Growth, Department of Pediatrics, Obstetrics and Gynaecology, University of Geneva, Geneva, Switzerland
| | - Didier Grandjean
- Neuroscience of Emotion and Affective Dynamics Lab, Swiss Center for Affective Sciences, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Petra S. Hüppi
- Division of Development and Growth, Department of Pediatrics, Obstetrics and Gynaecology, University of Geneva, Geneva, Switzerland
| | - Cristina Borradori-Tolsa
- Division of Development and Growth, Department of Pediatrics, Obstetrics and Gynaecology, University of Geneva, Geneva, Switzerland
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Kostenzer J, Hoffmann J, von Rosenstiel-Pulver C, Walsh A, Zimmermann LJ, Mader S. Neonatal care during the COVID-19 pandemic - a global survey of parents' experiences regarding infant and family-centred developmental care. EClinicalMedicine 2021; 39:101056. [PMID: 34401688 PMCID: PMC8355909 DOI: 10.1016/j.eclinm.2021.101056] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 07/13/2021] [Accepted: 07/15/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic restrictions affect provision and quality of neonatal care. This global study explores parents' experiences regarding the impact of the restrictions on key characteristics of infant and family-centred developmental care (IFCDC) during the first year of the pandemic. METHODS For this cross-sectional study, a pre-tested online survey with 52 questions and translated into 23 languages was used to collect data between August and November 2020. Parents of sick or preterm infants born during the pandemic and receiving special/intensive care were eligible for participation. Data analysis included descriptive statistics and statistical testing based on different levels of restrictive measures. FINDINGS In total, 2103 participants from 56 countries provided interpretable data. Fifty-two percent of respondents were not allowed to have another person present during birth. Percentages increased with the extent of restrictions in the respondents' country of residence (p = 0·002). Twenty-one percent of total respondents indicated that no-one was allowed to be present with the infant receiving special/intensive care. The frequency (p < 0·001) and duration (p = 0·001) of permitted presence largely depended on the extent of restrictions. The more restrictive the policy measures were, the more the respondents worried about the pandemic situation during pregnancy and after birth. INTERPRETATION COVID-19 related restrictions severely challenged evidence-based cornerstones of IFCDC, such as separating parents/ legal guardians and their newborns. Our findings must therefore be considered by public health experts and policy makers alike to reduce unnecessary suffering, calling for a zero separation policy. FUNDING EFCNI received an earmarked donation by Novartis Pharma AG in support of this study.
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Affiliation(s)
- Johanna Kostenzer
- European Foundation for the Care of Newborn Infants (EFCNI), Scientific Affairs, Hofmannstrasse 7A, Munich 81379, Germany
| | - Julia Hoffmann
- European Foundation for the Care of Newborn Infants (EFCNI), Scientific Affairs, Hofmannstrasse 7A, Munich 81379, Germany
| | | | - Aisling Walsh
- European Foundation for the Care of Newborn Infants (EFCNI), Scientific Affairs, Hofmannstrasse 7A, Munich 81379, Germany
| | - Luc J.I. Zimmermann
- European Foundation for the Care of Newborn Infants (EFCNI), Scientific Affairs, Hofmannstrasse 7A, Munich 81379, Germany
- Department of Paediatrics, Research School Oncology and Development, Maastricht UMC+, Maastricht, the Netherlands
| | - Silke Mader
- European Foundation for the Care of Newborn Infants (EFCNI), Scientific Affairs, Hofmannstrasse 7A, Munich 81379, Germany
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Family Presence Restrictions and Telemedicine Use in Neonatal Intensive Care Units during the Coronavirus Disease Pandemic. CHILDREN-BASEL 2021; 8:children8070590. [PMID: 34356569 PMCID: PMC8307335 DOI: 10.3390/children8070590] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/06/2021] [Accepted: 07/10/2021] [Indexed: 11/16/2022]
Abstract
We aimed to describe parental presence policy and telemedicine use in Japanese neonatal intensive care units (NICUs) before and during the coronavirus disease (COVID-19) pandemic. This cross-sectional study was performed through an online survey in 110 level III units from 19 November 2020 to 18 December 2020. Nurses’ evaluation of the current situation (during COVID-19) was compared with their retrospective pre-COVID-19 (December 2019) evaluation. Responses were received from 52 NICUs distributed across all regions in Japan. The median allowed parental presence time decreased from 12 h to 1 h, and 29 NICUs allowed entry of parents simultaneously during COVID-19. There was an increase in the number of units providing telemedicine through telephone and online visits during COVID-19 compared to that before COVID-19 (from 2% to 19%). The hybrid design NICUs, with 11–89% of beds in single-patient rooms, allowed a longer parental presence time in the NICUs than those with ≥90% of beds in multi-bed rooms. The number of units implementing kangaroo care decreased during COVID-19 compared to that before COVID-19. The need for telemedicine increased among Japanese NICUs to mitigate the adverse effect of parental restriction and limited physical contact due to the COVID-19 pandemic.
