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Alqarawi N, Alhalal E. Nurses' practices of children and family-centered care for chronically ill children: A cross-sectional study. J Pediatr Nurs 2024; 77:172-179. [PMID: 38522211 DOI: 10.1016/j.pedn.2024.03.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 03/18/2024] [Accepted: 03/18/2024] [Indexed: 03/26/2024]
Abstract
PURPOSE There is limited evidence of children and family-centered care (CFCC) practice in different cultural contexts, particularly regarding the factors that predict it among nurses providing care to chronically ill children. Also, the CFCC's impact on the quality of care has not been well studied. This study aimed to test a hypothesized model in which nurses' attributes and care environments predict CFCC, thereby increasing the quality of nursing care. DESIGN AND METHODS A multicenter cross-sectional study recruited a convenience sample of 405 nurses caring for chronically ill children in Saudi Arabia for an online survey between February 2023 and August 2023. Structural Equation Modeling evaluated the hypothesized model. RESULTS The hypothesized model fits the data based on the fit indices. Care environment affected CFCC (β = 0.831, p = .000), while nursing attributes only indirectly affected CFCC practices through the mediating effect of the work environment (β = 0.553, p = .000). The CFCC practices positively affect the quality of nursing care (β = 0.636, p = .000). CONCLUSIONS Nursing attributes impact the work environment, which affects the practice of CFCC and enhances the quality of care for chronically ill children. Investing in nurses' attributes and a positive work environment is crucial for nursing leaders to enhance CFCC practice and the quality of care. PRACTICAL IMPLICATIONS The findings of this study can be used to shape policies and develop interventions to improve nursing CFCC practices and promote better quality of care for chronically ill children.
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Affiliation(s)
- Nada Alqarawi
- Department of Basic Medical Sciences, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Saudi Arabia; College of Nursing, King Saud University, Riyadh, Saudi Arabia.
| | - Eman Alhalal
- Community and mental health nursing, Nursing college, King Saud University Riyadh, Saudi Arabia
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Kocakabak C, van den Hoogen A, Rothfus M, Campbell-Yeo M, Kostenzer J, Axelin A, Schofield P, Latour JM. Identifying outcomes and outcome measures in neonatal family-centered care trials: a systematic review. Pediatr Res 2024:10.1038/s41390-024-03293-2. [PMID: 38849484 DOI: 10.1038/s41390-024-03293-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 04/16/2024] [Accepted: 05/15/2024] [Indexed: 06/09/2024]
Abstract
BACKGROUND A wide range of outcomes for infants and parents has been reported in clinical trials testing FCC interventions. This systematic review aimed to identify outcomes, outcome measures, and time-points reported in experimental studies testing FCC interventions in neonatal care units. METHODS This review included experimental studies investigating FCC interventions in neonatal settings. Database searches were conducted in MEDLINE, EMBASE, CINAHL, Cochrane, PsycINFO, Scopus, JBI, Lilacs, and SciELO, completed in December 2022 and updated in November 2023. Critical appraisal was performed using the JBI checklist for randomized controlled trials, and a narrative synthesis process was used. Outcomes were categorized into the Comet Taxonomy core areas. RESULTS The search identified 8787 papers; 42 studies were included in the analysis. Totally, 60 outcomes were identified: 42 infant and 18 parents' outcomes. Outcomes were clustered into 12 domains for infants and five domains for parents and measured by 97 outcome measures. The included studies reported 25 and 27 different time-points for infants and parents, respectively. CONCLUSION This review of studies testing FCC interventions identified heterogeneity and inconsistency of outcomes, outcome measures, and time-points measuring the outcomes. Developing a core outcome set for FCC studies is warranted to benchmark the evidence and identify best-practices. IMPACT This systematic review identified inconsistency of outcomes, outcome measures, and time-points reported in quantitative studies testing family-centered care interventions in neonatal care settings. The lack of standardized outcomes and outcome measures reported in clinical trials makes it difficult to synthesize data to provide conclusive recommendations. This systematic review will contribute to the development of a core outcome set for research testing family-centered care interventions in neonatal care settings.
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Affiliation(s)
- Cansel Kocakabak
- School of Nursing and Midwifery, Faculty of Health, University of Plymouth, Plymouth, UK.
| | - Agnes van den Hoogen
- Department Women and Baby, Neonatology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, The Netherlands, Utrecht University, Utrecht, The Netherlands
| | - Melissa Rothfus
- Dalhousie Libraries, Dalhousie University, Halifax, NS, Canada
| | - Marsha Campbell-Yeo
- School of Nursing, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Johanna Kostenzer
- European Foundation for the Care of Newborn Infants, Munich, Germany
| | - Anna Axelin
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Patricia Schofield
- School of Nursing and Midwifery, Faculty of Health, University of Plymouth, Plymouth, UK
| | - Jos M Latour
- School of Nursing and Midwifery, Faculty of Health, University of Plymouth, Plymouth, UK
- Department of Nursing, Zhongshan Hospital, Fudan University, Shanghai, China
- Curtin School of Nursing, Curtin University, Perth, WA, Australia
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Padilla-Muñoz EM, Barbancho-Morant MM, Lanzarote-Fernández MD, Sanduvete-Chaves S, Chacón-Moscoso S. Psycho-emotional intervention with parents of very preterm babies during the first year: A single-arm pilot study. FAMILY PROCESS 2024. [PMID: 38659149 DOI: 10.1111/famp.13002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 03/11/2024] [Accepted: 03/17/2024] [Indexed: 04/26/2024]
Abstract
Studies of intervention programs that aim to improve the emotional state of parents of children admitted to the neonatal intensive care units (NICU) are scarce in Spain. The aims of this single-arm pilot study are to get to know the emotional profile of parents of high-risk preterm newborns, and to explore parents' patterns of emotional well-being before and after a psychological program called the Parental Empowerment Program, to increase parental readiness levels. The sample was made up of 100 parents (50 couples) who participated in the program. Measurements were taken of post-traumatic stress, depression, and resilience at 1 month and 12 months. Repeated measurements and dyadic data analyses were performed. One month after the birth of the baby and prior to the start of the program, mothers show more symptoms of stress and depression than fathers. After the intervention, both parents experienced improvements in their mood levels. The evidence obtained seems to show that high resilience levels and low post-traumatic stress symptoms are associated with reduced depression levels after implementing the program. However, the heterogeneity of the responses obtained, the observed associations between stress, resilience, and maternal depression, along with the reciprocal influence between maternal and paternal depression 1 year after the intervention, highlight the need for a more in-depth exploration of the interplay between risk and protective factors in this population. Despite the identified potential threats to validity, further work in this direction is recommended, including the implementation of clinical trials to demonstrate intervention efficacy. The adaptation of the parents' mutual emotional adjustment at each stage would allow them to participate more actively in the baby's care.
