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Harlow AB, Ledbetter L, Brandon DH. Parental presence, participation, and engagement in paediatric hospital care: A conceptual delineation. J Adv Nurs 2024; 80:2758-2771. [PMID: 38037504 DOI: 10.1111/jan.15996] [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: 03/03/2023] [Revised: 11/10/2023] [Accepted: 11/19/2023] [Indexed: 12/02/2023]
Abstract
AIM To delineate between the concepts of parental presence, participation, and engagement in paediatric hospital care. DESIGN The concepts' uses in the literature were analysed to determine attributes, influences, and relationships. METHODS Delineations of each concept are established and conceptual definitions are proposed following Morses' methods. DATA SOURCES MEDLINE (PubMed); CINAHL, PsycINFO, Sociology Source Ultimate (EBSCOhost); Embase, Scopus (Elsevier); Google Scholar. Search dates October 2021, February 2023. RESULTS Multinational publications dated 1991-2023 revealed these concepts represent a range of parental behaviours, beliefs, and actions, which are not always perceptible to nurses, but which are important in family-integrated care delivery. Parental presence is the state of a parent being physically and/or emotionally with their child. Parental participation reflects parents' performing caregiving activities with or without nurses. Parental engagement is a parents' state of emotional involvement in their child's health and the ways they act on their child's behalf. CONCLUSION These concepts' manifestations are important to parental role attainment but may be inadequately understood and considered by healthcare providers. IMPLICATIONS Nurses have influence over parents' parental presence, participation, and engagement in their child's care but need support from healthcare institutions to ensure equitable family-integrated care delivery. IMPACT Problem: Lack of clear definition among these concepts results in incomplete and at times inequitable family-integrated care delivery. FINDINGS Parental presence is an antecedent to parental participation, and parental presence and participation are elements of parental engagement. The concepts interact to influence one another. IMPACT Hospitalized children, their families, nurses, and researchers will benefit through a better understanding of the concepts' attributes, interactions, and implications for enhanced family-integrated care delivery.
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Affiliation(s)
| | - Leila Ledbetter
- Duke University Medical Center Library and Archives, Durham, North Carolina, USA
| | - Debra H Brandon
- Duke University School of Nursing, Durham, North Carolina, USA
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Weber A, Bakas T, Schulman-Green D, Voos KC, Rice JB, Bailey R, Reigel A, Oudat Q, Holmes M, Tubbs-Cooley HL, Kaplan HC. Family Management Skills Reported by Parents of Preterm Infants in the NICU Using the Self- and Family Management Framework (SFMF). Adv Neonatal Care 2024; 24:119-131. [PMID: 38127650 PMCID: PMC10978294 DOI: 10.1097/anc.0000000000001140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
BACKGROUND Across the globe, family-integrated care (FICare) has become an evidence-based standard in which parents deliver the majority of infant care in the neonatal intensive care unit (NICU). Because of extensive barriers to parent presence, adaptations to FICare may be required for successful implementation. Family management theory may provide structure to the Parent Education of FICare and help nurses guide parents' skill development as equal care members. PURPOSE To identify family management skills employed by NICU parents using the Self- and Family Management Framework (SFMF). METHODS We conducted secondary analyses of qualitative interview data from NICU parents (n = 17) who shared their experiences of using family management skills to care for their infant. We categorized skills according to 3 main self- and family management processes: Focusing on Infant Illness Needs; Activating Resources; and Living With Infant Illness. RESULTS Parents reported several family management skills currently identified in the SFMF, as well as new skills such as conflict management, power brokerage, and addressing resources related to social determinants of health. Parent activation of resources was critical to sustaining parent focus on the infant's illness needs. IMPLICATIONS FOR PRACTICE AND RESEARCH By teaching skills that parents reported as helping them manage infant care, neonatal nurses may better facilitate parent integration into the care team. Future researchers can incorporate the skills identified in this study into the design of family management interventions that facilitate FICare implementation in the United States.