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Veenendaal NR, Deierl A, Bacchini F, O’Brien K, Franck LS. Supporting parents as essential care partners in neonatal units during the SARS-CoV-2 pandemic. Acta Paediatr 2021; 110:2008-2022. [PMID: 33772861 PMCID: PMC8250667 DOI: 10.1111/apa.15857] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 03/23/2021] [Indexed: 12/18/2022]
Abstract
AIM To review the evidence on safety of maintaining family integrated care practices and the effects of restricting parental participation in neonatal care during the SARS-CoV-2 pandemic. METHODS MEDLINE, EMBASE, PsycINFO and CINAHL databases were searched from inception to the 14th of October 2020. Records were included if they reported scientific, empirical research (qualitative, quantitative or mixed methods) on the effects of restricting or promoting family integrated care practices for parents of hospitalised neonates during the SARS-CoV-2 pandemic. Two authors independently screened abstracts, appraised study quality and extracted study and outcome data. RESULTS We retrieved 803 publications and assessed 75 full-text articles. Seven studies were included, reporting data on 854 healthcare professionals, 442 parents, 364 neonates and 26 other family members, within 286 neonatal units globally. The pandemic response resulted in significant changes in neonatal unit policies and restricting parents' access and participation in neonatal care. Breastfeeding, parental bonding, participation in caregiving, parental mental health and staff stress were negatively impacted. CONCLUSION This review highlights that SARS-CoV-2 pandemic-related hospital restrictions had adverse effects on care delivery and outcomes for neonates, families and staff. Recommendations for restoring essential family integrated care practices are discussed.
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Affiliation(s)
- Nicole R. Veenendaal
- Department of Pediatrics/Neonatology OLVG Amsterdam The Netherlands
- Department of Pediatrics, Emma Children's Hospital Amsterdam UMC, Vrije Universiteit, University of Amsterdam Amsterdam The Netherlands
| | - Aniko Deierl
- Department of Neonatology Imperial College Healthcare NHS Trust London UK
| | | | - Karel O’Brien
- Department of Pediatrics Mount Sinai Hospital Toronto Ontario Canada
| | - Linda S. Franck
- School of Nursing University of California San Francisco San Francisco CA USA
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Consequences of visiting restrictions during the COVID-19 pandemic: An integrative review. Int J Nurs Stud 2021; 121:104000. [PMID: 34242976 PMCID: PMC8196532 DOI: 10.1016/j.ijnurstu.2021.104000] [Citation(s) in RCA: 182] [Impact Index Per Article: 60.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 05/17/2021] [Accepted: 06/05/2021] [Indexed: 12/18/2022]
Abstract
Background During the COVID-19 pandemic, visiting restrictions of different extents have been implemented. However, despite the long history of visiting restrictions in health care systems, little is known about their effects. Objectives This review sought to explore the consequences of visitor restrictions in health care services during the COVID-19 pandemic. Methods A systematic, integrative review was conducted in accordance with the PRISMA guidelines, based on a systematic search in PubMed, CHINAL full plus, Web of Science, PsychInfo, Scopus and the Cochrane Library. Results A total of 17 scientific papers covering intensive care, pediatric care, general medical care, hospital care, palliative care and nursing home settings were included. Although appreciation for the technical solutions enabling remote meetings was reported, visiting restrictions had several consequences, mainly negative, for the patient's health, the health and wellbeing of family members and the provision of care. Among physical health consequences, reduced nutrition intake, decreased activities of daily living and increased physical pain and symptoms were reported. Among mental health consequences for the