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Weser VU, Crocker A, Murray TS, Wright J, Truesdell EJK, Ciaburri R, Marks AM, Martinello RA, Hieftje KD. Barriers to Effective Infection Prevention in the Neonatal Intensive Care Unit: A Qualitative Study. Adv Neonatal Care 2024; 24:475-484. [PMID: 39196970 DOI: 10.1097/anc.0000000000001195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2024]
Abstract
BACKGROUND Infection prevention (IP) behaviors such as hand hygiene (HH) and mobile device disinfection are important to reduce the risk of infection transmission from both family members and hospital staff to critically ill neonates. PURPOSE To inform the design of educational interventions to improve both patient family and staff IP behaviors, we engaged separate groups of nurses and family members to understand perceptions about the spread of infection and barriers to implementing effective IP strategies. METHODS This was a qualitative study using focus groups to gather data from neonatal nurses and patient family members. Data were triangulated with hospital-wide survey data and analyzed using inductive content analysis. RESULTS Twelve nurses and 4 patient family members participated. Themes related to communication about IP between staff and family members emerged: stakeholders expressed discomfort with the timing and nature of just-in-time HH education. These communication challenges contributed to stress levels within the neonatal intensive care unit. This finding was reflected in the hospital-wide survey. IMPLICATIONS FOR PRACTICE AND RESEARCH Steps should be taken to improve communication about IP behaviors between patient family members and frontline staff. Reducing nurse burden of providing just-in-time HH reminders to patient family members through increased IP education may decrease stress and facilitate IP behaviors. This has the potential to decrease infection spread and improve patient outcomes. The development of interventions targeting stakeholder communication is therefore warranted, but additional research is needed to understand the timing and process for delivery of the educational material.
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Affiliation(s)
- Veronica U Weser
- Department of Pediatrics (Drs Weser, Murray, Truesdell, Marks, Martinello, and Hieftje), Department of Internal Medicine (Dr Martinello), Yale School of Medicine, New Haven, Connecticut; Yale School of Nursing (Ms Crocker), New Haven, Connecticut; Yale New Haven Children's Hospital (Dr Murray and Ms Ciaburri), New Haven, Connecticut; Department of Infection Prevention (Drs Murray and Martinello), Yale New Haven Health, New Haven, Connecticut; Department of Molecular, Cellular, and Developmental Biology (Mr Wright), Yale University, New Haven, Connecticut
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Abukari AS, Schmollgruber S. Perceived barriers of family-centred care in neonatal intensive care units: A qualitative study. Nurs Crit Care 2024; 29:905-915. [PMID: 38228405 DOI: 10.1111/nicc.13031] [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: 01/12/2023] [Revised: 12/22/2023] [Accepted: 12/24/2023] [Indexed: 01/18/2024]
Abstract
BACKGROUND Family-centered care (FCC) approach in neonatal intensive care units (NICUs) has been shown to improve family satisfaction and quality of care. However, several contextual barriers influence its use in NICUs, and these barriers are understudied in Ghana. AIM To describe FCC practice in Ghanaian NICUs in order to understand the contextual barriers. STUDY DESIGN The study employed a descriptive qualitative design. The researchers used a structured interview guide to collect the data in 24 interviews and 12 focus group discussions. We engaged families (n = 42), nurses and midwives (n = 33), and doctors (n = 9) to describe their perspectives on the barriers to FCC in two public tertiary hospital NICUs. The data were mapped, triangulated, and aggregated to inform the findings. Thematic analysis and MAXQDA qualitative software version 2020 were employed to analyse the data. This qualitative study followed the COREQ guidelines and checklist. RESULTS Perceived family barriers and perceived facility barriers to FCC were the two main themes. The perceived family barriers include family stress and anxiety, inadequate information sharing and education, culture and religion. The perceived facility barriers are inadequate space and logistics, workload and inadequate staff, restricted entry, and negative staff attitudes. CONCLUSION The findings of this study shed light on the barriers to FCC practice in neonatal care in Ghanaian NICUs. Family stress and anxiety, a lack of information sharing, cultures and religious beliefs, NICU workload and staffing shortages, restrictions on family entry into NICUs, and staff attitudes towards families are all contextual barriers to FCC practice. RELEVANCE TO CLINICAL PRACTICE Health facility managers and NICU staff may consider addressing these barriers to implement FCC in the NICU in order to enhance family satisfaction and quality neonatal care. The design of future NICUs should consider family comfort zones and subunits to accommodate families and their sick infants for optimal health care outcomes. The development of communication models and guidelines for respectful NICU care may aid in integrating families into ICUs and promoting quality health care outcomes.
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Affiliation(s)
- Alhassan Sibdow Abukari
- Department of Nursing Education, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Parktown, Johannesburg, South Africa
- Department of General Nursing, School of Nursing, Wisconsin International University College, Accra, Ghana
| | - Shelley Schmollgruber
- Department of Nursing Education, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Parktown, Johannesburg, South Africa
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Tajik F, Mahmoodi M, Azodi P, Jahanpour F. Nurse-mother communication and support: Perceptions of mothers in neonatal units. Heliyon 2024; 10:e29325. [PMID: 38644893 PMCID: PMC11033110 DOI: 10.1016/j.heliyon.2024.e29325] [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: 11/04/2023] [Revised: 04/03/2024] [Accepted: 04/05/2024] [Indexed: 04/23/2024] Open
Abstract
Introduction Having a hospitalized neonate is a stressful experience for parents, especially mothers. Thus, in recent years, a paradigm shift occurred in the neonatal units, focusing on the needs of parents and supporting them in addition to caring for neonates. The aim of this study was to evaluate the nurse-mother communication and support in neonatal units in Bushehr, Iran. Method This descriptive cross-sectional study was performed in neonatal units of 6 hospitals in Bushehr, Iran, in 2022. Using the census method, all eligible mothers who met the inclusion criteria were included in this study. Data collection tools included demographic information form, nurse-parent support tool and nurse-parent communication questionnaire. The collected data were analyzed by SPSS version 24 using descriptive statistics, independent t-test, one-way ANOVA and Pearson correlation test. Results The total mean score of nurse-parent support tool was 3.72 ± 0.72 and the total mean score of nurse-parent communication questionnaire was 59/27 ± 12/82. Caregiving support had the highest mean score (4.07 ± 73 0.73) and emotional support had the lowest (3.42 ± 91 0.91). Also, a statistically significant difference was seen between the admitted unit variable and the mean score of nurse-mother communication and support. Additionally, there was a statistically significant difference between the mechanical ventilation status of the neonate and the mean score of nurse-mother support. A significant positive correlation was seen between the neonatal gestational age and the mean score of nurse-mother communication. Conclusions The total mean score of nurse-parent support and communication was moderate. Therefore, nursing support and communication need to be improved. Planning is needed to enhance the role of neonatal nurses and strengthen their support and communication skills in line with the family-centered care approach.
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Affiliation(s)
- Farnoosh Tajik
- Department of Pediatric and Neonatal nursing, School of Nursing and Midwifery, Semnan University of Medical Sciences, Semnan, Iran
- MSc in Pediatric Nursing, Nursing and Midwifery Department, Member of Student Research Committee, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Marzieh Mahmoodi
- Biostatistics and Epidemiology Department, Health and Nutrition Faculty, Clinical Research Development Center, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Parviz Azodi
- Paramedical Sciences Department, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Faezeh Jahanpour
- Nursing and Midwifery Department, Bushehr University of Medical Sciences, Bushehr, Iran
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Mohagheghi P, Razavinia F, Khosravi A, Mousavi SS. Effect of a Multifaceted Approach on Perceived Support Among Mothers of Preterm Infants: A Quasi-Experimental Study. SAGE Open Nurs 2024; 10:23779608241231193. [PMID: 38529052 PMCID: PMC10962032 DOI: 10.1177/23779608241231193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 12/27/2023] [Accepted: 01/20/2024] [Indexed: 03/27/2024] Open
Abstract
Introduction Mothers of preterm infants need support to deal with the issues caused by the early birth of their infants. Objective The authors examined the impact of a multifaceted supportive approach on the mothers' perceived support levels. Methods The present quasi-experimental study was performed on 143 mother-preterm infant pairs, in two neonatal intensive care units (NICUs) of referral and educational hospitals in Tehran, Iran. The base of developed interventions was known to support system patterns of mothers with preterm infants. Different supportive interventions (appraisal, instrumental, emotional, and informational) of mothers were implemented during three months. The Nurse Parent Support Tool was applied for assessing perceptions of perceived support by mothers. Routine care was provided for the control group. The results were analyzed by STATA software 13. Categorical variables were analyzed by chi-square test, t-test, and inverse probability treatment weights. Results Following adjustments of mean differences of outcomes between study groups (95% confidence interval), all support scores, such as instrumental support, -1.23 (95% CI -1.04 to -1.43), total support, -1.83 (95% CI -1.6 to -2.06), appraisal support, -2.01 (95% CI -1.73 to -2.29), emotional support, -1.87 (95% CI -2.15 to 1.6), and informational support, -2.12 (95% CI -1.82 to -2.43), were significantly higher in the interventional group than in the control group (p < .001). Conclusions Support received by mothers of preterm infants determines maternal/neonatal health. Information sharing and effective ways to support are essential elements in the mother's ability to deal with the new, stressful situation. This multifaceted supportive approach considerably improved mothers' perceived support.
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Affiliation(s)
- Parisa Mohagheghi
- Pediatric Department Medical Faculty, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Razavinia
- Midwifery Department, Reproductive Health Promotion Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ahmad Khosravi
- Department of Epidemiology, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Seyedeh Saeedeh Mousavi
- Department of Reproductive Health and Midwifery, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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Horner S, Benbrook K, Hoffman M, Libutti L. Implementing Guidelines for NICU Parent Presence: Effects on Parent and Infant Stress. J Perinat Neonatal Nurs 2023:00005237-990000000-00024. [PMID: 37967272 DOI: 10.1097/jpn.0000000000000776] [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] [Indexed: 11/17/2023]
Abstract
BACKGROUND Relationships between parents and infants are essential for mitigating stressors encountered in neonatal intensive care units (NICUs) and are supported by parent presence and engagement. PURPOSE The purpose of this study was to compare NICU parent and infant outcomes pre- and postimplementation of an intervention aimed at increasing parent presence and engagement in the NICU. This family-centered care intervention consisted of communicating specific guidelines for parent presence. METHODS Data related to parent presence, skin-to-skin care, and breastfeeding; parental stress; infant outcomes including weight gain, length of stay, feeding status at discharge, and stress; and unit-level outcomes were collected from a convenience sample of 40 NICU families recruited preimplementation and compared with data for 38 NICU families recruited postimplementation of specific guidelines for parent presence. To establish comparability of groups, infants were assigned scores using the Neonatal Medical Index. RESULTS Parent presence, engagement in skin-to-skin care, and breastfeeding rates were not significantly different between groups. Stress-related outcomes were significantly decreased in NICU mothers, fathers, and infants, and infant feeding outcomes were improved in the postintervention group. CONCLUSIONS Specific guidelines for parent presence may represent an invitation for parents to engage with their NICU infants and may positively impact parent and infant stress.
