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Lægteskov TR, Holm KG, Petersen M, Lysdal RK, Hjelvang BR, Brødsgaard A. Father Groups in the Neonatal Intensive Care Unit: A Supportive Intervention. Adv Neonatal Care 2023; 23:478-486. [PMID: 37499694 DOI: 10.1097/anc.0000000000001092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
BACKGROUND Parents' participation in the neonatal intensive care unit (NICU) reduces length of stay and positively affects infants' psychological, cognitive, and behavioural outcomes. Healthcare professionals in the NICU focus on both parents, but tend to have the main focus on the mother and the infant. Therefore, fathers may experience a lack of support and feel that they are being disregarded in the NICU. PURPOSE To study fathers' experiences with father groups during NICU admission with their preterm infant. The father group is a 90-minute intervention based on dialogue between fathers and a male healthcare professional. METHODS A qualitative content analysis was conducted using 10 online semistructured interviews with fathers participating in a father group. The study was reported according to the Standards for Reporting Qualitative Research. RESULTS The overall theme emerging from our analysis was "Emotional support, encouragement, and an enhanced capacity to deal with the situation and with life in the NICU." This theme emerged from the categories "Meeting with peers and sharing reflections" and "Fathers' territory" based on 5 subcategories. IMPLICATIONS FOR PRACTICE Participation in father groups gives fathers recognition for being important as parents in the NICU, improves fathers' mental well-being, and enhances their coping capacity. Father groups support fathers in the NICU and can be integrated into NICU practices and policies to enhance a family-centered approach. IMPLICATIONS FOR RESEARCH This study revealed a need for further research to determine whether participation in a father group has a measurable effect on clinical outcomes.
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Affiliation(s)
- Tascha Ravn Lægteskov
- Departments of Paediatrics and Adolescent Medicine (Messrs Lægteskov, Petersen, and Lysdal and Drs Hjelvang and Brødsgaard) and Gynaecology and Obstetrics (Dr Brødsgaard), Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark; Hans Christian Andersen Children's Hospital, Odense University Hospital, and Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark (Dr Holm); and Nursing and Health Institute for Public Health, Aarhus University, Aarhus, Denmark (Dr Brødsgaard)
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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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3
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Gül U, Kobya Bulut H. Assessment of factors and father-infant attachment levels among Turkish's fathers of preterm infants. J Pediatr Nurs 2022; 64:e69-e76. [PMID: 35042639 DOI: 10.1016/j.pedn.2021.12.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 12/20/2021] [Accepted: 12/28/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Identify the factors affecting father-infant attachment among Turkishs fathers of preterm infants. DESIGN AND METHODS This cross-sectional study included 63 fathers of preterm infants between the ages of 6-12 months. Data were collected using the Father-Infant Descriptive Information Form and the Paternal-Infant Attachment Scale (PIAS). Descriptive statistics, independent sample t-tests, mann-whitney test, the kruskal wallis test, the tamhane test, spearman correlation analysis, and linear stepwise regression were used to evaluate the data. RESULTS The average PIAS scores of the fathers in the study was 62.97 ± 8.94. A statistically significant difference was found between the birth weight, clinical picture, and length of stay in the Neonatal Intensive Care Unit (NICU) and PIAS total score of preterm infants (p < 0.01). There was a significant difference between the unplanned hospitalization of the baby after discharge and the father's changing the baby's clothes and the PIAS score (p < 0.05). Birth weight and unplanned hospitalization explained 31% of PIAS total score. CONCLUSIONS According to the results, father-infant attachment levels of fathers of preterm infants were low. Father's involvement in changing the baby's clothes, preterm birth weight, clinical picture, and length of stay in the NICU were found to be associated with PIAS. PRACTICAL IMPLICATIONS It should be remembered that babies can be attached to their fathers as much as they are to their mothers. NICU nurses should initiate father-infant interaction early and ensure fathers' involvement in infant care in the NICU.
