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Cho IY, Han AY. Neonatal nurses' educational needs in a family-centered partnership program: Five ways of knowing. NURSE EDUCATION TODAY 2024; 133:106028. [PMID: 37992577 DOI: 10.1016/j.nedt.2023.106028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 10/26/2023] [Accepted: 11/05/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND Partnerships between parents and nurses are essential to provide comprehensive family-centered care (FCC) in the neonatal intensive care unit (NICU). OBJECTIVES We aimed to identify the educational needs of neonatal nurses to develop a family-centered partnership program with parents based on five ways of knowing. DESIGN We conducted focus group interviews with 18 NICU nurses working at a tertiary hospital. Data were analyzed using inductive content analysis. METHOD Data were collected from February to March 2023 through semi-structured interviews and then carefully transcribed and analyzed using a qualitative content analysis approach. RESULTS We used Carper and Chinn and Kramer's five ways of knowing as a framework for data analysis. Twelve categories emerged: staying updated with evidence-based practice, recognizing FCC, practicing neonatal nursing skills and participating in continued education and professional development (empirical knowledge); engaging in self-reflection and expressing therapeutic empathy (personal knowledge); fostering effective communication and leading cooperative readership, building integrity (esthetic knowledge); maintaining ethical responsibility (ethical knowledge); and developing collaborative teamwork, growing cultural competence (emancipatory knowledge). CONCLUSIONS This study could be used as a foundation for enhancing NICU nurses' partnerships with parents based on FCC and nurses' educational needs and preferences.
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Affiliation(s)
- In Young Cho
- College of Nursing, Chonnam National University, 160 Baekseo-ro, Dong-gu, Gwangju 61469, Republic of Korea
| | - A Young Han
- Department of Nursing, College of Life Science and Industry, Sunchon National University, 255, Jungang-ro, Suncheon-Si, Jeollanam-do 57922, Republic of Korea.
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Byiringiro S, Wong R, Logan J, Kaneza D, Gitera J, Umutesi S, Kirk CM. A qualitative study to explore the experience of parents of newborns admitted to neonatal care unit in rural Rwanda. PLoS One 2021; 16:e0252776. [PMID: 34388168 PMCID: PMC8362984 DOI: 10.1371/journal.pone.0252776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 05/21/2021] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Neonatal Care Units (NCUs) provide special care to sick and small newborns and help reduce neonatal mortality. For parents, having a hospitalized newborn can be a traumatic experience. In sub-Saharan Africa, there is limited literature about the parents' experience in NCUs. OBJECTIVE Our study aimed to explore the experience of parents in the NCU of a rural district hospital in Rwanda. METHODS A qualitative study was conducted with parents whose newborns were hospitalized in the Ruli District Hospital NCU from September 2018 to January 2019. Interviews were conducted using a semi-structured guide in the participants' homes by trained data collectors. Data were transcribed, translated, and then coded using a structured code book. All data were organized using Dedoose software for analysis. RESULTS Twenty-one interviews were conducted primarily with mothers (90.5%, n = 19) among newborns who were most often discharged home alive (90.5%, n = 19). Four themes emerged from the interviews. These were the parental adaptation to having a sick neonate in NCU, adaptation to the NCU environment, interaction with people (healthcare providers and fellow parents) in the NCU, and financial stressors. CONCLUSION The admission of a newborn to the NCU is a source of stress for parents and caregivers in rural Rwanda, however, there were several positive aspects which helped mothers adapt to the NCU. The experience in the NCU can be improved when healthcare providers communicate and explain the newborn's status to the parents and actively involve them in the care of their newborn. Expanding the NCU access for families, encouraging peer support, and ensuring financial accessibility for neonatal care services could contribute to improved experiences for parents and families in general.