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Affiliation(s)
- Susan Horner
- Neonatal Intensive Care Unit, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
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Wege M, von Blanckenburg P, Maier RF, Knoeppel C, Grunske A, Seifart C. Do parents get what they want during bad news delivery in NICU? J Perinat Med 2023; 51:1104-1111. [PMID: 37336635 DOI: 10.1515/jpm-2023-0134] [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: 03/29/2023] [Accepted: 06/02/2023] [Indexed: 06/21/2023]
Abstract
OBJECTIVES Little is known about parents' preferences in breaking bad news (BBN) in neonatology. The study was aimed at comparing parents' experiences with their first BBN discussion with a neonatologist/pediatric surgeon to their personal preferences. METHODS We conducted a quantitative survey amongst 54 parents of hospitalized preterm or term infants with severe diseases in two medium-size and one small German neonatal units. Parents answered self-rated questions on how they perceived BBN during their infant's hospital stay, asking for procedure and perception of BBN, their preferences and satisfaction with BBN. RESULTS Overall satisfaction with BBN was moderate to high (median (min-max): 8 (1-10) on a 1-10-Likert scale). A compassionate way of disclosure correlated highest with overall satisfaction with BBN. Thorough transmission of information in an easy to understand manner emerged as another crucial point and correlated significantly to satisfaction with BBN, too. The study revealed that it was highly important for parents, that physicians had good knowledge of the infant and the course of his/her disease, which was only met in a minority of cases. Moreover, there was a major discrepancy between expected and observed professional competence of the delivering physicians. Additionally, physicians did not set aside sufficient time for BBN and parents reported a lack of transporting assurance and hope. CONCLUSIONS In BBN physicians should draw greatest attention to ensure understanding in parents, with good knowledge of child and disease and sufficient time in a trustworthy manner. Physicians should focus on transporting competence, trust and gentleness.
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Affiliation(s)
- Mirjam Wege
- Children's Hospital, University Hospital, Philipps University of Marburg, Marburg, Germany
| | - Pia von Blanckenburg
- Department of Clinical Psychology and Psychotherapy, Philipps University of Marburg, Marburg, Germany
| | - Rolf Felix Maier
- Children's Hospital, University Hospital, Philipps University of Marburg, Marburg, Germany
| | - Carmen Knoeppel
- Children's Hospital, Hospital Bad Hersfeld GmbH, Bad Hersfeld, Germany
| | | | - Carola Seifart
- Faculty of Medicine, Deans Office, Research Group Medical Ethics, Philipps University of Marburg, Marburg, Germany
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Wege M, von Blanckenburg P, Maier RF, Seifart C. Does Educational Status Influence Parents' Response to Bad News in the NICU? CHILDREN (BASEL, SWITZERLAND) 2023; 10:1729. [PMID: 38002820 PMCID: PMC10670369 DOI: 10.3390/children10111729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 10/22/2023] [Accepted: 10/23/2023] [Indexed: 11/26/2023]
Abstract
Communication in neonatal intensive care units and the relationship between families and staff have been reported to influence parental mental well-being. Research has also shown an impact of parental educational level on their well-being. However, whether different educational levels result in different reactions to breaking bad news (BBN) by physicians remains unanswered so far. We therefore examined the impact of parental level of education on their mental state after a BBN conversation and their relation to physicians. A prospective quantitative survey was conducted amongst 54 parents whose preterm or term infants were hospitalized in three German neonatal units. Parental education was classified as low (lower secondary/less (1), n: 23) or high (higher secondary/more (2), n: 31). Parents answered questions about certain aspects of and their mental state after BBN and their trust in physicians. The two groups did not differ significantly in their mental condition after BBN, with both reporting high levels of exhaustion and worries, each (median (min;max): (1): 16 (6;20) vs. (2): 14 (5;20), (scaling: 5-20)). However, lower-educated parents reported a lower trust in physicians (median (min;max): (1): 2 (0;9) vs. (2): 1 (0;6), p < 0.05 (scaling: 0-10)) and felt less safe during BBN (median (min;max): (1): 15 (9;35) vs. (2): 13 (9;33), p < 0.05). Only among higher-educated parents was trust in physicians significantly correlated with the safety and orientation provided during BBN (r: 0.583, p < 0.05, r: 0.584, p < 0.01). Concurrently, only among less-educated parents was safety correlated with the hope conveyed during BBN (r: 0.763, p < 0.01). Therefore, in BBN discussions with less-educated parents, physicians should focus more on giving them hope to promote safety.
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Affiliation(s)
- Mirjam Wege
- Children’s Hospital, University Hospital, Philipps University of Marburg, 35033 Marburg, Germany;
| | - Pia von Blanckenburg
- Department of Clinical Psychology and Psychotherapy, Philipps University of Marburg, 35032 Marburg, Germany;
| | - Rolf Felix Maier
- Children’s Hospital, University Hospital, Philipps University of Marburg, 35033 Marburg, Germany;
| | - Carola Seifart
- Faculty of Medicine, Deans Office, Research Group Medical Ethics, Philipps University of Marburg, 35033 Marburg, Germany;
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Njoroge WFM, Gerstein ED, Lean RE, Paul R, Smyser CD, Rogers CE. Neonatal Intensive Care Unit Latent Profiles of Maternal Distress: Associations With 5-Year Maternal and Child Mental Health Outcomes. J Am Acad Child Adolesc Psychiatry 2023; 62:1123-1133. [PMID: 37084882 PMCID: PMC10543383 DOI: 10.1016/j.jaac.2023.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 01/23/2023] [Accepted: 04/12/2023] [Indexed: 04/23/2023]
Abstract
OBJECTIVE To examine profiles of distress of mothers of preterm infants in the neonatal intensive care unit (NICU) and relate profiles to maternal and child outcomes at child age 5 years. METHOD A racially and economically diverse sample of mothers (n = 94; 39% African American, 52% White) of preterm infants (≤30 weeks of gestation) completed validated questionnaires assessing depression, anxiety (state and trait), NICU stress, and life stress at NICU discharge of their infant. Mothers reported on their own and their children's symptomatology at child age 5. A latent profile analysis was conducted to categorize maternal symptomatology. RESULTS Latent profile analysis yielded 4 distinct maternal profiles: low symptomatology, high NICU stress, high depression and anxiety, and high state anxiety. Social determinants of health factors including age, education, neighborhood deprivation, and infant clinical risk distinguished the profiles. Mothers in the high depression and anxiety profile reported more anxiety and life stress at follow-up and reported their children experienced more anxious/depressed symptoms. CONCLUSION Existing literature has gaps related to examining multiple dimensions of NICU distress and understanding how patterns of mood/affective symptoms, life stressors, and related social determinants of health factors vary across mothers. In this study, one specific profile of maternal NICU distress demonstrated enduring risks for poorer maternal and child mental health outcomes. This new knowledge underscores sources of disparate health outcomes for mothers of preterm infants and the infants themselves. Universal screening is needed to identify at-risk dyads for poor health outcomes in need of individualized interventions that address both maternal and child well-being. DIVERSITY & INCLUSION STATEMENT We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list.
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Affiliation(s)
- Wanjikũ F M Njoroge
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Policy Lab, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Lifespan Brain Institute, Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, Pennsylvania.
| | | | - Rachel E Lean
- Washington University School of Medicine, St. Louis, Missouri
| | - Rachel Paul
- Washington University School of Medicine, St. Louis, Missouri
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McDonald R, Moloney W. Improving the Implementation of Family-Centered Care Within the Neonatal Care Unit: Empowering Parents to Participate in Infant Care. J Perinat Neonatal Nurs 2023; 37:242-251. [PMID: 37494692 DOI: 10.1097/jpn.0000000000000738] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
BACKGROUND Internationally, approximately 15 million babies are born prematurely every year. In New Zealand, 1 neonatal ward may care for 1000 infants annually. Family-centered care (FCC) is a philosophy used in neonates to enhance positive outcomes for infants, parents, and staff by recognizing the strengths and needs of infants and their families. OBJECTIVE This research assessed how a neonatal environment could be improved to ensure parents feel welcomed and empowered to participate in their infant's care. PARTICIPANTS Survey data from 67 health professionals and 51 parents of infants who received neonatal care for more than 7 days. Four in-depth interviews with parents and 5 with health professionals. METHODS A mixed-methods research design was used. Phase 1 collected quantitative data using the Family-Centered Care Questionnaire. Phase 2 composed of face-to-face interviews with health professionals and parents. RESULTS Implementing FCC practices to improve health outcomes for infants, parents, and staff is important. Recommendations for improvement were formulated from the themes. CONCLUSION The perspectives of parents and health professionals have enabled the development of recommendations to improve the implementation of FCC practice in the neonatal environment. These may lead to better parental experience and improved infant health outcomes.
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Affiliation(s)
- Rebecca McDonald
- Kidz First Neonatal Care, Middlemore Hospital, Auckland, New Zealand (Ms McDonald); and University of Auckland, Auckland, New Zealand (Dr Moloney)
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Abukari AS, Schmollgruber S. Concepts of family-centered care at the neonatal and paediatric intensive care unit: A scoping review. J Pediatr Nurs 2023:S0882-5963(23)00088-X. [PMID: 37120388 DOI: 10.1016/j.pedn.2023.04.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 04/03/2023] [Accepted: 04/04/2023] [Indexed: 05/01/2023]
Abstract
BACKGROUND Understanding family-centred care (FCC) concepts is critical for its implementation in any context. The researchers synthesised studies on FCC in neonatal and paediatric critical care units in order to present its concepts and gaps in the literature to guide further research in the area. METHOD The study used the JBI methodology, and the PRISMA-ScR guidelines confirmed the final report. The search for material, with the use of library sources, used Medline via PubMed, Cumulative Index to Nursing and Allied Health Literature, Scopus, Google Scholar, and Wiley Library online for papers published in English from 2015 to 2019 and updated to 2023. RESULTS From 904 references, 61 studies were identified for inclusion. The majority of the studies (29; 55.77%) were qualitative ethnography and phenomenology. Four themes and ten subthemes emerged from the data to support the main concepts of FCC. CONCLUSION To guide its useful integration and implementation, more research on family-centred care in neonatal and paediatric intensive care units, involving families, staff, and managers, should be undertaken. PRACTICE IMPLICATION Findings presented in this review may provide a guide for nurses to adjust nursing interventions for critically ill neonates and children in intensive care units.
