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Nambile Cumber S, Williams A, Elden H, Bogren M. Fathers' involvement in pregnancy and childbirth in Africa: an integrative systematic review. Glob Health Action 2024; 17:2372906. [PMID: 38993149 PMCID: PMC11249146 DOI: 10.1080/16549716.2024.2372906] [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: 04/22/2024] [Accepted: 06/24/2024] [Indexed: 07/13/2024] Open
Abstract
BACKGROUND As notions of masculinity evolve globally, it is important to understand their dimensions within geographic regions and life contexts. African men's involvement in their partners'pregnancy and childbirth has been explored to a limited extent in the peer-reviewed literature. This analysis provides a comprehensive examination of the existing literature on the diverse experiences of fathers across the African continent. AIM This study aims to provide an overview of fathers' experience of involvement in their partners' pregnancies andchildbirth in Africa. METHODS A systematic integrative literature review guided the process. The review comprised problem identification, literature search, data evaluation, data analysis and presentation of results. Systematic searches were conducted in the Cinahl, PubMed and Scopus databases. RESULTS The search identified 70 articles of which 31, relating to 11 African countries, were used. Of these, 20 were qualitative, 9 were quantitative and 2 were mixed-methods studies. Men's alienation from health services, and traditional gender norms that discourage fathers' supportive role during pregnancy were prevalent themes. Financial pressures also dominated fathers'experiences. At the same time, in 18 studies fathers expressed motivation to be involved partners and supportive fathers, despite stigma and exclusion from maternity services. CONCLUSION This integrative review shows that fathers' experiences of their involvement in their partners' pregnancy and childbirth across African countries are influenced by multiple factors. While unwelcoming health services, traditional gender norms, and low income are barriers to male involvement, education, younger age, and modern gender norms are associated with greater male involvement.
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Affiliation(s)
- Samuel Nambile Cumber
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Helen Elden
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Malin Bogren
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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van der Vaart M, Hauck AG, Mansfield R, Adams E, Bhatt A, Cobo MM, Crankshaw D, Dhami A, Hartley C, Monk V, Evans Fry R, Moultrie F, Robinson S, Yong J, Poorun R, Baxter L, Slater R. Parental experience of neonatal pain research while participating in the Parental touch trial (Petal). Pain 2024; 165:1727-1734. [PMID: 38284396 PMCID: PMC11247449 DOI: 10.1097/j.pain.0000000000003177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/30/2023] [Accepted: 12/10/2023] [Indexed: 01/30/2024]
Abstract
ABSTRACT Parental involvement in neonatal comfort care is a core component of family-centred care. Yet, parents experience a range of positive and negative feelings when providing pain-relieving interventions for their infants. Parents of infants who participated in the Parental touch trial ( Petal ), a multicentre randomised controlled trial investigating the impact of gentle parental touch on neonatal pain, were asked to complete an anonymous survey. This survey aimed to (1) explore parent-reported motivations in deciding to participate in the Petal trial; (2) understand parent-reported experiences related to trial participation; (3) understand parents' willingness to participate in future studies; and (4) evaluate parent-reported feelings while they were delivering a gentle touch intervention either before or after a clinically necessary blood test. One hundred six parents (1 parent per infant) took part in the survey. Primary motivators for participation were altruistic. Parents most frequently reported that they wanted their child to take part in the research because it has a potential benefit to babies in the future and because they wanted to improve scientific understanding. Parents reported that providing gentle touch to their children during painful procedures was associated with positive emotions, such as feeling "useful" (64%) and "reassured" (53%). Furthermore, nearly all parents (98%) were pleased to have participated in the Petal trial and would consider, or maybe consider, participating in further research studies. These results underscore the importance of structuring trials around parental involvement and providing opportunities for parents to be involved in providing comfort to their infants during necessary painful clinical procedures.
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Affiliation(s)
| | | | - Roshni Mansfield
- Department of Paediatrics, University of Oxford, Oxford, United Kingdom
- Newborn Care Unit, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Eleri Adams
- Newborn Care Unit, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Aomesh Bhatt
- Department of Paediatrics, University of Oxford, Oxford, United Kingdom
| | - Maria M. Cobo
- Department of Paediatrics, University of Oxford, Oxford, United Kingdom
- Colegio de Ciencias Biologicas y Ambientales, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - Daniel Crankshaw
- Department of Paediatrics, University of Oxford, Oxford, United Kingdom
| | - Amraj Dhami
- Department of Paediatrics, University of Oxford, Oxford, United Kingdom
| | - Caroline Hartley
- Department of Paediatrics, University of Oxford, Oxford, United Kingdom
| | - Vaneesha Monk
- Department of Paediatrics, University of Oxford, Oxford, United Kingdom
| | - Ria Evans Fry
- Department of Paediatrics, University of Oxford, Oxford, United Kingdom
| | - Fiona Moultrie
- Department of Paediatrics, University of Oxford, Oxford, United Kingdom
| | - Shellie Robinson
- Department of Paediatrics, University of Oxford, Oxford, United Kingdom
- Newborn Care Unit, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Jean Yong
- Newborn Care Unit, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Ravi Poorun
- University of Exeter Medical School, Exeter, United Kingdom
- Children's Services, Royal Devon University Healthcare NHS Foundation Trust, Exeter, United Kingdom
| | - Luke Baxter
- Department of Paediatrics, University of Oxford, Oxford, United Kingdom
| | - Rebeccah Slater
- Department of Paediatrics, University of Oxford, Oxford, United Kingdom
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Wells MB, Giannotti M, Aronson O. Partner and professional support are associated with father-infant bonding: A cross-sectional analysis of mothers, midwives, and child health nurses' influence on primiparous and multiparous fathers of infants in Sweden. Midwifery 2024; 136:104076. [PMID: 38941781 DOI: 10.1016/j.midw.2024.104076] [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: 11/29/2023] [Revised: 06/18/2024] [Accepted: 06/23/2024] [Indexed: 06/30/2024]
Abstract
OBJECTIVE To assess if received professional and social support are associated with father-infant bonding among primiparous (first-time) and multiparous (multi-time) fathers. BACKGROUND Early father-infant bonding predicts several positive child outcomes. However, while received professional and social support positively impacts fathers' transition into parenthood, little research has tested if these factors are associated with a stronger father-infant bond. METHODS In total, 499 fathers (296 primiparous and 203 multiparous) of infants (aged 0-12 months) completed a cross-sectional online survey between November 2018 and March 2020. The survey included items related to socio-demographics, having a planned pregnancy, postnatal midwifery support, child health nurse support, child health center attendance, and social support. The parent-infant bonding questionnaire (PBQ) was used to assess the father-infant bond. Multiple linear regression models were estimated for the total sample and based on paternal parity. Missing data were managed through multiple imputation procedures. FINDINGS Fathers reported fewer bonding disturbances if they received support from their partners, postnatal midwives, child health nurses, and attended more child health visits. Primiparous fathers reported fewer bonding disturbances when receiving support from their partners, postnatal midwives, and the child health nurse. However, multiparous fathers had more bonding disturbances than primiparous fathers and received less professional and partner support. CONCLUSIONS Receiving more partner and professional support is associated with less father-infant bonding disturbances. To encourage a better father-infant bond, clinicians should invite and support all fathers, regardless of parity, as they transition to parenthood.
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Affiliation(s)
- Michael B Wells
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
| | - Michele Giannotti
- Department of Psychology and Cognitive Sciences, University of Trento, Trento, Italy
| | - Olov Aronson
- Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden
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Ismail A, Mahdi A, Al-Nuaimi KM. Parents' Perception and Use of Skin-to-Skin Care in Jeddah, Saudi Arabia: A Cross-Sectional Study. Cureus 2024; 16:e56734. [PMID: 38646219 PMCID: PMC11033043 DOI: 10.7759/cureus.56734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2024] [Indexed: 04/23/2024] Open
Abstract
BACKGROUND Skin-to-skin care (SSC) between newborns and their parents provides many positive outcomes for both newborns and their parents. However, there is a lack of research assessing the perception of parents, especially fathers, of SSC in Saudi Arabia. PURPOSE The aim of the study is to assess parents' perception of SSC in Saudi Arabia. METHODS This cross-sectional study used an online survey. Data were collected from a convenience sample of 140 parents of hospitalized neonates between January and June 2023. Data were collected from one private hospital (Dr. Soliman Fakeeh Hospital) and one public hospital (King Abdulla Medical Complex) in Jeddah, Saudi Arabia. The parents' perceptions of SSC were assessed using the Parents' Perceptions of SSC tool. An independent t-test was used to compare mothers and fathers in their perceptions of SSC. RESULTS One hundred and forty parents completed the online survey (70 females and 70 males). The majority of the parents did not use SSC with their babies (n=102, 73%), did not read or hear about the use and benefits of skin-to-skin care (n=100, 71%), and did not receive information or training on SSC from healthcare professionals (n=112, 80%). Mothers' perception of SSC was significantly higher than that of fathers (p ≤ 0.05). CONCLUSION Fathers' perception of SSC was lower than that of mothers. Awareness and training programs are needed to inform parents, especially fathers, regarding SSC and its benefits in Saudi Arabia.
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Affiliation(s)
- Ahmad Ismail
- Nursing, Fakeeh College for Medical Sciences, Jeddah, SAU
| | - Amnah Mahdi
- Nursing, Fakeeh College for Medical Sciences, Jeddah, SAU
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Watkins V, Kavanagh SA, Macdonald JA, Rasmussen B, Maindal HT, Hosking S, Wynter K. "I always felt like I wasn't supposed to be there". An international qualitative study of fathers' engagement in family healthcare during transition to fatherhood. Midwifery 2024; 130:103928. [PMID: 38290320 DOI: 10.1016/j.midw.2024.103928] [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: 02/19/2023] [Revised: 12/20/2023] [Accepted: 01/16/2024] [Indexed: 02/01/2024]
Abstract
OBJECTIVE Engagement of fathers in family health services confers benefits for the health and wellbeing of the whole family. The childbirth continuum is traditionally considered a feminine event, however, commensurate with the changing paradigm of gender equity in family healthcare worldwide, the role of fathers is in transformation. The aim of the study is to explore father's perceptions and experiences of healthcare engagement during pregnancy and early infant care. DESIGN Qualitative free-text questions were embedded in a large multi-country, cross-sectional survey, to explored fathers' attendance, participation, and experience of health care during appointments with their pregnant partner and/or baby. SETTING AND PARTICIPANTS Expectant and new fathers were recruited through Prolific®, an international paid online survey platform. FINDINGS Qualitative responses (n=889) were provided by fathers from 28 countries, with experiences of a range of contexts and models of care; 46.8% of whose partners were pregnant and 53.2% had given birth since 2020. The findings suggest that although most fathers wanted to attend and participate in maternity and early parenting-related healthcare, multiple barriers were identified at the individual father, organisational context, and societal levels. Fathers reported negative social factors such as gender bias and restrictive gender norms as barriers to their healthcare engagement. In contrast, factors that enabled fathers to overcome barriers included the fathers' feelings of confidence in their partner's autonomy and decision-making skills, trusted professional relationships with clinicians, and clinicians with good interpersonal skills. KEY CONCLUSIONS Multiple barriers restrict the participation of fathers in healthcare for childbearing and early parenting. Knowledge of these barriers can inform healthcare redesign to include more successful engagement strategies for fathers, to benefit fathers, mothers, and infants alike. IMPLICATIONS FOR PRACTICE Health professionals consulting with the mother, father and infant triad are ideally placed to address the healthcare needs of both parents. Early engagement of fathers in family health care by use of inclusive interpersonal skills and the development of a trusted relationship has potential to improve paternal mental health, and may be associated with benefits for the health, wellbeing and safety of the whole family.
