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Hamon E, Bourdin B, Le Driant B. Parental representations after preterm birth: a narrative review. Front Psychol 2023; 14:1114418. [PMID: 37731868 PMCID: PMC10507618 DOI: 10.3389/fpsyg.2023.1114418] [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: 12/02/2022] [Accepted: 07/06/2023] [Indexed: 09/22/2023] Open
Abstract
Preterm birth accounts for nearly 15 million births annually worldwide and constitutes a considerable risk factor for atypical development. This birth context is a source of stress for the parents and often leads to an early separation between their child and them. Research on the influence of the birth status on the infant's attachment style has shown no systematic link between preterm birth and the development of insecure attachment in children born preterm. This has opened up research perspectives in understanding the role of environmental factors. A literature review was conducted to present an overview of the current findings on parental representations (PR), particularly maternal ones, and their role in the context of preterm birth. PR quality appears to be associated with specific dyadic interaction patterns, thus exposing vulnerability factors. Studies exploring PR have pointed out the importance of considering parental mental elaboration mechanisms and contextual moderators in supporting socio-emotional development among children born preterm. We discussed the challenges of investigating PR in the context of preterm birth for future studies and emphasized the need for research studies to be conducted according to a developmental and non-deterministic perspective. This narrative review also aimed to highlight the importance of family centered care interventions in the context of a public policy focused on the child's "First 1,000 days" of life.
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Affiliation(s)
- Emeline Hamon
- Centre de Recherche en Psychologie: Cognition, Psychisme et Organisations (UR 7273), Université de Picardie Jules Verne, Amiens, France
- FHU “1000 jours pour la santé” prendre soin avant de soigner, Université de Lille, Lille, France
| | - Béatrice Bourdin
- Centre de Recherche en Psychologie: Cognition, Psychisme et Organisations (UR 7273), Université de Picardie Jules Verne, Amiens, France
- FHU “1000 jours pour la santé” prendre soin avant de soigner, Université de Lille, Lille, France
| | - Barbara Le Driant
- Centre de Recherche en Psychologie: Cognition, Psychisme et Organisations (UR 7273), Université de Picardie Jules Verne, Amiens, France
- FHU “1000 jours pour la santé” prendre soin avant de soigner, Université de Lille, Lille, France
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Marie A, Clabaut L, Corbeil M, Vanlerberghe C, Vincent-Delorme C, Le Driant B. Parenting stress and needs for social support in mothers and fathers of deaf or hard of hearing children. Front Psychol 2023; 14:1229420. [PMID: 37720653 PMCID: PMC10499620 DOI: 10.3389/fpsyg.2023.1229420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/15/2023] [Indexed: 09/19/2023] Open
Abstract
Introduction Hearing parents of deaf or hard of hearing (DHH) children may experience parenting stress and social support could be a buffer to this stress. Differences in levels of these two indicators may exist between mothers and fathers. This study focuses on the parenting stress and social support needs of mothers and fathers of DHH children. Methods Twenty-seven French parental couples of DHH children completed the Parenting Stress Index and the Family Needs Survey, a questionnaire on social support needs. Results Their overall stress scores showed no difference, but subdomain scores show that mothers and fathers are more stressed by the child's hyperactivity, and fathers by the child's adaptability, than parents of children with normal hearing. Mothers are more stressed than fathers by role restriction; they feel less free because of their parenting role. Fathers have a lower quality of attachment to their child than mothers. Parents have a high social support need, especially for obtaining information about their child's individual characteristics and health situation. The ranking of mothers and fathers in the top 10 needs reveals different needs profiles. Parenting stress profiles show that mothers and fathers with higher-than-normal stress levels have a greater overall need for social support than mothers and fathers with lower than normal stress levels. Discussion This study highlights the value of assessing parenting stress and social support needs in parents of DHH children for a better understanding of their situation in research and its clinical implications, as well as the importance of differentiating outcomes for mothers and fathers.
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Affiliation(s)
- Amélie Marie
- CRP-CPO (UR 7273), University of Picardie Jules Verne, Amiens, France
| | - Laëtitia Clabaut
- Reference Center for Rare Diseases « Genetic Deafness », CHRU, Lille, France
| | - Marjolaine Corbeil
- Reference Center for Rare Diseases « Genetic Deafness », CHRU, Lille, France
| | | | | | - Barbara Le Driant
- CRP-CPO (UR 7273), University of Picardie Jules Verne, Amiens, France
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Laporte G, Sergerie-Richard S, Genest C, Aita M. Family Resilience as an Emerging Concept in Neonatology: Evidence From a Metasummary Review. J Perinat Neonatal Nurs 2023:00005237-990000000-00014. [PMID: 37582182 DOI: 10.1097/jpn.0000000000000761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/17/2023]
Abstract
BACKGROUND Family resilience can be observed through specific resilience-promoting processes, namely, shared belief systems, communication, and organizational processes, but the concept remains mostly unstudied in neonatology. This metasummary aims to evaluate the frequency of family resilience processes in qualitative scientific literature to illustrate how family resilience is exhibited in the neonatal intensive care unit (NICU) setting. METHODS A search among 4 databases yielded 7029 results, which were reviewed for inclusion. Following Sandelowski and Barroso's qualitative metasummary method, findings from each study were independently coded and frequency effect size was calculated. RESULTS Forty-six primary qualitative studies published between 2016 and 2022 conducted with parents of preterm infants who discussed their NICU hospitalization experience were included in this metasummary. All 9 of Walsh's family resilience processes were identified in the literature, and their frequency effect size ranged from 4% to 91%. Four additional themes emerged pertaining to specific family resilience behaviors exhibited by NICU families. CONCLUSION This analysis sheds new light on the most recent qualitative evidence of parents' experiences in the NICU by analyzing it through the lens of family resilience and posits family resilience as a promising concept in relation to the predominance of the family-centered care philosophy in neonatal units.