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Affiliation(s)
| | | | | | | | - Salvador Chacón-Moscoso
- Faculty of Psychology, Universidad de Sevilla, Sevilla, Spain
- Departamento de Psicología, Universidad Autónoma de Chile, Santiago, Chile
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Stelwagen M, Westmaas A, Van Kempen A, Scheele F. Rebalancing of professional identity roles in an integrated maternity and neonatal care setting designed to increase parent autonomy: a qualitative study among health professionals. J Interprof Care 2024:1-9. [PMID: 38655873 DOI: 10.1080/13561820.2024.2343843] [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: 05/24/2022] [Accepted: 04/09/2024] [Indexed: 04/26/2024]
Abstract
This case-based qualitative study explored the professional identity as experienced by health professionals working in an integrated maternal-neonatal ward when their practice changed from a "paternalistic" model, in which physicians and nurses were in charge, to a shared or "consumerist" model, to increase parent autonomy. We analyzed transcripts of focus group discussions and interviews with 60 health professionals on their experiences with empowering parents and described factors associated with themes of professional identity. The changes most affecting professional identity were the constant proximity of parents to their newborns and the single-family room design. These changes influenced three themes of professional identity: (1) connectedness and relationships (2) communication, and (3) competencies. A fourth theme, values, beliefs, and ethics, affected how the health professionals coped with the changes in the first three themes. When empowering parents of newborns in a hospital setting, health professionals experience beneficial as well as threatening shifts in their professional identities. Values, beliefs, and ethics associated with family integrated care helped health professionals to embrace their new roles, but other values, beliefs and ethics could create barriers. Continuous professional identity development in a patient-inclusive team is a topic for future research.
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Affiliation(s)
- Mireille Stelwagen
- Department of Teaching and Pediatrics, OLVG Hospital, Amsterdam, The Netherlands
| | - Alvin Westmaas
- Department of Social Psychology, Faculty of Health, University of Applied Sciences Leiden, Leiden, Netherlands
| | - Anne Van Kempen
- Department of Pediatrics, OLVG Hospital, Amsterdam, The Netherlands
| | - Fedde Scheele
- Department of Gynecology and Teaching, OLVG Hospital, Amsterdam, The Netherlands
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Feeley N, Kabajaasi O, Kenya-Mugisha N, Tagoola A, O'Brien K, Duby J. Benefits and Challenges of Implementing an Adaptation of Family Integrated Care in a Ugandan Setting. Adv Neonatal Care 2024; 24:172-180. [PMID: 38547483 DOI: 10.1097/anc.0000000000001161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
BACKGROUND Family Integrated Care (FICare) integrates parents as partners in neonatal intensive care unit care. Our team adapted and implemented this approach in a Ugandan unit for hospitalized neonates. PURPOSE This qualitative descriptive study examined the perceptions of mothers and healthcare professionals (HCPs) of the benefits and challenges of this new approach to care. METHODS Fifty-one mothers of hospitalized neonates born weighing greater than 2000 g participated in the program. They were taught to assess neonate danger signs, feeding, and weight. After discharge, a subsample (n = 15) participated in focus groups to explore benefits and challenges of their participation in care. Interviews with 8 HCPs were also conducted for the same purpose. Transcripts from focus groups and interviews were analyzed using inductive content analysis to describe the benefits and challenges from the perspectives of mothers and HCPs. RESULTS For mothers a benefit was decreased stress. Both mothers and HCPs reported that the knowledge and skills mothers acquired were a benefit as was their ability to apply these to the care of their neonate. Improved relations between mothers and HCPs were described, characterized by greater exchange of information and HCPs' attentiveness to mothers' assessments. Mothers felt ready for discharge and used their knowledge at home. HCPs noted a decrease in their workload. Challenges included the need for mothers to overcome fears about performing the tasks, their own well-being and literacy skills, and access to equipment. IMPLICATIONS FOR PRACTICE Mothers' participation in their neonates' care can have benefits for them and their neonate.