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Affiliation(s)
- Vanessa Watkins
- Deakin University, Centre for Quality and Patient Safety Research, School of Nursing and Midwifery, Faculty of Health, Geelong, Victoria, Australia; Deakin University, Institute for Health Transformation, Faculty of Health, Geelong, Victoria, Australia.
| | - Shane A Kavanagh
- Deakin University, Institute for Health Transformation, Faculty of Health, Geelong, Victoria, Australia; Deakin University, School of Health and Social Development, Faculty of Health, Geelong, Victoria, Australia
| | - Jacqui A Macdonald
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health; Geelong, Australia; Murdoch Children's Research Institute, Centre for Adolescent Health, Royal Children's Hospital, Parkville, Australia; University of Melbourne, Department of Paediatrics, Melbourne, Australia
| | - Bodil Rasmussen
- Deakin University, Centre for Quality and Patient Safety Research, School of Nursing and Midwifery, Faculty of Health, Geelong, Victoria, Australia; Deakin University, Institute for Health Transformation, Faculty of Health, Geelong, Victoria, Australia; Deakin University Centre for Quality and Patient Safety Research - Western Health Partnership, St Albans, Victoria, Australia; University of Copenhagen, Faculty of Health and Medical Sciences, Copenhagen, Denmark.; University of Southern Denmark, Faculty of Health Sciences and Steno Diabetes Center, Odense, Denmark; Aarhus University, Department of Public Health, Aarhus, Denmark
| | - Helle Terkildsen Maindal
- Deakin University, School of Health and Social Development, Faculty of Health, Geelong, Victoria, Australia; Aarhus University, Department of Public Health, Aarhus, Denmark; Health Promotion Research, Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Sarah Hosking
- Deakin University, Institute for Health Transformation, Faculty of Health, Geelong, Victoria, Australia
| | - Karen Wynter
- Deakin University, Centre for Quality and Patient Safety Research, School of Nursing and Midwifery, Faculty of Health, Geelong, Victoria, Australia; Deakin University, Institute for Health Transformation, Faculty of Health, Geelong, Victoria, Australia; Deakin University Centre for Quality and Patient Safety Research - Western Health Partnership, St Albans, Victoria, Australia; Monash University, Department of Psychiatry, School of Clinical Sciences, Clayton, Victoria, Australia
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Noergaard B, Ravn M, Kofoed PE. Parents' comfort and staffs' working-environment when infants are sitting skin-to-skin: a randomised controlled trial comparing a recliner and a hospital bed. ERGONOMICS 2023; 66:1909-1918. [PMID: 36695504 DOI: 10.1080/00140139.2023.2168768] [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: 06/08/2022] [Accepted: 01/10/2023] [Indexed: 06/17/2023]
Abstract
Skin-to-skin contact between parents and preterm infants is recommended because it has proven to be valuable for the infants' development and healing. However, it can be difficult to comply with this guideline and still ensure a good working environment for the staff.This randomised controlled trial compared a new recliner developed in collaboration with parents and staff with a hospital bed for use in neonatal and maternity care using parents' rating of own comfort/discomfort, self-reliance, and felt security, and the chair's/bed's functionality at two different days (Q1 and Q2) of hospitalisation. The physical work-environment was evaluated through a questionnaire to the staff.Ninety-seven parents and 53 health professionals participated. Parents had significantly lower discomfort, in the recliner at Q1 compared to the hospital bed. The staff had to twist and/or bend their back significantly less often when working at the recliner as compared to the hospital bed. Practitioner summary: Due to poor working environment, a participatory design project developed a new recliner that improved the possibility of infants having skin-to-skin contact with their parents. The recliner provided a better working-environment for the staff while focussing on improving comfort and self-reliance of the parents, as compared to a hospital bed. Abbreviations: NICU: Neonatal Intensive Care Unit; VELA: Vermund Larsen.
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Affiliation(s)
- Betty Noergaard
- Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital, University Hospital of Southern Denmark, Kolding, Denmark
- Institute of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Marianne Ravn
- Department of Maternity, Lillebaelt Hospital, University Hospital of Southern Denmark, Kolding, Denmark
| | - Poul-Erik Kofoed
- Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital, University Hospital of Southern Denmark, Kolding, Denmark
- Institute of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
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Stern-Delfils A, Leray I, Caeymaex L, Dicky O, Akrich M, Reynaud A, Bouvard C, Evrard A, Sizun J, Tscherning C, Kuhn P. Father's perceptions and care involvement for their very preterm infants at French neonatal intensive care units. Front Psychiatry 2023; 14:1229141. [PMID: 38034931 PMCID: PMC10687630 DOI: 10.3389/fpsyt.2023.1229141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 10/30/2023] [Indexed: 12/02/2023] Open
Abstract
Objectives We aimed to evaluate (1) fathers' perceptions and care involvement for their very premature infants and their views of the hospitalization period based on parental reports and (2) their evolution over time. Methods We used an online parental survey to assess answers from parents of very preterm infants who were successfully discharged from French neonatal units. We analysed answers from February 2014 to January 2019 to an anonymous internet-based survey from the GREEN committee of the French Neonatal Society. Responses were compared for period 1 (P1, 1998 to 2013) and period 2 (P2, 2014 to 2019). Results We analyzed 2,483 surveys, 124 (5%) from fathers and 2,359 (95%) from mothers. At birth, 1,845 (80%) fathers were present in the hospital, but only 879 (38%) were near the mother. The presence of fathers in the NICU increased from P1 to P2 (34.5% vs. 43.1%, p = 0.03). Nearly two thirds of fathers accompanied their infants during transfer to the NICU (1,204 fathers, 60.6%). Fathers and mothers had similar perceptions regarding relationships with caregivers and skin-to-skin contact with their infants. However, more fathers than mothers felt welcome in the NICU and in care involvement regarding requests for their wishes when they met their infant (79% vs. 60%, p = 0.02) and in the presentation of the NICU (91% vs. 76%; p = 0.03). Mothers and fathers significantly differed in the caring procedures they performed (p = 0.01), procedures they did not perform but wanted to perform (p < 0.001), and procedures they did not perform and did not want to perform (p < 0.01). Conclusion Most fathers were present at the births of their very preterm infants, but fewer fathers were near the mother at this time. Less than two thirds of fathers accompanied their infants to the NICU. There should be further changes to better meet the specific needs of the fathers of infants requiring care in the NICU. Continuing assessment with an online questionnaire may be useful to monitor changes over time in father's involvement in NICUs.
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Affiliation(s)
| | - Isabelle Leray
- Department of Neonatology, University Hospital of Strasbourg, Strasbourg, France
| | - Laurence Caeymaex
- NICU, Centre Hospitalier Intercommunal de Créteil, Créteil, France
- Centre d’Etudes Discours Images Textes Ecrits Communication (CEDITEC), Paris Est Créteil University, Créteil, France
| | - Odile Dicky
- NICU, University Hospital, Toulouse, France
- U1027 INSERM, Paul Sabatier University, Toulouse, France
| | - Madeleine Akrich
- Collectif inter-associatif autour de la naissance (CIANE), Paris, France
| | | | | | - Anne Evrard
- Collectif inter-associatif autour de la naissance (CIANE), Paris, France
| | | | - Charlotte Tscherning
- NICU, University Hospital, Toulouse, France
- U1027 INSERM, Paul Sabatier University, Toulouse, France
- NICU, Sidra Medicine Hospital, Well Cornell University Hospital, Doha, Qatar
- Center for Pathophysiology Toulouse-Purpan (CPTP), Inserm Unviversity of Toulouse, Toulouse, France
| | - Pierre Kuhn
- Department of Neonatology, University Hospital of Strasbourg, Strasbourg, France
- Institut des Neurosciences Cellulaires et Intégratives, CNRS UPR, Strasbourg University, Strasbourg, France
- Neonatal Research Unit, Department of Women’s and Children’s Health, Karolinska Institute, Stockholm, Sweden
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Obst KL, Oxlad M, Turnbull D, McPherson NO. "No One Asked Me If I'm Alright": A Mixed-Methods Study Exploring Information/Support Needs and Challenges Engaging Men Diagnosed With Male-Factor Infertility. Am J Mens Health 2023; 17:15579883231209210. [PMID: 38069523 PMCID: PMC10710112 DOI: 10.1177/15579883231209210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 09/12/2023] [Accepted: 10/04/2023] [Indexed: 12/18/2023] Open
Abstract
There is limited research exploring men's experiences of infertility, and fewer previous studies have examined what information and support men desire after being diagnosed specifically with male-factor infertility. We conducted a mixed-methods study utilizing a combined sequential, concurrent design (online survey/semi-structured interviews). Survey outcomes (N =12) were analyzed using quantitative data analysis, while qualitative survey data (N = 5) was analyzed by reflexive thematic analysis. Heterosexual men (>18 years), fluent in English, diagnosed solely with male-factor infertility/sub-fertility, who required assisted reproductive treatment within Australia in the past 5 years were recruited online and through fertility clinics Australia-wide. Most men reported that their information and support needs were only somewhat, slightly or not at all met. Preferred information sources on male infertility were a dedicated online resource, app, or fertility doctor/specialist, while support was preferred from fertility specialists and partners. Three themes were identified from the qualitative analysis about men's experiences and support needs when diagnosed with male infertility (a) Ultimate threat to masculinity; (b) Holistic care, and (c) the power of words. The information-rich data collected provided valuable insights into men's experiences of male-factor infertility and important considerations to improve recruitment for future research. A diagnosis of male-factor infertility has the potential to be deeply impactful and difficult to navigate for men. Adequate and holistic information, recognition of emotional impacts, proactive offers of support and sensitive language are needed to improve men's experiences when undergoing assisted reproductive technology.