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Affiliation(s)
- Alhassan Sibdow Abukari
- Department of Nursing Education, School of Therapeutics, Faculty of Health Sciences, University of the Witwatersrand, Ghana; Department of Nursing, School of Nursing & Midwifery, Wisconsin International University, Ghana
| | - Shelley Schmollgruber
- Department of Nursing Education, School of Therapeutics, Faculty of Health Sciences, University of the Witwatersrand, Ghana.
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NICU Parents of Black Preterm Infants: Application of the Kenner Transition Model. Adv Neonatal Care 2022; 22:550-559. [PMID: 35588065 DOI: 10.1097/anc.0000000000000980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Black infants in the United States have the highest incidence of both infant mortality (IM) and preterm birth among all racial/ethnic groups. The IM disparity for Black preterm infants often occurs after neonatal intensive care unit (NICU) discharge, when parents become the primary caregivers. The revised Kenner Transition Model (KTM) is situation specific and comprised 5 interrelated domains of parental need after NICU discharge that have not been previously applied to the transition from NICU to home of Black infants. PURPOSE This study's purpose was to explore the conceptual fit of parental readiness to care for their Black preterm infants after NICU discharge with the revised KTM. METHODS A qualitative descriptive research approach was used for this single-site study of NICU parents of Black preterm infants. Qualitative analysis of 10 parents' perceptions before NICU discharge was via semantic content analysis; data were organized into categories aligned with the KTM. The Transition Questionnaire (TQ), an adjunct to the KTM, provided self- report quantitative data. RESULTS All parents endorsed the "Information Needs," "Stress and Coping," and "Professional Support" domains of the KTM. Parent TQ responses indicated perceptions of moderate to high levels of home transition readiness after NICU discharge. IMPLICATIONS FOR PRACTICE AND RESEARCH The domains of the revised KTM were affirmed by parents of Black preterm infants in this study via coded interview and TQ responses. Additional study exploring the clinical assessment of transition readiness with theoretical grounding in diverse NICU families is warranted. VIDEO ABSTRACT AVAILABLE AT https://journals.lww.com/advancesinneonatalcare/Pages/videogallery.aspx .
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Vaz LE, Jungbauer RM, Jenisch C, Austin JP, Wagner DV, Everest SJ, Libak AJ, Harris MA, Zuckerman KE. Caregiver Experiences in Pediatric Hospitalizations: Challenges and Opportunities for Improvement. Hosp Pediatr 2022; 12:1073-1080. [PMID: 36412061 DOI: 10.1542/hpeds.2022-006645] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND There are limited qualitative data describing general pediatric hospitalizations through the caregivers' lens, and most focus on one particular challenge or time during the hospitalization. This qualitative study aimed to address a gap in the description of the breadth and depth of personal challenges caregivers may face during the entire hospitalization, irrespective of severity of patient illness or diagnosis, and explored caregiver-suggested interventions. METHODS Caregivers of pediatric patients on the hospitalist service at a Pacific Northwest children's hospital were interviewed to explore their hospitalization experience and solicit feedback for potential interventions. Content was coded iteratively using a framework analysis until thematic saturation was met. Findings were triangulated through 2 focus groups, 1 with parent advisors and the other with hospital physicians and nurses. RESULTS Among 14 caregivers (7 each of readmitted and newly admitted patients) and focus group participants, emergent domains on difficulties faced with their child's hospitalization were anchored on physiologic (sleep, personal hygiene, and food), psychosocial (feelings of isolation, mental stress), and communication challenges (information flow between families and the medical teams). Caregivers recognized that addressing physiologic and psychosocial needs better enabled them to advocate for their child and suggested interventions to ameliorate hospital challenges. CONCLUSIONS Addressing physiologic and psychosocial needs may reduce barriers to caregivers optimally caring and advocating for their child. Downstream consequences of unaddressed caregiver challenges should be explored in relation to participation in hospital care and confidence in shared decision-making, both vital components for optimization of family-centered care.
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Affiliation(s)
- Louise E Vaz
- Department of Pediatrics, Doernbecher Children's Hospital
| | - Rebecca M Jungbauer
- Pacific Northwest Evidence-Based Practice Center, Oregon Health and Science University, Portland, Oregon
| | - Celeste Jenisch
- Department of Pediatrics, Doernbecher Children's Hospital.,Build Exito Program, Portland State University, Portland, Oregon
| | - Jared P Austin
- Department of Pediatrics, Doernbecher Children's Hospital
| | - David V Wagner
- Department of Pediatrics, Doernbecher Children's Hospital
| | - Steven J Everest
- Build Exito Program, Portland State University, Portland, Oregon
| | - Alyssa J Libak
- Build Exito Program, Portland State University, Portland, Oregon
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Words matter: exploring communication between parents and neonatologists. J Perinatol 2022; 42:745-751. [PMID: 35031688 DOI: 10.1038/s41372-021-01293-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 11/16/2021] [Accepted: 12/01/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To evaluate how neonatologists and NICU parents perceive communication in the NICU. STUDY DESIGN A mixed-methods approach using an online survey and three focus groups with NICU parents and neonatologists, utilizing videos of simulated conversations between a neonatologist and mother. RESULTS A total of 72 participants responded to the online survey. Parents ranked the invasiveness of common NICU clinical procedures differently than the neonatologist standard but assessed the quality of the simulated conversation similarly. A total of 13 parents and 6 physicians participated in the focus groups. Major themes from both neonatologist and parent focus groups were the impact of making a connection with the parents, the importance of making decisions yet not making assumptions based on the divergent use of language by neonatologists and parents, and providing hope. CONCLUSIONS Parents and neonatologists differ in their perception of key aspects of NICU language use and communication but also agree on many aspects.
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Mautner E, Stern C, Avian A, Deutsch M, Fluhr H, Greimel E. Maternal Resilience and Postpartum Depression at the Neonatal Intensive Care Unit. Front Pediatr 2022; 10:864373. [PMID: 35620147 PMCID: PMC9127378 DOI: 10.3389/fped.2022.864373] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 04/06/2022] [Indexed: 12/05/2022] Open
Abstract
Background The neonatal intensive care unit causes maternal stress and postpartum depressive symptoms in preterm and term mothers. Personal resources like maternal resilience are usually not considered in counselling these women. Objective This study aims to evaluate the resilience and differences in postpartum depression after admission of newborns at the neonatal intensive care unit. Methods This prospective pilot study was conducted in a single teaching hospital in Austria from December 2016 until December 2018. Sixty women completed two internationally validated questionnaires, the Edinburgh Postnatal Depression Scale (EPDS) to evaluate depressive symptoms and the Resilience Scale RS-13 to measure maternal resilience during the postpartum period (3 to 10 days postpartum). Additionally, women answered two open questions about burdens and relief. Results Twenty women (34%) showed lower resilience scores. The 39 high-resilient women (66%) showed significantly less depression (p = 0.005). Women reported social support from their partner (n = 15), health professionals and psychologists (n = 15), family and friends (n = 12), and child-specific relief, e.g., spending time with the newborn and involvement in care (n = 7) as the most helpful variable during the first postpartum period. Conclusion The experience of having a newborn at the neonatal intensive care unit is a challenging event for women. Women have different resilience parameters. Mothers with lower resilience will benefit from social support and emotional health-promoting activities.
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Affiliation(s)
- Eva Mautner
- Division of Obstetrics, Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
- Department of Medical Psychology and Psychotherapy, Medical University of Graz, Graz, Austria
| | - Christina Stern
- Division of Obstetrics, Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
| | - Alexander Avian
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | - Maria Deutsch
- Division of Obstetrics, Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
- Department of Medical Psychology and Psychotherapy, Medical University of Graz, Graz, Austria
| | - Herbert Fluhr
- Division of Obstetrics, Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
| | - Elfriede Greimel
- Division of Obstetrics, Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
- Department of Medical Psychology and Psychotherapy, Medical University of Graz, Graz, Austria
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Salvador JT, Al‐Madani MM, Al‐Hussien AM, Alqahtani FM, Alvarez MOC, Hammad SS, Sudqi AI, Cabonce SG, Reyes LDV, Sanchez KB, Rosario AB, Agman DD, Al‐Mousa AA. REVISITING THE ROLES OF NEONATAL INTENSIVE CARE UNIT NURSES TOWARDS VISION 2030 OF SAUDI ARABIA: A DESCRIPTIVE PHENOMENOLOGICAL STUDY. J Nurs Manag 2022; 30:2906-2914. [DOI: 10.1111/jonm.13637] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/07/2022] [Accepted: 04/12/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Jordan Tovera Salvador
- Department of Nursing Education, College of Nursing Imam Abdulrahman Bin Faisal University Dammam Saudi Arabia
| | - Maha Mohammed Al‐Madani
- Department of Fundamentals in Nursing, College of Nursing Imam Abdulrahman Bin Faisal University Dammam Saudi Arabia
| | - Ahlam Mohammed Al‐Hussien
- Department of Fundamentals in Nursing, College of Nursing Imam Abdulrahman Bin Faisal University Dammam Saudi Arabia
| | - Friyal Mubarak Alqahtani
- Department of Community Health Nursing, College of Nursing Imam Abdulrahman Bin Faisal University Dammam Saudi Arabia
| | - Marc Oneel Castillo Alvarez
- Department of Fundamentals in Nursing, College of Nursing Imam Abdulrahman Bin Faisal University Dammam Saudi Arabia
| | - Sama Samer Hammad
- Department of Fundamentals in Nursing, College of Nursing Imam Abdulrahman Bin Faisal University Dammam Saudi Arabia
| | - Abdallah Ibrahim Sudqi
- Department of Fundamentals in Nursing, College of Nursing Imam Abdulrahman Bin Faisal University Dammam Saudi Arabia
| | - Suzette Golez Cabonce
- Department of Fundamentals in Nursing, College of Nursing Imam Abdulrahman Bin Faisal University Dammam Saudi Arabia
| | | | - Kathlynn Buenaobra Sanchez
- Department of Nursing Education, College of Nursing Imam Abdulrahman Bin Faisal University Dammam Saudi Arabia
| | - Ahrjaynes Balanag Rosario
- Department of Nursing Education, College of Nursing Imam Abdulrahman Bin Faisal University Dammam Saudi Arabia
| | - Darwin Damsani Agman
- Department of Fundamentals in Nursing, College of Nursing Imam Abdulrahman Bin Faisal University Dammam Saudi Arabia
| | - Ammar Ali Al‐Mousa
- Student, College of Nursing Imam Abdulrahman Bin Faisal University Dammam Saudi Arabia
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Schuetz Haemmerli N, Stoffel L, Schmitt KU, Khan J, Humpl T, Nelle M, Cignacco E. Enhancing Parents' Well-Being after Preterm Birth-A Qualitative Evaluation of the "Transition to Home" Model of Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074309. [PMID: 35409993 PMCID: PMC8998674 DOI: 10.3390/ijerph19074309] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 03/31/2022] [Accepted: 04/01/2022] [Indexed: 01/03/2023]
Abstract
There are few programs available aimed at preventing short- and long-term negative consequences after preterm birth and covering the entire care continuum. The “Transition to Home (TtH)” model is such a program, offering structured, individual support for families with preterm infants before and after hospital discharge. This study gathers and examines the parents’ views of receiving support from an interprofessional team under the TtH model of care during hospitalization and after discharge. Using a qualitative explorative design, 39 semi-structured interviews with parents were analyzed thematically. From this analysis, three main themes were identified: (1) TtH and the relevance of continuity of care; (2) Enhancement of parents’ autonomy and self-confidence; (3) Perception of interprofessional collaboration. Within these themes, the most relevant aspects identified were continuity of care and the appointment of a designated health care professional to anchor the entire care continuum. Emotional support complemented by non-medical approaches, along with strength-based and family resource-oriented communication, also emerged as key aspects. Continuous, family-centered care and well-organized interprofessional collaboration promote the well-being of the family after a premature birth. If the aspects identified in this study are applied, the transition from hospital to home will be smoothened for the benefit of affected families.