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Affiliation(s)
- Nancy Feeley
- Centre for Nursing Research, Jewish General Hospital & Lady Davis Institute for Medical Research, CIUSSS West-Central Montreal & Ingram School of Nursing, McGill University, Montreal, Québec, Canada (Dr Feeley); Walimu, Kampala, Uganda (Ms Kabajaasi and Dr Kenya-Mugisha); Department of Pediatrics, Jinja Regional Referral Hospital, Jinja, Uganda (Dr Tagoola); Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada (Dr O'Brien); and Department of Pediatrics, McGill University, Montreal, Québec, Canada (Dr Duby)
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Latour JM, Rennick JE, van den Hoogen A. Editorial: Family-centered care in pediatric and neonatal critical care settings. Front Pediatr 2024; 12:1402948. [PMID: 38606367 PMCID: PMC11007701 DOI: 10.3389/fped.2024.1402948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 03/19/2024] [Indexed: 04/13/2024] Open
Affiliation(s)
- Jos M. Latour
- Faculty of Health, University of Plymouth, Plymouth, United Kingdom
- Department of Nursing, Zhongshan Hospital, Fudan University, Shanghai, China
- The Curtin School of Nursing, Curtin University, Perth, WA, Australia
| | - Janet E. Rennick
- Department of Nursing, The Montreal Children’s Hospital, McGill University Health Centre, Montreal, QC, Canada
- Ingram School of Nursing, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
- Department of Pediatrics, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Agnes van den Hoogen
- Department Woman and Baby, Wilhelmina Children’s Hospital, University Medical Centre Utrecht, Utrecht, Netherlands
- Clinical Health Science, Utrecht University, Utrecht, Netherlands
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Wanduru P, Hanson C, Waiswa P, Kakooza-Mwesige A, Alvesson HM. Mothers' perceptions and experiences of caring for sick newborns in Newborn Care Units in public hospitals in Eastern Uganda: a qualitative study. Reprod Health 2023; 20:106. [PMID: 37474965 PMCID: PMC10360301 DOI: 10.1186/s12978-023-01649-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 07/11/2023] [Indexed: 07/22/2023] Open
Abstract
INTRODUCTION Mothers' participation in the care of their sick newborns in Newborn Care Units (NCUs) has been linked to several advantages including earlier discharge, fewer complications, better mother-baby bonding, and an easier transition to home after discharge. This study aimed to understand mothers' perceptions and experiences while participating in the care of their sick newborns in the NCUs to inform interventions promoting mothers' participation in public health facilities in Uganda. METHODS We conducted an exploratory qualitative study comprised of 18 in-depth interviews with mothers caring for their newborns in two NCUs at a Regional Referral and General hospital in Eastern Uganda between April and May 2022. The interviews were audio-recorded and then transcribed. For analysis, we used a thematic analysis approach. RESULTS The fear of losing their baby was an overarching theme that underlay mothers' perceptions, actions, and experiences in the NCU. Mothers' confidence in the care provided to their babies was based on their baby's outcomes. For example, when mothers saw almost immediate improvement after treatment, they felt more confident in the care than when this was not the case. Furthermore, mothers considered it essential that health care providers responded quickly in an emergency. Moreover, they expressed concerns about a lack of control over their personal space in the crowded NCU. Additionally, caring for babies in these settings is physically and financially taxing, with mothers requiring the combined efforts of family members to help them cope. CONCLUSION This study shows that for mothers of sick newborns in the NCU, the baby's survival is the first concern and the basis of mothers' confidence in the quality of care provided. Efforts to improve parental participation in NCUs must focus on lowering the costs incurred by families in caring for a baby in the NCU, addressing privacy and space concerns, leveraging the family's role, and avoiding compromising the quality of care in the process of participation.
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Affiliation(s)
- Phillip Wanduru
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
- Department of Health Policy, Planning, and Management, School of Public Health, Makerere University, Kampala, Uganda.
| | - Claudia Hanson
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, England
| | - Peter Waiswa
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Department of Health Policy, Planning, and Management, School of Public Health, Makerere University, Kampala, Uganda
| | - Angelina Kakooza-Mwesige
- Department of Paediatrics and Child Health, School of Medicine, Makerere University, Kampala, Uganda
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Petersen CB, de Lima RAG, Balieiro MMFG, Mandetta MA. Parent and staff perceptions of patient and family-centred care in a Brazilian paediatric's hospital: Quantitative study. J Eval Clin Pract 2023. [PMID: 36869575 DOI: 10.1111/jep.13825] [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: 02/15/2023] [Accepted: 02/16/2023] [Indexed: 03/05/2023]
Abstract
BACKGROUND Patient and family-centred care (PFCC) is a healthcare model has been acknowledged as the central pillar in the paediatric health care that recognizes the family's role and experience in the health care delivery. AIMS This study investigated and compared the perception of PFCC from the perspective of staff and parents of hospitalized children and adolescents. METHODS A quantitative and comparative cross-sectional survey was used in a convenience sample of 105 staff and 116 parents, who completed the Brazilian versions of the Perceptions of Family Centred Care-Parent and Staff questionnaires, with additional questions on their characteristics. Descriptive and analytical statistics were used, as well as the Kruskal-Wallis and Mann-Whitney tests and Spearman's correlation coefficient. RESULTS Both parents and staff responses were positive and parents had significantly higher scores for 19 of the 20 items (p < 0.001). The item related to parental participation did not show any significant difference between the groups. CONCLUSION The positive perception of PFCC for both groups is consistent with recommendations for expanded care that includes patient and family in healthcare settings. Parents' perception was more positive than staff perceptions of their delivery of family-centred care in hospital. The lowest score for the parent support subscale in both groups requires investigation.
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Affiliation(s)
| | - Regina Aparecida Garcia de Lima
- Department of Maternal-Infant Nursing and Public Health, Ribeirão Preto Nursing School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
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Vetcho S, Ullman AJ, Petsky H, Wiroonpanich W, Cooke M. Parent and interdisciplinary professional perceptions of family-centered care in Thai NICU: A qualitative study. Nurs Crit Care 2023; 28:47-55. [PMID: 34545671 DOI: 10.1111/nicc.12711] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 08/19/2021] [Accepted: 08/24/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Family-centered care (FCC) has been successfully incorporated into daily practice in many neonatal intensive care units (NICUs) worldwide. However, the implementation of FCC in lower-resourced settings, such as Thailand, can be challenging and needs to be further explored. AIMS To identify parents' and interdisciplinary professionals' perceptions of FCC and to describe the opportunities to improve FCC in a Thai NICU. DESIGN An exploratory qualitative approach was used. METHODS The data were collected through face-to-face, semi-structured, individual interviews based on an interview guide. This study was conducted before the outbreak of coronavirus disease 2019 (February 2020) in a hospital in southern Thailand. Inductive thematic analysis was used to analyse interview data. RESULTS Participants were parents (n = 9) and interdisciplinary professionals (n = 8). The results revealed four key themes: (a) Recognizing and responding to individual families' different readiness and their rights and values, (b) working in a parent-interdisciplinary partnership to provide care, (c) lacking resources and motivation and (d) understanding of care requirements and providing help/sympathy. CONCLUSIONS The interdisciplinary professionals accepted that FCC is necessary for clinical practice, but there are some challenges in the Thai NICUs context because of the system of health care delivery. The findings highlighted that interdisciplinary professionals often viewed parents' involvement as an obstacle to providing neonatal care. RELEVANCE TO CLINICAL PRACTICE Further research is recommended to investigate how FCC is operationalized by interdisciplinary professionals and how hospital administrators can be supported to implement the FCC approach into clinical practice in Thai NICUs.