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Affiliation(s)
- Kate L. Obst
- School of Psychology, Adelaide Health and Medical School, The University of Adelaide, Adelaide, South Australia, Australia
- Discipline of Reproduction and Development, School of Biomedicine, Adelaide Health and Medical School, The University of Adelaide, Adelaide, South Australia, Australia
- Freemasons Centre for Male Health and Wellbeing, The University of Adelaide, Adelaide, South Australia, Australia
| | - Melissa Oxlad
- School of Psychology, Adelaide Health and Medical School, The University of Adelaide, Adelaide, South Australia, Australia
- Freemasons Centre for Male Health and Wellbeing, The University of Adelaide, Adelaide, South Australia, Australia
| | - Deborah Turnbull
- School of Psychology, Adelaide Health and Medical School, The University of Adelaide, Adelaide, South Australia, Australia
- Freemasons Centre for Male Health and Wellbeing, The University of Adelaide, Adelaide, South Australia, Australia
| | - Nicole O. McPherson
- Discipline of Reproduction and Development, School of Biomedicine, Adelaide Health and Medical School, The University of Adelaide, Adelaide, South Australia, Australia
- Freemasons Centre for Male Health and Wellbeing, The University of Adelaide, Adelaide, South Australia, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia
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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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Noergaard B, Kofoed PE. Developing and Implementing a Father-Friendly Neonatal Intensive Care Unit Improved Nurses' Self-Efficacy. Adv Neonatal Care 2023:00149525-990000000-00078. [PMID: 37463518 PMCID: PMC10373848 DOI: 10.1097/anc.0000000000001088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
BACKGROUND The need for paternal support is rarely addressed in neonatal intensive care units (NICUs). Neonatal nurses often primarily focus on the needs of the mother and infant and may not be trained in support of fathers. PURPOSE To investigate nurses' self-efficacy (SE) in guiding and supporting fathers after implementing a father-friendly NICU. METHODS Nurses from the intervention NICU and 13 control NICUs were included in a before-and-after intervention study. Questionnaires measuring nurses' SE regarding support of fathers and mothers were obtained when starting the development process, before and 18 months after the implementation. The primary outcome was the difference between nurses' SE scores for father and mother questions in the intervention group compared with the control group. RESULTS In total, 294, 330, and 288 nurses responded to the first, second, and third questionnaires, respectively. From the first to third questionnaires, the intervention group showed a significantly higher increase in SE scores for father questions compared with the control group (0.53 vs 0.20, P = .005) and a nonsignificantly higher increase for mother questions (0.30 vs 0.09, P = .13). In the third questionnaire, the intervention group showed a higher SE score for father questions compared with the control group (9.02 vs 8.45, P = .002) and the first questionnaire (9.02 vs 8.49, P = .02). IMPLICATIONS FOR PRACTICE AND RESEARCH By implementing a father-friendly NICU, nurses' SE for providing support to fathers increased significantly. Training in a father-friendly approach increases nurses' ability to support both parents.
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Affiliation(s)
- Betty Noergaard
- Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital, University Hospital of Southern Denmark, Kolding, Denmark (Dr Noergaard, Dr Kofoed); and Institute of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark (Dr Kofoed)
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Wells MB, Gedaly LR, Aronson O. Midwives and child health nurses' support is associated with positive coparenting for fathers of infants: A cross-sectional analysis. J Clin Nurs 2023; 32:1443-1454. [PMID: 35441382 DOI: 10.1111/jocn.16329] [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: 12/02/2021] [Revised: 03/02/2022] [Accepted: 03/28/2022] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To examine if the professional support that fathers received from midwives and child health nurses was associated with improvements in fathers' coparenting. A secondary aim was to investigate if there were any support differences between fathers based on parity. BACKGROUND Stronger coparenting is associated with improved maternal, paternal and child health. It is unclear if routine prenatal and postnatal professional support is associated with improved coparenting in fathers of infants. DESIGN Cross-sectional online survey. METHODS In total, 612 fathers of infants (aged 0-24 months) completed baseline data between November 2018 and March 2020. Socio-demographics, pregnancy control variables, social support, professional support, being invited to attend and attending three specific visits for fathers, respectively, and the fathers' coparenting relationship, using the Brief Coparenting Relationship Scale, were assessed. The STROBE checklist was used as the reporting guideline for this study. RESULTS Fathers' attendance at child health visits, support from the prenatal and postnatal midwife, respectively, and total support from the child health nurse, are associated with more positive coparenting. Primiparous fathers reported more received social and professional support, as well as a more positive coparenting relationship than multiparous fathers. CONCLUSIONS Receiving clinical support from both midwives and child health nurses is associated with fathers' positive coparenting. All fathers should be invited and encouraged to attend prenatal, postnatal and child health visits to further support their coparenting relationship. Relative to primiparous fathers, multiparous fathers may require targeted and additional clinical support regarding their coparenting relationship. RELEVANCE TO CLINICAL PRACTICE With fathers becoming more involved in childrearing, having stronger coparenting skills can help them better adapt to their parental roles. Our findings help understand how routine professional support from midwives and child health nurses are experienced among new fathers and that multiparous fathers are in further need of coparenting support.
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Affiliation(s)
- Michael B Wells
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Lindsey R Gedaly
- Prevention Research Center, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Olov Aronson
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,School of Humanities, Education and Social Sciences, Örebro University, Örebro, Sweden
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12
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Risanger LI, Kofoed PE, Noergaard B, Vahlkvist S. Parents’ Perception of Staff Support in a Father-Friendly Neonatal Intensive Care Unit. CHILDREN 2023; 10:children10040673. [PMID: 37189922 DOI: 10.3390/children10040673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/30/2023] [Accepted: 03/30/2023] [Indexed: 04/05/2023]
Abstract
Healthcare professionals, especially nurses, play a central role in supporting parents during their stay in neonatal intensive care units (NICUs). Fathers often have their own support needs; however, studies have shown that these needs are rarely met to the same degree as those of the mothers. We developed a “father-friendly NICU” with the aim of providing good-quality care to the entire family. To evaluate the impact of this concept, we adopted a quasi-experimental design; using the Nurse Parent Support Tool (NPST), we investigated the differences in the fathers’ (n = 497) and mothers’ (n = 562) perception of the nursing support received on admission and discharge between before and after the intervention. In the historical control and intervention groups, the fathers’ median NPST scores at admission were 4.3 (range, 1.9–5.0) and 4.0 (range, 2.5–4.8), respectively (p < 0.0001); at discharge, these scores were 4.3 (range, 1.6–5.0) and 4.4 (range, 2.3–5.0), respectively (difference not significant). In the historical control and intervention groups, the mothers median NPST scores at admission were 4.5 (range, 1.9–5.0) and 4.1 (range, 1.0–4.8), respectively (p < 0.001); at discharge, these scores were 4.4 (range, 2.7–5.0) and 4.4 (range, 2.6–5), respectively (difference not significant). The parental perception of support did not increase after the intervention; however, the parents reported a high level of staff support both before and after the intervention. Further studies should focus on parental support needs during the different phases of hospitalization (i.e., admission, stabilization, and discharge).
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Affiliation(s)
- Linn Iren Risanger
- Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital, University Hospital of Southern Denmark, Sygehusvej 24, 6000 Kolding, Denmark
- H.C. Andersens Children’s Hospital, Odense University Hospital, 5000 Odense, Denmark
| | - Poul-Erik Kofoed
- Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital, University Hospital of Southern Denmark, Sygehusvej 24, 6000 Kolding, Denmark
- Department of Regional Health Research, University of Southern Denmark, 5000 Odense, Denmark
| | - Betty Noergaard
- Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital, University Hospital of Southern Denmark, Sygehusvej 24, 6000 Kolding, Denmark
| | - Signe Vahlkvist
- Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital, University Hospital of Southern Denmark, Sygehusvej 24, 6000 Kolding, Denmark
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13
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Wells MB, Jeon L. Paternal postpartum depression, coparenting, and father-infant bonding: Testing two mediated models using structural equation modeling. J Affect Disord 2023; 325:437-443. [PMID: 36640810 DOI: 10.1016/j.jad.2022.12.163] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 12/26/2022] [Accepted: 12/31/2022] [Indexed: 01/13/2023]
Abstract
BACKGROUND Impaired father-infant bonding is a mental health issue that has been understudied. The current study aimed to examine the extent to which fathers' depression symptoms and coparenting relationship, respectively, are associated with infant bonding, as well as how these two variables mediate in the association with infant bonding. METHODS Cross-sectional data from 612 fathers of infants (0-24 months) were used in this study. Path analyses on two competing mediation models were used to examine the direct and indirect associations between fathers' depression symptoms, coparenting relationship, and infant bonding, after controlling for several known covariates. RESULTS Whether fathers reported depression symptoms (Model 1) or reported lower levels of coparenting relationships (Model 2), they also reported higher levels of impaired infant bonding, rejection and anger, and anxiety about care after controlling for the covariates. The analysis further found significant indirect associations between father depression symptoms and father-infant bonding via the coparenting relationship (Model 1) as well as significant indirect associations between the coparenting relationship and father-infant bonding via father depression symptoms (Model 2). LIMITATIONS The cross-sectional data cannot show causal links. Specific efforts were made to recruit fathers with depression symptoms, and therefore prevalence rates may appear skewed. CONCLUSIONS Decreasing depression symptoms and improving coparenting quality can potentially improve father-infant bonding. Fathers' depression symptoms and coparenting quality can be bi-directionally related in the association with father-infant bonding. Early detection and preventive treatments for paternal depression symptoms and coparenting are warranted.