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Affiliation(s)
- Natascha Schuetz Haemmerli
- Department of Health Professions, Bern University of Applied Sciences, 3008 Bern, Switzerland; (K.-U.S.); (E.C.)
- Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland;
- Correspondence:
| | - Liliane Stoffel
- Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland;
| | - Kai-Uwe Schmitt
- Department of Health Professions, Bern University of Applied Sciences, 3008 Bern, Switzerland; (K.-U.S.); (E.C.)
- Insel Gruppe, Bern University Hospital, 3010 Bern, Switzerland
| | - Jeannine Khan
- Kantonale Schule für Berufsbildung, 5001 Aarau, Switzerland;
| | - Tilman Humpl
- Tilman Humpl, Department of Paediatrics, St. Elisabethen-Krankenhaus, Kliniken des Landeskreises Lörrach, 79539 Lörrach, Germany;
| | - Mathias Nelle
- Mathias Nelle, Children’s Hospital, Kreiskliniken Böblingen, 71302 Böblingen, Germany;
| | - Eva Cignacco
- Department of Health Professions, Bern University of Applied Sciences, 3008 Bern, Switzerland; (K.-U.S.); (E.C.)
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Perceptions of Parent Stressors in the Neonatal Intensive Care Unit Among the General Public and Healthcare Professionals. J Perinat Neonatal Nurs 2022; 36:186-197. [PMID: 35476773 DOI: 10.1097/jpn.0000000000000643] [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] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Intervention efforts to improve the psychosocial well-being of parents with an infant in the neonatal intensive care unit (NICU) are high priority. This study assessed public and healthcare professionals' perceptions of prominent NICU stressors to highlight areas where NICU parents are in need of further support. Relations with sample characteristics were also examined to establish the generalizability of known parent demographic/sociofamilial risk factors. METHODS A cross-sectional design was used to assess public (n = 96) and staff (n = 55) responses on the Parental Stressor Scale: Neonatal Intensive Care Unit (PSS:NICU). RESULTS The public perceived parental stress as being low to moderate. This was significantly lower than the staff estimate and highly comparable with past parent reports. Staff communication was perceived as most stressful by the public with this influenced by gender and education. Staff with more NICU experience were more likely to overestimate parental stress, particularly those working at the highest care level. CONCLUSIONS Collectively, these findings highlight preconceived anxiety around staff communication and behaviors and indicate that education on the potential for traumatic unit experiences to influence staff-parent communication may be important.
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Waldron MK. Parent Protector: Perceptions of NICU-to-Home Transition Readiness for NICU Parents of Black Preterm Infant. J Perinat Neonatal Nurs 2022; 36:173-185. [PMID: 35476771 DOI: 10.1097/jpn.0000000000000598] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Black infants have twice the incidence of infant mortality (IM), death before the first birthday, and preterm birth in comparison to other US racial/ethnic groups; these factors make Black infants a high-risk group. The literature on the factors impacting caregivers and home environments for these infants is sparse. The purpose of this descriptive qualitative study was to explore perceived parental readiness to care for their Black preterm infants at home after discharge from a neonatal intensive care unit (NICU). Ten NICU parents of Black preterm infants completed a structured interview and self-report questionnaires before hospital discharge; data were analyzed using descriptive and semantic content methods. Coded parent responses were categorized as Parent Protector of Infants' Health (n = 94, 29.2%); Hindrances to Parental Readiness for Transition to Home (n = 97, 30.1%), and Parent as Partner in NICU to Home Transition (n = 131, 40.6%). All parents rated themselves "confident" (n = 6) or "very confident" (n = 4) in their ability to care for their infant after NICU discharge. Partnership with the healthcare team was described as involving health information resources, effective communication, and, most importantly, support for the parental role as infant protector for transition to home for their high-risk infant after NICU discharge.
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Affiliation(s)
- Mia K Waldron
- Department of Nursing Science Professional Practice & Quality, Children's National Hospital, Washington, District of Columbia; and School of Medicine & Health Sciences, The George Washington University, Washington, District of Columbia
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Koivula K, Isokääntä S, Tavast K, Toivonen I, Tuomainen I, Kokki M, Honkalampi K, Sankilampi U, Kokki H. Psychiatric Symptoms, Posttraumatic Growth, and Life Satisfaction Among Parents of Seriously Ill Infants: A Prospective Case-Controlled Study. J Clin Psychol Med Settings 2022; 29:453-465. [PMID: 35344125 PMCID: PMC9184431 DOI: 10.1007/s10880-022-09868-7] [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] [Subscribe] [Scholar Register] [Accepted: 03/04/2022] [Indexed: 02/01/2023]
Abstract
We evaluated psychiatric symptoms, posttraumatic growth, and life satisfaction among the parents (n = 34) of newborns (n = 17) requiring therapeutic hypothermia or urgent surgery (interest group). Our control group included 60 parents of healthy newborns (n = 30). The first surveys were completed soon after diagnosis or delivery and the follow-up surveys 1 year later (participation rate 88% in the interest group and 70% in the control group). General stress was common in both groups but was more prevalent in the interest group as were depressive symptoms, too. Anxiety was more common in the interest group, although it showed a decrease from the baseline in both groups. Life satisfaction had an inverse correlation with all measures of psychiatric symptoms, and it was lower in the interest group in the early stage, but similar at 12 months due to the slight decline in the control group. Mothers in the interest group had more anxiety and depressive symptoms than fathers in the early stage. Mothers had more traumatic distress than fathers at both time points. Half of the parents experienced substantial posttraumatic growth at 12 months. In conclusion, the serious illness of an infant substantially affects the well-being of the parents in the early stages of illness and one year after the illness.
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Affiliation(s)
- Krista Koivula
- Department of Pediatrics, Kuopio University Hospital (KYS), Puijonlaaksontie 2, PO Box 100, 70029, Kuopio, Finland.
| | - Siiri Isokääntä
- Department of Anesthesiology and Intensive Care, Kuopio University Hospital, Kuopio, Finland.,School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Kati Tavast
- School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Iines Toivonen
- School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Iina Tuomainen
- School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Merja Kokki
- Department of Anesthesiology and Intensive Care, Kuopio University Hospital, Kuopio, Finland
| | - Kirsi Honkalampi
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland
| | - Ulla Sankilampi
- Department of Pediatrics, Kuopio University Hospital (KYS), Puijonlaaksontie 2, PO Box 100, 70029, Kuopio, Finland
| | - Hannu Kokki
- School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
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Mautner E, Stern C, Avian A, Deutsch M, Schöll W, Greimel E. Neonates in the Intensive Care Unit: Maternal Health-Related Quality of Life and Depression After Term and Preterm Births. Front Pediatr 2022; 9:684576. [PMID: 35071122 PMCID: PMC8770971 DOI: 10.3389/fped.2021.684576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 12/06/2021] [Indexed: 11/13/2022] Open
Abstract
Background/Objective: To examine maternal physical and mental health-related quality of life (HRQoL) and depression after early and late preterm and term births in the early postpartum period. Method: In a prospective pilot study, three groups of women whose newborns had to be treated in the neonatal ward during the immediate postpartum period were established and compared with each other: 20 women with extremely to very preterm birth, 20 with moderate to late preterm birth and 20 women with term birth. All participants completed the Short Form-12 Health Survey (SF-12) to measure HRQoL, and the Edinburgh Postnatal Depression Scale (EPDS) to detect depressive symptoms combined with independently developed questions to evaluate anxiety and psychological distress. Results: Maternal psychological HRQoL was significantly worse in the very preterm birth group compared to moderate to late preterm birth (p < 0.001) and full-term birth groups (p = 0.004). There were no differences between the birth groups in depressive symptoms (p = 0.083), anxiety (p = 0.238), perceived stress (p = 0.340) and the general psychological distress values (p = 0.755). In the EPDS, the depression screening instrument 30 to 65% were beyond the cut-off-value to detect major depression. Conclusions: During the early postpartum period, an extensive medical care focussing on acute stress, HRQoL parameters and depression may be a good step to improving maternal well-being.
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Affiliation(s)
- Eva Mautner
- Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
| | - Christina Stern
- Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
| | - Alexander Avian
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | - Maria Deutsch
- Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
| | - Wolfgang Schöll
- Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
| | - Elfriede Greimel
- Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
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21
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Lian BX, Amin Z, Aishworiya R. Juggling Multiple Roles amidst Uncertainty: The Asian Father's Perspective of an Infant in Neonatal Intensive Care Unit. Am J Perinatol 2021; 38:1420-1427. [PMID: 32526778 DOI: 10.1055/s-0040-1713179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Parents of preterm, very low birthweight (VLBW) infants in neonatal intensive care units (NICU) undergo emotional turmoil. Studies on parent's experiences typically focus on the maternal perspective. The purpose of the study is to explore the emotional needs and experiences of fathers of VLBW neonates in the NICU and to identify ways to improve their experiences. STUDY DESIGN This was a qualitative descriptive design study undertaken at the NICU of a tertiary university hospital. Convenience sampling with predefined inclusion and exclusion criteria was used to identify prospective participants. Semi-structured interviews were conducted with 15 fathers of infants until data saturation was reached. The COREQ (Consolidated Criteria for Reporting Qualitative Studies) checklist was used. RESULTS Father's experiences were classified into the topics of concerns, roles, and perspectives. Uncertainty was a predominant theme in each of these. Fathers assume multiple roles toward the child, wife, self, and family. Their concerns were multifaceted involving the child, family, work, and finances; they experienced a myriad of emotions, but these evolved into resilience eventually. CONCLUSION Fathers have unique concerns pertinent to having an infant in the NICU. They juggle multiple roles and transition to emotions of resilience. It is imperative to acknowledge the uncertainty and diverse roles of fathers, provide them with customized information, and develop more balanced parent-support groups. KEY POINTS · Fathers juggle multiple roles with a child in NICU.. · Uncertainty is a key part of their experience.. · Acknowledging their role and emotions is important..