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Affiliation(s)
- Ashley Weber
- Author Affiliations: University of Cincinnati College of Nursing, Cincinnati, Ohio (Drs Weber and Bakas and Mr Oudat); New York University Rory Meyers College of Nursing, New York City, New York (Dr Schulman-Green); Case Western Reserve University School of Medicine, Cleveland, Ohio (Dr Voos, Mr Bailey, and Mss Reigel and Holmes); Rainbow Babies and Children's Hospital, Cleveland, Ohio (Dr Rice); The Ohio State University, Columbus, Ohio (Dr Tubbs-Cooley); and Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio (Dr Kaplan)
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Rubinstein R, Gallagher K, Ho J, Bose J, Khashu M, Aladangady N. Investigating Father or Partner Involvement in Family Integrated Care in Neonatal Units: Protocol for a Prospective, Multicenter, Multiphase Study. JMIR Res Protoc 2024; 13:e53160. [PMID: 38526549 PMCID: PMC10990416 DOI: 10.2196/53160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 03/26/2024] Open
Abstract
BACKGROUND Neonatal unit (NU) admissions for premature babies can last for months, which can significantly impact parental mental health (MH) with symptoms of depression, stress, and anxiety. Literature suggests fathers experience comparable MH symptoms to mothers. Family integrated care (FICare) is a culture where parents are collaborators and partners in caring for their hospitalized newborns. FICare improves infant outcomes and maternal MH. Similar reports on fathers are limited. OBJECTIVE The primary aim of this study is to investigate the impact of supporting father or partner engagement in FICare of preterm infants on their MH up to 6 weeks postdischarge. The secondary aim is to investigate the impact on maternal MH. METHODS This is a 2-phase study: phase 1 to gather baseline information and phase 2 to assess the impact of enhanced father or partner engagement in FICare on their MH, involving 2 NUs (tertiary and level 2). Enhanced FICare will be developed and introduced (eg, information booklet, workbook, classes, and a father peer-support group) alongside standard FICare practices. Father or partner MH will be assessed with semistructured qualitative interviews and validated questionnaires: Generalized Anxiety Disorder Assessment, Patient Health Questionnaire, and Parental Stressor Scale: Neonatal Intensive Care Unit from NU admission to 6 weeks postdischarge. Mothers will be assessed by focus groups and the same questionnaires. Descriptive statistics and appropriate comparative tests, such as the 2-tailed t test, will be used to analyze and compare phase 1 and 2 data. Qualitative data will be coded line by line with the use of NVivo (Lumivero) and thematically analyzed. Simultaneously, systematic reviews (SRs) of fathers' experiences of FICare and their MH outcomes will be conducted. The study was approved by the National Research Ethics Committee (22/EM/0140) in August 2022. A parent advisory group was formed to advise on the study methodology, materials, involvement of participant parents, and dissemination of study findings. RESULTS A recent SR demonstrated that data saturation is likely to be achieved by interviewing 9 to 17 participants. We will study a maximum of 20 parents of infants born at less than 33 weeks' gestation in each phase. As of October 2023, the study was ongoing. The SR studies are registered with the PROSPERO database (324275 and 306760). The projected end date for data collection is July 2024; data analysis will be conducted in November 2024 and publication will occur in 2025. CONCLUSIONS The study aims to demonstrate the feasibility of using a father or partner-sensitive FICare model for parents of premature babies with a positive impact on their MH. It will demonstrate the feasibility of providing FICare to extremely premature babies receiving intensive care. This study may support the development of inclusive FICare guidelines for nonbirthing parents and their extremely premature infants. TRIAL REGISTRATION ClinicalTrials.gov: NCT06022991; https://classic.clinicaltrials.gov/ct2/show/NCT06022991. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/53160.