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Affiliation(s)
- Michael B Wells
- Women's and Children's Health, Karolinska Institutet, Sweden.
| | - Lieny Jeon
- School of Education and Human Development, University of Virginia, Charlottesville, VA, USA
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14
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Baldoni F, Giannotti M, Casu G, Agostini F, Mandolesi R, Peverieri S, Ambrogetti N, Spelzini F, Caretti V, Terrone G. The Perinatal Assessment of Paternal Affectivity (PAPA): Italian validation of a new tool for the screening of perinatal depression and affective disorders in fathers. J Affect Disord 2022; 317:123-130. [PMID: 36028014 DOI: 10.1016/j.jad.2022.08.049] [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: 01/19/2022] [Revised: 08/05/2022] [Accepted: 08/20/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Questionnaires for the screening of paternal perinatal psychological distress are based on clinical manifestations expressed by women, showing limitations in capturing the wide array of signs and symptoms exhibited by men. The current study aimed to validate the Perinatal Assessment of Paternal Affectivity, a new self-report tool for the screening of paternal depressive and affective disorder. METHOD This study used a cross-sectional design with a 3-month test-retest, involving respectively 385 (T1) and a sub-sample of 111(T2) fathers. Confirmatory factor analysis (CFA) was performed to test structural validity and concurrent validity was assessed by Spearman correlations. We assessed reliability using McDonald's ω and ordinal alpha. Group differences in PAPA scores based on sociodemographic were also tested. RESULTS The CFA reported a one factor structure as the optimal solution. The PAPA also showed adequate reliability and internal consistency as well as acceptable test-retest indices. Concurrent validity was confirmed by significant correlations between PAPA total score and standardized test scores. Non-Italian fathers and fathers who experienced recent stressful life events reported higher PAPA scores. LIMITATIONS Our sample was not homogeneous in terms of nationality and most of the participants, were from Northern Italy. Some risk factors associated with paternal parental psychological distress (e.g., unplanned pregnancy) have not been considered. CONCLUSION This study provides initial evidence of validity and reliability of the PAPA as a brief and sensitive screening tool to detect signs and symptoms of paternal affective disorder during both prenatal and postnatal period.
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Affiliation(s)
- F Baldoni
- Department of Psychology, University of Bologna, Italy
| | - M Giannotti
- Department of Psychology and Cognitive Sciences, University of Trento, Rovereto, Italy.
| | - G Casu
- Department of Psychology, University of Bologna, Italy
| | - F Agostini
- Department of Psychology, University of Bologna, Italy
| | - R Mandolesi
- Department of Psychology, University of Bologna, Italy
| | - S Peverieri
- Department of Psychology, University of Bologna, Italy
| | - N Ambrogetti
- Department of Psychology, University of Bologna, Italy
| | - F Spelzini
- Operative Unit of Obstetrics and Gynecology, Rimini Hospital, AUSL Romagna, Rimini, Italy
| | | | - G Terrone
- University of Rome Tor Vergata, Rome, Italy
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15
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Adama EA, Koliouli F, Provenzi L, Feeley N, van Teijlingen E, Ireland J, Thomson-Salo F, Khashu M. COVID-19 restrictions and psychological well-being of fathers with infants admitted to NICU-An exploratory cross-sectional study. Acta Paediatr 2022; 111:1771-1778. [PMID: 35708125 PMCID: PMC9349861 DOI: 10.1111/apa.16455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 05/11/2022] [Accepted: 06/14/2022] [Indexed: 11/28/2022]
Abstract
AIM To describe the impact of the COVID-19 restrictions on the caregiving activities and psychological well-being of fathers with infants admitted to neonatal units. METHODS Cross-sectional study using adapted COPE-IS and COPE-IU tools. Participants' recruitment occurred online via social media and parents' associations. Online survey in English, French and Italian were distributed and promoted via websites and social media platforms of parent's associations. The study was undertaken across 12 countries in Asia, Australia, Africa and Europe. RESULTS A total of 108 fathers of NICU infants completed the survey. COVID-19 related restrictions were categorised into 3 types: no restrictions, partial and severe restrictions. Fathers who experienced partial restrictions reported more involvement in caregiving activities but high levels of emotional difficulties and sleeping problems compared to those who experienced full or no restrictions. CONCLUSION Given the impact on the psychological well-being of fathers, restrictions should be avoided as much as possible in the neonatal unit and fathers given free access to their infants if they follow appropriate infection control precautions.
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Affiliation(s)
- Esther Abena Adama
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Flora Koliouli
- Laboratory of Qualitative Research in Psychology and Mental Health, Department of Psychology, School of Philosophy, National and Kapodistrian University of Athens, Athens, Greece
| | - Livio Provenzi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.,Developmental Psychobiology Research Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Nancy Feeley
- Ingram School of Nursing, and Centre for Nursing Research, & Lady Davis Institute for Medical Research, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | | | | | | | - Minesh Khashu
- University Hospitals Dorset and Bournemouth University, Poole, UK
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16
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Dong Q, Steen M, Wepa D, Eden A. Exploratory study of fathers providing Kangaroo Care in a Neonatal Intensive Care Unit. J Clin Nurs 2022. [PMID: 35712782 DOI: 10.1111/jocn.16405] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 05/19/2022] [Accepted: 05/24/2022] [Indexed: 12/01/2022]
Abstract
AIM AND OBJECTIVES To explore fathers' views and experiences of providing Kangaroo Care (KC) to their baby cared for in a Neonatal Intensive Care Unit (NICU). BACKGROUND Kangaroo Care has been known to improve the health outcome for preterm, low birth weight and medically vulnerable term infants and achieve the optimal perinatal health wellbeing for parents and infants. Historically, mothers are considered as the dominant KC providers, whereas fathers are spectators and have been overlooked. Little is known about the fathers' perspectives in providing KC in NICUs. METHODS Individual semi-structured interviews were conducted with 10 fathers who delivered KC to their baby when in the NICU. Data were analysed using Braun and Clarke's six-phase thematical framework. The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist was followed to report this qualitative study. FINDINGS Fathers in this study identified they were passing a silent language of love and connecting with their baby by the act of KC in a challenging environment. Three themes emerged: 'Positive psychological connection', 'Embracing father-infant Kangaroo Care' and 'Challenges to father-infant Kangaroo Care'. CONCLUSION The findings of this study show KC enhances the bonding and attachment between fathers and infants. The conceptualisation of the paternal role in caregiving to a newborn is evolving as a contemporary practice. Further research is warranted to confirm or refute the study findings. Policies and facilities should be modified to include father-infant KC within the fields of neonatal care. RELEVANCE TO CLINICAL PRACTICE It is important for nurses and other health professionals to support and enable fathers to give KC. Father-infant KC is recommended in neonatal care settings.
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Affiliation(s)
- Qiuxia Dong
- Neonatal Intensive Care Unit, Women's and Children's Hospital, North Adelaide, South Australia, Australia
- UniSA Clinical & Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - Mary Steen
- UniSA Clinical & Health Sciences, University of South Australia, Adelaide, South Australia, Australia
- Department of Nursing, Midwifery and Health, Faculty of Health and Life Sciences, University of Northumbria, Newcastle upon Tyne, UK
| | - Dianne Wepa
- UniSA Clinical & Health Sciences, University of South Australia, Adelaide, South Australia, Australia
- School of Nursing & Healthcare Leadership Faculty of Health Studies, University of Bradford, West Yorkshire, UK
| | - Amye Eden
- UniSA Clinical & Health Sciences, University of South Australia, Adelaide, South Australia, Australia
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17
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Koliouli F, Gaudron CZ, Bourque CJ, Raynaud JP. Parental sense of competence, paternal stress and perceived construction of the relationship with the premature newborn: A mixed method study. Early Hum Dev 2022; 168:105576. [PMID: 35483108 DOI: 10.1016/j.earlhumdev.2022.105576] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 04/06/2022] [Accepted: 04/15/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The aim of this study is to investigate the parental sense of competence, the paternal stress and the perceived construction of the relationship with the infant of during the hospitalization in a neonatal intensive care unit. METHODS Forty-eight French fathers of premature infants participated in this study, which took place in the Toulouse University Hospital in France. Mixed methods are used, a semi-structured interview and two self-reported questionnaires. RESULTS Main results show that fathers perceive the construction of the first relationship with their infant through the skin-to-skin and eye contact, along with their immediate presence by their child. The physical contact, although it may induce more stress, it motivates the father to be more involved in the caregiving process. Child's fragile appearance generates more stress to fathers. Finally, the stress linked to the construction of their relationship with the infant will affect their parental sense of competence. CONCLUSION Results are discussed with respect to recent literature and ways to improve professional practice are proposed.
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Affiliation(s)
- Flora Koliouli
- Developmental Psychology, Center of Qualitative Research in Psychology and Mental Health, Department of Psychology, National and Kapodistrian University of Athens, Greece.
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18
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Gül U, Kobya Bulut H. Assessment of factors and father-infant attachment levels among Turkish's fathers of preterm infants. J Pediatr Nurs 2022; 64:e69-e76. [PMID: 35042639 DOI: 10.1016/j.pedn.2021.12.027] [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: 09/20/2021] [Revised: 12/20/2021] [Accepted: 12/28/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Identify the factors affecting father-infant attachment among Turkishs fathers of preterm infants. DESIGN AND METHODS This cross-sectional study included 63 fathers of preterm infants between the ages of 6-12 months. Data were collected using the Father-Infant Descriptive Information Form and the Paternal-Infant Attachment Scale (PIAS). Descriptive statistics, independent sample t-tests, mann-whitney test, the kruskal wallis test, the tamhane test, spearman correlation analysis, and linear stepwise regression were used to evaluate the data. RESULTS The average PIAS scores of the fathers in the study was 62.97 ± 8.94. A statistically significant difference was found between the birth weight, clinical picture, and length of stay in the Neonatal Intensive Care Unit (NICU) and PIAS total score of preterm infants (p < 0.01). There was a significant difference between the unplanned hospitalization of the baby after discharge and the father's changing the baby's clothes and the PIAS score (p < 0.05). Birth weight and unplanned hospitalization explained 31% of PIAS total score. CONCLUSIONS According to the results, father-infant attachment levels of fathers of preterm infants were low. Father's involvement in changing the baby's clothes, preterm birth weight, clinical picture, and length of stay in the NICU were found to be associated with PIAS. PRACTICAL IMPLICATIONS It should be remembered that babies can be attached to their fathers as much as they are to their mothers. NICU nurses should initiate father-infant interaction early and ensure fathers' involvement in infant care in the NICU.