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Affiliation(s)
- Siriporn Vetcho
- School of Nursing and Midwifery, Griffith University, Brisbane, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia.,Faculty of Nursing, Prince of Songkla University, Hatyai Campus, Songkhla, Thailand
| | - Amanda J Ullman
- School of Nursing and Midwifery, Griffith University, Brisbane, Queensland, Australia.,Children's Health Queensland and Health Service, Centre of Children's Health Research, South Brisbane, Queensland, Australia.,School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Queensland, Australia
| | - Helen Petsky
- School of Nursing and Midwifery, Griffith University, Brisbane, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
| | | | - Marie Cooke
- School of Nursing and Midwifery, Griffith University, Brisbane, Queensland, Australia
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Tatterton MJ, Fisher MJ, Storton H, Walker C. The role of children's hospices in perinatal palliative care and advance care planning: The results of a national British survey. J Nurs Scholarsh 2022. [DOI: 10.1111/jnu.12866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 11/19/2022] [Accepted: 12/02/2022] [Indexed: 12/24/2022]
Affiliation(s)
- Michael J. Tatterton
- School of Nursing and Healthcare Leadership, Faculty of Health Studies University of Bradford Bradford UK
- Bluebell Wood Children's Hospice North Anston UK
- International Children's Palliative Care Network c/o Together for Short Lives Bristol UK
| | - Megan J. Fisher
- School of Nursing and Healthcare Leadership, Faculty of Health Studies University of Bradford Bradford UK
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Brødsgaard A, Andersen BL, Skaaning D, Petersen M. From Expressing Human Milk to Breastfeeding-An Essential Element in the Journey to Motherhood of Mothers of Prematurely Born Infants. Adv Neonatal Care 2022; 22:560-570. [PMID: 34923499 PMCID: PMC10519291 DOI: 10.1097/anc.0000000000000962] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Lactation and breastfeeding present an extraordinary challenge for mothers of prematurely born infants. PURPOSE To explore the significance of and the circumstances that affect lactation for mothers of premature infants. METHODS A qualitative exploratory study based on single, in-depth, semistructured interviews with 16 purposefully sampled mothers of premature infants admitted to the neonatal intensive care unit (NICU). Data were analyzed using content analysis. The study was reported according to Standards for Reporting Qualitative Research. FINDINGS The overall theme was "From expressing human milk to breastfeeding-an essential element in the journey to motherhood." The theme emerged from 3 categories: the birth preparation time has been interrupted; expressing human milk is essential for lactation; and the motherhood journey encompasses breastfeeding. The analysis also revealed that the categories were impacted by initiating, performing, and maintaining lactation and further influenced by inhibitors and promoters. IMPLICATIONS FOR PRACTICE The promoters for performing milk expression and breastfeeding should be stimulated and the inhibitors should be eliminated. The achievement of "zero separation" and mother-infant couplet care in the NICU would be beneficial. In order for mothers to maintain successful lactation, it is essential that they receive supportive around-the-clock access to health professionals with expertise in lactation and breastfeeding until exclusive breastfeeding is well established. IMPLICATIONS FOR RESEARCH The study highlights the need to investigate mother-infant as one entity rather than separately as mother and infant.
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Affiliation(s)
- Anne Brødsgaard
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital, Amager Hvidovre, Denmark (Drs Brødsgaard and Skaaning and Mss Andersen and Petersen); and Nursing and Health Care, Institute of Public Health, Aarhus University, Aarhus, Denmark (Dr Brødsgaard)
| | - Bente Lund Andersen
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital, Amager Hvidovre, Denmark (Drs Brødsgaard and Skaaning and Mss Andersen and Petersen); and Nursing and Health Care, Institute of Public Health, Aarhus University, Aarhus, Denmark (Dr Brødsgaard)
| | - Diana Skaaning
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital, Amager Hvidovre, Denmark (Drs Brødsgaard and Skaaning and Mss Andersen and Petersen); and Nursing and Health Care, Institute of Public Health, Aarhus University, Aarhus, Denmark (Dr Brødsgaard)
| | - Mette Petersen
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital, Amager Hvidovre, Denmark (Drs Brødsgaard and Skaaning and Mss Andersen and Petersen); and Nursing and Health Care, Institute of Public Health, Aarhus University, Aarhus, Denmark (Dr Brødsgaard)
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Fatima S, Idrees T, Mansoor M, Idrees Z, Hussain Z, Hamid S. Awareness of mothers coming to obstetric wards of allied hospitals regarding neonatal care and the working of community health workers in their districts. Ann Med Surg (Lond) 2022; 82:104750. [PMID: 36268409 PMCID: PMC9577840 DOI: 10.1016/j.amsu.2022.104750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/15/2022] [Accepted: 09/18/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction Neonatal mortality remains a significant challenge not only to the world,but especially to a developing country like Pakistan. It can be majorly attributed to the sub-par healthcare, insufficient and under-recognised community health workers, and the lack of knowledge of proper newborn care on the part of the parents. This study targets the level of knowledge of the mothers and the services provided by community health care workers as the main factors determining neonatal care. Methods A cross-sectional study was conducted in the OBS (obstetrics) wards of Hospitals affiliated with Rawalpindi Medical University from January 2022 to June 2022. The sample size was 138. Data was collected by one-on-one interviews, using a standardized USAID Community Health Worker Assessment and Improvement Matrix questionnaire. Data analysis was done using SPSS v28. Chi-square test was applied to check for significance. Results Out of the total 138 participants, 47.8% (n = 66/138) were between the ages of 21-25. Results showed that women between the ages of 21-25 (P = 0.000058) and women who had their first child between the ages of 23-27 had good knowledge about neonatal care. 45% (n = 62/138) of the participants had poor knowledge of neonatal care, whereas 55% (n = 76/138) had good knowledge (P = 0.000002). As for the role of community health workers, only 20-30% of the participants were being provided with their services; hence their performance was not found to be adequate. Conclusions The world of medicine is moving rapidly toward a new framework of the health systems in which the real foundation will be based on what actually takes place in the community, therefore, community health workers can play an important role in improving maternal and neonatal care. Family-centered care, appropriate age of first conception and motherhood, and proper guidance to first-time parents can ensure significant improvement in neonatal care in the future.