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Affiliation(s)
- Rupa Rubinstein
- Neonatal Unit, Homerton Healthcare NHS Foundation Trust, London, United Kingdom
- Blizard Institute, Queen Mary University London, London, United Kingdom
| | - Katie Gallagher
- Institute of Women's Health, University College London, London, United Kingdom
| | - John Ho
- Neonatal Unit, Whipps Cross University Hospital, Barts Health, London, United Kingdom
| | - Julian Bose
- Inspire Cornwall Community Interest Company's DadPad, The Health and Wellbring Innovation Centre, Truro, United Kingdom
| | - Minesh Khashu
- Neonatal Unit, University Hospitals Dorset NHS Foundation Trust, Dorset, United Kingdom
| | - Narendra Aladangady
- Neonatal Unit, Homerton Healthcare NHS Foundation Trust, London, United Kingdom
- Blizard Institute, Queen Mary University London, London, United Kingdom
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Worrall S, Christiansen P, Khalil A, Silverio SA, Fallon V. Associations between prematurity, postpartum anxiety, neonatal intensive care unit admission, and stress. Front Psychiatry 2024; 15:1323773. [PMID: 38463430 PMCID: PMC10921229 DOI: 10.3389/fpsyt.2024.1323773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 02/02/2024] [Indexed: 03/12/2024] Open
Abstract
Introduction It is well established that a premature birth increases the likelihood of developing anxiety during the postpartum period, and that the environment of the neonatal intensive care unit (NICU) might be a contributing factor. Mothers of earlier premature infants may experience these anxieties to a higher degree compared to mothers of later premature infants. The aim of this study was to explore the association between prematurity and postpartum-specific anxiety, and the relationship between postpartum-specific anxiety and stress in the NICU. Materials and methods Mothers (N = 237) of infants aged between birth and 12 months completed an online survey containing the Postpartum Specific Anxiety Scale - Research Short Form (PSAS-RSF) and the Parental Stressor Scale: Neonatal Intensive Care Unit (PSS:NICU). Structural equation modeling was used to analyze the relationship between gestational age and postpartum-specific anxiety, with one-way ANOVAs used to analyze this relationship with respect to categories of gestational age. Hierarchical regression models analyzed the relationship between postpartum-specific anxiety and stress in the NICU. Results For the PSAS-RSF, Practical Infant Care Anxieties (p = 0.001), Maternal Competence and Attachment Anxieties (p = 0.033), and Infant Safety and Welfare Anxieties (p = 0.020) were significantly associated with week of gestation. Practical Infant Care and Infant Safety and Welfare Anxieties were significantly higher for mothers of late premature infants, compared to mothers of term infants (p < 0.001; p = 0.019). There were no significant between-group differences with respect to Maternal Competence and Attachment Anxieties. After controlling for potential confounders, Infant Safety and Welfare Anxieties were significantly associated with increased stress in the NICU (p < 0.001) as measured by the PSS:NICU. Conclusions Our findings highlight the need for interventions for mothers with premature infants, which specifically target anxieties reflected in the PSAS-RSF, such as routine care and increasing maternal self-efficacy.
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Affiliation(s)
- Semra Worrall
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
| | - Paul Christiansen
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
| | - Asma Khalil
- Fetal Medicine Unit, Liverpool Women’s NHS Foundation Trust, Liverpool, United Kingdom
- Fetal Medicine Unit, St George’s University Hospitals NHS Foundation Trust, London, United Kingdom
| | - Sergio A. Silverio
- Department of Women & Children’s Health, School of Life Course & Population Sciences, King’s College London, London, United Kingdom
- School of Psychology, Faculty of Health, Liverpool John Moores University, Liverpool, United Kingdom
| | - Victoria Fallon
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
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Mvula MG, Frade Garcia A, Namwali L, Matanje BL, Mphande I, Munyaneza F, Kapira S, Hansen A. Introduction of a novel neonatal warming device in Malawi: an implementation science study. Int Health 2024:ihad114. [PMID: 38214598 DOI: 10.1093/inthealth/ihad114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 11/09/2023] [Accepted: 01/04/2024] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND Neonatal hypothermia significantly contributes to infant morbidity and mortality in low-resource settings like Malawi. Kangaroo mother care (KMC) is essential but faces challenges in providing continuous thermal support. The Dream Warmer is a neonatal warming device that was developed to complement KMC. We studied its implementation outside a research environment. METHODS Using an implementation science approach, we conducted a prospective interventional cohort study in two hospitals and four health centres in Malawi. Through audits and surveys, we assessed the effect of the Dream Warmer on neonatal hypothermia as well as healthcare provider (HCP) and parent attitudes regarding thermoregulation and related issues. RESULTS The Dream Warmer raised no safety concerns and effectively treated hypothermia in 90% of uses. It was positively received by HCPs and parents, who reported it had a favourable effect on the care of small and sick newborns. Challenges identified included a scarcity of water and electricity, lack of availability of the device and HCPs forgetting to prepare it in advance of need or to use it when indicated. Feedback for future training was obtained. The Dream Warmer's strong safety and effectiveness performance is consistent with results from strict research studies. Training materials can be adapted to optimize integration into daily practice and provide educational content for parents. CONCLUSIONS The Dream Warmer is a safe and effective device to treat neonatal hypothermia, particularly when KMC is insufficient. We gained an understanding of how to optimize implementation through robust HCP and family education to help combat hypothermia.
