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Stefana A, Barlati S, Beghini R, Biban P. Fathers' experiences of nurses' roles and care practices during their preterm infant's stay in the neonatal intensive care unit. Intensive Crit Care Nurs 2024; 85:103803. [PMID: 39173552 DOI: 10.1016/j.iccn.2024.103803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 05/21/2024] [Accepted: 08/09/2024] [Indexed: 08/24/2024]
Abstract
INTRODUCTION Neonatal intensive care unit (NICU) nurses play a crucial role in providing infant care, as well as in bridging the communication gap with parents. AIM Explore fathers' perceptions and interactions with nurses during their preterm infants' stay in a NICU. DESIGN Qualitative study using ethnographic data collection techniques. METHODS Twenty fathers of preterm infants were purposively sampled in a level III NICU in Italy. Data collection comprised 120 h of participant observation, 68 informal conversations, and 20 semi-structured interviews. Data analysis was performed using reflexive thematic analysis. RESULTS Analysis revealed five primary themes: (i) communication and clarity about infants' health condition and progress, (ii) inclusiveness and guidance from nurses, (iii) fathers' satisfaction with nurses' support for mother, (iv) nurses' personal attention to the babies, and (v) nurses' varied personalities. CONCLUSION Nurses are crucial in facilitating father-infant bonding in the NICU. Although the content of nurse communication is critical for fathers, the delivery style becomes especially relevant during their infant's hospitalization. Discrepancies in messages and guidance can negatively impact fatherly confidence and their ability to care for their preterm infants and support partners. Thus, training that emphasizes the recognition of the unique ways that fathers exhibit distress is crucial. RELEVANCE TO CLINICAL PRACTICE Nurses play a critical role in shaping the fathers' experiences in NICU. Emphasizing clear communication and individualized care is vital. To strengthen father support in NICU settings, recommended approaches include regular training, holistic care, fostering inclusivity, emotional support, and improving bonding opportunities. REPORTING METHOD Adherence to the COREQ guidelines.
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Affiliation(s)
- Alberto Stefana
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
| | - Stefano Barlati
- Department of Mental Health and Addiction Services, Spedali Civili Hospital, Brescia, Italy; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Renzo Beghini
- Neonatal Intensive Care Unit, Mother and Child Department, University Hospital of Verona, Verona, Italy
| | - Paolo Biban
- Pediatric Emergency Room, Department of Neonatal and Pediatric Critical Care, University of Verona, Verona, Italy
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Pascual A, Wielenga JM, Ruhe K, van Kaam AH, Denswil NP, Maaskant JM. The fundamentals of a parental peer-to-peer support program in the NICU: a scoping review. Matern Health Neonatol Perinatol 2024; 10:19. [PMID: 39354584 PMCID: PMC11445949 DOI: 10.1186/s40748-024-00190-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Accepted: 08/31/2024] [Indexed: 10/03/2024] Open
Abstract
PURPOSE AND BACKGROUND Parental peer support is part of the Family Integrated Care model in NICUs. However, little attention has been devoted to the specific content and organization of parental peer support programs. This scoping review aimed to identify (1) the preferred content of a parental peer support intervention, (2) the organizational processes, and (3) the suggested educational curriculum for peer support providers within existing programs in neonatal care. DISCUSSION Parental peer support programs have the goal to provide emotional support, information and assistance, and are to empower parents in the NICU. To achieve these goals, veteran parents receive training in communication skills, roles and boundaries, mental health, (non)medical aspects in the NICU and post-discharge preparation. Data on the organizational components remain limited. Hence, the question remains how the organization of a parental peer support program, and the training and supervision of veteran parents should be managed. IMPLICATIONS FOR RESEARCH AND PRACTICE This scoping review provides a variety of aspects that should be considered when developing and implementing a parental peer support program in the NICU. Program development preferably involves NICU staff at an early stage. Future research should focus on the support of diverse populations in terms of culture, social economic status and gender, and on the effects of parental peer support on parent and infant.