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Affiliation(s)
- Berenice Xueli Lian
- Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, Singapore, Singapore
| | - Zubair Amin
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ramkumar Aishworiya
- Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, Singapore, Singapore
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22
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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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Schmöker A, Ericson J, Flacking R, Udo C. Needs and Perceptions Relative to Emotional Support in Parents With Preterm Infants. J Perinat Neonatal Nurs 2021; Publish Ahead of Print:00005237-900000000-99937. [PMID: 34643604 DOI: 10.1097/jpn.0000000000000604] [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] [Indexed: 11/25/2022]
Abstract
Objectives of this study were to explore parents' needs for emotional support and how such support could be best delivered during admittance to a neonatal unit. This study took place at 6 neonatal units in Sweden. Forty-two semistructured interviews were analyzed using qualitative content analysis: 26 individual telephone interviews with mothers of preterm infants 6 to 10 months after discharge and 16 face-to-face interviews with parents of preterm infants admitted to neonatal units. The main category to emerge was needs and preferences for emotional support , which consisted of 2 generic categories: emotional needs and preferences for potential support interventions . Emotional needs define the importance of comprehending the new situation, finding meaning, and managing the situation through resources. Preferences for potential support interventions identify possible ways to deliver emotional support in the form of parental group, diary writing, professional counseling, and Internet support. The results highlight the importance of supporting parents' sense of coherence in their situation and parenthood by offering different interventions according to parent preferences. Parental groups could serve as a keystone for emotional support with the possibility to combine with other support mechanisms.
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Affiliation(s)
- Annika Schmöker
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden (Ms Schmöker); School of Education, Health and Social Studies, Dalarna University, Falun, Sweden (Ms Schmöker, and Drs Ericson, Flacking, and Udo); Center for Clinical Research Dalarna, Uppsala University, Sweden (Drs Ericson and Udo); Department of Paediatrics, County of Dalarna, Falun, Sweden (Dr Ericson); and Department of Health Care Sciences, Palliative Research Centre, Ersta Sköndal University College, Stockholm, Sweden (Dr Udo)
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24
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Miller JJ, Serwint JR, Boss RD. Clinician-family relationships may impact neonatal intensive care: clinicians' perspectives. J Perinatol 2021; 41:2208-2216. [PMID: 34091604 PMCID: PMC8178652 DOI: 10.1038/s41372-021-01120-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 05/11/2021] [Accepted: 05/25/2021] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Collaborative clinician-family relationships are necessary for the delivery of successful patient- and family-centered care (PFCC) in the NICU. Challenging clinician-family relationships may undermine such collaboration and the potential impacts on patient care are unknown. STUDY DESIGN Consistent caregivers were surveyed to describe their relationships and collaboration with families of infants hospitalized ≥ 28 days. Medical record review collected infant and family characteristics hypothesized to impact relationships. Mixed methods analysis was performed. RESULTS Clinicians completed 243 surveys representing 77 families. Clinicians reported low collaboration with families who were not at the bedside and/or did not speak English. Clinicians perceived most clinician-family relationships impact the infant's hospital course. Negative impacts included communication challenges, mistrust or frustration with the team and disruptions to patient care. CONCLUSION This study identifies features of clinician-family relationships that may negatively impact an infant's NICU stay. Targeting supports for these families is necessary to achieve effective PFCC.
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25
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Rossi R, Bauer NH, Becke-Jakob K, Grab D, Herting E, Mitschdörfer B, Olbertz DM, Rösner B, Schlembach D, Tillig B, Trotter A, Kehl S. Empfehlungen für die strukturellen Voraussetzungen der
perinatologischen Versorgung in Deutschland (Entwicklungsstufe S2k,
AWMF-Leitlinien-Register Nr. 087–001, März 2021). Z Geburtshilfe Neonatol 2021; 225:306-319. [PMID: 34384132 DOI: 10.1055/a-1502-5869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Rainer Rossi
- Klinik für Kinder- und Jugendmedizin, Vivantes Klinikum Neukölln, Berlin
| | - Nicola H Bauer
- Studienbereich Hebammenwissenschaft, Department für angewandte Gesundheitswissenschaften, Hochschule für Gesundheit, Bochum
| | | | - Dieter Grab
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Ulm
| | - Egbert Herting
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Lübeck
| | | | - Dirk M Olbertz
- Abt. Neonatologie und Neonatologische Intensivmedizin, Klinikum Südstadt Rostock
| | - Bianka Rösner
- Klinik für Neonatologie, Charité, Campus Virchow, Berlin
| | - Dietmar Schlembach
- Spezielle Geburtshilfe und Perinatalmedizin, Klinik für Geburtsmedizin, Vivantes Klinikum Neukölln, Berlin
| | - Bernd Tillig
- Klinik für Kinderchirurgie, Neugeborenenchirurgie und Kinderurologie, Vivantes Klinikum Neukölln, Berlin
| | - Andreas Trotter
- Klinik für Kinder und Jugendliche, Hegau-Bodensee-Klinikum Singen
| | - Sven Kehl
- Frauenklinik, Universitätsklinikum Erlangen
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Abstract
Background: In the neonatal intensive care unit, immigrant parents may experience even
greater anxiety than other parents, particularly if they and the nurses do
not share a common language. Aim: To explore the complex issues of trust and the nurse–mother relationship in
neonatal intensive care units when they do not share a common language. Design and methods: This study has a qualitative design. Individual semi-structured in-depth
interviews and two focus group interviews were conducted with eight
immigrant mothers and eight neonatal intensive care unit nurses,
respectively. Data analysis was based on Braun and Clarke’s thematic
analytic method. Ethical considerations: Approval was obtained from the hospital’s Scientific Committee and the Data
Protection Officer. Interviewees were informed in their native language
about confidentiality and they signed an informed consent form. Results: Trust was a focus for mothers and nurses alike. The mothers held that they
were satisfied that their infants received the very best care. They seemed
to find the nurses’ care and compassion unexpected and said they felt
empowered by learning how to care for their infant. The nurses discussed the
mother’s vulnerability, dependency on their actions, attitudes and
behaviour. Discussion: Lack of a common language created a challenge. Both parties depended on
non-verbal communication and eye contact. The nurses found that being
compassionate, competent and knowledgeable were important trust-building
factors. The mothers were relieved to find that they were welcome, could
feel safe and their infants were well cared for. Conclusion: The parents of an infant admitted to the neonatal intensive care unit have no
choice but to trust the treatment and care their infant receives. Maternal
vulnerability challenges the nurse’s awareness of the asymmetric
distribution of power and ability to establish a trusting relationship with
the mother. This is particularly important when mother and nurse do not
share a verbal language. The nurses worked purposefully to gain trust.
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Affiliation(s)
- Nina Margrethe Kynø
- Lovisenberg Diaconal University College, Norway; Oslo University Hospital, Norway
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Labrie NHM, van Veenendaal NR, Ludolph RA, Ket JCF, van der Schoor SRD, van Kempen AAMW. Effects of parent-provider communication during infant hospitalization in the NICU on parents: A systematic review with meta-synthesis and narrative synthesis. PATIENT EDUCATION AND COUNSELING 2021; 104:1526-1552. [PMID: 33994019 DOI: 10.1016/j.pec.2021.04.023] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 04/21/2021] [Accepted: 04/22/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To synthesize and analyse the literature on the effects of parent-provider communication during infant hospitalization in the neonatal (intensive) care unit (NICU) on parent-related outcomes. METHODS Systematic review with meta-synthesis and narrative synthesis. Databases (PubMed, PsycINFO, Cochrane Library, CINAHL, Web of Science, Scopus) were searched in October/November 2019. Studies reporting, observing, or measuring parent-related effects of parent-provider communication in the NICU were included. Study quality was assessed using the Quality Assessment Tool for Studies with Diverse Designs. Qualitative studies were meta-synthesized using deductive and inductive thematic analysis. Quantitative studies were analysed using narrative synthesis. RESULTS 5586 records were identified; 77 were included, reporting on N = 6960 parents, N = 693 providers, and N = 300 NICUs. Analyses revealed five main (positive and negative) effects of parent-provider interaction on parents' (1) coping, (2) knowledge, (3) participation, (4) parenting, and (5) satisfaction. Communication interventions appeared impactful, particularly in reducing parental stress and anxiety. Findings confirm and refine the NICU Communication Framework. CONCLUSIONS Parent-provider communication is a crucial determinant for parental well-being and satisfaction with care, during and following infant hospitalization in the NICU. R. Practice Implications: Providers should particularly consider the impact on parents of their day-to-day interaction - the most occurring form of communication of all.
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Affiliation(s)
- Nanon H M Labrie
- Athena Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Department of Pediatrics and Neonatology, OLVG, Amsterdam, The Netherlands.
| | - Nicole R van Veenendaal
- Department of Pediatrics and Neonatology, OLVG, Amsterdam, The Netherlands; Amsterdam UMC, University of Amsterdam, Vrije Universiteit, Emma Children's Hospital, Amsterdam, The Netherlands
| | | | - Johannes C F Ket
- Medical Library, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Lorié ES, Wreesmann WJW, van Veenendaal NR, van Kempen AAMW, Labrie NHM. Parents' needs and perceived gaps in communication with healthcare professionals in the neonatal (intensive) care unit: A qualitative interview study. PATIENT EDUCATION AND COUNSELING 2021; 104:1518-1525. [PMID: 33423822 DOI: 10.1016/j.pec.2020.12.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 11/21/2020] [Accepted: 12/13/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To explore parents' needs and perceived gaps concerning communication with healthcare professionals during their preterm infants' admission to the neonatal (intensive) care unit (NICU) after birth. METHODS Semi-structured, retrospective interviews with 20 parents of preterm infants (March 2020), admitted to a Dutch NICU (level 2-4) minimally one week, one to five years prior. The interview guide was developed using Epstein and Street's Framework for Patient-Centered Communication. Online interviews were audio-taped and transcribed verbatim. Deductive and inductive thematic analysis was performed by two independent coders. RESULTS Communication needs and gaps emerged across four main functions of NICU communication: Building/maintaining relationships, exchanging information, (sharing) decision-making, and enabling parent self-management. Communication gaps included: lack of supportive physician communication, disregard of parents' views and agreements, missing communication about decisions, and the absence of written (discharge) information. CONCLUSION This study improves our understanding and conceptualization of adequate NICU communication by revealing persisting gaps in parent-provider interaction. Also, this study provides a steppingstone for further integration of parents as equal partners in neonatal care and communication. PRACTICE IMPLICATIONS The results are relevant to practitioners in the field of neonatal and pediatric care, providing suggestions for tangible improvements in NICU care in the Netherlands and beyond.