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Affiliation(s)
- Uğur Gül
- Akdeniz University, Faculty of Nursing-Department of Pediatric Nursing, Konyaaltı Antalya, Turkey.
| | - Hacer Kobya Bulut
- Karadeniz Technical University Faculty of Health Science, Department of Pediatric Nursing, 61080 Trabzon, Turkey
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Orr E, Ballantyne M, Gonzalez A, Jack SM. Mobilizing Forward: An Interpretive Description of Supporting Successful Neonatal Intensive Care Unit-To-Home Transitions for Adolescent Parents. QUALITATIVE HEALTH RESEARCH 2022; 32:831-846. [PMID: 35316117 PMCID: PMC9152603 DOI: 10.1177/10497323221079785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Pregnancy and parenting in adolescence and the transition home following the hospitalization of an infant in the neonatal intensive care unit (NICU) are two relatively complex phenomena; and whilst each have been consistently explored within the relevant literature, little is understood about the care required when they intersect. Using interpretive description methodology to guide our exploration, we conducted semi-structured interviews with 23 expert providers caring for adolescent parents involved in NICU-to-home transitions to describe this process in their practice. Findings suggest that supporting successful NICU-to-home transitions for adolescent parents relied strongly on understanding the impact of the NICU experience, establishing therapeutic relationships and facilitating supportive partnerships between the NICU and parents as well as the NICU and supportive services post-discharge. Findings highlight the opportunity for more integrated models of care within the NICU and extending into the community to address the complex biopsychosocial care needs of this parent population.
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Affiliation(s)
- Elizabeth Orr
- Department of Nursing, Brock University Faculty of Applied Health
Science, St. Catharines, Ontario, Canada
| | - Marilyn Ballantyne
- School of Nursing, McMaster University, Hamilton, Ontario, Canada
- Holland Bloorview Kids Rehabilitation
Hospital, Toronto, Ontario, Canada
| | - Andrea Gonzalez
- Department of Psychiatry & Behavioural
Neurosciences, McMaster University, Hamilton, Ontario, Canada
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Yurtsever Gök P, Efe E. The effect of Web-based preterm infant care training on mothers' self-confidence. Health Care Women Int 2022:1-13. [PMID: 35254227 DOI: 10.1080/07399332.2022.2039150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 02/03/2022] [Accepted: 02/03/2022] [Indexed: 10/18/2022]
Abstract
The internet can be used as an alternative method in infant care education for mothers of preterm infants. This study was conducted to examine the effect of the Web-based infant care training program given to mothers of preterm infants on the self-confidence levels of mothers. This nonrandomized controlled study with a posttest design was conducted in Ministry of Health training and research hospital and university hospital. The study group comprised 84 mothers and their infants (intervention group: N = 42; control group: N = 42). Mothers with preterm infants in the intervention group participated in the Web-based program. The self-confidence of the mothers was evaluated before and after the training. The mothers' Pharis self-confidence scale mean scores were higher than the control group, but there was no significant difference. Web-based education program can be an alternative method that can be used in the education of mothers with preterm infants.
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Affiliation(s)
- Pelin Yurtsever Gök
- Newborn Intensive Care Unit, Konya Training and Research Hospital, Konya, Turkey
| | - Emine Efe
- Child Health Nursing Department, Akdeniz University, Nursing Faculty, Antalya, Turkey
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McKay K, O’Nions E, Wayland S, Ferguson D, Kennedy E. Fears, Reassurance, and Milestones: A Twitter Analysis around World Prematurity Day during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010807. [PMID: 34682550 PMCID: PMC8535517 DOI: 10.3390/ijerph182010807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 10/05/2021] [Accepted: 10/12/2021] [Indexed: 12/02/2022]
Abstract
Preterm birth (birth <37 completed weeks’ gestation) is common, affecting 10.6% of live births globally (nearly 15 million babies per year). Having a new baby admitted to a neonatal unit often triggers stress and anxiety for parents. This paper seeks to explore experiences of preterm birth via Twitter. The intermingling of COVID-19 restrictions and World Prematurity Day allows for an understanding of both the additional stresses incurred as a consequence of the pandemic and the more “everyday” experiences in the NICU and beyond. The content analysis of the data included 3161 tweets. Three themes were identified: 1. COVID-19 was not the only trauma; 2. Raising awareness, especially World Prematurity Day; and, 3. Baby milestones. These themes highlight the multi-level challenges faced by parents of premature babies and the healthcare professionals involved in their care. The COVID-19 pandemic and the consequent restrictions imposed on parents’ contact with their babies have resulted in immense emotional strain for families. The reported COVID-19 pandemic “baby blind spot” appears to particularly impact this group of babies. Improved understanding of the lived experiences of preterm babies and their families should inform greater awareness and improved support.