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Affiliation(s)
- Uğur Gül
- Akdeniz University, Faculty of Nursing-Department of Pediatric Nursing, Konyaaltı Antalya, Turkey.
| | - Hacer Kobya Bulut
- Karadeniz Technical University Faculty of Health Science, Department of Pediatric Nursing, 61080 Trabzon, Turkey
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19
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Govindaswamy P, Laing S, Spence K, Waters D, Walker K, Badawi N. Neonatal medical trainee doctors' perceptions and parents' self-reported needs and stressors in a surgical neonatal intensive care unit: An individualised approach. J Paediatr Child Health 2022; 58:687-696. [PMID: 34725877 DOI: 10.1111/jpc.15819] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 10/04/2021] [Accepted: 10/18/2021] [Indexed: 11/30/2022]
Abstract
AIM As more infants survive surgery in the newborn period for major congenital anomalies, the focus has shifted to the quality of care for parents as well as infants. In contemporary neonatal intensive care units (NICUs), doctors are encouraged to practice family-centred care and partner with parents in their infant's care. This study explored doctors' perceptions and parents' self-reported needs and stressors in a surgical NICU. METHODS From January 2014 to September 2015, parents of infants admitted for general surgery for a major congenital anomaly who were present in the NICU between 48 and 72 h of admission and doctors caring for their infant at the time of data collection were invited to participate. Matched data were provided using the Neonatal Family Needs Inventory and the Parental Stressor Scale:NICU. RESULTS Matched data for 12 doctor-parent dyads showed that doctors (neonatal medical trainees) consistently under-rated the importance of parents' needs and identified fewer of mothers' than fathers' most important needs. Doctors also consistently under-rated parents' stressors. They perceived few of fathers', but all of mothers', greatest stressors. Thematic analysis revealed four themes: infant pain management; parental autonomy; empathy; and communicating reassurance and education to parents. CONCLUSION The findings suggest incongruences between doctors' perceptions and parents' self-reported needs and stressors. While there is hesitation in making recommendations with this sample size, the findings highlight issues that may inform further research and contribute to a dialogue regarding the role of doctors in family-centred relationship-based models of care in the NICU.
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Affiliation(s)
- Priya Govindaswamy
- Grace Centre for Newborn Care, Children's Hospital at Westmead, Sydney, New South Wales, Australia.,Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Sharon Laing
- Grace Centre for Newborn Care, Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Kaye Spence
- Grace Centre for Newborn Care, Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Donna Waters
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.,Sydney Nursing School, University of Sydney, Sydney, New South Wales, Australia
| | - Karen Walker
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.,Newborn Care, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Nadia Badawi
- Grace Centre for Newborn Care, Children's Hospital at Westmead, Sydney, New South Wales, Australia.,Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
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20
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Azeez S, Obst KL, Due C, Oxlad M, Middleton P. Overwhelming and unjust: A qualitative study of fathers' experiences of grief following neonatal death. DEATH STUDIES 2022; 46:1443-1454. [PMID: 35107411 DOI: 10.1080/07481187.2022.2030431] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Limited research has examined the grief experiences of fathers following neonatal death. Using a qualitative research design, ten fathers were interviewed, and thematic analysis resulted in three overarching themes: 'A complicated grief experience: Neonatal death is highly emotional', 'Grief is multidimensional' and 'Sense of injustice'. Overall, results showed that grief was a multidimensional experience for fathers, with expressions of grief including strong feelings of anger and guilt and the manifestation of grief in physical symptoms. In addition, the findings also indicated a sense of injustice that contributed to the disenfranchisement of grief for fathers. The results of this study contribute to developing a better understanding of the grief that fathers experience following neonatal death, and can inform improvements in healthcare practices after the death of a baby in the neonatal period, including father-specific programs and adequate provision of information.
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Affiliation(s)
- Shazleen Azeez
- School of Psychology, University of Adelaide, Adelaide, South Australia
| | - Kate Louise Obst
- School of Psychology, University of Adelaide, Adelaide, South Australia
| | - Clemence Due
- School of Psychology, University of Adelaide, Adelaide, South Australia
| | - Melissa Oxlad
- School of Psychology, University of Adelaide, Adelaide, South Australia
| | - Philippa Middleton
- South Australian Health and Medical Research Institute, Adelaide, South Australia
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21
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Abstract
BACKGROUND The unique perspective of fathers with an infant in the neonatal unit on the development of emotional closeness toward their infant is not well understood. The purpose of this study is to explore experiences and instances of emotional closeness from the perspective of fathers as well as factors influencing emotional closeness during an infant's hospitalization in the neonatal unit. METHODS This qualitative descriptive study employed one-on-one interviews with fathers recruited in a level 3 neonatal unit. The interview data were analyzed with thematic analysis, and emerging themes and subthemes were organized according to dimensional analysis. RESULTS Eight fathers agreed to take part in this study. According to the participants, emotional closeness was a complex process composed of multiple dimensions. More specifically, emotional closeness was a difficult-to-describe, mixed, and growing feeling influenced by multiple factors such as the environment, co-parenting, and the father-infant relationship. It occurred in the contexts of presence and separation in the neonatal unit and was part of the development of the father-infant relationship. IMPLICATIONS FOR PRACTICE The results presented in this article are important for neonatal intensive care unit nurses who support fathers in the development of their fathering role. By knowing more about the process and dimensions of emotional closeness, nurses can direct their interventions with fathers to enhance emotional closeness and better understand their experience. IMPLICATIONS FOR RESEARCH No previous study has addressed emotional closeness as a complex process with multiple components like the current study. These findings contribute to our understanding of the process of emotional closeness for fathers.
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22
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Abdelmageed RI, Youssef AM, El-Farrash RA, Mohamed HM, Abdelaziz AW. Measurement of Cumulative Preterm Neonatal and Maternal Stressors During Neonatal Intensive Care Unit Admission. J Pediatr Psychol 2021; 47:595-605. [PMID: 34865092 DOI: 10.1093/jpepsy/jsab124] [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: 07/08/2021] [Revised: 10/29/2021] [Accepted: 10/30/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES By nature, the neonatal intensive care unit (NICU) environment is stressful for both infants and mothers. This study aimed to explore and quantify the severity of early life stressors in premature infants admitted to the NICU and evaluate the effect of cumulative neonatal stressors on maternal mental health. METHODS This cross-sectional study included 100 preterm infants admitted to the NICU for at least 10 days. Daily experiences with painful/stressful procedures for 10 days were determined using the Neonatal Infant Stressor Scale. The included mothers were assessed for their psychological well-being 1 week after NICU admission using the Parental Stressor Scale: NICU and Edinburgh Postnatal Depression Scale. RESULTS During the first 10 days of NICU admission, preterm infants experienced an average of 350.76 ± 84.43 acute procedures and an average of 44.84 ± 11.12 cumulative hours of chronic events, with the highest scores recorded on first 3 days of admission. Although intravenous flushing for patency was the most frequent acute procedure, blood gas sampling was the most painful. Forty-five percent of the mothers showed significant depressive symptoms, with the maternal role alteration reported as the most stressful experience, especially for young and new mothers (p < .001). The cumulative stressors experienced by infants were significantly associated with elevated maternal perception of psychological maladjustment (p < .001). CONCLUSION This study confirmed that the NICU environment is stressful for both infants and mothers, with the total cumulative stressors experienced by preemies in the NICU having an negative impact on maternal mental health.
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Affiliation(s)
| | - Azza M Youssef
- Pediatrics Department, Faculty of Medicine, Ain Shams University, Egypt
| | | | | | - Asmaa W Abdelaziz
- Pediatrics Department, Faculty of Medicine, Ain Shams University, Egypt
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23
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Kynø NM, Fugelseth D, Knudsen LMM, Tandberg BS. Starting parenting in isolation a qualitative user-initiated study of parents' experiences with hospitalization in Neonatal Intensive Care units during the COVID-19 pandemic. PLoS One 2021; 16:e0258358. [PMID: 34714832 PMCID: PMC8555791 DOI: 10.1371/journal.pone.0258358] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 09/25/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Worldwide, strict infection control measures including visitation regulations were implemented due to the COVID-19 pandemic at Neonatal Intensive Care Units (NICUs). These regulations gave restricted access for parents to their hospitalized infants. The consequence was limited ability to involve in the care of their infants. At Oslo University Hospital entry to NICU was denied to all except healthy mothers in March 2020. The absolute access ban for fathers lasted for 10 weeks. The aim of this study was to explore parental experiences with an infant hospitalized in the NICU during this absolute visitation ban period. METHODS We invited post discharge all parents of surviving infants that had been hospitalized for at least 14 days to participate. They were interviewed during autumn 2020 using an explorative semi-structured interview approach. Data were analyzed via inductive thematic analysis. RESULTS Nine mothers and four fathers participated. The COVID-19 regulations strongly impacted the parent's experiences of their stay. The fathers' limited access felt life-impacting. Parents struggled to become a family and raised their voices to be heard. Not being able to experience parenthood together led to emotional loneliness. The fathers struggled to learn how to care for their infant. The regulations might lead to a postponed attachment. On the other hand, of positive aspect the parents got some quietness. Being hospitalized during this first wave was experienced as exceptional and made parents seeking alliances by other parents. Social media was used to keep in contact with the outside world. CONCLUSIONS The regulations had strong negative impact on parental experiences during the NICU hospitalization. The restriction to fathers' access to the NICU acted as a significant obstacle to early infant-father bonding and led to loneliness and isolation by the mothers. Thus, these COVID-19 measures might have had adverse consequences for families.
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Affiliation(s)
- Nina M. Kynø
- Division of Paediatric and Adolescent Medicine, Department of Neonatal Intensive Care, Oslo University Hospital, Oslo, Norway
- Department of Nursing and Health Promotion, Acute and Critical Illness, Oslo Metropolitan University, Faculty of Health Sciences, Oslo, Norway
- * E-mail:
| | - Drude Fugelseth
- Division of Paediatric and Adolescent Medicine, Department of Neonatal Intensive Care, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | | | - Bente Silnes Tandberg
- Department of Paediatric and Adolescent Medicine, Drammen Hospital, Vestre Viken Hospital Trust, Drammen, Norway
- Lovisenberg Diaconal University College, Oslo, Norway
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Filippa M, Saliba S, Esseily R, Gratier M, Grandjean D, Kuhn P. Systematic review shows the benefits of involving the fathers of preterm infants in early interventions in neonatal intensive care units. Acta Paediatr 2021; 110:2509-2520. [PMID: 34053115 PMCID: PMC8453504 DOI: 10.1111/apa.15961] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/17/2021] [Accepted: 05/27/2021] [Indexed: 11/28/2022]
Abstract
Aim This review identifies interventions involving the fathers of preterm infants that have been tested in neonatal intensive care units (NICU). It examines their effects on the fathers and infants and highlights any differences between fathers and mothers who took part in the same interventions. Methods A systematic search was performed in English from 1995 to 1 September 2020, using the CINAHL, Cochrane Central Register of Controlled Trials, Embase, PubMed and PsycINFO databases. We examined 14 peer‐reviewed studies that investigated NICU interventions involving 478 fathers, whose 511 infants were born before 37 weeks of gestation. These included empirical studies with clinical outcomes. Results Studies on fathers' interventions in NICUs were limited and mainly restricted to basic skin‐to‐skin contact or tactile interventions. The interventions had similar general positive effects on mothers and fathers when it came to infant physiological and behavioural reactions. There was also evidence of a positive effect on the fathers, including their mental health. Conclusion Including fathers as active partners in the care of their preterm newborn infants produced good outcomes for both of them. Further research is needed to develop new, multimodal and interactive interventions that provide fathers with positive contact with their preterm infants.