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Affiliation(s)
- A Pascual
- Department of Neonatology, Emma Children's Hospital, Amsterdam UMC, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands.
| | - J M Wielenga
- Department of Neonatology, Emma Children's Hospital, Amsterdam UMC, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands
| | - K Ruhe
- Department of Neonatology, Emma Children's Hospital, Amsterdam UMC, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands
| | - A H van Kaam
- Department of Neonatology, Emma Children's Hospital, Amsterdam UMC, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands
- Amsterdam Reproduction & Development Research Institute, Amsterdam, The Netherlands
| | - N P Denswil
- Medical Library, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
| | - J M Maaskant
- Department of Pediatrics, Amsterdam UMC, Emma Children's Hospital, University of Amsterdam, Amsterdam, The Netherlands
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Bansal S, Molloy EJ, Rogers E, Bidegain M, Pilon B, Hurley T, Lemmon ME. Families as partners in neonatal neuro-critical care programs. Pediatr Res 2024:10.1038/s41390-024-03257-6. [PMID: 38886506 DOI: 10.1038/s41390-024-03257-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 04/07/2024] [Accepted: 04/15/2024] [Indexed: 06/20/2024]
Abstract
Parents of neonates with neurologic conditions face a specific breadth of emotional, logistical, and social challenges, including difficulties coping with prognostic uncertainty, the need to make complex medical decisions, and navigating new hopes and fears. These challenges place parents in a vulnerable position and at risk of developing mental health issues, which can interfere with bonding and caring for their neonate, as well as compromise their neonate's long-term neurodevelopment. To optimize neurologic and developmental outcomes, emerging neonatal neuro-critical care (NNCC) programs must concurrently attend to the unique needs of the developing newborn brain and of his/her parents. This can only be accomplished by embracing a family-centered care environment-one which prioritizes effective parent-clinician communication, longitudinal parent support, and parents as equitable partners in clinical care. NNCC programs offer a multifaceted approach to critical care for neonates at-risk for neurodevelopmental impairments, integrating expertise in neonatology and neurology. This review highlights evidence-based strategies to guide NNCC programs in developing a family-partnered approach to care, including primary staffing models; staff communication, implicit bias, and cultural competency trainings; comprehensive and tailored caregiver training; single-family rooms; flexible visitation policies; colocalized neonatal and maternal care; uniform mental health screenings; follow-up care referrals; and connections to peer support. IMPACT: Parents of neonates with neurologic conditions are at high-risk for experiencing mental health issues, which can adversely impact the parent-neonate relationship and long-term neurodevelopmental outcomes of their neonates. While guidelines to promote families as partners in the neonatal intensive care unit (NICU) have been developed, no protocols integrate the unique needs of parents in neonatal neurologic populations. A holistic approach that makes families true partners in the care of their neonate with a neurologic condition in the NICU has the potential to improve mental and physical well-being for both parents and neonates.
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Affiliation(s)
- Simran Bansal
- Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA
| | - Eleanor J Molloy
- Paediatric Research Laboratory, Trinity Translational Medicine Institute (TTMI), St. James' Hospital, Dublin, Ireland
- Discipline of Paediatrics, Dublin Trinity College, The University of Dublin, Dublin, Ireland
- Trinity Research in Childhood Centre (TriCC), Children's Health Ireland & Coombe Hospital, Dublin, Ireland
| | - Elizabeth Rogers
- Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA
| | - Margarita Bidegain
- Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA
| | | | - Tim Hurley
- Paediatric Research Laboratory, Trinity Translational Medicine Institute (TTMI), St. James' Hospital, Dublin, Ireland
- Discipline of Paediatrics, Dublin Trinity College, The University of Dublin, Dublin, Ireland
| | - Monica E Lemmon
- Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA.
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA.
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Padilla-Muñoz EM, Barbancho-Morant MM, Lanzarote-Fernández MD, Sanduvete-Chaves S, Chacón-Moscoso S. Psycho-emotional intervention with parents of very preterm babies during the first year: A single-arm pilot study. FAMILY PROCESS 2024. [PMID: 38659149 DOI: 10.1111/famp.13002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 03/11/2024] [Accepted: 03/17/2024] [Indexed: 04/26/2024]
Abstract
Studies of intervention programs that aim to improve the emotional state of parents of children admitted to the neonatal intensive care units (NICU) are scarce in Spain. The aims of this single-arm pilot study are to get to know the emotional profile of parents of high-risk preterm newborns, and to explore parents' patterns of emotional well-being before and after a psychological program called the Parental Empowerment Program, to increase parental readiness levels. The sample was made up of 100 parents (50 couples) who participated in the program. Measurements were taken of post-traumatic stress, depression, and resilience at 1 month and 12 months. Repeated measurements and dyadic data analyses were performed. One month after the birth of the baby and prior to the start of the program, mothers show more symptoms of stress and depression than fathers. After the intervention, both parents experienced improvements in their mood levels. The evidence obtained seems to show that high resilience levels and low post-traumatic stress symptoms are associated with reduced depression levels after implementing the program. However, the heterogeneity of the responses obtained, the observed associations between stress, resilience, and maternal depression, along with the reciprocal influence between maternal and paternal depression 1 year after the intervention, highlight the need for a more in-depth exploration of the interplay between risk and protective factors in this population. Despite the identified potential threats to validity, further work in this direction is recommended, including the implementation of clinical trials to demonstrate intervention efficacy. The adaptation of the parents' mutual emotional adjustment at each stage would allow them to participate more actively in the baby's care.