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Affiliation(s)
- Samuel Byiringiro
- Maternal and Child Health Department, Partners In Health/Inshuti Mu Buzima, Rwinkwavu, Rwanda
- Bill and Joyce Cummings Institute of Global Health, University of Global Health Equity, Butaro, Rwanda
| | - Rex Wong
- Bill and Joyce Cummings Institute of Global Health, University of Global Health Equity, Butaro, Rwanda
- School of Public Health, Yale University, New Haven, Connecticut, United States of America
| | - Jenae Logan
- Bill and Joyce Cummings Institute of Global Health, University of Global Health Equity, Butaro, Rwanda
| | | | - Joseph Gitera
- Clinical and Public Health Services Division, Ministry of Health, Kigali, Rwanda
| | - Sharon Umutesi
- Maternal, Child and Community Health Division, Rwanda Biomedical Center, Kigali, Rwanda
| | - Catherine M. Kirk
- Maternal and Child Health Department, Partners In Health/Inshuti Mu Buzima, Rwinkwavu, Rwanda
- Bill and Joyce Cummings Institute of Global Health, University of Global Health Equity, Butaro, Rwanda
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Goals of Parents Whose Infant Is in the Neonatal Intensive Care Unit: An Explorative Study. Adv Neonatal Care 2020; 20:499-505. [PMID: 32243323 DOI: 10.1097/anc.0000000000000725] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The aim of many neonatal intensive care units (NICU) today is to promote a family-centered practice that addresses parental concerns and needs. However, the specific goals of parents are often unaddressed by the healthcare team. The aim of this study was to understand the goals of parents whose infant was in the NICU to enhance collaboration and communication between parents and health professionals. METHODS A written questionnaire was disseminated to parents whose infant was in the NICU at the Kingston Health Sciences Centre. A thematic analysis of the goals was completed to identify key emergent themes and their implications. RESULTS A total of 23 questionnaires were disseminated to parents and 13 (57%) were returned. Returned questionnaires were most often completed by the mother (n = 9, 70%), and a total of 40 goals were recorded. Three key emergent themes were identified, which included feeding and weight gain, eliminating medical equipment, and successful hospital discharge. IMPLICATIONS FOR PRACTICE Understanding the goals of parents whose infant was in the NICU can enhance communication between parents and their healthcare team, thus aiding the implementation of a family-centered practice. IMPLICATIONS FOR RESEARCH Future larger sample sizes studies across several NICUs would increase the generalizability of results and garner a larger volume of data to establish significant trends between specific infant and parent demographic data and the associated goals.
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Gómez-Cantarino S, García-Valdivieso I, Moncunill-Martínez E, Yáñez-Araque B, Ugarte Gurrutxaga MI. Developing a Family-Centered Care Model in the Neonatal Intensive Care Unit (NICU): A New Vision to Manage Healthcare. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197197. [PMID: 33019680 PMCID: PMC7579288 DOI: 10.3390/ijerph17197197] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 09/25/2020] [Accepted: 09/28/2020] [Indexed: 12/20/2022]
Abstract
Family-centered care (FCC) currently takes a greater role in health care, due to the increasing empowerment parents experience. Within neonatal intensive care units (NICUs), family participation has an impact on the humanized care of the preterm newborn (PN). This integrative review conducted according to Whittemore and Knafl investigated current knowledge of the FCC model and its application in PN care in specific units. The data were collected from PubMed, Cochrane, CINHAL, Scopus, and Google Scholar. A total of 45 articles were used, of which 13 were selected which met inclusion criteria. Their methodological quality was evaluated using the mixed method appraisal tool (MMAT), and after they were analyzed and grouped into four thematic blocks: (1) parental participation; (2) health parental training; (3) benefits of family empowerment; and (4) humanized care. The results revealed that FCCs promote the integration of health equipment and family. In addition, parents become the primary caregivers. The benefits of the family–PN binomial enable an earlier hospital discharge. Humanized care involves an ethical approach, improving health care. Changes are still needed by health managers to adapt health services to the needs of the family and PNs.
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Affiliation(s)
- Sagrario Gómez-Cantarino
- Department of Nursing, Physical and Occupational Therapy University of Castilla-La Mancha, 45071 Campus Toledo, Spain; (S.G.-C.); (M.I.U.G.)
| | - Inmaculada García-Valdivieso
- Mostoles University Hospital (HMOS), Madrid Health Service (SERMAS), 28935 Mostoles, Spain
- Correspondence: ; Tel.: +34-916-64-86-00-(8728)
| | - Eva Moncunill-Martínez
- Toledo Hospital Complex (CHT), Neonatal and Pediatric Oncology Unit, Castilla-La Mancha Health Service (SESCAM), Theoretical collaborator University of Castilla-La Mancha, 45071 Campus Toledo, Spain;
| | - Benito Yáñez-Araque
- Department of Physical Activity and Sports Sciences, University of Castilla-La Mancha, 45071 Campus Toledo, Spain;
| | - M. Idoia Ugarte Gurrutxaga
- Department of Nursing, Physical and Occupational Therapy University of Castilla-La Mancha, 45071 Campus Toledo, Spain; (S.G.-C.); (M.I.U.G.)