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Affiliation(s)
- Manuela Filippa
- Neuroscience of Emotion and Affective Dynamics Lab Swiss Center for Affective Sciences and Faculty of Psychology and Educational Sciences University of Geneva Geneva Switzerland
- Division of Development and Growth Department of Pediatrics Geneva University Hospitals Geneva Switzerland
| | - Sahar Saliba
- Department of Psychomotor Therapy Faculty of Public Health Lebanese University Beirut Lebanon
| | - Rana Esseily
- Ethology, Cognition and Development Laboratory UPL University of Paris Nanterre Nanterre France
| | - Maya Gratier
- Ethology, Cognition and Development Laboratory UPL University of Paris Nanterre Nanterre France
| | - Didier Grandjean
- Neuroscience of Emotion and Affective Dynamics Lab Swiss Center for Affective Sciences and Faculty of Psychology and Educational Sciences University of Geneva Geneva Switzerland
| | - Pierre Kuhn
- Department of Neonatal Medicine Hautepierre Hospital University Hospital, University of Strasbourg Strasbourg France
- Centre National de la Recherche Scientifique and University of StrasbourgInstitut des Neurosciences Cellulaires et Intégratives Strasbourg France
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Former Neonatal Intensive Care Unit Fathers' Involvement 4 Years Later: A Qualitative Study. J Pediatr Nurs 2021; 60:31-39. [PMID: 33607536 DOI: 10.1016/j.pedn.2021.02.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 02/02/2021] [Accepted: 02/02/2021] [Indexed: 11/23/2022]
Abstract
PURPOSE To explore the experience of fathering a previous Newborn Intensive Care Unit (NICU) infant four years after hospitalization. DESIGN AND METHODS Nineteen fathers of former NICU infants were interviewed using a semi-structured schedule. RESULTS Most of the fathers had children with ongoing health issues (84%). The median age of the fathers was 38 years old. Racial demographics included 12 white fathers (63%), 5 black fathers (26%), and 2 Hispanic fathers (11%). Themes that emerged included adjustments, prepared for anything, closeness, ambivalent normalcy, and vigilance. These fathers of former infants with health issues made 'adjustments' in their lives to be available and better fathers for their children. They familiarized themselves with their children's ongoing health issues so they could be better protectors and be 'prepared for anything', but considered their children 'normal kids' while still maintaining 'vigilance' for future health needs. Fathers described that the experience of having an infant with health issues helped them to develop 'closeness' with the child and boosted their confidence as fathers. CONCLUSION This involvement/confidence pattern is critically important to establishing and maintaining fathering, especially for fathers of children with disabilities. PRACTICE IMPLICATIONS Pediatric practitioners can continue to encourage this pattern after the initial hospital stay.
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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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Reliability and Validity of the Arabic Version of the Parental Stressor Scale and Nurse Parental Support Tool: Opening Up Research on Parental Needs in Neonatal Intensive Care Units in Egypt. Adv Neonatal Care 2021; 21:E101-E109. [PMID: 33278101 DOI: 10.1097/anc.0000000000000826] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The admission of a newborn infant to a neonatal intensive care unit (NICU) due to preterm birth or high-risk conditions, such as perinatal injury, sepsis, hypoxia, congenital malformation, or brain injury, is a stressful experience for mothers. There is currently a lack of research on maternal perceived stress and support in Egyptian NICUs and no validated Arabic tool to investigate this further. PURPOSE To determine the reliability and validity of the Arabic language versions of the Parental Stressor Scale: NICU (PSS:NICU) and the Nurse Parental Support Tool (NPST). METHODS Egyptian mothers completed the PSS:NICU and the NPST at the time of their infants' discharge from the NICU. Reliability was assessed with Cronbach α and Spearman-Brown coefficient. The multifactorial structure of the PSS:NICU Arabic version was tested. Associations with sociodemographic and clinical variables were explored with bivariate correlations and t tests. RESULTS Sixty-eight mothers of preterm (PT) infants and 52 mothers of ill full-term (IFT) infants completed the study. Mothers of PT and IFT infants did not differ for sociodemographic variables. High internal consistency (α range between .93 and .96) emerged for both tools. Spearman-Brown coefficients ranged between 0.86 and 0.94. The multidimensional structure of the PSS:NICU was confirmed and 3 core dimensions explained up to 71.48% of the variance. Perceived nursing support did not diminish the effects of stress in mothers of infants admitted to the NICU, regardless of PT or IFT infants' status. A longer NICU stay was associated with greater stress in mothers of PT infants. The presence of comorbidities was significantly associated with stress of mothers of IFT infants. IMPLICATIONS FOR RESEARCH Future research is needed to develop evidence-based support for mothers whose infants are admitted to a NICU in Egypt. The availability of validated and reliable PSS:NICU and NPST scales in Arabic will facilitate cross-country and cross-cultural research on maternal stress in the NICU. IMPLICATIONS FOR PRACTICE Neonatal care nurses in Egypt will be able to increase their understanding of the stressors experienced by mothers of infants admitted to the NICU. This will in turn enable the introduction of neonatal care policies aimed at reducing specific stressors and provide improved maternal support.
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Ladur AN, van Teijlingen E, Hundley V. Male involvement in promotion of safe motherhood in low- and middle-income countries: A scoping review. Midwifery 2021; 103:103089. [PMID: 34293604 DOI: 10.1016/j.midw.2021.103089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 05/19/2021] [Accepted: 07/07/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Maternal health programmes that focus on the woman alone are limiting in LMICs as pregnant women often relate to maternity services through a complex social web that reflects power struggles within the kinship and the community. METHODS A scoping review was conducted to explore the rationale for male involvement in maternal health in LMICs. This review was guided by the question: What is the current state of knowledge regarding the inclusion of men in maternal health services in LMICs? The literature search was conducted using mySearch, Bournemouth University`s iteration of the EBSCO Discovery Service (EDS) tool. The review process used the Preferred Reporting Items for Systematic Reviews to select papers for inclusion. FINDINGS Thirty three studies met the inclusion criteria. Findings describe the rationale for involving men in maternity care, alongside the criticisms and challenges inherent in engaging with men in maternal health. Involving men in maternity services can improve health outcomes for women and infants. Health strategies aimed at educating men are relevant in equipping men with knowledge and skills that help men to be supportive of women`s wellbeing during pregnancy and childbirth. CONCLUSION Men can serve as advocates for women and reinforce their partner`s choices in accessing skilled care and infant feeding. Further research is required to examine the effect of male involvement on women`s autonomy and to assess health education interventions aimed at mitigating harmful outcomes of involving men in maternity services.
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Affiliation(s)
- Alice Norah Ladur
- Centre for Midwifery, Maternal & Perinatal Health, Faculty of Health and Social Sciences, Bournemouth University, 10 St Paul's Ln, Boscombe BH8 8AJ, United Kingdom; Department of Health Sciences and Special Education, Africa Renewal University, P.O Box 35138, Kampala, Uganda.
| | - Edwin van Teijlingen
- Centre for Midwifery, Maternal & Perinatal Health, Faculty of Health and Social Sciences, Bournemouth University, 10 St Paul's Ln, Boscombe BH8 8AJ, United Kingdom.
| | - Vanora Hundley
- Centre for Midwifery, Maternal & Perinatal Health, Faculty of Health and Social Sciences, Bournemouth University, 10 St Paul's Ln, Boscombe BH8 8AJ, United Kingdom.
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Alnuaimi N, Tluczek A. Father's Bonding With an Infant Born Prematurely: A Qualitative Meta-synthesis. West J Nurs Res 2021; 44:493-505. [PMID: 33834922 DOI: 10.1177/01939459211002909] [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: 11/16/2022]
Abstract
There is no current theory that explains the process of a fathers' bonding with their infants born prematurely. Through meta-synthesis of 19 qualitative studies, we developed a conceptual framework to illustrate how fathers perceive the relationship with their premature infant formed over the first 18 months of life. It details the contextual factors that contribute to that process. Findings reveal a complex process comprised of five stages, derived from five core themes and related subthemes. Fathers progress through five sequential stages to establish their role as fathers and form emotional connections with their child. Stages include: (a) feeling alien and lacking emotional connection to the infant, (b) caregiving engagement and claiming the role as a father, (c) claiming the infant as their own, (d) adjusting to having the infant home, and (5) normalizing family life. This conceptual framework can inform future research and clinical interventions designed to foster father-infant bonding.
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Affiliation(s)
- Nisreen Alnuaimi
- School of Nursing, University of Wisconsin-Madison, Madison, WI, USA
| | - Audrey Tluczek
- School of Nursing, University of Wisconsin-Madison, Madison, WI, USA
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Abstract
During the 2009 H1N1 pandemic, containment strategies aimed at limiting the spread of the virus were implemented but not to the extent as the current COVID-19 pandemic. Research is ongoing regarding disease symptomatology, transmission, and treatment for COVID-19. There are limited data regarding the effects of social distancing practices and restrictive hospital-visitation policies on the parent-infant dyad. The purpose of this commentary is to explore the implications of isolation practices on the parent-infant dyad during a pandemic.
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Cajiao-Nieto J, Torres-Giménez A, Merelles-Tormo A, Botet-Mussons F. Paternal symptoms of anxiety and depression in the first month after childbirth: A comparison between fathers of full term and preterm infants. J Affect Disord 2021; 282:517-526. [PMID: 33433381 DOI: 10.1016/j.jad.2020.12.175] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 09/26/2020] [Accepted: 12/23/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Although men have a higher risk of developing a mental disorder during the perinatal period, few studies have focused on new fathers' mental health screening. This study compares anxiety and depression symptoms between fathers with newborn infants in the neonatal intensive care unit (NICU) and fathers of healthy full-term infants, assessing the impact of stress caused by the NICU.. METHODS A longitudinal and prospective study with control (n= 33) and study groups (n=51) was designed. The dependent variables assessed were post-natal depression and anxiety-state while the social and demographic information, health background and the parental stress in the neonatal unit were the independent variables. The fathers were assessed twice during the first month after birth. RESULTS Significant differences in the EPDS scores were found between both groups in the first assessment (p = .006) but not in the second assessment (p = .60). Significant differences in STAI scores were found between the groups for both assessments (p = .003 and p = .002). The stress caused by the infant's appearance and behavior was predictive of depression and anxiety in the study group. LIMITATIONS The sample was collected at one hospital, immigrants were underrepresented, and no prenatal assessment of paternal mental health is available. CONCLUSIONS Our results suggest that the hospitalization of newborn infants increases the risk of developing anxiety or depression disorder in fathers. Health providers should be aware of the emotional changes in men shortly after childbirth and include them in the screening of and support for mental health disorders.