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Affiliation(s)
- Kathy McKay
- Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Liverpool L69 3GL, UK
- Research and Development Unit, Tavistock and Portman NHS Foundation Trust, London NW3 5BA, UK;
- Correspondence:
| | - Elizabeth O’Nions
- Research Department of Clinical, Educational & Health Psychology, University of College London, London WC1E 6BT, UK;
| | - Sarah Wayland
- School of Health, University of New England, Armidale 2350, Australia;
| | - David Ferguson
- Formerly, Faculty of Transdisciplinary Innovation, University of Technology Sydney, Sydney 2007, Australia;
| | - Eilis Kennedy
- Research and Development Unit, Tavistock and Portman NHS Foundation Trust, London NW3 5BA, UK;
- Research Department of Clinical, Educational & Health Psychology, University of College London, London WC1E 6BT, UK;
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Adama EA, Adua E, Bayes S, Mörelius E. Support needs of parents in neonatal intensive care unit: An integrative review. J Clin Nurs 2021; 31:532-547. [PMID: 34312923 DOI: 10.1111/jocn.15972] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 06/09/2021] [Accepted: 06/22/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Having an infant in the neonatal intensive care unit (NICU) is associated with intense emotional stress for both mothers and fathers. However, with the right support from staff, this stress can be reduced significantly. Although evidence on needs of parents in the neonatal unit exists, there is lack of a systematic integrative review on the support needs of parents in the neonatal unit. Current review evidence is needed to support busy neonatal unit clinicians in their practice. AIM AND OBJECTIVES The purpose of this integrative review is to explore the current available evidence to describe and understand the support needs of parents of infants in the NICU. METHODS The integrative review process of Whittemore and Knafl (2005) was used to guide this study. Six databases-MEDLINE, CINHAL, PubMed, Scopus, Google Scholar and PsycINFO-were searched for eligible studies using relevant keywords. Primary studies published in English language from 2010 to 2021 were reviewed following a pre-determined inclusion criteria. Studies that met the inclusion criteria were critically appraised using the Mixed Methods Appraisal Tool (MMAT). The review report is guided by the PRISMA 2020 checklist for systematic reviews. RESULTS Overall, 24 primary qualitative, quantitative and mixed methods studies were included in the review. Analysis of included studies resulted in six themes that demonstrate the support needs of parents in the NICU; 1. Information needs; 2. Emotionally intelligent staff; 3. Hands-on support; 4. Targeted support; 5. Emotional needs; and 6. Practical needs. CONCLUSION This review has presented the current evidence on the needs of parents from their own perspective. Healthcare workers' understanding and supporting these needs in the NICU is likely to increase parental satisfaction and improve health outcomes for parents, infants and their family. RELEVANCE TO CLINICAL PRACTICE Parents of infants in the NICU require staff support to enhance their experiences, well-being, caring and parenting confidence during admission and post-discharge. As parents are in constant need for informational, emotional and practical support, continuing professional development for NICU staff should place emphasis on effective communication strategies, enhancing emotional intelligence and empathy among staff. NICU staff should build positive ongoing relationships with parents and provide targetted support for mothers and fathers.
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Affiliation(s)
- Esther Abena Adama
- School of Nursing and Midwifery, Edith Cowan University, Perth, Western Australia, Australia
| | - Eric Adua
- School of Nursing and Midwifery, Edith Cowan University, Perth, Western Australia, Australia.,Department of Biochemistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Sara Bayes
- School of Nursing and Midwifery, Edith Cowan University, Perth, Western Australia, Australia.,Faculty of Health Sciences, School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, Victoria, Australia
| | - Evalotte Mörelius
- School of Nursing and Midwifery, Edith Cowan University, Perth, Western Australia, Australia.,Perth Children's Hospital, Perth, Western Australia, Australia
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The Complexity of the NICU-to-Home Experience for Adolescent Mothers: Meleis' Transitions Theory Applied. ANS Adv Nurs Sci 2020; 43:349-359. [PMID: 33136587 DOI: 10.1097/ans.0000000000000299] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Quality care for individuals and families during periods of transition is one of the major issues facing health care systems and providers today. The transition-home from the neonatal intensive care unit (NICU) as experienced by adolescent mothers is poorly understood-placing young mothers and their infants at risk of poor outcomes following NICU discharge. Meleis' Transitions Theory offers a unique theoretical perspective for understanding this transition experience and also serves to highlight the complexity of the NICU-to-home transition for this population of young mothers that is not currently elucidated in the literature.