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Affiliation(s)
- Esther S Lorié
- Athena Institute, Vrije Universiteit Amsterdam, the Netherlands
| | | | - Nicole R van Veenendaal
- Department of Pediatrics and Neonatology, OLVG Amsterdam, the Netherlands; Amsterdam UMC, University of Amsterdam, Vrije Universiteit, Emma Children's Hospital, Amsterdam, the Netherlands
| | | | - Nanon H M Labrie
- Athena Institute, Vrije Universiteit Amsterdam, the Netherlands; Department of Pediatrics and Neonatology, OLVG Amsterdam, the Netherlands.
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Wreesmann WJW, Lorié ES, van Veenendaal NR, van Kempen AAMW, Ket JCF, Labrie NHM. The functions of adequate communication in the neonatal care unit: A systematic review and meta-synthesis of qualitative research. PATIENT EDUCATION AND COUNSELING 2021; 104:1505-1517. [PMID: 33341329 DOI: 10.1016/j.pec.2020.11.029] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 11/20/2020] [Accepted: 11/23/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To assess the main functions of parent-provider communication in the neonatal (intensive) care unit (NICU) and determine what adequate communication entails according to both parents and health professionals. METHODS A systematic review and meta-synthesis of qualitative research. PubMed, Ebsco/PsycINFO, Wiley/Cochrane Library, Ebsco/CINAHL, Clarivate Analytics/Web of Science Core Collection, and Elsevier/Scopus were searched in October-November 2019 for records on interpersonal communication between parents and providers in neonatal care. Title/abstract screening and full-text analysis were conducted by multiple, independent coders. Data from included articles were analyzed using deductive and inductive thematic analysis. RESULTS 43 records were included. Thematic analysis of data resulted in the development of the NICU Communication Framework, including four functions of communication (1. building/maintaining relationships, 2. exchanging information, 3. (sharing) decision-making, 4. enabling parent self-management) and five factors that contribute to adequate communication across these functions (topic, aims, location, route, design) and, thereby, to tailored parent-provider communication. CONCLUSION The NICU Communication Framework fits with the goals of Family Integrated Care to encourage parent participation in infants' care. This framework forms a first step towards the conceptualization of (adequate) communication in NICU settings. PRACTICE IMPLICATIONS Findings can be used to improve NICU communication in practice, in particular through the mnemonic TAILORED.
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Affiliation(s)
| | - Esther S Lorié
- Athena Institute, Vrije Universiteit Amsterdam, the Netherlands
| | - Nicole R van Veenendaal
- Department of Pediatrics and Neonatology, OLVG, Amsterdam, the Netherlands; Amsterdam UMC, University of Amsterdam, Vrije Universiteit, Emma Children's Hospital, Amsterdam, the Netherlands
| | | | | | - Nanon H M Labrie
- Athena Institute, Vrije Universiteit Amsterdam, the Netherlands; Department of Pediatrics and Neonatology, OLVG, Amsterdam, the Netherlands.
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Annuar WSHWM, Ludin SM, Amran NA. Parents' experience in taking care of critically ill children while hospitalisation. ENFERMERIA CLINICA 2021. [PMID: 33849233 DOI: 10.1016/j.enfcli.2020.10.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The objective of study is to explore the experiences of parents taking care of their critically ill child at the Neonatal Intensive Care Unit (NICU) or the Paediatric Intensive Care Unit (PICU) in the Malaysian hospital. A total of ten parents were interviewed and selected for purposive sampling. The data was analysed using a thematic analysis based on the Colaizzi's approach. The study identified four emerging themes from data that included participation in care, participation in decision-making, challenges and coping mechanisms throughout the child's hospitalisation. Parents have emphasised the importance of their participation in the care and decision-making of their child. They also have their own coping mechanisms that would make their journey less traumatic. Nurses need to enhance their communication skills and improve nurse-parent relationships.
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Affiliation(s)
| | - Salizar Mohamed Ludin
- Critical Care Nursing Department, Kulliyyah of Nursing, International Islamic University Malaysia, Kuantan, Pahang, Malaysia.
| | - Nurfatin Amirah Amran
- Undergraduate Student in Nursing, Kulliyyah of Nursing, International Islamic University Malaysia, Kuantan, Pahang, Malaysia
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31
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Hames JL, Gasteiger C, McKenzie MR, Rowley S, Serlachius AS, Juth V, Petrie KJ. Predictors of parental stress from admission to discharge in the neonatal special care unit. Child Care Health Dev 2021; 47:243-251. [PMID: 33171525 DOI: 10.1111/cch.12829] [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: 06/29/2020] [Revised: 11/02/2020] [Accepted: 11/03/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Exacerbated parental stress during a stay in the neonatal intensive care unit can negatively impact the development of the hospitalized infant, strain the dyadic relationship and put parents at risk for poor mental health. It is therefore important to identify risk factors of stress throughout the duration of a hospitalization. This longitudinal study aimed to investigate sources of stress for mothers and fathers who had a baby in the neonatal special care unit. METHODS Parents of 57 singletons and 11 twins (68 infants) admitted to a neonatal special care unit (46% for prematurity) were recruited. Sixty-four mothers and 20 fathers were assessed at admission, and 60 mothers and 16 fathers at discharge. Participants reported their satisfaction with hospital information and completed the Perceived Stress Scale, the Brief Illness Perception Questionnaire and the Dyadic Adjustment Scale. RESULTS Parents demonstrated similar stress trajectories, with stress on average declining over time. Higher maternal stress at admission was associated with a belief that the baby's illness would have a longer timeline, lower perceptions of treatment efficacy and lower satisfaction with the information received from medical staff. Younger age and lower levels of education predicted higher maternal stress at discharge. Fathers had higher stress at discharge when they were older, had a baby born at younger gestation and felt they had less control. At admission, information satisfaction was positively associated with parental beliefs about treatment efficacy and understanding the infant's condition. At discharge, information satisfaction was negatively associated with beliefs about illness severity and the likely time frame of the illness. CONCLUSION The findings highlight that parents' perceptions of their baby's illness and treatment at admission and discharge have a significant association with stress. Clinical staff can use these factors to identify parents who are at risk of exhibiting a greater level of stress over the hospitalization period.
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Affiliation(s)
- Jessica L Hames
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Chiara Gasteiger
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Melanie R McKenzie
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Simon Rowley
- Newborn Services, Auckland City Hospital, Auckland, New Zealand
| | - Anna S Serlachius
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Vanessa Juth
- Sue and Bill Gross School of Nursing, College of Health Sciences, University of California Irvine, Irvine, California, USA
| | - Keith J Petrie
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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Needs of Socioeconomically Diverse Fathers of Premature Hospitalized Infants: A Multicenter Study. Adv Neonatal Care 2021; 21:E11-E22. [PMID: 32769372 DOI: 10.1097/anc.0000000000000767] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND To effectively practice true family-centered care (FCC) in the neonatal intensive care unit (NICU) setting, a nurse needs to understand the perceptions and concerns of all fathers. Although research is emerging on fathers' perceptions and experiences, the samples of fathers represented are not from diverse socioeconomic, racial, and ethnic populations, which limit the findings' generalizability. PURPOSE The purpose of this study was to determine the needs of NICU fathers and whether these needs differed based on sociodemographic factors. METHODS A quantitative, comparative, descriptive design was used to determine the needs of NICU fathers. Additional analysis was conducted to determine whether the needs differed based on education, income, and gestational age, whether the father preferred speaking English or Spanish, and whether these sociodemographic factors could predict needs. To determine sociodemographic factors and needs, a demographic questionnaire and the NICU Family Needs Inventory were administered to 99 fathers in 6 level III NICUs. RESULTS Data were analyzed using independent sample t test, 1-way analysis of variance, and multiple linear regression. The results showed that fathers reported a broad span of needs and fathers from disadvantaged populations may have greater needs in certain areas. IMPLICATIONS FOR PRACTICE These results emphasize the importance of the nurses' role in assessing the needs of NICU fathers. By understanding fathers' needs, nurses can provide individualized FCC to fathers to help them be more involved in the care and support of their infant. IMPLICATIONS FOR RESEARCH Further research is needed to support these findings and test interventions that promote communication between providers and fathers.
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Lebel V, Charette S. Nursing Interventions to Reduce Stress in Families of Critical Care Patients: An Integrative Review. Crit Care Nurse 2021; 41:32-44. [PMID: 33560437 DOI: 10.4037/ccn2021188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND Having a family member admitted to an intensive care unit is a stressful experience that may lead to psychological symptoms including depression, anxiety, and posttraumatic stress disorder. OBJECTIVE To better understand the phenomenon of stress experienced by families of intensive care unit patients and identify nursing interventions that may help reduce it. METHODS An integrative literature review was performed to identify principal stressors for families of patients receiving care in neonatal, pediatric, and adult intensive care units and recommended nursing interventions. RESULTS The principal stressors in the 3 types of intensive care units were change in parental role or family dynamics, appearance and behavior of the patient, the care setting, and communication with the health care staff. Nursing interventions should focus on valuing the role of family members in patient care, improving communication, and providing accurate information. CLINICAL RELEVANCE Family members of intensive care patients will benefit from nursing interventions that adequately acknowledge and address the stress they experience. CONCLUSION Nurses play a crucial role in helping to reduce the stress experienced by family members of intensive care unit patients.
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Affiliation(s)
- Valérie Lebel
- Valérie Lebel is a professor, Department of Nursing, Université du Québec en Outaouais, Quebec, Canada
| | - Sylvie Charette
- Sylvie Charette is a professor, Department of Nursing, Université du Québec en Outaouais
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Bibl K, Wagner M, Steinbauer P, Gröpel P, Wimmer S, Olischar M, Berger A, Hladschik-Kermer B. NeoAct: A Randomized Prospective Pilot Study on Communication Skill Training of Neonatologists. Front Pediatr 2021; 9:675742. [PMID: 34055701 PMCID: PMC8158577 DOI: 10.3389/fped.2021.675742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 04/19/2021] [Indexed: 11/21/2022] Open
Abstract
Background: This randomized interventional study evaluated the impact of a 1-day experiential communication skills training on neonatologists' performance in doctor-parents-communication. Methods: 17 neonatologists with different levels of professional experience from the Medical University of Vienna were randomized into one of two study groups: The intervention group (IG) as opposed to the control group (CG) participated in a 1-day experiential communication training. Eight weeks after the training, participants' communication skills were assessed during an objective structured clinical examination (OSCE). Neonatologists were assessed in a simulated conversation by how effectively they performed when conveying complex health-related information to parents of ill infants. Participants in the control group (CG) were assessed first during the OSCE and received their communication training later on. Self-assessment questionnaires before and after the workshop and OSCE were completed. Results: The study determined that neonatologists in the IG subjectively perceived that their competence level regarding their communication skills had increased after the workshop, while this was not reflected by their performance during the OSCE assessment. Discussion: A 1-day experiential communication skills training significantly increased physicians' self-evaluation concerning their communicative competence. This perceived competence did not manifest itself in increased communication skills during the OSCE. Conclusion: Repeated training is needed.