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Affiliation(s)
| | | | | | | | - Salvador Chacón-Moscoso
- Faculty of Psychology, Universidad de Sevilla, Sevilla, Spain
- Departamento de Psicología, Universidad Autónoma de Chile, Santiago, Chile
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Hassan H, Williams F, Cordwell J, Mann J. Ethnic minority fathers' experiences of the Neonatal Care Unit: barriers to accessing psychological support. J Reprod Infant Psychol 2023:1-13. [PMID: 38018095 DOI: 10.1080/02646838.2023.2287079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 11/19/2023] [Indexed: 11/30/2023]
Abstract
BACKGROUND The Neonatal Care Unit is a challenging environment for parents. Previous literature documents the need for increased and more specialised understanding of support for fathers. There remains a dearth of literature on the experiences of ethnic minority fathers in particular, who may be less likely to access psychological support available. METHOD This project aimed to understand the barriers ethnic minority fathers face when accessing psychology support at a Neonatal Care Unit in England. Seven fathers from ethnic minority backgrounds participated in semi-structured interviews after their babies were discharged. RESULTS Data were analysed using a Reflexive Thematic Analysis approach. Three main themes were identified: 'Psychology is a Threat', 'It's Not Really Talked About in our Culture', and 'A Space for Mum, Not Me'. These themes are discussed in reference to the extant literature, and recommendations are provided to improve access to support in this neonatal unit. CONCLUSIONS There is a need to recognise interacting influences of gender and cultural norms in supporting these fathers, including understanding the role of psychology, consideration of stigma, and knowing families in relation to their cultural context.
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Affiliation(s)
- Hibah Hassan
- The Oxford Institute of Clinical Psychology Training and Research, University of Oxford, Oxford, UK
| | - Fin Williams
- The Oxford Institute of Clinical Psychology Training and Research, University of Oxford, Oxford, UK
| | - Jacinta Cordwell
- Children's Psychological Medicine, Oxford University Hospitals NHS Trust, Oxford, UK
| | - Joanna Mann
- Children's Psychological Medicine, Oxford University Hospitals NHS Trust, Oxford, UK
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Bansal S, Willis R, Barks MC, Pollak KI, Brandon D, Kaye EC, Lemmon ME. Supporting Disclosure of Unmet Mental Health Needs among Parents of Critically Ill Infants. J Pediatr 2023; 262:113596. [PMID: 37399922 PMCID: PMC10757990 DOI: 10.1016/j.jpeds.2023.113596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 05/11/2023] [Accepted: 06/26/2023] [Indexed: 07/05/2023]
Abstract
OBJECTIVE To characterize (1) the prevalence of mental health discussion and (2) facilitators of and barriers to parent disclosure of mental health needs to clinicians. STUDY DESIGN Parents of infants with neurologic conditions in neonatal and pediatric intensive care units participated in a longitudinal decision-making study from 2018 through 2020. Parents completed semi-structured interviews upon enrollment, within 1 week after a conference with providers, at discharge, and 6 months post-discharge. We used a conventional content analysis approach and NVIVO 12 to analyze data related to mental health. RESULTS We enrolled 61 parents (n = 40 mothers, n = 21 fathers) of 40 infants with neurologic conditions in the intensive care unit. In total, 123 interviews were conducted with 52 of these parents (n = 37 mothers, n = 15 fathers). Over two-thirds of parents (n = 35/52, 67%) discussed their mental health in a total of 61 interviews. We identified two key domains when approaching the data through the lens of mental health: (1) self-reported barriers to communicating mental health needs: parents shared uncertainty about the presence or benefit of support, a perceived lack of mental health resources and emotional support, and concerns about trust; (2) self-reported facilitators and benefits of communicating mental health needs: parents described the value of supportive team members, connecting to peer support, and speaking to a mental health professional or neutral third party. CONCLUSIONS Parents of critically ill infants are at high risk of unmet mental health needs. Our results highlight modifiable barriers and actionable facilitators to inform interventions to improve mental health support for parents of critically ill infants.
