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van Zijl AC, Obermann-Borst SA, Hogeveen M, Verweij EJ, de Vries WB, Geurtzen R, Labrie NH. Mind the gap: Comparing parents' information needs about impending preterm birth to current clinical practices using a mixed methods approach. PEC INNOVATION 2024; 4:100297. [PMID: 38962499 PMCID: PMC11219962 DOI: 10.1016/j.pecinn.2024.100297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 05/16/2024] [Accepted: 05/29/2024] [Indexed: 07/05/2024]
Abstract
Objective To identify parents' information needs about impending very preterm birth and compare these needs to current information practices in the Netherlands. Methods Step 1: We surveyed N = 203 parents of preterm infants to assess their information needs. Data were analyzed using inductive thematic analysis. Step 2a: We collected information resources from hospitals (N = 9 NICUs) and via an online search. These materials were analyzed using deductive thematic analysis. Step 2b: We compared findings from Steps 1-2a. Results We identified four themes pertaining to parents' information needs: (1) participation in care, (2) emotional wellbeing, (3) experience/success stories, and (4) practical information about prematurity. Clinicians' communicative skills and time were considered prerequisites for optimal information-provision. Notably, hospital resources provided mainly medical information about prematurity with some emphasis on participation in care, while parent associations mainly focused on emotional wellbeing and experience/success stories. Conclusion While parents demonstrate clear information needs about impending very preterm birth, current information resources satisfy these partially. Innovation Our multidisciplinary research team included both scholars and veteran NICU parents. As such, we identified parents' information needs bottom-up. These parent-driven insights will be used to design an innovative, tailored information platform for parents about impending very preterm birth.
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Affiliation(s)
- Angela C.M. van Zijl
- Department of Neonatology, Wilhelmina Children's Hospital, Lundlaan 6, 3582 EA Utrecht, the Netherlands
| | - Sylvia A. Obermann-Borst
- Care4Neo, Neonatal Patient and Parent Advocacy Organization, Marshallweg 13 (unit 2), 3068 JN Rotterdam, the Netherlands
| | - Marije Hogeveen
- Department of Neonatology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, the Netherlands
| | - E.J.T. Joanne Verweij
- Department of Obstetrics, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands
| | - Willem B. de Vries
- Department of Pediatrics, Emma Children's Hospital, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands
| | - Rosa Geurtzen
- Department of Neonatology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, the Netherlands
| | - Nanon H.M. Labrie
- Department of Language, Literature & Communication, Vrije Universiteit Amsterdam, De Boelelaan 1105, 1081 HV Amsterdam, the Netherlands
- Department of Pediatrics|Neonatology, OLVG Amsterdam, Jan Tooropstraat 164, 1061 AE Amsterdam, the Netherlands
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Bater ML, Gould JF, Collins CT, Anderson PJ, Stark MJ. Child development education in the Neonatal Unit: Understanding parent developmental literacy needs, priorities and preferences. PATIENT EDUCATION AND COUNSELING 2024; 119:108058. [PMID: 37976667 DOI: 10.1016/j.pec.2023.108058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 10/25/2023] [Accepted: 11/07/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVE To describe child development knowledge needs, priorities, and preferences for education to enhance developmental literacy among parents with children admitted to the neonatal unit (NNU). METHODS Two separate cohorts completed a survey; 1) Parents with children graduated from Australian NNUs (n = 316); 2) Parents with infants' inpatient at two South Australian NNUs (n = 209). RESULTS Parents considered it extremely important to understand child development (Graduates: 80%; Inpatients: 71%). Inpatient parents reported lower child development knowledge. Almost half (42%) of graduate parents described the child development education provided by neonatal staff as poor or inadequate. There was consistency in preferences for developmental literacy education provision. Parents desired education to commence during NNU and continue post discharge. Priorities included content specific to preterm birth and how to support child development over the first two years of life. Individualised education by a Neonatal Nurse/Midwife was most preferred. CONCLUSION Mothers and fathers value guidance to support their child's development during NNU admission and early childhood. Our study highlights the importance of improved early developmental literacy education for parents with children admitted to the neonatal unit. PRACTICE IMPLICATIONS Our findings can be used to inform the creation of future educational resources targeting improved parent developmental literacy.