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Affiliation(s)
| | - Alejandro Frade Garcia
- Boston Children's Hospital, Boston, MA 02115, USA
- Harvard Medical School, Boston, MA 02115, USA
| | | | | | | | | | | | - Anne Hansen
- Boston Children's Hospital, Boston, MA 02115, USA
- Harvard Medical School, Boston, MA 02115, USA
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Franck LS, Hodgson C, Gay CL, Bisgaard R, Cormier DM, Joe P, Lothe B, Sun Y. Mobile-Enhanced Family-Integrated Care for Preterm Infants: Nurse and Physician Views About Implementation. Adv Neonatal Care 2023; 23:565-574. [PMID: 37948639 DOI: 10.1097/anc.0000000000001117] [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: 11/12/2023]
Abstract
BACKGROUND The mobile-enhanced family-integrated care (mFICare) model addresses inconsistencies in family-centered care (FCC) delivery, with an evidence-based bundle of staff training, parent participation in rounds, parent classes, parent peer mentors, expanded role for parents in infant caregiving, and a parent-designed app. PURPOSE Our aim was to explore the views of neonatal intensive care unit (NICU) nurses and physicians about mFICare implementation, including what worked well and what could be improved. METHODS As part of a larger study to compare mFICare with FCC, we invited registered nurses, nurse practitioners, and fellow and attending physicians at the 3 study sites to participate in a survey about mFICare implementation. Data were analyzed with descriptive statistics and thematic analysis. RESULTS The majority of the 182 respondents with experience delivering mFICare positively rated parent-led rounds, parent classes, parent skills acquisition, and the nurse-family relationship resulting from participation in mFICare. Respondents were less familiar or neutral regarding the parent peer mentor and app components of mFICare. Most respondents agreed that the mFICare program improved parent empowerment, and they shared suggestions for optimizing implementation. Physicians experienced more challenges with parent participation in rounds than nurses. Three themes emerged from the free-text data related to emotional support for parents, communication between staff and parents, and the unique experiences of families receiving mFICare. IMPLICATIONS FOR PRACTICE AND RESEARCH The mFICare program was overall acceptable to nurses and physicians, and areas for improvement were identified. With implementation refinement, mFICare can become a sustainable model to enhance delivery of FCC in NICUs.
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Affiliation(s)
- Linda S Franck
- Department of Family Health Care Nursing, University of California San Francisco (UCSF) (Drs Franck, Hodgson, and Gay); Intensive Care Nursery (Ms Bisgaard) and Division of Neonatology, UCSF Benioff Children's Hospital, San Francisco, California (Dr Sun); Division of Neonatology, UCSF Benioff Children's Hospital, Oakland, California (Dr Joe); NICU and Pediatrics, Community Regional Medical Center, Fresno, California (Dr Cormier); and Will's Way Foundation, Chicago, Illinois (Ms Lothe)
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Keles E, Bagci U. The past, current, and future of neonatal intensive care units with artificial intelligence: a systematic review. NPJ Digit Med 2023; 6:220. [PMID: 38012349 PMCID: PMC10682088 DOI: 10.1038/s41746-023-00941-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 10/05/2023] [Indexed: 11/29/2023] Open
Abstract
Machine learning and deep learning are two subsets of artificial intelligence that involve teaching computers to learn and make decisions from any sort of data. Most recent developments in artificial intelligence are coming from deep learning, which has proven revolutionary in almost all fields, from computer vision to health sciences. The effects of deep learning in medicine have changed the conventional ways of clinical application significantly. Although some sub-fields of medicine, such as pediatrics, have been relatively slow in receiving the critical benefits of deep learning, related research in pediatrics has started to accumulate to a significant level, too. Hence, in this paper, we review recently developed machine learning and deep learning-based solutions for neonatology applications. We systematically evaluate the roles of both classical machine learning and deep learning in neonatology applications, define the methodologies, including algorithmic developments, and describe the remaining challenges in the assessment of neonatal diseases by using PRISMA 2020 guidelines. To date, the primary areas of focus in neonatology regarding AI applications have included survival analysis, neuroimaging, analysis of vital parameters and biosignals, and retinopathy of prematurity diagnosis. We have categorically summarized 106 research articles from 1996 to 2022 and discussed their pros and cons, respectively. In this systematic review, we aimed to further enhance the comprehensiveness of the study. We also discuss possible directions for new AI models and the future of neonatology with the rising power of AI, suggesting roadmaps for the integration of AI into neonatal intensive care units.