patient, loneliness, depressive symptoms, agitation, aggression, reduced cognitive ability and overall dissatisfaction were observed. For family members, worry, anxiety and uncertainty occurred, and they reported an increased need for information from care providers. Family members of neonatal intensive care unit patients reported less bonding with their child and family relation disturbances due to the restrictions. For care providers, visiting restrictions added the burdens of ethical dilemmas, learning new technical means to enable social interaction and an increased demand for communication with families and providing social support to both family members and patients. Conclusions When implementing visiting restrictions in health care services, decision makers and nurses need to be aware of their potential negative effects and adapt the provision of care to compensate for such effects. Nurses in all sectors should be aware that visiting restrictions may affect patients, families, and health care services for longer than the actual pandemic. Since the level of evidence regarding effect from visiting restrictions is low, further studies is strongly needed.
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Cena L, Biban P, Janos J, Lavelli M, Langfus J, Tsai A, Youngstrom EA, Stefana A. The Collateral Impact of COVID-19 Emergency on Neonatal Intensive Care Units and Family-Centered Care: Challenges and Opportunities. Front Psychol 2021; 12:630594. [PMID: 33716895 PMCID: PMC7943863 DOI: 10.3389/fpsyg.2021.630594] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 01/25/2021] [Indexed: 12/28/2022] Open
Abstract
The ongoing Coronavirus disease 2019 (COVID-19) pandemic is disrupting most specialized healthcare services worldwide, including those for high-risk newborns and their families. Due to the risk of contagion, critically ill infants, relatives and professionals attending neonatal intensive care units (NICUs) are undergoing a profound remodeling of the organization and quality of care. In particular, mitigation strategies adopted to combat the COVID-19 pandemic may hinder the implementation of family-centered care within the NICU. This may put newborns at risk for several adverse effects, e.g., less weight gain, more nosocomial infections, increased length of NICU stay as well as long-term worse cognitive, emotional, and social development. This article aims to contribute to deepening the knowledge on the psychological impact of COVID-19 on parents and NICU staff members based on empirical data from the literature. We also provided evidence-based indications on how to safely empower families and support NICU staff facing such a threatening emergency, while preserving the crucial role of family-centered developmental care practices.
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Affiliation(s)
- Loredana Cena
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Paolo Biban
- Department of Neonatal and Pediatric Critical Care, Verona University Hospital, Verona, Italy
| | - Jessica Janos
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Manuela Lavelli
- Department of Human Sciences, University of Verona, Verona, Italy
| | - Joshua Langfus
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Angelina Tsai
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Eric A. Youngstrom
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Alberto Stefana
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
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Ashini A, Alsoufi A, Elhadi M. Parental perception of neonatal ICU visitation during the COVID-19 pandemic. Int J Gynaecol Obstet 2021; 153:554-555. [PMID: 33615470 PMCID: PMC9087493 DOI: 10.1002/ijgo.13650] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 01/25/2021] [Accepted: 02/19/2021] [Indexed: 11/08/2022]
Affiliation(s)
- Aimen Ashini
- Faculty of Medicine, University of Tripoli, Tripoli, Libya
| | - Ahmed Alsoufi
- Faculty of Medicine, University of Tripoli, Tripoli, Libya
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