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Affiliation(s)
- Megan L Bater
- Discipine of Paediatrics, Adelaide Medical School, the University of Adelaide, Adelaide, Australia; SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, Australia; Neonatal Unit, Women's and Children's Hospital, Adelaide, Australia; Robinson Research Institute, University of Adelaide, Adelaide, Australia.
| | - Jacqueline F Gould
- Discipine of Paediatrics, Adelaide Medical School, the University of Adelaide, Adelaide, Australia; SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, Australia; School of Psychology, the University of Adelaide, Adelaide, Australia
| | - Carmel T Collins
- Discipine of Paediatrics, Adelaide Medical School, the University of Adelaide, Adelaide, Australia; SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Peter J Anderson
- Turner Institute for Brain and Mental Health & School of Psychological Sciences, Monash University, Melbourne, Australia; Murdoch Children's Research Institute, Melbourne, Australia
| | - Michael J Stark
- Discipine of Paediatrics, Adelaide Medical School, the University of Adelaide, Adelaide, Australia; SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, Australia; Neonatal Unit, Women's and Children's Hospital, Adelaide, Australia; Robinson Research Institute, University of Adelaide, Adelaide, Australia
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Huang L, Zhao BY, Li XT, Huang SX, Chen TT, Cheng X, Li SJ, Li H, Hu RF. Effects of an online family-focused parenting support intervention on preterm infants' physical development and parents' sense of competence and care ability: A randomized controlled trial. Int J Nurs Stud 2024; 149:104625. [PMID: 37952471 DOI: 10.1016/j.ijnurstu.2023.104625] [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: 06/10/2023] [Revised: 10/12/2023] [Accepted: 10/17/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND Parenting of preterm infants presents unique challenges, particularly during their transition from hospital to home. Early discharge programs can assist parents during this critical period. However, the feasibility of delivering a family-focused online discharge program remains understudied. OBJECTIVES This study was conducted to investigate the impact of a family-focused online parenting support intervention on parents' sense of competence, depression, caregiving, social support, family functioning, and the weight and length of preterm infants. METHODS We conducted a single-blind, two-arm randomized controlled trial with a repeated-measures design. Participants were recruited from a specialized tertiary hospital in China between May and December 2022. Forty-five families were randomly assigned to the intervention group and 44 to the control group. The intervention included three components: (1) two one-hour group sessions and three 30-minute individual sessions of online parenting support; (2) two follow-up telephone calls (15-30 min each) post-discharge; and (3) access to online parenting resources. Primary outcomes included parenting sense of competence, parental care ability, and preterm infants' weight and length. Secondary outcomes included depression, social support, and family functioning. Measurements were taken at baseline, preterm infant discharge, one month post-discharge, and three months post-discharge. A generalized estimating equation model was employed based on the intention-to-treat principle for outcome comparison. RESULTS Parents in the intervention group showed significant improvements in parenting sense of competence (P < 0.001), parental care ability (P < 0.001), depression (P < 0.001), and social support (P = 0.002). However, no statistically significant differences were observed in preterm infants' weight and length, or in family functioning (P > 0.05). CONCLUSIONS Although the intervention did not affect preterm infants' outcomes, the positive enhancements in parenting sense of competence, care ability, depression, and social support indicate that online family-focused parenting support can effectively prepare parents for hospital discharge and the early transition period.
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Affiliation(s)
- Long Huang
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Bing-Yue Zhao
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Xiao-Ting Li
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Shui-Xiu Huang
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Ting-Ting Chen
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Xiao Cheng
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Si-Jia Li
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Hao Li
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Rong-Fang Hu
- The School of Nursing, Fujian Medical University, Fuzhou, China.
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Hua W, Zhou J, Wang L, Li C, Zheng Q, Yuwen W, Jiang L. 'It turned my life upside down': Parents' emotional experience of the transition with their preterm infant from birth to discharge Home-A qualitative study. Aust Crit Care 2023; 36:679-686. [PMID: 36464525 DOI: 10.1016/j.aucc.2022.10.007] [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: 05/15/2022] [Revised: 10/06/2022] [Accepted: 10/09/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND A smooth transition from the neonatal intensive care unit (NICU) to home is critical for establishing parents' competence as primary caregivers and ensuring infant health. In the clinical context with a restrictive visiting policy, family-centred care is challenging to implement, prohibiting a smooth transition of care for the families. According to Meleis' Transition Theory, parents might experience emotional change initiated by critical events during this transition. OBJECTIVES The aim of this study was to understand parents' emotional experience of their preterm infant's birth to discharge home from the NICU to facilitate the care transition better. METHODS This qualitative descriptive study using semistructured interviews was conducted between June and August 2020. Purposive sampling was used to recruit 17 parents (6 fathers and 11 mothers) from the NICU of a tertiary hospital in eastern China. Data were analysed using content analysis. RESULTS The following three situational themes characterised by three-phase emotions related to 16 critical events were obtained from the data and were used to describe parents' experiences during the transition: Theme 1, Life falling apart; Theme 2, Feeling anxious and struggling with uncertainty; and Theme 3, Feeling both hopeful and inadequate at discharge. CONCLUSIONS Parents of preterm infants have distinctive emotional experiences in each phase during their infants' transition from the NICU to home. Awareness of parents' critical events and emotional experiences in each phase could help NICU staff anticipate and provide timely and targeted support for parents. The next step is to develop a family-centred intervention for healthcare providers to better prepare parents for the transition from the NICU to home.