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Affiliation(s)
- Simran Bansal
- Department of Pediatrics, Duke University School of Medicine, Durham, NC
| | - Rheaya Willis
- Department of Psychiatry, Perelman School of Medicine at University of Pennsylvania, Philadelphia, PA
| | - Mary C Barks
- Department of Pediatrics, Duke University School of Medicine, Durham, NC
| | - Kathryn I Pollak
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC; Duke Cancer Institute, Durham, NC
| | - Debra Brandon
- Department of Pediatrics, Duke University School of Medicine, Durham, NC; Duke University School of Nursing, Durham, NC
| | - Erica C Kaye
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN
| | - Monica E Lemmon
- Department of Pediatrics, Duke University School of Medicine, Durham, NC; Department of Population Health Sciences, Duke University School of Medicine, Durham, NC.
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Lægteskov TR, Holm KG, Petersen M, Lysdal RK, Hjelvang BR, Brødsgaard A. Father Groups in the Neonatal Intensive Care Unit: A Supportive Intervention. Adv Neonatal Care 2023; 23:478-486. [PMID: 37499694 DOI: 10.1097/anc.0000000000001092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
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.
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Affiliation(s)
- Tascha Ravn Lægteskov
- Departments of Paediatrics and Adolescent Medicine (Messrs Lægteskov, Petersen, and Lysdal and Drs Hjelvang and Brødsgaard) and Gynaecology and Obstetrics (Dr Brødsgaard), Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark; Hans Christian Andersen Children's Hospital, Odense University Hospital, and Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark (Dr Holm); and Nursing and Health Institute for Public Health, Aarhus University, Aarhus, Denmark (Dr Brødsgaard)
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Mhango P, Nyondo-Mipando AL. Factors influencing fathers' involvement in the care of hospitalized preterm newborns in Balaka, Malawi. BMC Pediatr 2023; 23:432. [PMID: 37644490 PMCID: PMC10463498 DOI: 10.1186/s12887-023-04253-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 08/17/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Malawi has one of the highest incidences of premature birth, with twice the mortality compared to full-term. Excluding fathers from preterm newborn care has negative consequences, including father feeling powerless, missed bonding opportunities with the newborn, additional strain on the mother, and negative family dynamics such as breakdown in communication, reduced trust, and strained relationships. In Malawi, there is no deliberate policy to have fathers involved in preterm care despite having high incidence of preterm birth and neonatal mortality. There is also limited literature on the factors that influence fathers' involvement in the care. The aim of the study was to explore factors influencing fathers' involvement in the care of hospitalized preterm newborns. METHODS A descriptive qualitative study design was used, guided by Theory of planned behaviour and the model proposed by Lamb on male involvement. Sixteen in-depth interviews were conducted with fathers of preterm infants purposively and conveniently sampled in June 2021. Interviews were digitally recorded and transcribed verbatim. Data were organized and analyzed using Nvivo software and thematic analysis approach was used because the approach allows deeper understanding of the data, identification of patterns and themes, and provides rich insights into participants' experiences and perspectives. RESULTS The barriers and facilitators that influence a father's involvement in the care of preterm newborn babies include: perceived difficulty with care activities and benefits of involvement, gender roles and socio-cultural beliefs, work and other family responsibilities, social support, baby's physical appearance/nature and health status, feedback from the baby, multiple births, and hospital's physical environment and provision of basic needs. CONCLUSION The study found that fathers value their involvement in caring for hospitalized preterm newborns but face barriers. Evidence-based interventions like education programs, training sessions, and support groups can help fathers overcome barriers and promote better outcomes for infants and families.
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Affiliation(s)
- Patani Mhango
- Department of Health Systems and Policy, School of Global and Public Health, Kamuzu University of Health Sciences (KUHeS), Private Bag 360, Blantyre, Malawi.