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Affiliation(s)
- Katharina Bibl
- Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Department of Pediatrics, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Michael Wagner
- Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Department of Pediatrics, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Philipp Steinbauer
- Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Department of Pediatrics, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Peter Gröpel
- Division of Sport Psychology, Department of Sport Science, University of Vienna, Vienna, Austria
| | - Sabrina Wimmer
- Department for Medical Psychology, Department for Public Health, Medical University Vienna, Vienna, Austria
| | - Monika Olischar
- Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Department of Pediatrics, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Angelika Berger
- Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Department of Pediatrics, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Birgit Hladschik-Kermer
- Department for Medical Psychology, Department for Public Health, Medical University Vienna, Vienna, Austria
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Promoting parental education of infants hospitalized in a children's hospital in Tabriz, Iran: a best practice implementation project. JBI Evid Implement 2020; 19:288-295. [PMID: 34491924 DOI: 10.1097/xeb.0000000000000259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Parents of infants admitted to hospital have high information needs. A good educational program will improve the outcomes and communication needs of these parents. Results from some studies have shown that patient education in Iran is inappropriate and should be improved. OBJECTIVES The aim of this evidence implementation project was to evaluate the current practice and implement the best practice related to promoting patient education in a children's hospital in Tabriz, Iran. METHODS A clinical audit was undertaken using the Joanna Briggs Institute Practical Application of Clinical Evidence System tool. Eight audit criteria that represent the best practice recommendations for patient education were used. A baseline audit was conducted followed by implementing multiple strategies, and the project was finalized with a follow-up audit to determine a change in practice. RESULTS Significant improvements in the follow-up audit in comparison with the baseline audit were as follows: evaluation of patient learning has been undertaken to determine met and unmet needs (from 65 to 77%); patients' learning needs, readiness to learn, and their learning style have been assessed before the implementation of an educational initiative (from 55 to 66%); and educational resources in different formats (e.g., written handouts, brochures, and links to online materials) are available in the ward (from 33 to 77%). Strategies that were implemented to achieve change in practice included conducting workshops and conferences, determining a trained nurse as responsible for educating parents, training in discharge time, the presentation of educational films daily, conducting group training, and installing related posters in the department and patient's room. The other five criteria were less compliant with best practice in the follow-up audit rather than the baseline audit; however, all of them except one (Criterion 3) were still up to 75% compliant, which is considered excellent by the audit team. CONCLUSION The follow-up audit results indicated an improvement in providing parental education. It can be concluded that these interventions can facilitate the implementation of evidence into clinical practice.
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Kim AR. Addressing the Needs of Mothers with Infants in the Neonatal Intensive Care Unit: A Qualitative Secondary Analysis. Asian Nurs Res (Korean Soc Nurs Sci) 2020; 14:327-337. [PMID: 32937202 DOI: 10.1016/j.anr.2020.09.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 09/07/2020] [Accepted: 09/08/2020] [Indexed: 11/27/2022] Open
Abstract
PURPOSE Mothers of infants hospitalized in neonatal intensive care units (NICUs) need to be recognized as essential partners of the care team as their presence and involvement are key to infants' health and developmental outcomes. Addressing mothers' perceived needs is beneficial for the improvement of supportive nursing care; however, little qualitative research on their unmet needs has been conducted in South Korea. This study assessed mothers' perspectives on their NICU experiences and their unmet needs within the South Korean cultural context. METHOD A cross-sectional, multicentered, secondary analysis study was conducted using the written responses to an open-ended questionnaire. Of the 344 NICU-experienced mothers, 232 throughout South Korea (seven cities and five provinces) voluntarily completed the questionnaire via smartphone-based or web-based surveys. Their narrative responses were analyzed using thematic content analysis guided by the critical incident technique. RESULTS Four themes emerged. NICU-experienced mothers of preterm infants referred to the "family-friendly environment" (16.4%) as a positive experience. The greatest unmet need was "relationship-based support" (58.2%), followed by "information and education-based support" (20.0%) and "system-level challenges" (5.4%). CONCLUSION The importance of creating a family-friendly NICU environment should be emphasized by ensuring 24-hour unrestricted access and encouraging active parental involvement in infant care, as well as actively supporting NICU families through supportive words and actions. The assurance of antiinfection management and better staffing levels should be fundamentally guaranteed to NICU staff.
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Affiliation(s)
- Ah Rim Kim
- Department of Nursing, Far East University, Chungbuk, Republic of Korea.
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37
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Williams L, I'Anson J, Malarkey M, Purcell A, de Vries N, McKinlay C. Information sharing in neonatal intensive care: Parental perceptions and preferences. J Paediatr Child Health 2020; 56:1121-1125. [PMID: 32129561 DOI: 10.1111/jpc.14842] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 11/21/2019] [Accepted: 02/19/2020] [Indexed: 11/28/2022]
Abstract
AIM Information sharing is a key component of family-centred care, which has traditionally occurred through patient information leaflets. Although patients' access to health information is rapidly changing with internet and mobile technologies, there are few data on parents' perception and preferences for information sharing. Our aim was to evaluate parents' perception of information sharing in neonatal care, to determine parents' preferred medium for health information and to identify priority content for inclusion in a smartphone application. METHODS Parents at Kidz First Neonatal Care (KFNC) were eligible to take part in our survey, which comprised five sections: (i) demographics, (ii) information in neonatal care, (iii) printed information in neonatal care, (iv) parental views about development of a neonatal smartphone application and (v) general feedback. Parental satisfaction with information sharing in KFNC was assessed with a modified version of the Empowerment of Parents in the Intensive Care-neonatology questionnaire. Descriptive and summary statistics were calculated, and free text data were analysed by content analysis. RESULTS Forty-one surveys were received, with 62% completed by mothers. Parents were supportive of electronic information, with 88% highly scoring the question 'I would download and use a free neonatal care app'. However, parental views on the need to continue printed material if a neonatal care smartphone application was provided were mixed. Of those parents who provided free-text recommendations, priority content included information about neonatal conditions, preparing for discharge and available supports. CONCLUSION Parents had positive perceptions of information sharing in neonatal care and were strongly supportive of the introduction of a neonatal phone application.
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Affiliation(s)
- Logan Williams
- Kidz First Neonatal Care, Counties Manukau Health, Auckland, New Zealand.,Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Julie I'Anson
- Kidz First Neonatal Care, Counties Manukau Health, Auckland, New Zealand
| | - Moira Malarkey
- Kidz First Neonatal Care, Counties Manukau Health, Auckland, New Zealand
| | - Anevili Purcell
- Kidz First Neonatal Care, Counties Manukau Health, Auckland, New Zealand
| | - Nathalie de Vries
- Paediatrics, MidCentral District Health Board, Palmerston North, New Zealand
| | - Christopher McKinlay
- Kidz First Neonatal Care, Counties Manukau Health, Auckland, New Zealand.,Liggins Institute, University of Auckland, Auckland, New Zealand
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Marçola L, Zoboli I, Polastrini RTV, Barbosa SMMD. BREAKING BAD NEWS IN A NEONATAL INTENSIVE CARE: THE PARENT'S EVALUATION. ACTA ACUST UNITED AC 2020; 38:e2019092. [PMID: 32520300 PMCID: PMC7274530 DOI: 10.1590/1984-0462/2020/38/2019092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 06/09/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To describe the reports of parents of newborns (NB) with congenital malformations hospitalized in a Neonatal Intensive Care Unit (NICU) who received bad news, in order to identify the issues related to the perception of bad news given adequately or inadequately. METHODS A cross-sectional study was conducted from January to October 2018, in which parents of newborns with congenital malformations hospitalized in NICUs were interviewed at visiting hours, according to inclusion criteria. The questionnaire had semi-structured questions related to reception of bad news. Analysis of the data was descriptive. RESULTS 28 mothers and two fathers were interviewed and 16 (53.3%) reported having had at least one bad news in the NICU. Of those, 10 (62.5%) considered appropriate the way in which the news was given. The justifications were: sincerity of the professional, delicacy to give the news, giving hope to the family, use of appropriate words and demonstration of caring about the newborn. Six participants (37.5%) considered inadequate the way of breaking bad news. The reasons were: unpreparedness and lack of knowledge about the child's case, use of difficult language, haste or anxiety and discouragement of family hope. Most of the news was given by a professional alone, often by a medical resident. CONCLUSIONS The communication of bad news was considered adequate by the parents, although this perception was not unanimous. This study, therefore, indicates that it is necessary to improve the communication of bad news in this NICU. Training professionals can assist in this process.
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Affiliation(s)
| | - Ivete Zoboli
- Universidade de São Paulo, São Paulo, SP, Brazil
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Laudato N, Yagiela L, Eggly S, Meert KL. Understanding parents' informational needs in the pediatric intensive care unit: A qualitative study. PROGRESS IN PEDIATRIC CARDIOLOGY 2020. [DOI: 10.1016/j.ppedcard.2019.101172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Vetcho S, Cooke M, Ullman AJ. Family-Centred Care in Dedicated Neonatal Units: An Integrative Review of International Perspectives. ACTA ACUST UNITED AC 2020. [DOI: 10.1016/j.jnn.2019.09.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Heidari H, Mardani-Hamooleh M. Nurses' Perception of Family-Centered Care in Neonatal Intensive Care Units. J Pediatr Intensive Care 2020; 9:16-20. [PMID: 31984152 PMCID: PMC6978175 DOI: 10.1055/s-0039-1695060] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 07/13/2019] [Indexed: 01/17/2023] Open
Abstract
Family-centered care (FCC) is one of the important elements of care in neonatal intensive care units (NICUs). The aim of this study was to understand the nurses' perception of FCC in NICUs. This qualitative study was performed using conventional content analysis. Participants in this study included 18 nurses who were selected by a purposeful method. Semistructured, in-depth and face-to-face interviews were conducted with the participants. All interviews were written down, reviewed, and analyzed. Two categories were identified after the data analysis: (1) prerequisite for providing FCC and (2) parents' participation. Prerequisite for providing FCC consisted of two subcategories namely suitable facilities and adequate personnel. Parents' participation included subcategories of parents: neonate's attachment and parents' training. Nurses' perception of FCC in NICUs can facilitate an appropriate condition for the participation of family members in the care of neonates.