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Affiliation(s)
- Sumia Fatima
- Rawalpindi Medical University, Rawalpindi, Pakistan
| | | | | | | | | | - Sidra Hamid
- Physiology and Department of Education, Rawalpindi Medical University, Pakistan
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13
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Ruhe K, van den Hoogen A, Bröring‐Starre T, Wielenga JM, van Weissenbruch MM. Getting a grip in the middle of chaos: Preparing for preterm parenthood during a high-risk pregnancy - Parental experiences and needs. Acta Paediatr 2022; 111:1324-1330. [PMID: 35429200 PMCID: PMC9321692 DOI: 10.1111/apa.16361] [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: 12/03/2021] [Revised: 03/23/2022] [Accepted: 04/13/2022] [Indexed: 12/05/2022]
Abstract
Aim Admitting an infant to a neonatal intensive care unit (NICU) is stressful for parents. A great source of stress is the loss of their desired parental role. This study explores parents’ experiences and needs during a high‐risk pregnancy in preparation for their role as parents of a preterm infant. Methods An exploratory qualitative study was conducted among parents with a preterm infant admitted to two level‐III NICUs in the Netherlands. A thematic analysis was performed. Results Nineteen interviews were conducted with parents of preterm infants (26–34 weeks gestational age). Getting a grip in the middle of chaos was identified as the central theme. In the pre‐admission phase, coping with potential preterm parenthood was a theme, with coping strategies as subthemes that changed over time from avoidance to being ready to parent a preterm infant. The theme envisioning the NICU emerged in the NICU admission phase, with subthemes preterm care journey and opportunities for involvement fostering parental empowerment. Conclusion Timing and content of information about a parental role in the NICU should be tailored to the individual expectant parent. A customisable intervention bundle may provide a vision of the NICU and the parents’ active role in care.
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Affiliation(s)
- Kiki Ruhe
- Department of Neonatology Amsterdam University Medical Centers, location VUmc Amsterdam The Netherlands
| | - Agnes van den Hoogen
- Department of Neonatology Wilhelmina Children’s Hospital University Medical Center Utrecht Utrecht The Netherlands
| | - Tinka Bröring‐Starre
- Department of Child Psychiatry and Psychosocial Care Amsterdam University Medical Centers Amsterdam The Netherlands
| | - Joke M. Wielenga
- Department of Neonatology Emma Children's Hospital Amsterdam University Medical Centers, AMC Amsterdam The Netherlands
| | - Mirjam M. van Weissenbruch
- Department of Neonatology Amsterdam University Medical Centers, location VUmc Amsterdam The Netherlands
- Department of Neonatology Amsterdam University Medical Centers Vrije Universiteit Amsterdam The Netherlands
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14
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Vetcho S, Cooke M, Petsky H, Saito A, Ullman AJ. Family-centred care change during COVID-19. Nurs Crit Care 2022; 27:460-468. [PMID: 35234320 PMCID: PMC9115396 DOI: 10.1111/nicc.12766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 02/14/2022] [Accepted: 02/15/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Family-centred care (FCC) is an approach to promote family and health care provider partnership. This has been incorporated into neonatal intensive care units (NICUs) worldwide. However, FCC in low resource health settings, such as Thailand, is challenging and further impacted by coronavirus disease 2019 (COVID-19). AIMS To evaluate FCC innovations to improve respect, collaboration and support in a Thai NICU. STUDY DESIGN A quasi-experimental study was conducted in an NICU in southern Thailand. Pre-implementation was prior to COVID-19, and parental and staff perceptions of FCC were measured via Perceptions of Family Centred Care-Parent (PFCC-P) and -Staff (PFCC-S) survey. The FCC innovations were developed by stakeholders based on the COVID-19 restrictions, pre-survey results, parents' and clinicians' interviews and integrative review, then implemented via a flowchart. Post-implementation evaluation was via repeated surveys. Comparisons were made pre-and post-implementation, with Mann-Whitney U-test statistics for parents and Wilcoxon's Rank Sum for staff. RESULTS A total of 185 (85 pre; 100 post) parents and 20 (pre and post; paired group) health care professionals participated. Because of COVID-19, many planned interventions were unfeasible, however, other innovations achieved (e.g., structured telephone updates, information booklet revision). There was an increase in parents' perception of respect ([median] 2.50-3.50), collaboration (2.33-3.33) and support (2.60-3.60) domains and overall (2.50-3.43; p < .001; 95% CI: 2.93-3.11). Interdisciplinary professionals' perception of FCC did not significantly change pre-and post-implementation/COVID-19 pandemic for respect (3.00-2.92), collaboration (3.22-3.33), support (3.20-3.20) and overall (3.15-3.20; 95% CI: 3.10-3.25). CONCLUSION Despite the challenges of COVID-19 restricting NICU access, the provision of FCC was maintained and even improved. RELEVANCE TO CLINICAL PRACTICE Further research is necessary to develop FCC practice innovations associated with communication, across diverse health care systems and resources.