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Integration of Maternity and Neonatal Care to Empower Parents. J Obstet Gynecol Neonatal Nurs 2019; 49:65-77. [PMID: 31809695 DOI: 10.1016/j.jogn.2019.11.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2019] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To describe the transition from a traditional hospital design with separate maternity and neonatal departments to a design in which maternity and neonatal health care infrastructures are integrated to empower parents. DESIGN A descriptive, qualitative analysis. SETTING A mother and child center in a teaching hospital in Amsterdam. PARTICIPANTS Six staff members who were involved in the transition. METHODS We analyzed the content of all relevant policy reports and other related documents that were produced during the transition from April 2010 to October 2014. This content was supplemented with in-depth, semistructured interviews with the six participants. We used thematic analysis and Bravo et al.'s model of patient empowerment to analyze the documents and the qualitative interview data. RESULTS We identified eight themes. At the health care system level, the four themes were Joint Vision and Goal, Integration of Three Wards Into One With Single-Family Rooms, Reorganization of the Health Care Team, and New Equipment. At the health care provider level, the three themes were Training for Extension of Professional Goals, Intensified Coaching for Parents, and Implementing Patient Centeredness. The single theme at the patient level was Opinions and Experiences of Parents. CONCLUSION We found a good fit between the new design and Bravo et al.'s model of patient empowerment. Challenges that remain include the adaptation of staff training programs and further development of the infrastructure in collaboration with staff and parents. The experiences of parents and staff members will be evaluated in future studies.
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Fróes GF, Mendes ENW, Pedroza GDA, Cunha MLCD. Stress experienced by mothers of preterm newborns in a neonatal intensive care unit. ACTA ACUST UNITED AC 2019; 41:e20190145. [PMID: 31800799 DOI: 10.1590/1983-1447.2020.20190145] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 08/15/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To evaluate the stress level of mothers of preterm infants with gestational age ≤34 weeks, hospitalized in neonatal intensive care. METHOD A cross-sectional study with 74 mothers of premature infants in neonatal intensive care, who answered the "Parental Stress Scale: Neonatal Intensive Care Unit" instrument, validated in Brazil. RESULTS The mean stress level was 4.41 (± 0.77) and the general stress level was 4.36 (± 0.76), with a significant difference (p <0.001) between the subscale "Alteration in parental roles" and other subscales, meaning that mothers were in a very stressful situation. CONCLUSION All items in the subscale "Alteration in parental roles" of the "Parental Stress Scale: Neonatal Intensive Care Unit" were identified as the main source of stress experienced by mothers. This study suggests carrying out further studies with other methodologies to increase the knowledge of maternal stress in the national context, applying care interventions involving the parents.
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Affiliation(s)
- Graciela Feier Fróes
- Universidade Federal do Rio Grande do Sul (UFRGS). Escola de Enfermagem, Curso de Pós-Graduação em Enfermagem. Porto Alegre, Rio Grande do Sul, Brasil.,Hospital de Clínicas de Porto Alegre (HCPA). Porto Alegre, Rio Grande do Sul, Brasil
| | - Eliane Norma Wagner Mendes
- Universidade Federal do Rio Grande do Sul (UFRGS). Escola de Enfermagem, Curso de Graduação em Enfermagem. Porto Alegre, Rio Grande do Sul, Brasil
| | - Géssica de Almeida Pedroza
- Universidade Federal do Rio Grande do Sul (UFRGS). Escola de Enfermagem, Curso de Graduação em Enfermagem. Porto Alegre, Rio Grande do Sul, Brasil
| | - Maria Luzia Chollopetz da Cunha
- Universidade Federal do Rio Grande do Sul (UFRGS). Escola de Enfermagem, Curso de Pós-Graduação em Enfermagem. Porto Alegre, Rio Grande do Sul, Brasil
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Richardson B, Dol J, Rutledge K, Monaghan J, Orovec A, Howie K, Boates T, Smit M, Campbell-Yeo M. Evaluation of Mobile Apps Targeted to Parents of Infants in the Neonatal Intensive Care Unit: Systematic App Review. JMIR Mhealth Uhealth 2019; 7:e11620. [PMID: 30985282 PMCID: PMC6487340 DOI: 10.2196/11620] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 10/10/2018] [Accepted: 10/29/2018] [Indexed: 01/07/2023] Open
