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Labrie NHM, van Veenendaal NR, Ludolph RA, Ket JCF, van der Schoor SRD, van Kempen AAMW. Effects of parent-provider communication during infant hospitalization in the NICU on parents: A systematic review with meta-synthesis and narrative synthesis. PATIENT EDUCATION AND COUNSELING 2021; 104:1526-1552. [PMID: 33994019 DOI: 10.1016/j.pec.2021.04.023] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 04/21/2021] [Accepted: 04/22/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To synthesize and analyse the literature on the effects of parent-provider communication during infant hospitalization in the neonatal (intensive) care unit (NICU) on parent-related outcomes. METHODS Systematic review with meta-synthesis and narrative synthesis. Databases (PubMed, PsycINFO, Cochrane Library, CINAHL, Web of Science, Scopus) were searched in October/November 2019. Studies reporting, observing, or measuring parent-related effects of parent-provider communication in the NICU were included. Study quality was assessed using the Quality Assessment Tool for Studies with Diverse Designs. Qualitative studies were meta-synthesized using deductive and inductive thematic analysis. Quantitative studies were analysed using narrative synthesis. RESULTS 5586 records were identified; 77 were included, reporting on N = 6960 parents, N = 693 providers, and N = 300 NICUs. Analyses revealed five main (positive and negative) effects of parent-provider interaction on parents' (1) coping, (2) knowledge, (3) participation, (4) parenting, and (5) satisfaction. Communication interventions appeared impactful, particularly in reducing parental stress and anxiety. Findings confirm and refine the NICU Communication Framework. CONCLUSIONS Parent-provider communication is a crucial determinant for parental well-being and satisfaction with care, during and following infant hospitalization in the NICU. R. Practice Implications: Providers should particularly consider the impact on parents of their day-to-day interaction - the most occurring form of communication of all.
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Affiliation(s)
- Nanon H M Labrie
- Athena Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Department of Pediatrics and Neonatology, OLVG, Amsterdam, The Netherlands.
| | - Nicole R van Veenendaal
- Department of Pediatrics and Neonatology, OLVG, Amsterdam, The Netherlands; Amsterdam UMC, University of Amsterdam, Vrije Universiteit, Emma Children's Hospital, Amsterdam, The Netherlands
| | | | - Johannes C F Ket
- Medical Library, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Fifty Years of Progress in Neonatal and Maternal Transport for Specialty Care. J Obstet Gynecol Neonatal Nurs 2021; 50:774-788. [PMID: 34166650 DOI: 10.1016/j.jogn.2021.04.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2021] [Indexed: 11/23/2022] Open
Abstract
Specialty care for preterm and critically ill infants has evolved over many years. Neonatal intensive care nurseries were developed, and physicians and nurses learned how to provide intensive care for these infants. Neonatal and maternal (in utero) transport to tertiary centers became common in regionalized systems of care to facilitate the specialized care of high-risk neonates when childbirth occurred in settings without specialized personnel or equipment. Annually, nearly 70,000 neonatal transports occur in the United States. Although specialty care helps reduce rates of neonatal mortality, racial disparities and disparities between urban and rural areas exist. The purpose of this article is to review the progress achieved in neonatal and maternal transport over the past 50 years. The knowledge developed can be used to improve the care provided to women, their fetuses, and infants.