- Centre for Reproductive Health, Kamuzu University of Health Sciences (KUHeS), Private Bag 360, Blantyre, Malawi.
| | - Alinane Linda Nyondo-Mipando
- Department of Health Systems and Policy, School of Global and Public Health, Kamuzu University of Health Sciences (KUHeS), Private Bag 360, Blantyre, Malawi
- Maternal and Fetal Health Group, Malawi Liverpool Wellcome Programme, Blantyre, Malawi
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Suzuki D, Ohashi Y, Shinohara E, Usui Y, Yamada F, Yamaji N, Sasayama K, Suzuki H, Nieva RF, da Silva Lopes K, Miyazawa J, Hase M, Kabashima M, Ota E. The Current Concept of Paternal Bonding: A Systematic Scoping Review. Healthcare (Basel) 2022; 10:2265. [PMID: 36421589 PMCID: PMC9690989 DOI: 10.3390/healthcare10112265] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/04/2022] [Accepted: 11/08/2022] [Indexed: 07/30/2023] Open
Abstract
Bonding is crucial to perinatal mental health. Despite an extensive body of literature on maternal bonding, few studies have focused on paternal bonding. This scoping review aimed to clarify the current state of the concept of paternal-infant/fetus bonding. The eligibility criteria were drawn from the population concept and context elements to answer the following questions: "what is paternal bonding?" and "what are the constructs of the concept of paternal bonding?" The review comprised 39 studies. Paternal bonding was associated with both positive and negative paternal behavior and thought and may be determined based on fathers' beliefs and rearing history. Most studies showed that father-child interaction is one of the factors promoting paternal bonding. However, fathers generally felt more distant from their babies post-delivery than mothers. Only a few studies originally defined paternal bonding; most relied on the definitions of maternal bonding. We found different descriptions lacking consensus. Few studies examined the differences between paternal and maternal bonding. No consensus exists on the concept, constructs, and assessment of paternal bonding. The causal relationship between paternal bonding and other variables is unexplored. Future studies should explore fathers' perspectives and experiences, focusing on the unknown aspects of paternal bonding identified in this review.
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Affiliation(s)
- Daichi Suzuki
- Department of Nursing, Faculty of Health and Medical Sciences, Kanagawa Institute of Technology, Atsugi 243-0292, Japan
| | - Yukiko Ohashi
- Department of Nursing, Faculty of Nursing, Josai International University, Togane 283-8555, Japan
- Kitamura Institute of Mental Health Tokyo, Shibuya-ku, Tokyo 151-0063, Japan
- Research Institute of Imperial Gift Foundation Boshi-Aiiku-Kai, Minato-ku, Tokyo 106-8580, Japan
| | - Eriko Shinohara
- Department of Nursing, School of Medicine, Yokohama City University, Yokohama 236-0004, Japan
| | - Yuriko Usui
- Department of Midwifery and Women’s Health, Division of Health Sciences & Nursing, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Fukiko Yamada
- Department of Midwifery, St. Luke’s International University, Chuo-ku, Tokyo 104-0044, Japan
| | - Noyuri Yamaji
- Global Health Nursing, Graduate School of Nursing Science, St. Luke’s International University, Chuo-ku, Tokyo 104-0044, Japan
| | - Kiriko Sasayama
- Department of Nursing, Global Health Nursing, International University of Health and Welfare, Narita 286-8686, Japan
| | - Hitomi Suzuki
- Global Health Nursing, Graduate School of Nursing Science, St. Luke’s International University, Chuo-ku, Tokyo 104-0044, Japan
| | - Romulo Fernandez Nieva
- Gender Studies and Criminology Programme, School of Sociology, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand
| | - Katharina da Silva Lopes
- Graduate School of Public Health, St. Luke’s International University, Chuo-ku, Tokyo 104-0045, Japan
| | - Junko Miyazawa
- Department of Nursing, Faculty of Nursing, Josai International University, Togane 283-8555, Japan
| | - Michiko Hase
- Pediatric Nursing, Department of Nursing, Faculty of Nursing, Musashino University, Koto-ku, Tokyo 135-8181, Japan
| | - Minoru Kabashima
- Department of Nursing, Faculty of Nursing, Josai International University, Togane 283-8555, Japan
| | - Erika Ota
- Global Health Nursing, Graduate School of Nursing Science, St. Luke’s International University, Chuo-ku, Tokyo 104-0044, Japan
- Tokyo Foundation for Policy Research, Minato-ku, Tokyo 106-6234, Japan
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Dollberg DG, Harlev Y, Malishkevitch S, Leitner Y. Parental Reflective Functioning as a Moderator of the Link Between Prematurity and Parental Stress. Front Psychiatry 2022; 13:804694. [PMID: 35280157 PMCID: PMC8905191 DOI: 10.3389/fpsyt.2022.804694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 01/27/2022] [Indexed: 11/13/2022] Open