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Affiliation(s)
- Haydeh Heidari
- Faculty of Nursing and Midwifery, Modeling in Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Marjan Mardani-Hamooleh
- Nursing Care Research Center, Nursing Midwifery Department, Iran University of Medical Sciences, Tehran, Iran,Address for correspondence Marjan Mardani-Hamooleh, PhD Nursing Care Research Center, Nursing Midwifery Department, Iran University of Medical SciencesZafar Str, Vanak Sq, PO Box1419733171, TehranIran
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Petty J, Jarvis J, Thomas R. Listening to the parent voice to inform person-centred neonatal care. ACTA ACUST UNITED AC 2019. [DOI: 10.1016/j.jnn.2019.01.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Reid S, Bredemeyer S, Chiarella M. Integrative Review of Parents' Perspectives of the Nursing Role in Neonatal Family-Centered Care. J Obstet Gynecol Neonatal Nurs 2019; 48:408-417. [PMID: 31150595 DOI: 10.1016/j.jogn.2019.05.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2019] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES To identify the perceptions of mothers and fathers of newborns admitted to NICUs regarding the role of neonatal nurses in the provision of family-centered care and how neonatal nurses were able to interpret and meet parents' needs. DATA SOURCES We conducted literature searches in the CINAHL, MEDLINE, Embase, PsycINFO, Dissertations and Theses Global, and Maternity and Infant Care databases. STUDY SELECTION Articles on qualitative and quantitative studies were selected if they were published in English from 2009 to 2018; they were set in countries with similar health care resources in Australasia, Canada, Europe, Scandinavia, the United Kingdom, and the United States; and the data were collected from parents. We identified 31 studies for analysis. DATA EXTRACTION We used the thematic analysis method of Braun and Clarke to extract data elements that were grouped and coded into themes and subthemes. DATA SYNTHESIS Through ongoing iterative analysis, we generated six themes from the 18 subthemes that in combination presented the experiences of parents in the context of family-centered care provided by neonatal nurses: Process of Becoming a Parent, Neonatal NursesSupportingParents, Infant Safety, Communication, Barriers to Parenting, and Parenting Inhibited by Neonatal Nurses. CONCLUSION The six themes reflected the contribution made by neonatal nurses to family-centered care in the NICU. The parents' perspectives of nurses were mostly positive, but some negative aspects attributed to nurses identified in earlier studies persisted.
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Lee CH, Jang MH, Choi YS, Shin H. [The Relationship between Parental Stress and Nurses' Communication as Perceived by Parents of High-risk Newborns]. CHILD HEALTH NURSING RESEARCH 2019; 25:184-195. [PMID: 35004411 PMCID: PMC8650925 DOI: 10.4094/chnr.2019.25.2.184] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 02/26/2019] [Accepted: 03/30/2019] [Indexed: 11/06/2022] Open
Abstract
PURPOSE This study aimed to characterize the relationship between parental stress and nurses' communication as perceived by parents of high-risk newborns in a neonatal intensive care unit (NICU). METHODS The participants were 54 parents of high-risk newborns in a NICU. Data were collected from January to March 2018. Parental stress and parents' perceptions of nurses' communication ability and styles were measured using a questionnaire. RESULTS The average scores for parental stress and nurses' communication ability were 3.39 and 4.38 respectively, on a 5-point scale. Parents most commonly reported that nurses showed a friendly communication style, followed by informative and authoritative styles. Mothers and fathers reported significantly different levels of parental stress. Parental stress showed a negative correlation with nurses' perceived verbal communication ability. Higher scores for nurses' verbal communication ability and for friendly and informative communication styles were associated with lower parental stress induced by the environment, the baby's appearance and behaviors, and treatments in the NICU. CONCLUSION The findings of this study suggest that nurses need to offer proper information for parents and to support parents by encouraging them to express their emotions of stress and by providing parents with therapeutic communication and opportunities to participate in care.
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Affiliation(s)
| | | | | | - Hyunsook Shin
- Corresponding author Hyunsook Shin https://orcid.org/0000-0002-2795-5582 College of Nursing Science, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea TEL +82-2-961-9141 FAX +82-2-961-9398 E-MAIL
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Petty J, Jarvis J, Thomas R. Understanding parents' emotional experiences for neonatal education: A narrative, interpretive approach. J Clin Nurs 2019; 28:1911-1924. [PMID: 30698304 DOI: 10.1111/jocn.14807] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Revised: 12/17/2018] [Accepted: 01/20/2019] [Indexed: 10/27/2022]
Abstract
AIMS AND OBJECTIVES To explore the emotional experiences of parents who have had premature babies to inform and educate neonatal nurses and health professionals in this field. BACKGROUND Parents find the neonatal unit a daunting and unfamiliar place leading to anxiety, uncertainty and fear about the future of their baby. Parents have significant emotional needs in relation to assisting them to cope with their neonatal experience. In line with a family-centred approach to neonatal education, it is essential to teach health professionals about the emotional impact of neonatal care based on an appreciation of the parent experience. DESIGN A narrative-based, interpretive approach was undertaken in line with constructivist learning theory. METHODS Twenty narrative interviews took place, with a total of 23 parents of premature babies. Following core story creation to create coherent stories from the raw transcripts, thematic analysis of the narrative constructs using the principles of Braun and Clarke's, International Journal of Qualitative Studies on Health and Well-Being, 2014, 9, 1, framework was undertaken. The study methods were compliant with the consolidated criteria for reporting qualitative research (COREQ). FINDINGS Thematic analysis revealed key themes relating to the following: parents' emotions through the whole neonatal experience, feelings towards the baby, the environment, the staff and the transitions through the different phases of neonatal care. Both negative and positive experiences were reported. CONCLUSION Understanding the emotional experience from the parent's perspective, following birth of their premature baby, informs empathic, family-centred teaching and learning within the neonatal education arena. RELEVANCE TO CLINICAL PRACTICE Students and health professionals alike can learn what is important in the delivery of care that addresses the emotional needs of parents and families. Educators can use narratives and key messages from parents, both negative and positive, to teach family-centred principles to nurses and health professionals as a core component of a narrative curricula and potentially to enhance empathy.
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Affiliation(s)
| | - Joy Jarvis
- University of Hertfordshire, Hatfield, UK
| | - Rebecca Thomas
- Centre for Staff and Educational Development, University of East Anglia, Norwich, UK
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Ong SL, Abdullah KL, Danaee M, Soh KL, Soh KG, Japar S. Stress and anxiety among mothers of premature infants in a Malaysian neonatal intensive care unit. J Reprod Infant Psychol 2018; 37:193-205. [PMID: 30480464 DOI: 10.1080/02646838.2018.1540861] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE This study aims to determine maternal stress and anxiety as perceived by mothers whose premature infants were admitted to the neonatal intensive care unit (NICU) and to identify maternal stress and its relationship with maternal and infant characteristics and anxiety. BACKGROUND Vulnerable premature infants commonly require special care in the NICUs. In most cases, prolonged hospitalization results in stress and anxiety for the mothers. METHODS A non-probability convenience survey was used in a public hospital, with 180 mothers completing the 26-item Perceived Stress Scale (PSS) and a 40-item State-Trait Anxiety Inventory (STAI). RESULTS 56.5% of mothers had high levels of stress, 85.5% of mothers had a high level of state-anxiety and 67.8% of mothers had a high level of trait-anxiety. The stress experienced by these mothers had a significant relationship with anxiety, and was found to be associated with state and trait anxiety levels, but not with maternal and infant characteristics. CONCLUSION Mothers in this setting revealed high levels of stress and anxiety during their premature infants' NICU admission. An immediate interventional programme focusing on relieving mothers' anxiety and stress is needed to prevent maternal stress and anxiety at an early stage.
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Affiliation(s)
- Swee Leong Ong
- a School of Nursing Science, Faculty of Medicine , Universiti Sultan Zainal Abidin , Terengganu , Malaysia
| | - Khatijah Lim Abdullah
- b Department of Nursing Science , University Malaya , Kuala Lumpur , Malaysia.,c Faculty of Nursing , Universitas Airlangga , Surabaya , East Java Indonesia
| | - Mahmoud Danaee
- d Academic Development Center (ADeC) , University Malaya , Kuala Lumpur , Malaysia
| | - Kim Lam Soh
- e Department of Nursing, Faculty of Medicine and Health Sciences , Universiti Putra Malaysia , Serdang , Malaysia
| | - Kim Geok Soh
- f Department of Sport Studies, Faculty of Education , Universiti Putra Malaysia , Serdang , Malaysia
| | - Salimah Japar
- e Department of Nursing, Faculty of Medicine and Health Sciences , Universiti Putra Malaysia , Serdang , Malaysia
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Son YJ, Lee SK, Nam S, Shim JL. Exploring Research Topics and Trends in Nursing-related Communication in Intensive Care Units Using Social Network Analysis. Comput Inform Nurs 2018; 36:383-392. [PMID: 29742551 DOI: 10.1097/cin.0000000000000444] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study used social network analysis to identify the main research topics and trends in nursing-related communication in intensive care units. Keywords from January 1967 to June 2016 were extracted from PubMed using Medical Subject Headings terms. Social network analysis was performed using Gephi software. Research publications and newly emerging topics in nursing-related communication in intensive care units were classified into five chronological phases. After the weighting was adjusted, the top five keyword searches were "conflict," "length of stay," "nursing continuing education," "family," and "nurses." During the most recent phase, research topics included "critical care nursing," "patient handoff," and "quality improvement." The keywords of the top three groups among the 10 groups identified were related to "neonatal nursing and practice guideline," "infant or pediatric and terminal care," and "family, aged, and nurse-patient relations," respectively. This study can promote a systematic understanding of communication in intensive care units by identifying topic networks. Future studies are needed to conduct large prospective cohort studies and randomized controlled trials to verify the effects of patient-centered communication in intensive care units on patient outcomes, such as length of hospital stay and mortality.
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Affiliation(s)
- Youn-Jung Son
- Author Affiliations: Red Cross College of Nursing, Chung-Ang University (Dr Son), Seoul; College of Nursing, Keimyung University (Dr Lee), Daegu; National Center of Excellence in Software, Chungnam National University (Dr Nam), Daejeon; and Department of Nursing, College of Medicine, Dongguk University (Dr Shim), Gyeongju-si, Gyeongsangbuk-do, Republic of Korea
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Sorèze Y. [Intervention and role of the paediatrician in the delivery room]. SOINS. PEDIATRIE, PUERICULTURE 2018; 39:26-29. [PMID: 29576209 DOI: 10.1016/j.spp.2018.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Some newborns require the presence of a paediatrician in the delivery room, for emergency care. This generally leads to hospitalisation in neonatal intensive care or neonatology. Prematurity and respiratory distress are the main causes. These unexpected situations are a source of anxiety for the parents. It is essential that the multidisciplinary team draws on both its technical and relational expertise, in order to provide optimal treatment to the infant while supporting the parents with the necessary empathy.
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Affiliation(s)
- Yohan Sorèze
- Service de réanimation néonatale et pédiatrique, Hôpital Armand-Trousseau, AP-HP, 26 avenue du Docteur Arnold Netter, 75012 Paris, France.
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Patriksson K, Berg M, Nilsson S, Wigert H. Communicating with parents who have difficulty understanding and speaking Swedish: An interview study with health care professionals. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.jnn.2017.07.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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