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Affiliation(s)
- Wenzhe Hua
- Shanghai Jiao Tong University School of Nursing, 227 Chongqing Road, Shanghai, 200025, PR China
| | - Jingxin Zhou
- Department of Neonatology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kong Jiang Road, Shanghai, 200092, PR China
| | - Liying Wang
- Department of Psychology, University of Washington, 3920 15th Ave NE, Seattle, WA, 98195, USA
| | - Chenxing Li
- Department of Psychology, University of Washington, 3920 15th Ave NE, Seattle, WA, 98195, USA
| | - Qiaomu Zheng
- Shanghai Jiao Tong University School of Nursing, 227 Chongqing Road, Shanghai, 200025, PR China
| | - Weichao Yuwen
- School of Nursing and Healthcare Leadership, University of Washington, 1959 NE Pacific St, Seattle, WA, 98195, USA
| | - Liping Jiang
- Department of Nursing, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kong Jiang Road, 200092, Shanghai, PR China.
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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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Lebel V, Argiropoulos N, Robins S, Charbonneau L, Feeley N. Family-centred care and breastfeeding self-efficacy determined how ready mothers were for their infants to be discharged from a neonatal intensive care unit. Acta Paediatr 2022; 111:2299-2306. [PMID: 36057447 DOI: 10.1111/apa.16538] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 08/16/2022] [Accepted: 09/02/2022] [Indexed: 11/28/2022]
Abstract
AIM We examined if a range of factors were associated with how ready mothers were for their infants to be discharged from a neonatal intensive care unit (NICU). METHODS This was a secondary analysis of a study on the well-being of mothers whose infants were hospitalised in the level 3 NICU at the Jewish General Hospital in Canada. We studied 132 mother-infant dyads: 70 from an open ward NICU and 62 from the purpose-built NICU with pods or single family rooms that replaced it in 2016. The mothers completed a questionnaire on NICU stress and their perceptions of family-centred care on enrolment and another on breastfeeding self-efficacy and readiness to go home a week before discharge. The infants' characteristics were retrieved from the medical files. RESULTS The infants were born at a mean age of 29.8 ±3.1 weeks. Greater family-centred care during early hospitalisation (p=0.01) and greater breastfeeding self-efficacy in the period before discharge (p=0.04) were significantly associated with higher readiness for discharge. The unit design was not a significantly associated with readiness for discharge. CONCLUSION The quality of early family-centred care and breastfeeding self-efficacy were significantly associated with how ready mothers were for their preterm infant to be discharged from the NICU.