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Affiliation(s)
- Elif Keles
- Northwestern University, Feinberg School of Medicine, Department of Radiology, Chicago, IL, USA.
| | - Ulas Bagci
- Northwestern University, Feinberg School of Medicine, Department of Radiology, Chicago, IL, USA
- Northwestern University, Department of Biomedical Engineering, Chicago, IL, USA
- Department of Electrical and Computer Engineering, Chicago, IL, USA
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Alsadaan N, Ramadan OME, Alqahtani M, Shaban M, Elsharkawy NB, Abdelaziz EM, Ali SI. Impacts of Integrating Family-Centered Care and Developmental Care Principles on Neonatal Neurodevelopmental Outcomes among High-Risk Neonates. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1751. [PMID: 38002842 PMCID: PMC10670637 DOI: 10.3390/children10111751] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 10/23/2023] [Accepted: 10/24/2023] [Indexed: 11/26/2023]
Abstract
BACKGROUND Integrating family-centered care (FCC) and developmental care (DC) principles in neonatal care settings may improve neurodevelopmental outcomes for high-risk neonates. However, the combined impact of FCC and DC has been underexplored. This study aimed to investigate the effects of integrated FCC and DC on neurodevelopment and length of hospital stay in high-risk neonates. METHODS A quasi-experimental pre-post study was conducted among 200 high-risk neonates (<32 weeks gestation or <1500 g) admitted to neonatal intensive care units (NICU) in Saudi Arabia. The intervention group (n = 100) received integrated FCC and DC for 6 months. The control group (n = 100) received standard care. Neurodevelopment was assessed using the Bayley Scales of Infant Development-III. Length of stay and readmissions were extracted from medical records. RESULTS The intervention group showed significant improvements in cognitive, motor, and language scores compared to controls (p < 0.05). The intervention group had a 4.3-day reduction in the mean length of stay versus a 1.4-day reduction in controls (p = 0.02). Integrated care independently predicted higher cognitive scores (p = 0.001) and shorter stays (p = 0.006) in regression models. CONCLUSION Integrating FCC and DC in neonatal care enhances neurodevelopmental outcomes and reduces hospitalization for high-risk neonates compared to standard care. Implementing relationship-based, developmentally supportive models is critical for optimizing outcomes in this vulnerable population.
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Affiliation(s)
- Nourah Alsadaan
- College of Nursing, Jouf University, Sakaka 72388, Al Jawf, Saudi Arabia; (O.M.E.R.); (M.S.); (N.B.E.); (E.M.A.)
| | | | - Mohammed Alqahtani
- College of Applied Medical Sciences, Department of Nursing, King Faisal University, Al Hofuf 31982, Al-Ahsa, Saudi Arabia;
| | - Mostafa Shaban
- College of Nursing, Jouf University, Sakaka 72388, Al Jawf, Saudi Arabia; (O.M.E.R.); (M.S.); (N.B.E.); (E.M.A.)
| | - Nadia Bassuoni Elsharkawy
- College of Nursing, Jouf University, Sakaka 72388, Al Jawf, Saudi Arabia; (O.M.E.R.); (M.S.); (N.B.E.); (E.M.A.)
| | - Enas Mahrous Abdelaziz
- College of Nursing, Jouf University, Sakaka 72388, Al Jawf, Saudi Arabia; (O.M.E.R.); (M.S.); (N.B.E.); (E.M.A.)
| | - Sayed Ibrahim Ali
- Department of Family and Community Medicine, College of Medicine, King Faisal University, Al Hofuf 31982, Al-Ahsa, Saudi Arabia
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Effects of Family Participatory Nursing on Clinical Outcomes of Premature Infants in NICU and Families’ Psychological Status. CONTRAST MEDIA & MOLECULAR IMAGING 2022; 2022:7420909. [PMID: 35854782 PMCID: PMC9277171 DOI: 10.1155/2022/7420909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/14/2022] [Accepted: 06/21/2022] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to explore the effects of family participatory nursing on the clinical outcomes of premature infants in the neonatal intensive care unit (NICU) and their families’ psychological status. Total of 150 premature infants were admitted to the NICU of our hospital from December 2019 to December 2021, and their families were selected by convenience sampling method and divided into control group (n = 78, from December 2019 to December 2020) and observation group (n = 72, from January 2020 to December 2021) according to the admission time. The infants in the control group were given routine nursing, while those in the observation group received family participatory nursing. In the observation group, the length of stay and duration of oxygen therapy were shorter, the weight gain speed was higher, and the incidence rate of nosocomial infection was lower than those in control groups
. The time of reaching full gastrointestinal feeding was earlier, the daily milk intake and exclusive breastfeeding rate were higher, and the feeding intolerance rate was lower in observation group than those in control group
. Observation group exhibited significantly higher body weight, Z-value of body weight, NBNA score at 7 d after hospitalization, 15-month mental development index (MDI), and psychomotor development index (PDI) scores than control group
. In addition, the families’ somatization, depression and anxiety factor scores, and total score of SCL-90 in the observation group were lower than those in the control group, while each dimension score and total score of MPOC-20 were higher than those in control groups
. Family participatory nursing is of great significance in ameliorating the clinical outcomes of premature infants in the NICU, which can shorten the length of stay, improve feeding conditions, facilitate infant growth and development, and enhance their families’ psychological status and nursing satisfaction.