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Ochandorena-Acha M, Noell-Boix R, Yildirim M, Cazorla-Sánchez M, Iriondo-Sanz M, Troyano-Martos MJ, Casas-Baroy JC. Experiences and coping strategies of preterm infants' parents and parental competences after early physiotherapy intervention: qualitative study. Physiother Theory Pract 2020; 38:1174-1187. [PMID: 32892686 DOI: 10.1080/09593985.2020.1818339] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Birth before term is a stressful experience for parents because of the unexpected delivery or admission to the neonatal intensive care unit. OBJECTIVE This research aimed to evaluate the impact of the early PT intervention on preterm infants' parents' experiences, and also to obtain knowledge about parents' experiences and perceived difficulties during preterm infants' care. METHODS This qualitative study is based on the methods of phenomenology. In the first phase, open interviews were developed to allow researchers to immerse themselves in the context of the study and refine the questions for the semi-structured interviews. Data collected from the semi-structured interviews were analyzed through content analysis. RESULTS The results were summarized around three themes: 1) parental competence; 2) difficulties during preterm infants' care; and 3) coping strategies. Each theme was divided into two sub-themes. CONCLUSION Mothers and fathers of preterm infants experienced difficulties when caring for their babies. Parents that received the early physiotherapy intervention felt empowered to take care of their babies and to enhance infants' development. These parents were more capable of developing coping strategies after the intervention. Parents that did not receive the early physiotherapy intervention expressed difficulties when caring for their preterm babies.
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Affiliation(s)
- Mirari Ochandorena-Acha
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare. Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), Vic, Spain
| | - Rosa Noell-Boix
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare. Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), Vic, Spain
| | - Meltem Yildirim
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare. Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), Vic, Spain
| | - Maria Cazorla-Sánchez
- Neonatal Department, Sant Joan De Deu Barcelona Children's Hospital, Barcelona, Spain
| | - Martín Iriondo-Sanz
- Neonatal Department, Sant Joan De Deu Barcelona Children's Hospital, Barcelona, Spain
| | | | - Joan Carles Casas-Baroy
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare. Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), Vic, Spain
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Fernández-Alcántara M, Schul-Martin L, García Caro MP, Montoya-Juárez R, Pérez-Marfil MN, Zech E. 'In the hospital there are no care guidelines': experiences and practices in perinatal loss in Spain. Scand J Caring Sci 2020; 34:1063-1073. [PMID: 31922624 DOI: 10.1111/scs.12816] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 12/16/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND OBJECTIVES Healthcare professionals play an important role in supporting and attending to families that experience a perinatal loss. Previous research has identified the existence of obstacles that professionals may encounter during their practices. The main objective of the current research was to identify and examine the subjective experiences and practices of experienced professionals attending to perinatal loss in the hospital context in Spain. DESIGN Qualitative descriptive design. SETTING Three different hospitals in Spain. PARTICIPANTS Sixteen professionals were interviewed, including doctors, nurses, midwives, nursing assistants, a psychologist and a funeral home manager. METHODS Individual semi-structured interviews focusing on three areas were carried out: practices with the baby-foetus, practices with parents and interaction with the team. A thematic analysis was performed using the three main focuses of the semi-structured interview (deductive approach) and the codes that emerged from the data (inductive approach). RESULTS Regarding guideline-based care for the baby/foetus, participants made a distinction between the initial process of care for the baby and the decision-making process with parents. Where support for families was concerned, participants identified considerable variability in the practices used and lack of organisational and care guidelines, psychological support and follow-up. Finally, interactions with other team members were perceived as a source of support, although participants identified a significant lack of coordination. CONCLUSION Participants reported variability of practices in care for the baby and parents, lack of continuity-of-care guidelines and the importance of support from a coordinated healthcare team.