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Murthy P, Dosani A, Sikdar KC, Koleade A, Rai B, Scotland J, Lodha A. Parental perception of neonatal retro-transfers from level 3 to level 2 neonatal intensive care units. J Matern Fetal Neonatal Med 2021; 35:5546-5554. [PMID: 33586586 DOI: 10.1080/14767058.2021.1887125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The primary objective of this study was to determine the overall parental satisfaction with retro-transfers from a level 3 to a level 2 Neonatal Intensive Care Unit (NICU). The secondary objectives were to explore factors that caused parental satisfaction associated with retro-transfer and investigate the factors that could be modified to improve the retro-transfer process. METHODS This is a retrospective cross-sectional study. Questionnaires were mailed to all parents of infants transferred from level 3 to level 2 NICUs from 2016 to 2017. Independent samples t-tests, Spearman's rank correlations, and multiple logistic regression analyses were conducted to identify factors associated with parental retro-transfer satisfaction. RESULTS Our response rate was 39.1% (n = 140). Of all parents, 64.29% parents were extremely satisfied with the overall retro-transfer process. In our bivariate analyses, multiple factors were found to be strongly associated with parental retro-transfer satisfaction, including parental level of education, the amount of notice and rationale given for the retro-transfer and the level of parental communication and engagement with their infant's healthcare team before and after transfer. Multiple logistic regression analyses revealed that when questions regarding the retro-transfer were answered and the level 2 NICU team demonstrated a concrete understanding of the infant's medical issues and history, parental satisfaction increased. CONCLUSION Majority of parents were satisfied with the retro-transfer process. However, close collaboration and ongoing and open lines of communication between parents and the level 3 NICU healthcare teams will increase parental retro-transfer satisfaction rates.
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Affiliation(s)
- P Murthy
- Department of Pediatrics, University of Calgary, Calgary, Canada.,Alberta Health Services, Calgary, Canada.,Rockyview General Hospital, Calgary, Canada
| | - A Dosani
- School of Nursing and Midwifery, Mount Royal University, Calgary, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, Canada.,O'Brien Institute for Public Health, University of Calgary, Calgary, Canada
| | - K C Sikdar
- Alberta Health Services, Calgary, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, Canada
| | - A Koleade
- Alberta Health Services, Calgary, Canada
| | - B Rai
- Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - J Scotland
- Alberta Health Services, Calgary, Canada.,Rockyview General Hospital, Calgary, Canada
| | - A Lodha
- Department of Pediatrics, University of Calgary, Calgary, Canada.,Alberta Health Services, Calgary, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, Canada.,Alberta Children's Hospital Research Institute, University of Calgary Calgary, Canada
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Ringham CL, MacKinnon K. Mothering Work and Perinatal Transfer: An Institutional Ethnographic Investigation. Can J Nurs Res 2019; 53:27-38. [PMID: 31684752 DOI: 10.1177/0844562119884388] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND While maternal or infant transfer is generally the safest course of action when health complications arise, the process of shifting from one hospital to another is stressful for mothers and their infants. There is limited understanding of how institutional processes coordinate patient transfer in ways that increase tensions for women and their families who are trying to navigate the institutional systems during health crises. METHODS This institutional ethnographic study explored womens' experience of transfer. Interviews were conducted with a purposive sample of six childbearing women. The analysis highlights tensions and contradictions between patient care and institutional demands and shows how ordinary institutional decision-making practices impacted participants in unexpected ways. RESULTS Women experienced uncertainty and stress when trying to convince health-care providers they needed care. Before, during, and after transfer, participants navigated home responsibilities, childcare, and getting care closer to home in difficult circumstances. CONCLUSION The effort and skill women need to care for their infants and families as they are transferred is extraordinary. This study offers insight into the resources and support childbearing women need to accomplish the work of caring for their families in the face of perinatal crisis and multiple transfers.
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Affiliation(s)
- Catherine L Ringham
- Faculty of Nursing and Alberta Health Services, University of Calgary, Calgary, AB, Canada
| | - Karen MacKinnon
- School of Nursing, University of Victoria, Victoria, BC, Canada
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Aagaard H, Hall EOC, Ludvigsen MS, Uhrenfeldt L, Fegran L. Parents' experiences of neonatal transfer. A meta-study of qualitative research 2000-2017. Nurs Inq 2018; 25:e12231. [PMID: 29446189 DOI: 10.1111/nin.12231] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2017] [Indexed: 12/15/2022]
Abstract
Transfers of critically ill neonates are frequent phenomena. Even though parents' participation is regarded as crucial in neonatal care, a transfer often means that parents and neonates are separated. A systematic review of the parents' experiences of neonatal transfer is lacking. This paper describes a meta-study addressing qualitative research about parents' experiences of neonatal transfer. Through deconstruction and reflections of theories, methods, and empirical data, the aim was to achieve a deeper understanding of theoretical, empirical, contextual, historical, and methodological issues of qualitative studies concerning parents' experiences of neonatal transfer over the course of this meta-study (2000-2017). Meta-theory and meta-method analyses showed that caring, transition, and family-centered care were main theoretical frames applied and that interviewing with a small number of participants was the preferred data collection method. The meta-data-analysis showed that transfer was a scary, unfamiliar, and threatening experience for the parents; they were losing familiar context, were separated from their neonate, and could feel their parenthood disrupted. We identified 'wavering and wandering' as a metaphoric representation of the parents' experiences. The findings add knowledge about meta-study as an approach for comprehensive qualitative research and point at the value of meta-theory and meta-method analyses.