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Affiliation(s)
- Siriporn Vetcho
- School of Nursing and Midwifery, Griffith University, Brisbane.,Menzies Health Institute Queensland, Griffith University, Brisbane.,Faculty of Nursing, Prince of Songkla University, Songkhla
| | - Marie Cooke
- School of Nursing and Midwifery, Griffith University, Brisbane
| | - Helen Petsky
- School of Nursing and Midwifery, Griffith University, Brisbane.,Menzies Health Institute Queensland, Griffith University, Brisbane
| | - Amornrat Saito
- School of Nursing and Midwifery, Griffith University, Brisbane.,Menzies Health Institute Queensland, Griffith University, Brisbane
| | - Amanda J Ullman
- School of Nursing and Midwifery, Griffith University, Brisbane.,Children's Health Queensland and Health Service, Centre of Children's Health Research, Brisbane, Australia.,School of Nursing, Midwifery and Social Work, The University of Queensland, St Lucia, Australia
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15
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Improving Family-Centered Care for Infants in Neonatal Intensive Care Units: Recommendations From Frontline Healthcare Professionals. Adv Neonatal Care 2022; 22:79-86. [PMID: 33993155 DOI: 10.1097/anc.0000000000000854] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Family-centered care is a philosophy and healthcare delivery model adopted by many neonatal intensive care units (NICUs) worldwide, yet practice varies widely. PURPOSE The aim of this study was to synthesize recommendations from frontline NICU healthcare professionals regarding family-centered care. METHODS Data were obtained from the baseline phase of a multicenter quasi-experimental study comparing usual family-centered NICU care (baseline) with mobile-enhanced family integrated care (intervention). Members of the NICU clinical care team completed a family-centered care survey and provided free-text comments regarding practice of family-centered care in their NICU and recommendations for improvement. The comments were analyzed using a directed content analysis approach by a research team that included NICU nurses and parents. RESULTS Of the 382 NICU healthcare providers from 6 NICUs who completed the survey, 68 (18%) provided 89 free-text comments/recommendations about family-centered care. Almost all comments were provided by nurses (91%). Six main themes were identified: language translation; communication between staff and families; staffing and workflow; team culture and leadership; education; and NICU environment. The need for greater resources for staffing, education, and environmental supports was prominent among the comments, as was team culture and staff-parent communications. IMPLICATIONS FOR PRACTICE The NICU healthcare professionals identified a range of issues that support or impede delivery of family-centered care and provided actionable recommendations for improvement. IMPLICATIONS FOR RESEARCH Future research should include economic analyses that will enable determination of the return on investment so that NICUs can better justify the human and capital resources needed to implement high-quality family-centered care.
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16
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Murphy M, Shah V, Benzies K. Effectiveness of Alberta Family-Integrated Care on Neonatal Outcomes: A Cluster Randomized Controlled Trial. J Clin Med 2021; 10:jcm10245871. [PMID: 34945163 PMCID: PMC8708302 DOI: 10.3390/jcm10245871] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 12/11/2021] [Accepted: 12/13/2021] [Indexed: 11/16/2022] Open
Abstract
Family-Integrated Care (FICare) empowers parents to play an active role as a caregiver for their infant in the neonatal intensive care unit (NICU). This model of care is associated with improved neonatal outcomes, such as improved weight gain and higher breastfeeding rates at discharge in infants admitted to level III NICUs; however, its effectiveness in level II NICUs remains unproven. The objective of this study was to evaluate the effectiveness of the model on neonatal outcomes in a cluster randomized controlled trial conducted in 10 level II NICUs randomized to Alberta FICare or standard care. Mothers and their preterm infants born between 32+0 and 34+6 weeks' gestational age were included. The primary outcome was the proportion of infants who regained their birth weight (BW) after 14 days of life. The analysis included 353 infants/308 mothers at Alberta FICare sites and 365 infants/306 mothers at standard care sites. There was no difference in the proportion of infants who had regained their BW by 14 days between the groups. A lack of perceived improved weight gain trajectory for those in the FICare group is attributed to a shorter length of hospital stay and infants being discharged prior to regaining BW.
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Affiliation(s)
- Madeleine Murphy
- Department of Pediatrics, Mount Sinai Hospital, 600 University Avenue, Toronto, ON M5G 1X5, Canada; (M.M.); (V.S.)
| | - Vibhuti Shah
- Department of Pediatrics, Mount Sinai Hospital, 600 University Avenue, Toronto, ON M5G 1X5, Canada; (M.M.); (V.S.)
