Are fathers supported by neonatal teams?: An exploration of the literature

Father Groups in the Neonatal Intensive Care Unit: A Supportive Intervention

BACKGROUND

Parents' participation in the neonatal intensive care unit (NICU) reduces length of stay and positively affects infants' psychological, cognitive, and behavioural outcomes. Healthcare professionals in the NICU focus on both parents, but tend to have the main focus on the mother and the infant. Therefore, fathers may experience a lack of support and feel that they are being disregarded in the NICU.

PURPOSE

To study fathers' experiences with father groups during NICU admission with their preterm infant. The father group is a 90-minute intervention based on dialogue between fathers and a male healthcare professional.

METHODS

A qualitative content analysis was conducted using 10 online semistructured interviews with fathers participating in a father group. The study was reported according to the Standards for Reporting Qualitative Research.

RESULTS

The overall theme emerging from our analysis was "Emotional support, encouragement, and an enhanced capacity to deal with the situation and with life in the NICU." This theme emerged from the categories "Meeting with peers and sharing reflections" and "Fathers' territory" based on 5 subcategories.

IMPLICATIONS FOR PRACTICE

Participation in father groups gives fathers recognition for being important as parents in the NICU, improves fathers' mental well-being, and enhances their coping capacity. Father groups support fathers in the NICU and can be integrated into NICU practices and policies to enhance a family-centered approach.

IMPLICATIONS FOR RESEARCH

This study revealed a need for further research to determine whether participation in a father group has a measurable effect on clinical outcomes.

The Needs of NICU Fathers in Their Own Words: A Qualitative Descriptive Study

BACKGROUND

Neonatal intensive care unit (NICU) nurses need a better understanding of fathers' needs and perceptions in order to provide more family holistic care. Previous research aimed at exploring fathers' experiences in the NICU resulted in identifying some needs; however, these studies mostly occurred outside the United States where practices may differ. Therefore, research is needed to explore NICU fathers' needs within the United States.

PURPOSE

The purpose of this study was to explore the needs of fathers who previously had a premature infant in the NICU.

METHODS

This qualitative descriptive study used semistructured interviews collected to obtain in-depth knowl-edge of fathers' needs in the NICU. Twenty-eight fathers were recruited through 3 parent support organizations: Hand to Hold, NICU Parent Support Network, and March of Dimes.

RESULTS

Results revealed 3 themes: need for support, clarity and to be recognized.

IMPLICATIONS FOR PRACTICE

Fathers have specific needs in the NICU that need to be addressed and that may differ from mothers. Awareness of addressing fathers' needs promotes more holistic care to fathers, supports coping within the NICU environment and the multifaceted impact of the experience, and helps them engage in the care of their infant.

IMPLICATIONS FOR RESEARCH

Further research is needed to explore the needs of fathers from diverse backgrounds and those who perceive to be or are less involved in their infant's care as well as their experiences and needs related to the recent COVID-19 pandemic. Comparative research is also needed to identify differences between mothers' and fathers' needs in order to determine interventions that promoting more holistic, family-centered care.

NICU Fathers: Improving the Quality of Paternal Support in the NICU

BACKGROUND

Parental support in the neonatal intensive care unit (NICU) is critical; yet, the nursing staff may struggle to provide optimal support to NICU fathers. Generally, fathers are not viewed as equally competent caregivers when compared with mothers, and fathers often impart these beliefs on themselves. Increasing the nursing staff's knowledge and understanding of paternal support can change attitudes and foster positive behavior changes, enhancing the perception of support received by NICU fathers.

PURPOSE

To implement a needs assessment and educational intervention for the nursing staff designed to increase the perception of nursing support received by NICU fathers.

METHODS

The Nurse Parents Support Tool (NPST) was administered to the clinical nursing staff and fathers in a pre/posttest design comparing support given by nurses with the fathers' perception of received support. Data from the preintervention assessment was used to design an educational intervention on improving fathers' support. Following the intervention, a postintervention NPST was administered to fathers to determine whether there was an improvement in support perception.

FINDINGS/RESULTS

Improvement in the NICU fathers' perception of nursing staff support was noted between father groups. In addition, the NPST can be used to assess paternal support needs and develop staff education.

IMPLICATIONS FOR PRACTICE

Support provided to NICU fathers can enhance the father's perception of himself as an equal and competent caregiver, leading to improved father-infant bonding as the child ages. Educational interventions targeting father support should be a routine part of nursing staff training.

IMPLICATIONS FOR RESEARCH

Future research should examine the long-term effects of early paternal support on psychosocial, cognitive, and developmental outcomes of NICU infants.

Needs of Socioeconomically Diverse Fathers of Premature Hospitalized Infants: A Multicenter Study

BACKGROUND

To effectively practice true family-centered care (FCC) in the neonatal intensive care unit (NICU) setting, a nurse needs to understand the perceptions and concerns of all fathers. Although research is emerging on fathers' perceptions and experiences, the samples of fathers represented are not from diverse socioeconomic, racial, and ethnic populations, which limit the findings' generalizability.