Abstract
We examined group differences between parents, both mothers and fathers, of premature and full-term infants to determine whether they differed in their reports of subjective parenting stress and in their level of parental reflective functioning (PRF). We also tested whether each parent's reflective functioning moderated the links between birth status (prematurity vs. full-term) and parenting stress. A sample of 73 cohabiting, heterosexual Israeli families with a premature (28-36th week gestational age, N = 34) or full-term infant (37th week and above gestational age, N = 39) participated, comprising the two parents' groups. Infants' age averaged 7.07 months (SD = 1.28). Each parent completed the Parent Stress Inventory (PSI) individually to determine his/her subjective personal and childrearing stress levels. The Parent Development Interview (PDI-R2-S) was used to obtain each parent's PRF (self and child/relation-focused) level. Findings showed that the premature and full-term parents did not differ in their PSI scores or PRF levels. However, mothers' self-focused PRF moderated the link between prematurity and personal parenting stress, whereas fathers' self-focused PRF moderated the link between prematurity and childrearing parenting stress. Furthermore, fathers' and mothers' PRF operated differently in the premature and full-term parents' groups. The findings highlight the importance of mothers' and fathers' PRF in predicting parents' subjective stress in general and particularly in the case of infant prematurity. We discuss these findings and their relevance for preventive and therapeutic perinatal interventions.
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Affiliation(s)
- Daphna G Dollberg
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Tel Aviv, Israel
| | - Yael Harlev
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Tel Aviv, Israel
| | - Sivan Malishkevitch
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Tel Aviv, Israel
| | - Yael Leitner
- Child Development Center, Dana-Dwek Children's Hospital, Sourasky Medical Center, Tel Aviv, Israel
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How do women, men, and health providers perceive interventions to influence men's engagement in maternal and newborn health? A qualitative evidence synthesis. Soc Sci Med 2021; 291:114475. [PMID: 34695645 DOI: 10.1016/j.socscimed.2021.114475] [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] [Received: 07/03/2021] [Revised: 10/06/2021] [Accepted: 10/08/2021] [Indexed: 12/29/2022]
Abstract
Globally, there is growing awareness of the important contributions men can make as key stakeholders in maternal and newborn health (MNH), and increased investment in interventions designed to influence men's engagement to improve MNH outcomes. Interventions typically target men, women, couples or health providers, yet how these stakeholders perceive and experience interventions is not well understood and the fact that women may experience these interventions as disempowering has been identified as a major concern. This review aims to synthesise how women, men, and providers perceive and experience interventions designed to influence men's engagement in MNH, in order to identify perceived benefits and risks of participating in interventions, and other key factors affecting uptake of and adherence to interventions. We conducted a qualitative evidence synthesis based on a systematic search of the literature, analysing a purposive sample of 66 out of 144 included studies to enable rich synthesis. Women, men and providers report that interventions enable more and better care for women, newborns and men, and strengthen family relationships between the newborn, father and mother. At the same time, stakeholders report that poorly designed or implemented interventions carry risks of harm, including constraining some women's access to MNH services and compounding negative impacts of existing gender inequalities. Limited health system capacity to deliver men-friendly MNH services, and pervasive gender inequality, can limit the accessibility and acceptability of interventions. Sociodemographic factors, household needs, and peer networks can influence how men choose to support MNH, and may affect demand for and adherence to interventions. Overall, perceived benefits of interventions designed to influence men's engagement in MNH are compelling, reported risks of harm are likely manageable through careful implementation, and there is clear evidence of demand from women and men, and some providers, for increased opportunities and support for men to engage in MNH.