| | - Karen Benzies
- Faculty of Nursing, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada
- Departments of Pediatrics and Community Health Sciences, Cumming School of Medicine, University of Calgary, 3300 University Drive NW, Calgary, AB T2N 4N1, Canada
- Correspondence:
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17
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Axelin A, Feeley N, Cambell-Yeo M, Silnes Tandberg B, Szczapa T, Wielenga J, Weis J, Pavicic Bosnjak A, Jonsdottir RB, George K, Blomqvist YT, Bohlin K, Lehtonen L. Symptoms of depression in parents after discharge from NICU associated with family-centred care. J Adv Nurs 2021; 78:1676-1687. [PMID: 34897769 PMCID: PMC9299776 DOI: 10.1111/jan.15128] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 11/03/2021] [Accepted: 11/27/2021] [Indexed: 12/01/2022]
Abstract
Aims The aim of this study was to examine the potential association of family‐centred care as perceived by parents during a NICU stay with parents’ depressive symptoms at discharge and at 4 months corrected for infant age. Design A longitudinal, multicentre cohort study was conducted from 2018 to 2020 in 23 NICUs across 15 countries. Methods Parents (n = 635 mothers, n = 466, fathers) of infants (n = 739) born before 35 weeks of gestation and admitted to the participating NICUs were enrolled to the study during the first weeks of their infants’ hospitalizations. They responded to Digi‐FCC daily text messages inquiring about their perception of family‐centred care provided by NICU staff. In addition, they completed a questionnaire assessing their overall perception of family‐centred care at discharge. Parents’ depressive symptoms were measured by the Edinburgh Postnatal Depression Scale at discharge and again after discharge when their infants were at 4 months corrected for age. Results The mothers’ and the fathers’ perceptions of family‐centred care were associated with their depressive symptoms at discharge and at 4 months corrected age, controlling for gestational age, multiple birth, parent education and relationship status. Parents’ participation in infant care, care‐related decisions and emotional support provided to parents by staff explained the variation in the parents’ perceptions of family‐centred care. The factors facilitating the implementation of family‐centred care included unlimited access to the unit for the parents and for their significant others, as well as amenities for parents. Conclusions Our study shows that family‐centred NICU care associates with parents’ depressive symptoms after a NICU stay. Impact Depression is common in parents of preterm infants. The provision of family‐centred care may protect the mental well‐being of parents of preterm infants.
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Affiliation(s)
- Anna Axelin
- Department of Nursing Science, University of Turku, Turku, Finland.,Department of Women's and Children's Health, University of Uppsala, Uppsala, Sweden
| | - Nancy Feeley
- Ingram School of Nursing, McGill University, Montréal, Canada.,Centre for Nursing Research, Lady Davis Institute, Jewish General Hospital, Montréal, Canada
| | - Marsha Cambell-Yeo
- School of Nursing, Faculty of Health and Departments of Pediatrics, Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Bente Silnes Tandberg
- Department of Pediatric and Adolescent Medicine, Drammen Hospital, Vestre Viken Hospital Trust, Drammen, Norway
| | - Tomasz Szczapa
- Department of Neonatology, Neonatal Biophysical Monitoring and Cardiopulmonary Therapies Research Unit, Poznan University of Medical Sciences, Poznan, Poland
| | - Joke Wielenga
- IC Neonatology, Emma Children's Hospital, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Janne Weis
- Department of Neonatology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Anita Pavicic Bosnjak
- Department of Obstetrics and Gynecology, Clinical Hospital Sveti Duh Zagreb, Zagreb, Croatia.,Division on Breastfeeding Support, Human Milk Bank, Croatian Tissue and Cell Bank, Department for Transfusion Medicine and Transplantation Biology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Rakel B Jonsdottir
- Faculty of Nursing, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Kendall George
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Sippy Downs, Qld, Australia
| | - Ylva T Blomqvist
- Neonatal Intensive Care Unit, University Children's Hospital, Uppsala, Sweden.,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Kajsa Bohlin
- Department of Neonatology, Karolinska University Hospital, Stockholm, Sweden.,Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Liisa Lehtonen
- Department of Pediatrics and Adolescent Medicine, Turku University Hospital, Turku, Finland.,Department of Clinical Medicine, University of Turku, Turku, Finland
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18
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Chan SH, Shorey S. Healthcare professionals' sense of coherence of parental involvement in neonatal intensive care units: A framework synthesis. Res Nurs Health 2021; 44:875-890. [PMID: 34414586 DOI: 10.1002/nur.22178] [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: 05/18/2021] [Revised: 08/01/2021] [Accepted: 08/07/2021] [Indexed: 11/08/2022]
Abstract
Family-centered care is recognized as the gold standard in pediatric healthcare practice. However, despite the acknowledgment of its benefits and importance, inconsistent and questionable implementation persists in neonatal intensive care units (NICUs) without a consolidated understanding of healthcare professionals' experiences. Therefore, this review aims to explore and consolidate healthcare professionals' perspectives on parental participation in the NICU. A systematic review of qualitative studies was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Seven electronic databases were searched from their respective dates of inception until December 30, 2020. Twenty-eight studies were included in this review. The analysis was conducted via a framework synthesis approach using Antonovsky's Sense of Coherence theory. Three over-arching themes, guided by Antonovsky's Sense of Coherence theory emerged: (1) "Comprehensibility of parental involvement in family-centered care," (2) "Manageability of parental involvement in care and decision-making," and (3) "Meaningfulness of parental involvement in shared decision-making in neonatal care," with nine corresponding subthemes. Healthcare professionals had mixed views of parental involvement, recognizing the benefits attributed to infants and parents, but were greatly hindered by organizational, environmental, and personal obstacles that weakened their sense of coherence in coping with the situation, making them feel unconfident and unprepared to involve parents in care. To cope, more integrated and formalized support was required. Organizational, environmental, and policy changes, as well as psychological support, were strategies identified to enhance healthcare professionals' sense of coherence, and consequently, their ability to cope.