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Affiliation(s)
- Geneviève Laporte
- Faculty of Nursing, Université de Montréal, Montreal, Canada (Ms Laporte and Drs Genest and Aita); CHU Sainte-Justine Research Centre, Montreal, Canada (Ms Laporte and Dr Aita); Nursing Excellence Center, CIUSSS-EMTL, Montreal, Canada (Ms Sergerie-Richard); Centre for Research and Intervention on Suicide, Ethical Issues and End-of-Life Practices (CRISE), and Centre de recherche de l'Institut universitaire en santé mentale de Montréal (CR-IUSMM), Université du Québec à Montréal, Montreal, Canada (Dr Genest); and Quebec Network on Nursing Intervention Research (RRISIQ), Montreal, Canada (Dr Aita)
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Noergaard B, Kofoed PE. Developing and Implementing a Father-Friendly Neonatal Intensive Care Unit Improved Nurses' Self-Efficacy. Adv Neonatal Care 2023:00149525-990000000-00078. [PMID: 37463518 PMCID: PMC10373848 DOI: 10.1097/anc.0000000000001088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
BACKGROUND The need for paternal support is rarely addressed in neonatal intensive care units (NICUs). Neonatal nurses often primarily focus on the needs of the mother and infant and may not be trained in support of fathers. PURPOSE To investigate nurses' self-efficacy (SE) in guiding and supporting fathers after implementing a father-friendly NICU. METHODS Nurses from the intervention NICU and 13 control NICUs were included in a before-and-after intervention study. Questionnaires measuring nurses' SE regarding support of fathers and mothers were obtained when starting the development process, before and 18 months after the implementation. The primary outcome was the difference between nurses' SE scores for father and mother questions in the intervention group compared with the control group. RESULTS In total, 294, 330, and 288 nurses responded to the first, second, and third questionnaires, respectively. From the first to third questionnaires, the intervention group showed a significantly higher increase in SE scores for father questions compared with the control group (0.53 vs 0.20, P = .005) and a nonsignificantly higher increase for mother questions (0.30 vs 0.09, P = .13). In the third questionnaire, the intervention group showed a higher SE score for father questions compared with the control group (9.02 vs 8.45, P = .002) and the first questionnaire (9.02 vs 8.49, P = .02). IMPLICATIONS FOR PRACTICE AND RESEARCH By implementing a father-friendly NICU, nurses' SE for providing support to fathers increased significantly. Training in a father-friendly approach increases nurses' ability to support both parents.
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Affiliation(s)
- Betty Noergaard
- Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital, University Hospital of Southern Denmark, Kolding, Denmark (Dr Noergaard, Dr Kofoed); and Institute of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark (Dr Kofoed)
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Reimer A, Mause L, Hoffmann J, Hagemeier A, Dresbach T, Scholten N. How does stress affect maternal and paternal perceptions of relationship strain after a preterm birth? Results of a retrospective survey study. Acta Paediatr 2023; 112:762-769. [PMID: 36627542 DOI: 10.1111/apa.16664] [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: 11/16/2022] [Revised: 12/29/2022] [Accepted: 01/09/2023] [Indexed: 01/12/2023]
Abstract
AIM Strain on couple relationships is associated with a lower well-being. As premature birth is known to pose stress to parents, this study explores whether interparental relationship strain comes to pass within mothers and fathers during their infant's stay in a neonatal intensive care unit. METHODS A retrospective cross-sectional survey was conducted with parents who experienced a preterm birth (September to December 2020). Linear regression was used to analyse associations between stress and relationship strain. RESULTS The study included 437 mothers and 301 fathers. Fathers experienced lower relationship strain (M = 2.49, SD = 1.00) than mothers (M = 3.37, SD = 1.04). Overall, a significant association between relationship strain and stress due to the infant's behaviour and appearance was found for mothers (β = 0.16, p = 0.02) and fathers, with a significantly higher association for fathers (β = 0.27, p ≤ 0.002). With regard to parental role alterations, only mothers showed a significant association (β = 0.21, p ≤ 0.001). CONCLUSION Although mothers showed higher levels of stress and relationship strain, stress may also have an impact on fathers. Therefore, research should focus on stress prevention measures to meet both maternal and paternal needs.