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Abstract
The experience of having a child in the neonatal intensive care unit (NICU) is often unexpected, traumatic, and presents numerous stressors for new fathers. Past research has shown that parents of all genders with children in the NICU experience clinically significant psychological symptoms, yet the bulk of research and intervention efforts to date have focused on the needs of mothers. This paper will provide a review of the literature, outline current knowledge about the specific needs of men with children in the NICU, and recommend areas of focus for future research. The paper will also highlight the need to tailored interventions that specifically address the unique needs of fathers.
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Azeez S, Obst KL, Oxlad M, Due C, Middleton P. Australian fathers' experiences of support following neonatal death: a need for better access to diverse support options. J Perinatol 2021; 41:2722-2729. [PMID: 34556801 PMCID: PMC8460396 DOI: 10.1038/s41372-021-01210-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 09/09/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To explore fathers' experiences of support following neonatal death, including the availability and perceived adequacy of support, barriers and facilitators to support and desired support. STUDY DESIGN Semi-structured interviews were conducted with ten Australian fathers who had experienced the death of a baby in the neonatal period at least 6 months previously. Data were analysed using thematic analysis. RESULTS Two overarching themes were identified: From hospital to home: Continuity of care and Self and community barriers to support. Fathers who could access the support they required found this to be beneficial. Overall, however, supports were perceived as inadequate in variety and availability, with more follow-up support from the hospital desired. Fathers highlighted limited opportunities to form emotional connections with others and a strong desire to talk about their baby. CONCLUSION Healthcare professionals and support organisations can more effectively assist fathers by increasing the variety of supports available and facilitating follow-up or referrals after hospital discharge.
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Affiliation(s)
- Shazleen Azeez
- School of Psychology, University of Adelaide, Adelaide, SA, Australia.
| | - Kate Louise Obst
- grid.1010.00000 0004 1936 7304School of Psychology, University of Adelaide, Adelaide, SA Australia
| | - Melissa Oxlad
- grid.1010.00000 0004 1936 7304School of Psychology, University of Adelaide, Adelaide, SA Australia
| | - Clemence Due
- grid.1010.00000 0004 1936 7304School of Psychology, University of Adelaide, Adelaide, SA Australia
| | - Philippa Middleton
- grid.430453.50000 0004 0565 2606South Australian Health and Medical Research Institute, Adelaide, SA Australia
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Fathers of Children With Congenital Heart Disease: Sources of Stress and Opportunities for Intervention. Pediatr Crit Care Med 2020; 21:e1002-e1009. [PMID: 32639475 PMCID: PMC7609567 DOI: 10.1097/pcc.0000000000002388] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To examine sources of stress for fathers of children with congenital heart disease and opportunities for intervention to prevent or reduce paternal mental health problems. DESIGN Qualitative study using online crowdsourcing, an innovative research methodology to create an online community to serve as a research sample. SETTING Yammer, an online social networking site. SUBJECTS Geographically diverse sample of 70 parents (25 fathers and 45 mothers) of young children with congenital heart disease. INTERVENTIONS Participants joined a private group on Yammer and responded to 37 open-ended study questions over a 6-month period. Qualitative data were coded and analyzed using an iterative process, and themes regarding sources of stress for fathers of children with congenital heart disease and opportunities for intervention were identified. MEASUREMENTS AND MAIN RESULTS Four broad themes regarding sources of stress for fathers of children with congenital heart disease emerged from the qualitative data from both mothers and fathers: societal expectations for fatherhood and standards of masculinity, balancing work and family responsibilities, feeling overlooked as a partner in care, and lack of father supports. To begin to address these sources of stress, participants recommended that care teams acknowledge and normalize the impact of congenital heart disease on fathers, provide support for balancing work and family responsibilities, recognize and promote father knowledge and engagement, and provide formal and informal supports for fathers of children with congential heart disease. CONCLUSIONS Fathers of children with congenital heart disease experience unique sources of stress in the absence of targeted interventions to meet their needs. Care teams play an important role in acknowledging the experiences of fathers and including and engaging fathers in care.
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Fisher D, Khashu M, Adama EA, Feeley N, Garfield CF, Ireland J, Koliouli F, Lindberg B, Nørgaard B, Provenzi L, Thomson-Salo F, van Teijlingen E. Fathers in neonatal units: Improving infant health by supporting the baby-father bond and mother-father coparenting. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.jnn.2018.08.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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