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Affiliation(s)
| | - Anna Torres-Giménez
- Perinatal Mental Health Unit, Department of Psychiatry and Clinical Psychology, Institute of Neuroscience, Hospital Clinic, IDIBAPS, Barcelona, Spain; Faculty of Psychology, Universitat de Barcelona. Spain
| | | | - Francesc Botet-Mussons
- Institute Clinic of Obstetrics, Gynecology and Neonatology (ICGON), Hospital Clínic, Barcelona, Spain; Faculty of Medicine. Universitat de Barcelona, Spain
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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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Baldoni F, Ancora G, Latour JM. Being the Father of a Preterm-Born Child: Contemporary Research and Recommendations for NICU Staff. Front Pediatr 2021; 9:724992. [PMID: 34552898 PMCID: PMC8450441 DOI: 10.3389/fped.2021.724992] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 08/16/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Most studies on parental reactions to a preterm birth and to hospitalization of the newborn in Neonatal Intensive Care Units (NICUs) have involved mothers. However, emotional responses and behaviors of fathers are equally important. Usually, the father is the first to meet the preterm newborn, to find out information about baby's condition and to communicate to the mother and other family members. In this context he is often left alone and can show psychological difficulties including affective disorders such as depression or anxiety. This paper describes the role of fathers in the NICU, the best practices to support fathers, and to explain the role of a psychologist in the NICU staff. Considerations and suggestions are provided on the difficulties encountered to support parents, with a focus on the role of fathers during the COVID-19 pandemic. Methods and Discussion: Considering contemporary research data and following an attachment perspective, we analyze the role of the father of a preterm-born child in the relation with the partner and in newborn caring. Research has shown that involving fathers in newborn care in NICU and at home is essential not only because it promotes the father/son attachment relationship and has positive effects on the psychological and somatic development of the newborn, but also for the health of the mother and whole family. Conclusion: Recommendations are provided to enhance the functions of fathers in the NICU, promote their involvement in the care of their infant, and interventions to prevent the manifestation of psychological suffering and/or perinatal affective disorders. The commitments of a psychologist in a NICU team are presented and require not only clinical skills, but also the ability to manage the emotional and relational difficulties of fathers, family and NICU staff. Considerations and suggestions are provided on the difficulties encountered by parents in the NICU during the COVID-19 pandemic.
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Affiliation(s)
- Franco Baldoni
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Gina Ancora
- Neonatal Intensive Care Unit, Infermi Hospital, Rimini, Italy
| | - Jos M Latour
- Faculty of Health, School of Nursing and Midwifery, University of Plymouth, Plymouth, United Kingdom.,Department of Nursing, Hunan Children's Hospital, Changsha, China
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Pisoni C, Provenzi L, Moncecchi M, Caporali C, Naboni C, Stronati M, Montirosso R, Borgatti R, Orcesi S. Early parenting intervention promotes 24-month psychomotor development in preterm children. Acta Paediatr 2021; 110:101-108. [PMID: 32392381 DOI: 10.1111/apa.15345] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 04/30/2020] [Accepted: 05/05/2020] [Indexed: 11/30/2022]
Abstract
AIM Although parenting is key to promoting healthy development of at-risk preterm infants, parents have often restricted access to neonatal intensive care units (NICUs). This study aimed to assess the effect of an early parenting intervention on the psychomotor outcome in preterm children at 24 months of corrected age. METHODS Forty-two preterm children and their parents were consecutively recruited at a level III NICU in Northern Italy and randomly allocated to early intervention (two educational peer-group sessions and four individual infant observation sessions) or care as usual (no educational or infant observation sessions). During NICU stay, parents provided information on daily holding and skin-to-skin. Psychomotor development was measured at 24 months of corrected age using the Griffith Mental Development Scales. RESULTS There were no significant differences in socio-demographic and clinical variables between early intervention (n = 21; 13 females) and care as usual (n = 21; 12 females) groups. At 24 months of corrected age, children in the early intervention arm had greater scores for global psychomotor development as well as for Hearing-Speech and Personal-Social sub-scales, compared to those in the care as usual group. CONCLUSION The present NICU parenting intervention was found to be associated with better psychomotor outcomes in preterm children at 24-month age. The effects were especially evident for domains related to language and socio-emotional functioning. Results are promising and should be retested with more heterogeneous and representative preterm sample.
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Affiliation(s)
| | - Livio Provenzi
- Child Neurology and Psychiatry Unit IRCCS Mondino Foundation Pavia Italy
| | - Michela Moncecchi
- Child Neurology and Psychiatry Unit IRCCS Mondino Foundation Pavia Italy
| | - Camilla Caporali
- Child Neurology and Psychiatry Unit IRCCS Mondino Foundation Pavia Italy
| | - Cecilia Naboni
- Child Neurology and Psychiatry Unit IRCCS Mondino Foundation Pavia Italy
| | | | - Rosario Montirosso
- 0‐3 Center for the at‐Risk Infant Scientific Institute IRCCS E. Medea Lecco Italy
| | - Renato Borgatti
- Child Neurology and Psychiatry Unit IRCCS Mondino Foundation Pavia Italy
- Department of Brain and Behavioral Sciences University of Pavia Pavia Italy
| | - Simona Orcesi
- Child Neurology and Psychiatry Unit IRCCS Mondino Foundation Pavia Italy
- Department of Brain and Behavioral Sciences University of Pavia Pavia Italy
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A global perspective on parental stress in the neonatal intensive care unit: a meta-analytic study. J Perinatol 2020; 40:1739-1752. [PMID: 32901116 DOI: 10.1038/s41372-020-00798-6] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 08/15/2020] [Accepted: 08/20/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The Parental Stressor Scale: Neonatal Intensive Care Unit (PSS:NICU) is a well-validated tool to assess different sources of stress in parents during the NICU hospitalization of their infant. The present meta-analytic study assessed the relative impact of different NICU-related sources of parental stress in a pool of studies conducted in a wide set of different countries. Also, differences in stress levels by parent gender and country, as well as the impact of infants' neonatal characteristics and clinical conditions were explored. METHODS Records were searched on PubMed, Scopus, and Web of Science (January 1993-December 2019). A purposive open search string was adopted: ["PSS:NICU"] OR ["PSS-NICU"] OR ["Parental Stressor Scale"]. A multiple random-effect meta-analysis was conducted on data from 53 studies extracted by independent coders. RESULTS Parental role alteration emerged as the greatest source of stress for both mothers and fathers. Mothers reported higher stress levels compared to fathers. A significant difference emerged only for the subscale related to sights and sounds physical stimuli. No significant effects of infants' neonatal characteristics (gestational age, birth weight) and clinical conditions (comorbidities) emerged. A marginal positive effect of NICU length of stay emerged on the global level of parents' stress. CONCLUSIONS The current meta-analysis underlines that parental stress related to NICU admission is a worldwide healthcare issue. Immediate and tailored support to parents after the birth of their at-risk infant should be prioritized to reduce parental stress and to promote mothers and fathers' emotional well-being and new-born neurodevelopmental outcomes.
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Kim THM, Delahunty-Pike A, Campbell-Yeo M. Effect of Fathers' Presence and Involvement in Newborn Care in the NICU on Mothers' Symptoms of Postpartum Depression. J Obstet Gynecol Neonatal Nurs 2020; 49:452-463. [PMID: 32663437 DOI: 10.1016/j.jogn.2020.05.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2020] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVE To determine the prevalence of symptoms of postpartum depression (PPD) and examine how fathers' presence and involvement in the care of their newborns affect symptoms of PPD within the first 2 weeks after birth among mothers with newborns in the NICU. DESIGN Observational cohort study. SETTING Open-bay, 40-bed, tertiary level NICU in Eastern Canada. PARTICIPANTS Mothers (N = 105) of newborns who were anticipated to survive and required more than 5 days of hospitalization in the NICU. METHODS Participants completed the Postpartum Depression Screening Scale (PDSS) 14 days after they gave birth. They kept daily diaries to record the amount of time that fathers spent by the newborns' bedsides (i.e., presence) and actively caring for their newborns (i.e., involvement such as skin to skin). Participants completed daily diaries from the time of enrollment in the study until their newborns were discharged home. We analyzed the data using linear regression; score on the PDSS was the dependent variable, and fathers' presence and involvement were the independent variables. We adjusted for covariates. RESULTS The prevalence of positive screening for symptoms of major PPD was 24.1% (n = 20), and the prevalence of significant symptoms of PPD was 27.7% (n = 23). Participants reported that fathers were present in the NICU an average of 3.8 hours per day and were actively involved with their newborns 53% of the time. Fathers' involvement was significantly associated with lower scores on the PDSS (adjusted β = -3.85; 95% confidence interval [CI] [-6.10, -1.60]). A history of anxiety was significantly associated with greater scores on the PDSS (adjusted β = 12.06, 95% CI [2.07, 22.05]). Maternal age and income less than $50,000 CAD were marginally associated with greater scores on the PDSS (adjusted β = -0.86, 95% CI [-1.77, 0.05] and adjusted β = 10.69, 95% CI [-0.73, 22.11], respectively). The overall explained variance in the PDSS scores with the independent variables was R2 = 0.35. CONCLUSION Fathers' involvement in the care of their newborns in the NICU was significantly associated with fewer symptoms of PPD among mothers. We recommend research with targeted interventions to promote fathers' involvement in the NICU to potentially mitigate the symptoms of PPD among mothers of newborns in the NICU.