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Affiliation(s)
- Hanne Aagaard
- Department of Public Health, Aarhus University, Aarhus C, Denmark.,Lovisenberg Diaconal University College, Oslo, Norge
| | | | - Mette S Ludvigsen
- Clinical Research Unit, Randers Regional Hospital, Randers, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Lisbeth Uhrenfeldt
- Danish Center of Systematic Reviews: A Joanna Briggs Institute Centre of Excellence, The Center of Clinical Guidelines-Clearing House, Aalborg University, Aalborg, Denmark.,Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.,Department of Nursing and Health Sciences, Nord University, Bodø, Norway
| | - Liv Fegran
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
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Sommer CM, Cook CM. Disrupted bonds - parental perceptions of regionalised transfer of very preterm infants: a small-scale study. Contemp Nurse 2016; 50:256-66. [PMID: 26514339 DOI: 10.1080/10376178.2015.1114421] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Routine regionalised transfer of preterm infants occurs throughout Westernised countries. Transfer to lower acuity units occurs once infants are ready for convalescence and signals an infant's improving health. However, many parents find transfer traumatic. AIMS To investigate parents' perceptions of preterm infants' transfer; to provide neonatal clinicians with insights to facilitate optimal service provision. METHODS Participants had experienced their baby born at less than 29 weeks gestation, and subsequent transfer. Six parents were interviewed. DESIGN Data were analysed using a general inductive approach. FINDINGS Three themes were interpreted through data analysis: NICU - incomparable haven; abandonment; and parental expertise side-lined. These themes represent a journey of interrupted identity that parents undergo when their baby is transferred to another unit. CONCLUSION Despite studies recommending more family-centred transfer planning, gaps persist. Nursing care might be enhanced by incorporating insight into parental experiences and promotion of collaborative changes within and between units.
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Granrud MD, Ludvigsen E, Andershed B. Parents' experiences of their premature infants' transportation from a university hospital NICU to the NICU at two local hospitals. J Pediatr Nurs 2014; 29:e11-8. [PMID: 24582644 DOI: 10.1016/j.pedn.2014.01.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Revised: 01/23/2014] [Accepted: 01/24/2014] [Indexed: 11/16/2022]
Abstract
The aim of this study was to describe how the parents of premature infants experience the transportation of their baby from the neonatal intensive care unit at a university hospital (NICU-U) to such a unit at a local hospital (NICU-L). This descriptive qualitative study comprises interviews with nine sets of parents and two mothers. The qualitative content analysis resulted in one theme: living in uncertainty about whether the baby will survive, and three categories: being distanced from the baby; fearing that something would happen to the baby during transportation; and experiencing closeness to the baby. The results also revealed that the parents experienced developmental, situational and health-illness transitions.
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Affiliation(s)
- Marie Dahlen Granrud
- Department of Nursing, Hedmark University College, Elverum, Norway; Neonatal Intensive Care Unit, Innlandet Hospital Trust, Norway
| | - Elin Ludvigsen
- Neonatal Intensive Care Unit, Innlandet Hospital Trust, Norway
| | - Birgitta Andershed
- Department of Nursing, Gjøvik University College, Norway, and Department of Palliative Research Centre, Ersta Sköndal University College and Ersta Hospital, Stockholm, Sweden.
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