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Affiliation(s)
- Alinda Reimer
- Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Human Sciences and Faculty of Medicine, University of Cologne and University Hospital Cologne, Cologne, Germany
| | - Laura Mause
- Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Human Sciences and Faculty of Medicine, University of Cologne and University Hospital Cologne, Cologne, Germany
| | - Jan Hoffmann
- Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Human Sciences and Faculty of Medicine, University of Cologne and University Hospital Cologne, Cologne, Germany
| | - Anna Hagemeier
- Medical Faculty and University Hospital Cologne, Institute of Medical Statistics and Computational Biology, University of Cologne, Cologne, Germany
| | - Till Dresbach
- Department of Neonatology and Paediatric Intensive Care Medicine, University Hospital Bonn, Bonn, Germany
| | - Nadine Scholten
- Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Human Sciences and Faculty of Medicine, University of Cologne and University Hospital Cologne, Cologne, Germany
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Namiiro FB, Nolens B, Rujumba J, Kiguli S, Batte A, van den Akker T. "My baby is fine, no need for more clinic visits." Facilitators and barriers for utilisation of follow-up services for children born preterm in low-resource setting: Parents' perceptions. Trop Med Int Health 2023; 28:194-202. [PMID: 36708235 DOI: 10.1111/tmi.13857] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVES We sought to understand the facilitators and barriers impacting utilisation of follow-up services for children born preterm as perceived by parents in a low-resource setting. METHODS We conducted a qualitative study at Mulago Hospital, Uganda, with parents of children born preterm and aged 22-38 months at the time of the study. We collected data using five in-depth interviews and four focus group discussions. Data were analysed using thematic analysis informed by the social-ecological model. RESULTS Ten subthemes emerged that could be grouped into three main themes: (1) Individual: parents' knowledge, parenting skills, perception of follow-up and infant's condition; (2) Relationship: support for the mother and information sharing; (3) Institution: facility setup, cost of care, available personnel and distance from the facility. Parents of preterm infants perceived receiving timely information, better understanding of prematurity and its complications, support from spouses, availability of free services and encouragement from health workers as facilitators for utilisation of follow-up services. Limited male involvement, parents' negative perception of follow-up, stable condition of infant, health facility challenges especially congestion at the hospital, distance and care costs were key barriers. CONCLUSION An interplay of facilitators and barriers at individual, interpersonal and health system levels encourage or deter parents from taking their preterm children for follow-up services. Improving utilisation of services will require educating parents on the importance of follow-up even when children are not sick, eliciting maternal support from spouses and peers and addressing health system gaps that make follow-up unattractive and costly.
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Affiliation(s)
| | - Barbara Nolens
- Department of Obstetrics & Gynaecology, Canisius-Wilhemina Hospital, Nijmegen, The Netherlands
| | - Joseph Rujumba
- Department of Pediatrics and Child Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Sarah Kiguli
- Department of Pediatrics and Child Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Anthony Batte
- Child Health and Development Centre, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Thomas van den Akker
- Department of Obstetrics and Gynaecology, Leiden University Medical Center, Leiden, The Netherlands.,Athena Institute, VU University, Amsterdam, The Netherlands
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Chandrasekaran SA, John HB, Ross BJ, Arumugam A, Balan I, Samuel R. Torn between two worlds: parental experiences of neonatal follow-up for infants with hypoxic ischaemic encephalopathy in India-a qualitative study using interpretative phenomenological analysis. BMJ Open 2022; 12:e063732. [PMID: 36424107 PMCID: PMC9693659 DOI: 10.1136/bmjopen-2022-063732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE This study aimed to understand the barriers and facilitators of a neonatal follow-up programme, as perceived by parents of infants born with hypoxic ischaemic encephalopathy (HIE). DESIGN This study applied a qualitative study design using interpretative phenomenological analysis. It included focus group discussions, face-to-face in-depth interviews and telephonic interviews. Data were analysed using thematic content analysis. SETTING Neonatal follow-up clinic of a tertiary hospital in South India. The study was conducted between March and December 2020. PARTICIPANTS Five fathers and eight mothers of infants with HIE. RESULTS Parents of children with HIE are torn between two worlds-an atmosphere of support and one of criticism. Three main themes were identified: (1) neonatal intensive care unit (NICU) stay: distressful versus reassuring experiences; (2) parenthood: supportive versus unsupportive environments; and (3) neonatal follow-up: adherence versus non-adherence. CONCLUSION Parents of children with HIE experience sociocultural barriers in the NICU, after discharge and during the follow-up period. These lead to a complex array of emotional and physical consequences that affect parenting and follow-up care.
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Affiliation(s)
| | - Hima B John
- Neonatology, Christian Medical College, Vellore, India
| | | | - Asha Arumugam
- Neonatology, Christian Medical College, Vellore, India
| | - Indira Balan
- Neonatology, Christian Medical College, Vellore, India
| | - Reema Samuel
- Psychiatry, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
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