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Personalized support of parents of extremely preterm infants before, during and after birth. Semin Fetal Neonatal Med 2022; 27:101335. [PMID: 35780043 DOI: 10.1016/j.siny.2022.101335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The emotional turmoil associated with extremely preterm birth is inescapable parents. How each parent handles the unexpected, makes sense of the unknown and learns to parent their child is uniquely personal. A rigid standardized approach to support families through their journey before and during neonatal intensive care disregards this individuality. This article reviews general concepts and practices that can be learned and applied by clinicians to promote resiliency and help parents cope adaptively. This review will describe how to personalize parenting support during the antenatal consultation and hospitalization for parents of extremely premature infants. To facilitate this, mindsets and care delivery models need to shift from inflexible standardized protocols to flexible guidelines that enable personalized communications, support structures and care delivery models tailored to each person's characteristics, preferences, and values.
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Liang X, Miao A, Zhang W, Li M, Xing Y. Effect of family integrated care on physical growth and language development of premature infants: a retrospective study. Transl Pediatr 2022; 11:965-977. [PMID: 35800279 PMCID: PMC9253945 DOI: 10.21037/tp-22-210] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 05/27/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Premature birth (PTB) increases the long-term risk of diseases such as hypertension, heart disease, and diabetes in adulthood. It is an independent disease with the largest global burden in terms of high mortality and lifelong negative health impacts. The purpose of this study was to analyze the physical growth and language development of premature infants (PIs) at the age of 18 months, and to explore the impact of family integrated care (FIcare) on PI. METHODS This study retrospectively included mothers and their PIs born in the Neonatal Pediatrics Department, Affiliated Hospital of Nantong University from January 2018 to September 2020 and hospitalized in the neonatal intensive care unit (NICU) within 24 hours after birth. The weight, head circumference, body length, and language development of each child were followed up at the age of 1, 3, 6, 12, and 18 months and recorded, and the relationship between FIcare and physical growth and language development of PIs was evaluated. RESULTS The development quotient (DQ) score and language development score of the FIcare group were always higher than those of the control group from 6 to 18 months, and the difference was statistically significant (P<0.05). Multiple regression analysis showed that the body length of the FIcare group participants was longer than that of control group participants. The head circumference of infants was positively correlated with gestational age, birth head circumference, and family average monthly income. The head circumference of FIcare group participants was longer than that of control group participants. The DQ score was positively correlated with gestational age, and the FIcare group participants scored higher than control group participants. Logistic regression analysis showed that early language milestone (ELM) scale score and gestational age were positively correlated with mother's education, and the score of FIcare group participants was higher than that of control group participants (P<0.05). CONCLUSIONS Compared with the traditional nursing model, the implementation of FIcare for the hospitalized PIs in the NICU can actively promote the physical growth and language development of infants.
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Affiliation(s)
- Xiangyan Liang
- Department of Neonatal Pediatrics, Affiliated Hospital of Nantong University, Nantong, China
| | - Aimei Miao
- Department of Neonatal Pediatrics, Affiliated Hospital of Nantong University, Nantong, China
| | - Wei Zhang
- Department of Neonatal Pediatrics, Affiliated Hospital of Nantong University, Nantong, China
| | - Min Li
- Department of Neonatal Pediatrics, Affiliated Hospital of Nantong University, Nantong, China
| | - Yan Xing
- Department of Neonatal Pediatrics, Affiliated Hospital of Nantong University, Nantong, China
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Cummings CL. Humanism, humility and compassion in perinatology: From research & discovery to clinical practice & education. Semin Perinatol 2022; 46:151519. [PMID: 34887110 DOI: 10.1016/j.semperi.2021.151519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Christy L Cummings
- Assistant Professor of Pediatrics, Ethics Associate, Division of Newborn Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
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