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Affiliation(s)
- Manuel Fernández-Alcántara
- Mind, Brain, and Behaviour Research Centre (CIMCYC), University of Granada, Granada, Spain.,Department of Health Psychology, University of Alicante, Alicante, Spain
| | - Laetitia Schul-Martin
- Psychological Sciences Research Institute, Catholic University of Louvain, Louvain, Belgium
| | - Mª Paz García Caro
- Mind, Brain, and Behaviour Research Centre (CIMCYC), University of Granada, Granada, Spain.,Department of Nursing, University of Granada, Granada, Spain
| | - Rafael Montoya-Juárez
- Mind, Brain, and Behaviour Research Centre (CIMCYC), University of Granada, Granada, Spain.,Department of Nursing, University of Granada, Granada, Spain
| | - Mª Nieves Pérez-Marfil
- Mind, Brain, and Behaviour Research Centre (CIMCYC), University of Granada, Granada, Spain.,Department of Personality, Psychological Assessment and Treatment, University of Granada, Granada, Spain
| | - Emmanuelle Zech
- Psychological Sciences Research Institute, Catholic University of Louvain, Louvain, Belgium
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Yu X, Zhang J, Yuan L. Chinese Parents' Lived Experiences of having Preterm Infants in NICU: A Qualitative Study. J Pediatr Nurs 2020; 50:e48-e54. [PMID: 31787470 DOI: 10.1016/j.pedn.2019.11.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 10/11/2019] [Accepted: 11/09/2019] [Indexed: 11/26/2022]
Abstract
PURPOSE To explore Chinese parents' experiences and expectations of having preterm infants in a Chinese neonatal intensive care unit. DESIGN AND METHODS A qualitative descriptive design with semi-structured interviews was used to describe the experiences and expectations of parents of preterm infants in a neonatal intensive care unit in the central region of China. Purposive sampling was adopted to recruit parents (n = 15) of preterm infants and data were collected by face-to-face interviews from January to May 2018. Themes were identified by thematic analysis. This study followed the consolidated criteria for reporting qualitative research (COREQ). RESULTS Five themes emerged from the analysis: (1) mixed emotional experiences; (2) separation from the infants; (3) perceived incompetence in taking care of preterm infants; (4) obtained support through various sources; (5) desired more from healthcare professionals. CONCLUSIONS Parents experienced additional emotional burdens due to separation from their infants as well as a lack of an effective approach to their associated needs. While NICU staff adopted several strategies to help parents cope with their infant hospitalization, these parents still expected to receive more support from healthcare providers to meet their needs. PRACTICE IMPLICATIONS Healthcare providers should be more aware of parents' various needs in neonatal intensive care units and of their important role as constant caregivers. Hospital-based neonatal care should be specifically designed to supply positive support and necessary strategies for parents to strengthen their confidence in parenting infants.
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Affiliation(s)
- Xiaoyan Yu
- School of Health Sciences, Wuhan University, Wuhan, China; Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jun Zhang
- School of Health Sciences, Wuhan University, Wuhan, China.
| | - Lu Yuan
- Wuhan Medical Care Center for Women and Children, Wuhan, China
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12
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Felipin LCS, Oliveira RRD, Merino MDFGL, Rodrigues BC, Higarashi IH. Associated factors for acute kidney injury in preterm infants. Rev Bras Enferm 2019; 72:118-124. [DOI: 10.1590/0034-7167-2018-0231] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 09/23/2018] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objective: to analyze the prevalence and factors associated with acute kidney injury in preterm newborns. Method: a cross-sectional study based on records data of preterm newborns hospitalized in two neonatal units in northwest Paraná State in 2015. For data analysis, the logistic regression model was used by the stepwise forward method and Fisher’s Exact Test. Results: 132 preterm newborns, with a prevalence of 7.5% of acute kidney injury, were hospitalized. Majority of males, extremely preterm and very low birth weight. Associated factors were the use of non-nephrotoxic antibiotics and the presence of mechanical pulmonary ventilation, increasing the chance of developing acute kidney damage by 2.98 and 1.33/day, respectively. Hospitalization days constituted a protection factor. Conclusion: this study was able to identify the prevalence, and outline the variables associated with acute kidney injury in preterm newborns in a particular care situation.