PURPOSE

The purpose of this study was to determine the needs of NICU fathers and whether these needs differed based on sociodemographic factors.

METHODS

A quantitative, comparative, descriptive design was used to determine the needs of NICU fathers. Additional analysis was conducted to determine whether the needs differed based on education, income, and gestational age, whether the father preferred speaking English or Spanish, and whether these sociodemographic factors could predict needs. To determine sociodemographic factors and needs, a demographic questionnaire and the NICU Family Needs Inventory were administered to 99 fathers in 6 level III NICUs.

RESULTS

Data were analyzed using independent sample t test, 1-way analysis of variance, and multiple linear regression. The results showed that fathers reported a broad span of needs and fathers from disadvantaged populations may have greater needs in certain areas.

IMPLICATIONS FOR PRACTICE

These results emphasize the importance of the nurses' role in assessing the needs of NICU fathers. By understanding fathers' needs, nurses can provide individualized FCC to fathers to help them be more involved in the care and support of their infant.

IMPLICATIONS FOR RESEARCH

Further research is needed to support these findings and test interventions that promote communication between providers and fathers.

An Integrative Review of Fathers' Needs in the Neonatal Intensive Care Unit

Having a child admitted to the neonatal intensive care unit (NICU) is traumatic for both parents, but mothers and fathers may have different experiences, and thus, different needs. The purpose of this integrative review was to identify the needs of fathers of premature infants. A systematic review of 7 databases was conducted, and studies were evaluated by the Critical Appraisal Programme checklist. To provide structure for searching and reporting findings, the Whittemore and Knafle interpretive methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis methodology were used. A total of 19 articles were identified. The resulting themes included: need to be close to infant and involved in infant's care; need for information; need for a better NICU environment; need for emotional support; and need for a relationship with the NICU staff.

The Role of the NICU in Father Involvement, Beliefs, and Confidence: A Follow-up Qualitative Study

BACKGROUND

Fathers are important to infant outcomes. Infants of involved fathers have improved weight gain, sleep, and psychosocial behaviors. Father involvement with neonatal intensive care unit (NICU) infants reduces the length of stay.

PURPOSE

The purpose of this study was to explore and describe involvement, confidence, and beliefs of fathers of infants who were hospitalized in the NICU and discharged home in order to begin to investigate NICU father involvement from a longitudinal perspective.

METHODS

This exploratory qualitative study was conducted 4 to 5 years after the initial NICU stay using telephone interviews. Fathers who participated in this study were selected from participants of a previous NICU study. Qualitative analysis was conducted using standard procedures for grounded theory.

RESULTS

Nineteen fathers participated in the study. The major themes were "It was scary," "Just be there," "It was rough," "It's not about yourself," "A special bond," and "Almost a treat." The fathers reported that the NICU providers, nurses, and staff helped them to overcome uncertainty and lack of knowledge, which helped them improve their confidence and involvement during the NICU stay.

IMPLICATIONS FOR PRACTICE

Fathers see nurses as a source of support. Nurses can encourage fathers to visit regularly and participate in infant care activities. NICU presence aids fathers in developing confidence and knowledge in parenting during their child's infancy, which can set the stage for ongoing involvement.

IMPLICATIONS FOR RESEARCH

Future work should continue to focus on longitudinal studies of fathering and the role of the NICU in encouraging involvement and parenting readiness.

Fathers' Needs and Masculinity Dilemmas in a Neonatal Intensive Care Unit in Denmark

Background:

Most healthcare professionals in neonatal intensive care units typically focus on the infants and mothers; fathers often feel powerless and find it difficult to establish a father-child relationship. In family-centered healthcare settings, exploring fathers' experiences and needs is important because men's roles in society, especially as fathers, are changing.

Purpose:

To describe fathers' needs when their infants are admitted to a neonatal intensive care unit and to discuss these needs within a theoretical framework of masculinity to advance understanding and generate meaningful knowledge for clinical practices.

Methods:

This qualitative study used participant observation, interviews, multiple sequential interviews, and a focus group discussion. Data were analyzed using grounded theory principles.

Results:

Analysis of the fathers' needs generated 2 primary themes: (1) Fathers as caregivers and breadwinners and (2) fathers and emotions. Fathers wished to be involved and to take care of their infants but have to balance cultural and social norms and expectations of being breadwinners with their wishes to be equal coparents.

Implications for Practice/Research:

Health professionals in neonatal intensive care units must be aware of fathers' need and desire to be equal coparents. Nurses should play a key role by, for example, showing that fathers are as important to their infants as are the mothers, helping them become involved in childcare, and ensuring that they are directly informed about their children's progress. Further research in other cultural settings would contribute to knowledge regarding fatherhood and the role of fathers in childcare.