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Affiliation(s)
- Valérie Lebel
- Nursing Department, Université du Québec en Outaouais, Saint-Jérôme, Québec, Canada
| | - Nikolas Argiropoulos
- Centre for Nursing Research & Lady Davis Institute, Jewish General Hospital, Montreal, Québec, Canada
| | - Stephanie Robins
- Nursing Department, Université du Québec en Outaouais, Saint-Jérôme, Québec, Canada
| | - Lyne Charbonneau
- Department of Nursing, Jewish General Hospital, Montreal, Québec, Canada
| | - Nancy Feeley
- Centre for Nursing Research & Lady Davis Institute, Jewish General Hospital, Montreal, Québec, Canada.,Ingram School of Nursing, McGill University, Montreal, Québec, Canada
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Ruhe K, van den Hoogen A, Bröring‐Starre T, Wielenga JM, van Weissenbruch MM. Getting a grip in the middle of chaos: Preparing for preterm parenthood during a high-risk pregnancy - Parental experiences and needs. Acta Paediatr 2022; 111:1324-1330. [PMID: 35429200 PMCID: PMC9321692 DOI: 10.1111/apa.16361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 03/23/2022] [Accepted: 04/13/2022] [Indexed: 12/05/2022]
Abstract
Aim Admitting an infant to a neonatal intensive care unit (NICU) is stressful for parents. A great source of stress is the loss of their desired parental role. This study explores parents’ experiences and needs during a high‐risk pregnancy in preparation for their role as parents of a preterm infant. Methods An exploratory qualitative study was conducted among parents with a preterm infant admitted to two level‐III NICUs in the Netherlands. A thematic analysis was performed. Results Nineteen interviews were conducted with parents of preterm infants (26–34 weeks gestational age). Getting a grip in the middle of chaos was identified as the central theme. In the pre‐admission phase, coping with potential preterm parenthood was a theme, with coping strategies as subthemes that changed over time from avoidance to being ready to parent a preterm infant. The theme envisioning the NICU emerged in the NICU admission phase, with subthemes preterm care journey and opportunities for involvement fostering parental empowerment. Conclusion Timing and content of information about a parental role in the NICU should be tailored to the individual expectant parent. A customisable intervention bundle may provide a vision of the NICU and the parents’ active role in care.
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Affiliation(s)
- Kiki Ruhe
- Department of Neonatology Amsterdam University Medical Centers, location VUmc Amsterdam The Netherlands
| | - Agnes van den Hoogen
- Department of Neonatology Wilhelmina Children’s Hospital University Medical Center Utrecht Utrecht The Netherlands
| | - Tinka Bröring‐Starre
- Department of Child Psychiatry and Psychosocial Care Amsterdam University Medical Centers Amsterdam The Netherlands
| | - Joke M. Wielenga
- Department of Neonatology Emma Children's Hospital Amsterdam University Medical Centers, AMC Amsterdam The Netherlands
| | - Mirjam M. van Weissenbruch
- Department of Neonatology Amsterdam University Medical Centers, location VUmc Amsterdam The Netherlands
- Department of Neonatology Amsterdam University Medical Centers Vrije Universiteit Amsterdam The Netherlands
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McKenzie K, Lynch E, Msall ME. Scaffolding Parenting and Health Development for Preterm Flourishing Across the Life Course. Pediatrics 2022; 149:186921. [PMID: 35503323 PMCID: PMC9847416 DOI: 10.1542/peds.2021-053509k] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/27/2021] [Indexed: 01/21/2023] Open
Abstract
Advances in obstetrics and neonatal medicine have resulted in improved survival rates for preterm infants. Remarkably, >75% extremely (<28 weeks) preterm infants who leave the NICU do not experience major neurodevelopmental disabilities, although >50% experience more minor challenges in communication, perception, cognition, attention, regulatory, and executive function that can adversely impact educational and social function resulting in physical, behavioral, and social health issues in adulthood. Even late premature (32-36 weeks) infants have more neurodevelopmental challenges than term infants. Although early intervention and educational programs can mitigate risks of prematurity for children's developmental trajectories, restrictive eligibility requirement and limitations on frequency and intensity mean that many premature infants must "fail first" to trigger services. Social challenges, including lack of family resources, unsafe neighborhoods, structural racism, and parental substance use, may compound biological vulnerabilities, yet existing services are ill-equipped to respond. An intervention system for premature infants designed according to Life Course Health Development principles would instead focus on health optimization from the start; support emerging developmental capabilities such as self-regulation and formation of reciprocal secure early relationships; be tailored to each child's unique neurodevelopmental profile and social circumstances; and be vertically, horizontally, and longitudinally integrated across levels (individual, family, community), domains (health, education), and time. Recognizing the increased demands placed on parents, it would include parental mental health supports and provision of trauma-informed care. This developmental scaffolding would incorporate parenting, health, and developmental interventions, with the aim of improved health trajectories across the whole of the life course.
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Affiliation(s)
- Kamryn McKenzie
- University of Chicago Kennedy Research Center on Intellectual and Neurodevelopmental Disabilities, Chicago, Illinois
| | - Emma Lynch
- University of Chicago Kennedy Research Center on Intellectual and Neurodevelopmental Disabilities, Chicago, Illinois
| | - Michael E. Msall
- Address correspondence to Address correspondence to: Michael E. Msall, MD, Section of Developmental and Behavioral Pediatrics, University of Chicago Kennedy Research Center and Comer Children's Hospital, 936 East 61 St Street, Room 207, Chicago, IL 60637. E-mail:
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