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Amorim M, Alves E, Kelly-Irving M, Silva S. Needs of parents of very preterm infants in Neonatal Intensive Care Units: A mixed methods study. Intensive Crit Care Nurs 2019; 54:88-95. [DOI: 10.1016/j.iccn.2019.05.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 03/29/2019] [Accepted: 05/31/2019] [Indexed: 11/16/2022]
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14
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Lundqvist P, Weis J, Sivberg B. Parents’ journey caring for a preterm infant until discharge from hospital‐based neonatal home care—A challenging process to cope with. J Clin Nurs 2019; 28:2966-2978. [DOI: 10.1111/jocn.14891] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 03/16/2019] [Accepted: 04/14/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Pia Lundqvist
- Department of Health Sciences, Faculty of Medicine Lund University Lund Sweden
| | - Janne Weis
- Neonatal Department and the Research Unit for Women’s and Children’s Health Copenhagen University Hospital Copenhagen Denmark
| | - Bengt Sivberg
- Department of Health Sciences, Faculty of Medicine Lund University Lund Sweden
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15
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Experiences of Mothers of Extremely Preterm Infants after Hospital Discharge. J Pediatr Nurs 2019; 45:e2-e8. [PMID: 30581066 DOI: 10.1016/j.pedn.2018.12.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 12/07/2018] [Accepted: 12/07/2018] [Indexed: 11/21/2022]
Abstract
PURPOSE The purpose of this study was to describe and understand the experiences of mothers of extremely preterm infants during the first twelve months at home following discharge from a neonatal intensive care unit. DESIGN AND METHODS A qualitative, interpretative approach using Gadamer's philosophical hermeneutics was carried out. One focus group and fifteen in-depth, semi-structured interviews were conducted twelve months after hospital discharge. Responses were recorded, transcribed and analyzed using computer-assisted qualitative data analysis. RESULTS The study´s participants were twenty women. The following themes emerged from the data analysis: 1) 'The journey home: the discharge process', which included the sub-themes 'escaping the hospital environment: between desire and fear' and 'preparing parents for hospital discharge: practice and formal support'; and 2) 'The difficulty of living with an extremely preterm infant', including the sub-themes 'the challenge of an unexpected form of childcare', 'overprotection of and bond with a child with special needs' and 'disturbance in the social/familiar setting: when a mother becomes a nurse'. CONCLUSIONS The process of hospital discharge and the first months at home are difficult. The birth and care of an extremely preterm infant affect the mothers' quality of life as well as their family and social life. Practice and early discharge programmes can make the discharge process easier. PRACTICE IMPLICATIONS The knowledge and understanding of the experience of mothers of extremely preterm infants in the first months at home after hospital discharge could help healthcare professionals to develop educational strategies and counselling interventions in accordance with the mothers' needs.
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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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Abstract
A neonatal early discharge (NED) program is a supported process where preterm infants leave hospital before they have established full sucking feeds and are gavage fed by their parents while they transition to breast- and/or bottle-feeds. While there is some evidence in the literature describing the outcomes of this process for preterm infants, there is even more limited evidence of the effects and outcomes of these NED programs on parents. The objective of this study was to summarize and critically appraise the literature regarding the effects of NED on parents. A literature search was conducted for English language publications since 2007 using MEDLINE, Cumulative Index of Nursing and Allied Health Literature (CINAHL), PsycINFO, and Google Scholar. A total of 20 primary articles met the inclusion criteria for the review. An integrative thematic synthesis identified 4 themes: establishing parenting skills/confidence; bonding with the newborn; psychological distress; and the need for support and resources. Findings suggest that parents have various concerns regarding discharge from the neonatal unit and therefore support from healthcare professionals and family plays a crucial role during the experience. There were also various external factors such as socioeconomic status and cultural differences that impact on parents differently, and it is therefore challenging to draw definite conclusions. This warrants further research in the area.
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Petty J, Whiting L, Green J, Fowler C. Parents' views on preparation to care for extremely premature infants at home. Nurs Child Young People 2018; 30:e1084. [PMID: 29975481 DOI: 10.7748/ncyp.2018.e1084] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2018] [Indexed: 11/09/2022]
Abstract
AIM To gain insight into the post-discharge experiences of parents in relation to the adequacy of preparation for caring for extremely premature infants at home. METHOD A narrative approach was drawn on to facilitate data collection, through face-to-face semi-structured interviews with 14 parents of extremely premature infants. FINDINGS Constant comparative analysis was used to allow the emergence of five key research themes - emotional and mental health of parents, uncertain outcomes, ongoing health needs of the baby, educational needs of health professionals, and parental support and preparation for transition home. CONCLUSION Parental experience of being discharged home with a premature baby can be emotionally challenging and necessitates a range of support mechanisms to help them to cope with this period of transition. Health professionals can direct parents to appropriate counselling services, resources and peer support groups. Tailored education is needed for community-based health professionals, such as health visitors, to equip them to support parents practically and emotionally during the transition home and beyond. In addition, health professionals can learn much from parents about what is needed to support them.