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Affiliation(s)
- Shu Hui Chan
- Nursing Division, KK Women's and Children's Hospital, Singapore, Singapore
| | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Singapore, Singapore
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19
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A Multisite Survey of NICU Healthcare Professionals' Perceptions About Family-Centered Care. Adv Neonatal Care 2021; 21:205-213. [PMID: 33417328 DOI: 10.1097/anc.0000000000000805] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Family-centered care contributes to improved outcomes for preterm and ill infants. Little is known about the perceptions of neonatal intensive care unit (NICU) healthcare professionals regarding the degree to which their NICU practices or values family-centered care. PURPOSE The aims of this study were to describe attitudes and beliefs of NICU healthcare professionals about family-centered care and to explore professional characteristics that might influence those views. METHODS Data were derived from the baseline phase of a multicenter quasi-experimental study comparing usual family-centered NICU care with mobile-enhanced family-integrated care. Neonatal intensive care unit healthcare professionals completed the Family-Centered Care Questionnaire-Revised (FCCQ-R), a 45-item measure of 9 core dimensions of Current Practice and Necessary Practice for family-centered care. RESULTS A total of 382 (43%) NICU healthcare professionals from 6 NICUs completed 1 or more of the FCCQ-R subscales, 83% were registered nurses. Total and subscale scores on the Necessary Practice scale were consistently higher than those on the Current Practice scale for all dimensions of family-centered care (mean: 4.40 [0.46] vs 3.61 [0.53], P < .001). Only years of hospital experience and NICU site were significantly associated with Current Practice and Necessary Practice total scores. IMPLICATIONS FOR PRACTICE Ongoing assessment of the perceptions of NICU healthcare professionals regarding their current practice and beliefs about what is necessary for the delivery of high-quality family-centered care can inform NICU education, quality improvement, and maintenance of family-centered care during the COVID-19 pandemic. IMPLICATIONS FOR RESEARCH Further research is needed to identify additional factors that predict family-centered care perceptions and behaviors.
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20
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Stelwagen M, van Kempen A, Westmaas A, Vet E, Scheele F. Parents' Experiences With a Model of Integrated Maternity and Neonatal Care Designed to Empower Parents. J Obstet Gynecol Neonatal Nurs 2021; 50:181-192. [PMID: 33428875 DOI: 10.1016/j.jogn.2020.11.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2020] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To explore the experiences of parents with an integrated maternity and neonatal ward designed to empower parents by providing family-integrated care (FICare) to mother-newborn couplets in single-family rooms. DESIGN A qualitative analysis with a contextual constructivist approach. SETTING An integrated maternity and neonatal level 2 ward designed to empower parents in a teaching hospital in Amsterdam, the Netherlands. Maternity and neonatal care, up to and including highly complex care, is provided to mother-newborn couplets in single-family rooms according to the principles of FICare. PARTICIPANTS Twenty-seven mothers and nine fathers of newborns who were hospitalized for at least 7 days. METHODS We held four focus group discussions and eight semistructured interviews 1 to 3 months after discharge of the newborn to explore which experiences (mechanisms) facilitated or impeded aspects of parent empowerment (outcomes) under which specific conditions of the integrated infrastructure (contexts). We used the realist evaluation model to analyze the data. RESULTS Our analysis revealed five themes of parent empowerment (outcomes): Feeling Respected, Gaining Self-Management Tools, Insights Into the Newborn's Condition, Perceived Control, and Self-Efficacy. For each theme, participants reported facilitating and impeding experiences (mechanisms) that were initiated and influenced by the combination of single-family rooms, couplet care, rooming-in, and FICare (contexts). Unrestricted physical proximity to their newborns, 24 hours per day, in a safe private environment offered parents intensive learning experiences through active participation in care. It helped them to achieve independent parenthood at the time of discharge, but it also generated challenges such as power conflicts with the staff; prioritizing care for themselves, siblings, or the newborn; feelings of isolation; and lack of sleep. CONCLUSION Providing FICare to mother-newborn couplets in single-family rooms offers parents an intensive learning context for independent parenthood at the time of discharge. Health care professionals should be aware of the challenges and facilitators experienced by parents in the context of close physical proximity to their newborns 24 hours per day in single-family rooms. This awareness will allow them to better support parents in their empowerment process toward independent parenthood at the time of discharge.
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21
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Ferreira A, Ferretti E, Curtis K, Joly C, Sivanthan M, Major N, Daboval T. Parents' Views to Strengthen Partnerships in Newborn Intensive Care. Front Pediatr 2021; 9:721835. [PMID: 34646796 PMCID: PMC8504452 DOI: 10.3389/fped.2021.721835] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 08/16/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Parental involvement in their newborn's neonatal intensive care reduces stress and helps with the parent-child attachment, transition to home, and future development. However, parents' perspectives are not often sought or considered when adapting family-centered care in neonatal intensive care units (NICUs). Aim: To identify what parents believe helps or hinders their involvement in their newborn's care when admitted to our Level 3B NICU. Methods: Between August and October 2018, nine mothers and one father were interviewed during three 60- to 90-min audiotaped focus groups using a semi-structured interview tool. From the content analysis of the verbatims, three reviewers identified key themes that affected how involved parents could be in their newborn's care. Results: Parents provided examples of factors that facilitated or restricted their involvement. The analysis identified themes: (1) parent-staff interactions, (2) supportive/trustworthy healthcare professionals, (3) consistency in care and caring staff, (4) family, couple, and peer support, (5) newborn status, (6) resources and education for parents, (7) the NICU environment, and (8) academic and research participation. Conclusion: We identified a conceptual framework to allow our NICU team to prioritize working strategies to strengthen parental involvement in newborn care. In addition to implementing ways to involve parents, we need to address parents' satisfaction with their participation. These findings may help other investigators explore parents' expectations toward their NICU experience.
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Affiliation(s)
- Alexie Ferreira
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.,Department of Pediatrics, University of Ottawa, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Emanuela Ferretti
- Department of Pediatrics, University of Ottawa, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.,Neonatal Intensive Care Unit, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | | | - Cynthia Joly
- Neonatal Intensive Care Unit, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Myuri Sivanthan
- Health Care Systems Division, Health Canada, Ottawa, ON, Canada.,Telfer School of Management, University of Ottawa, Ottawa, ON, Canada
| | - Nathalie Major
- Department of Pediatrics, University of Ottawa, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Thierry Daboval
- Department of Pediatrics, University of Ottawa, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.,Neonatal Intensive Care Unit, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
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