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Provenzi L, Giusti L, Caglia M, Rosa E, Mascheroni E, Montirosso R. Evidence and Open Questions for the Use of Video-Feedback Interventions With Parents of Children With Neurodevelopmental Disabilities. Front Psychol 2020; 11:1374. [PMID: 32625153 PMCID: PMC7314919 DOI: 10.3389/fpsyg.2020.01374] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Accepted: 05/22/2020] [Indexed: 11/13/2022] Open
Abstract
The Video-Feedback Intervention (VFI) is a technique aimed at promoting positive parenting that has been found to be supportive of child development and parent-child interaction in different at-risk and clinical populations. The application of VFI with parents of children with neurodevelopmental disabilities (ND; e.g., cerebral palsy, sensory and/or psychomotor delay, and genetic syndromes) is growing. Nonetheless, no systematic review is currently available documenting whether this type of intervention improves children's developmental outcomes (e.g., behavioral stability and cognitive abilities), parental caregiving skills (e.g., responsive parenting), and parental emotional well-being (e.g., depressive symptomatology). In the present mini-review, 212 VFI records were retrieved from three databases (i.e., PubMed, Scopus, and Web of Science), and 10 papers were finally included. Abstracted information included age, diagnosis, methodological aspects (timing, setting, and themes), and child/parent outcomes. Significant improvements from pre- to post-VFI were observed in all studies. Specifically, the VFIs were significantly associated with better children developmental outcomes and parental caregiving skills. Inconsistent findings emerged for the VFI effects on parental emotional well-being. Overall, the current mini-review supports the potential effectiveness of parent-focused VFI interventions for parents of children with ND, despite the presence of open questions that need to be addressed in future clinical trials.
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Affiliation(s)
| | | | | | | | | | - Rosario Montirosso
- 0-3 Centre for the at-Risk Infant, Scientific Institute, IRCCS E. Medea, Lecco, Italy
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Govindaswamy P, Laing SM, Waters D, Walker K, Spence K, Badawi N. Fathers' needs in a surgical neonatal intensive care unit: Assuring the other parent. PLoS One 2020; 15:e0232190. [PMID: 32374739 PMCID: PMC7202595 DOI: 10.1371/journal.pone.0232190] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 04/08/2020] [Indexed: 11/19/2022] Open
Abstract
Objectives Fathers of infants admitted to Neonatal Intensive Care Unit (NICU) play an important role and have individual needs that are often not recognised. While there is considerable evidence regarding mothers’ needs in the NICU, information about fathers’ is particularly limited. This study identifies the needs of fathers of newborns admitted to NICU for general surgery of major congenital anomalies, and whether health-care professionals meet these needs. Methods Forty-eight fathers of infants admitted for surgery between February 2014 and September 2015 were enrolled in a prospective cohort study. Fathers completed the Neonatal Family Needs Inventory comprising 56 items in 5 subscales (Support, Comfort, Information, Proximity, Assurance) at admission and discharge and whether these needs were met; as well as the Social Desirability Scale. Results Responses showed Assurance was the most important subscale (M 3.8, SD .26). Having questions answered honestly (M 3.9, SD .20) and knowing staff provide comfort to their infant (M 3.94, SD .24) were fathers’ most important needs. By discharge, fathers expressed a greater importance on being recognised and more involved in their infant’s care. More than 91% indicated their ten most important needs were met by the NICU health-care professionals, with no significant changes at discharge. Clergical visits (M 2.08, SD 1.21) were least important. Conclusions Reassurance is a priority for fathers of neonates in a surgical NICU, particularly regarding infant pain management and comfort. It is important that health-care professionals provide reliable, honest information and open-access visiting. Notably, fathers seek greater recognition of their role in the NICU—beyond being the ‘other’ parent.
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Affiliation(s)
- Priya Govindaswamy
- Grace Centre for Newborn Care, Children’s Hospital at Westmead, Westmead, Australia
- Sydney Medical School, University of Sydney, Sydney, Australia
- * E-mail:
| | | | - Donna Waters
- Sydney Medical School, University of Sydney, Sydney, Australia
- Sydney Nursing School, University of Sydney, Sydney, Australia
| | - Karen Walker
- Sydney Medical School, University of Sydney, Sydney, Australia
- Sydney Nursing School, University of Sydney, Sydney, Australia
| | - Kaye Spence
- Grace Centre for Newborn Care, Children’s Hospital at Westmead, Westmead, Australia
| | - Nadia Badawi
- Grace Centre for Newborn Care, Children’s Hospital at Westmead, Westmead, Australia
- Sydney Medical School, University of Sydney, Sydney, Australia
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Furukawa R, Driessnack M, Kobori E. The effect of video‐mediated communication on father‐infant bonding and transition to fatherhood during and after
Satogaeri Bunben. Int J Nurs Pract 2020; 26:e12828. [DOI: 10.1111/ijn.12828] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 01/26/2020] [Accepted: 02/16/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Ryoko Furukawa
- Faculty of Science and Nursing Juntendo University Mishima‐shi Japan
| | - Martha Driessnack
- School of Nursing Oregon Health and Science University Portland Oregon
| | - Eiko Kobori
- Faculty of Nursing Setsunan University Hirakata Japan
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The Role of the NICU in Father Involvement, Beliefs, and Confidence: A Follow-up Qualitative Study. Adv Neonatal Care 2020; 20:80-89. [PMID: 31567277 DOI: 10.1097/anc.0000000000000665] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
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.
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Obst KL, Due C, Oxlad M, Middleton P. Men's grief following pregnancy loss and neonatal loss: a systematic review and emerging theoretical model. BMC Pregnancy Childbirth 2020; 20:11. [PMID: 31918681 PMCID: PMC6953275 DOI: 10.1186/s12884-019-2677-9] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 12/13/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Emotional distress following pregnancy loss and neonatal loss is common, with enduring grief occurring for many parents. However, little is known about men's grief, since the majority of existing literature and subsequent bereavement care guidelines have focused on women. To develop a comprehensive understanding of men's grief, this systematic review sought to summarise and appraise the literature focusing on men's grief following pregnancy loss and neonatal loss. METHODS A systematic review was undertaken with searches completed across four databases (PubMed, PsycINFO, Embase, and CINAHL). These were guided by two research questions: 1) what are men's experiences of grief following pregnancy/neonatal loss; and 2) what are the predictors of men's grief following pregnancy/neonatal loss? Eligible articles were qualitative, quantitative or mixed methods empirical studies including primary data on men's grief, published between 1998 and October 2018. Eligibility for loss type included miscarriage or stillbirth (by any definition), termination of pregnancy for nonviable foetal anomaly, and neonatal death up to 28 days after a live birth. RESULTS A final sample of 46 articles were identified, including 26 qualitative, 19 quantitative, and one mixed methods paper. Findings indicate that men's grief experiences are highly varied, and current grief measures may not capture all of the complexities of grief for men. Qualitative studies identified that in comparison to women, men may face different challenges including expectations to support female partners, and a lack of social recognition for their grief and subsequent needs. Men may face double-disenfranchised grief in relation to the pregnancy/neonatal loss experience. CONCLUSION There is a need to increase the accessibility of support services for men following pregnancy/neonatal loss, and to provide recognition and validation of their experiences of grief. Cohort studies are required among varied groups of bereaved men to confirm grief-predictor relationships, and to refine an emerging socio-ecological model of men's grief. TRIALS REGISTRATION PROSPERO registration number: CRD42018103981.
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Affiliation(s)
- Kate Louise Obst
- School of Psychology, University of Adelaide, Adelaide, South Australia, Australia.
| | - Clemence Due
- School of Psychology, University of Adelaide, Adelaide, South Australia, Australia
| | - Melissa Oxlad
- School of Psychology, University of Adelaide, Adelaide, South Australia, Australia
| | - Philippa Middleton
- South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
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Tandberg BS, Flacking R, Markestad T, Grundt H, Moen A. Parent psychological wellbeing in a single-family room versus an open bay neonatal intensive care unit. PLoS One 2019; 14:e0224488. [PMID: 31689307 PMCID: PMC6830777 DOI: 10.1371/journal.pone.0224488] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 10/15/2019] [Indexed: 01/30/2023] Open
Abstract
Background Studies of parents’ psychological well-being in single-family rooms in neonatal intensive care units have shown conflicting results. Aims To compare emotional distress in the form of depression, anxiety, stress and attachment scores among parents of very preterm infants cared for in a single-family rooms unit vs an open bay unit. Study design Prospective survey design. Subject Parents (132) of 77 infants born at 28 0/7–32 0/7 weeks of gestation in the two units. Outcome measures Duration of parental presence was recorded. Scores for depression (The Edinburgh Postnatal Depression Scale), anxiety (The State–Trait–Anxiety Inventory, Short Form Y), stress (The Parent Stressor Scale: neonatal intensive care unit questionnaire and The Parenting Stress Index—short form) and attachment (Maternal Postnatal Attachment Scale) measured 14 days after delivery, at discharge, expected term date and four months post-term. Results Parents were present 21 hours/day in the single-family room unit vs 7 hours/day in the Open bay unit. Ninety-three percent of the fathers in the single-family rooms unit were present more than 12 hours per day during the first week. Mothers in the single-family rooms had a significantly lower depression score -1.9 (95% CI: -3.6, -0.1) points from birth to four months corrected age compared to mothers in the Open bay unit, and 14% vs 52% scored above a cut-off point considered being at high risk for depression (p<0.005). Both mothers and fathers in the single-family rooms reported significantly lower stress levels during hospitalization. There were no differences between the groups for anxiety, stress or attachment scores after discharge. Conclusion The lower depression scores by the mothers and lower parental stress scores during hospitalization for both parents supports that single-family rooms care contribute to parents’ psychological wellbeing.
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Affiliation(s)
- Bente Silnes Tandberg
- Department of Paediatric and Adolescent Medicine, Drammen Hospital, Vestre Viken Hospital Trust, Drammen, Norway
- Lovisenberg Diaconal University College, Oslo, Norway
- Department of Clinical Science, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
- * E-mail:
| | - Renée Flacking
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
| | - Trond Markestad
- Department of Clinical Science, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - Hege Grundt
- Department of Paediatrics, Haukeland University Hospital, Bergen, Norway
| | - Atle Moen
- Department of Paediatric and Adolescent Medicine, Drammen Hospital, Vestre Viken Hospital Trust, Drammen, Norway
- Department of Neonatology, Oslo University Hospital, Oslo, Norway
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Hunt H, Abbott R, Boddy K, Whear R, Wakely L, Bethel A, Morris C, Prosser S, Collinson A, Kurinczuk J, Thompson-Coon J. “They’ve walked the walk”: A systematic review of quantitative and qualitative evidence for parent-to-parent support for parents of babies in neonatal care. ACTA ACUST UNITED AC 2019. [DOI: 10.1016/j.jnn.2019.03.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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