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Affiliation(s)
- Julia Petty
- Department of nursing and social work, University of Hertfordshire, England
| | - Lisa Whiting
- University of Hertfordshire, Hertfordshire, England
| | - Janet Green
- University of Technology Sydney, New South Wales, Australia
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Garne Holm K, Brødsgaard A, Zachariassen G, Smith AC, Clemensen J. Parent perspectives of neonatal tele-homecare: A qualitative study. J Telemed Telecare 2018; 25:221-229. [PMID: 29792079 DOI: 10.1177/1357633x18765059] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Neonatal homecare for preterm infants is a method of supporting families and monitoring infant growth in the home setting. Telehealth may be used to deliver specialist neonatal care remotely, using online communication methods. This study explored parental experiences with neonatal tele-homecare (NTH). METHODS Semi-structured interviews were conducted with 49 parents whose preterm infants had received NTH from a neonatal intensive care unit (NICU) in Denmark. Interview transcripts were analysed using Malterud's systematic text condensation. RESULTS Parents experienced NTH as a personalised method for linking to specialist staff in the NICU. NTH promoted the parent's role as the primary care provider, further strengthening the parent-infant relationship. DISCUSSION From the perspective of parents with preterm infants requiring specialist care, NTH is a useful method of supporting families in the home. Telehealth provides effective communication links with NICU specialists and encourages family-centred care.
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Affiliation(s)
- Kristina Garne Holm
- 1 Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,2 Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | - Anne Brødsgaard
- 3 Department of Pediatrics, Copenhagen University Hospital Amager Hvidovre, Capital Region of Denmark, Denmark.,4 Department of Nursing Science, Faculty of Public Health, Aarhus University, Denmark
| | - Gitte Zachariassen
- 1 Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,2 Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | - Anthony C Smith
- 5 Centre for Online Health, University of Queensland, Brisbane, Australia
| | - Jane Clemensen
- 1 Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,2 Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark.,6 Centre of Innovative Medical Technology, Odense University Hospital, Odense, Denmark
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Evolución de indicadores de cuidados tras una intervención de alta precoz en recién nacidos prematuros. ENFERMERIA CLINICA 2017. [DOI: 10.1016/j.enfcli.2017.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Flacking R, Thomson G, Axelin A. Pathways to emotional closeness in neonatal units - a cross-national qualitative study. BMC Pregnancy Childbirth 2016; 16:170. [PMID: 27430590 PMCID: PMC4949764 DOI: 10.1186/s12884-016-0955-3] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Accepted: 07/09/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Research shows evidence for the importance of physical and emotional closeness for the infant, the parent and the infant-parent dyad. Less is known about how, when and why parents experience emotional closeness to their infants in a neonatal unit (NU), which was the aim of this study. METHODS A qualitative study using a salutogenic approach to focus on positive health and wellbeing was undertaken in three NUs: one in Sweden, England and Finland. An 'emotional closeness' form was devised, which asked parents to describe moments/situations when, how and why they had felt emotionally close to their infant. Data for 23 parents of preterm infants were analyzed using thematic networks analysis. RESULTS A global theme of 'pathways for emotional closeness' emerged from the data set. This concept related to how emotional, physical, cognitive and social influences led to feelings of emotional closeness between parents and their infants. The five underpinning organising themes relate to the: Embodied recognition through the power of physical closeness; Reassurance of, and contributing to, infant wellness; Understanding the present and the past; Feeling engaged in the day to day and Spending time and bonding as a family. CONCLUSION These findings generate important insights into why, how and when parents feel emotionally close. This knowledge contributes to an increased awareness of how to support parents of premature infants to form positive and loving relationships with their infants. Health care staff should create a climate where parents' emotions and their emotional journey are individually supported.
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Affiliation(s)
- Renée Flacking
- School of Education, Health and Social Studies, Dalarna University, 79188, Falun, Sweden.
| | - Gill Thomson
- Maternal and Infant Nutrition and Nurture Unit (MAINN), School of Community Health and Midwifery, University of Central Lancashire, Preston, UK
| | - Anna Axelin
- Department of Nursing Science, University of Turku, Turku, Finland
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