Abstract
Background Parents of preterm infants increasingly use their mobile phone to search for health information. In a recent review, websites targeted toward parents with infants in the neonatal intensive care unit (NICU) were found to have poor to moderate quality educational material; however, there is a dearth of literature regarding mobile apps for NICU parents. Objective This study aimed to identify and evaluate apps targeting parents of infants in the NICU for quality of information, usability, and credibility. Methods We systematically searched the Apple App Store and Google Play using 49 key terms (eg, “preterm infant”) from July 26 to August 18, 2017. English apps targeting NICU parents that cost less than $20 were included. Apps for health care professionals, e-books/magazines, or nonrelevant results were excluded. In total, 3 tools were used for evaluation: Mobile Application Rating Scale (MARS) to measure quality; Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-AV) to measure the app’s content usability; and Trust it or Trash It to measure credibility. Results The initial search yielded 6579 apps, with 49 apps eligible after title and description screening. In total, 27 apps met the eligibility criteria with 9 apps available in both app stores; of those, the app with the most recent update date was chosen to be included in the analysis. Thus, 18 unique apps were included for final analysis. Using MARS, 7 apps (7/18, 39%) received a good score on overall quality (ie, 4.0 out of 5.0), with none receiving an excellent score. In addition, 8 apps (8/18, 44%) received a PEMAT-AV score between 51% and 75% on the understandability subscale, and 8 apps (8/18, 44%) scored between 76% and 100% on the actionability subscale. Trust It or Trash It deemed 13 apps (13/18, 72%) as trash for reasons including no identification of sources or lack of current information, with only 5 (5/18, 28%) deemed trustworthy. Reviewer’s expert evaluation found 16 apps contained content that matched information provided by multiple sources; however, most apps did not meet other objective measurement items to support credibility. When comparing the MARS overall quality and subjective quality scores with trustworthiness of apps, there was no statistically significant difference. A statistically significant difference was found between the 2 MARS quality scores, indicating that, on average, apps were ranked significantly lower on subjective quality compared with overall quality measures. Conclusions This evaluation revealed that of the available apps targeting NICU parents, less than half should be considered as acceptable educational material. Over two-thirds of the apps were found to have issues regarding credibility and just over a quarter were considered good quality. The apps currently available for NICU parents are lacking and of concern in terms of quality and credibility.
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Affiliation(s)
- Brianna Richardson
- School of Nursing, Dalhousie University, Halifax, NS, Canada.,Faculty of Health, Dalhousie University, Halifax, NS, Canada.,Centre for Pediatric Pain, Izaak Walton Killam Health Centre, Halifax, NS, Canada
| | - Justine Dol
- Faculty of Health, Dalhousie University, Halifax, NS, Canada.,Centre for Pediatric Pain, Izaak Walton Killam Health Centre, Halifax, NS, Canada
| | - Kallen Rutledge
- Centre for Pediatric Pain, Izaak Walton Killam Health Centre, Halifax, NS, Canada
| | - Joelle Monaghan
- Centre for Pediatric Pain, Izaak Walton Killam Health Centre, Halifax, NS, Canada
| | - Adele Orovec
- Centre for Pediatric Pain, Izaak Walton Killam Health Centre, Halifax, NS, Canada
| | - Katie Howie
- Centre for Pediatric Pain, Izaak Walton Killam Health Centre, Halifax, NS, Canada
| | - Talia Boates
- Centre for Pediatric Pain, Izaak Walton Killam Health Centre, Halifax, NS, Canada
| | - Michael Smit
- School of Information Management, Dalhousie University, Halifax, NS, Canada
| | - Marsha Campbell-Yeo
- School of Nursing, Dalhousie University, Halifax, NS, Canada.,Centre for Pediatric Pain, Izaak Walton Killam Health Centre, Halifax, NS, Canada.,Division of Neonatal Perinatal Medicine, Department of Pediatrics, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada.,Division of Neonatal Perinatal Medicine, Department of Pediatrics, Faculty of Medicine, Izaak Walton Killam Health Centre, Halifax, NS, Canada
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