1
|
Alle YF, Akenaw B, Seid S, Bayable SD. Parental satisfaction and its associated factors towards neonatal intensive care unit service: a cross-sectional study. BMC Health Serv Res 2022; 22:1266. [PMID: 36261864 PMCID: PMC9583552 DOI: 10.1186/s12913-022-08645-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 09/24/2022] [Accepted: 10/07/2022] [Indexed: 11/18/2022] Open
Abstract
Background Parental satisfaction is a well-established outcome indicator and tool for assessing a healthcare system’s quality, as well as input for developing strategies for providing acceptable patient care. This study aimed to assess parental satisfaction with neonatal intensive care unit service and its associated factors. Method A cross-sectional study design was conducted on parents whose neonates were admitted to the neonatal intensive care unit at Debre Tabor Comprehensive Specialized Hospital, in North Central Ethiopia. Data were collected by adopting an EMPATHIC-N instrument during the day of neonatal discharge, after translating the English version of the instrument to the local language (Amharic). Both Bivariable and multivariable logistic analyses were done to identify factors associated with parental satisfaction with neonatal intensive care unit service. P < 0.05 with 95% CI was considered statistically significant. Results The data analysis was done on 385 parents with a response rate of 95.06%. The overall average satisfaction of parents with neonatal intensive care unit service was 47.8% [95% CI= (43.1–52.5)]. The average parental satisfaction of neonatal intensive care unit service in the information dimension was 50.40%; in the care and treatment dimension was 36.9%, in the parental participation dimension was 50.1%, in the organization dimension was 59.0% and the professional attitude dimension was 48.6%. Gender of parents, residency, parental hospital stay, birth weight, and gestational age were factors associated with parental satisfaction. Conclusion There was a low level of parental satisfaction with neonatal intensive care unit service. Among the dimensions of EMPATHIC-N, the lowest parental satisfaction score was in the care and treatment while the highest parental satisfaction score was in the organization dimension.
Collapse
Affiliation(s)
- Yewlsew Fentie Alle
- Departement of Anesthesia, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, 272, Ethiopia.
| | - Bantigegn Akenaw
- Departement of Anesthesia, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, 272, Ethiopia
| | - Shimelis Seid
- Departement of Anesthesia, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, 272, Ethiopia
| | - Samuel Debas Bayable
- Departement of Anesthesia, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| |
Collapse
|
2
|
Ferrari RM, McClain EK, Tucker C, Charles N, Verbiest S, Lewis V, Bryant K, Stuebe AM. Postpartum Health Experiences of Women with Newborns in Intensive Care: The Desire to Be by the Infant Bedside as a Driver of Postpartum Health. J Midwifery Womens Health 2022; 67:114-125. [PMID: 35037387 DOI: 10.1111/jmwh.13330] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 09/09/2021] [Accepted: 10/06/2021] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Women with infants in a neonatal intensive care unit (NICU) encounter multiple challenges following childbirth, including greater burden of chronic disease and increased risk for depression, compared with women with well infants. At the same time, they are confronted with the trauma of a hospitalized infant while also managing their postpartum recovery. Limited research exists describing the health needs of these women, despite the many numbers living this experience daily. This study aimed to better understand postpartum health needs of women with infants in the NICU in the 90 days following birth and to propose actionable system improvements to address identified needs. METHODS The authors conducted in-depth individual interviews with 50 postpartum women of infants admitted to the NICU at a quaternary care hospital. Eligible women were aged at least 18 years, spoke English or Spanish, and had infants in the NICU longer than 3 days. Interview topics included NICU experience, recommended and desired health care, and suggestions for improvement. Interviews were audiotaped and transcribed verbatim. The authors used qualitative description techniques including memo-writing, coding, matrices, diagramming, and team discussion to analyze the data. RESULTS Women reported significant intrapartum health conditions and concerns (eg, preeclampsia, emergency cesarean birth, anxiety) and described unmet social, emotional, mental, and physical health needs. Unmet practical needs while in the NICU (eg, a place to rest, affordable parking, access to food, childcare) caused considerable burden. Despite disease burden and emergent health needs, few women reported regular monitoring of their postpartum health by maternal health care providers. Women frequently minimized and delayed care for their health needs so as to remain by the infant bedside. DISCUSSION Women with infants in the NICU would benefit from patient-centered care that provides greater attention to their postpartum health and recovery while also supporting their drive to remain close to their hospitalized infant.
Collapse
Affiliation(s)
- Renée M Ferrari
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Erin K McClain
- Collaborative for Maternal and Infant Health, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Christine Tucker
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Nkechi Charles
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Sarah Verbiest
- Collaborative for Maternal and Infant Health, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,Jordan Institute for Families, School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Virginia Lewis
- Multilingual Research Advancement for Health (MURAL), North Carolina Translational and Clinical Sciences Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Katherine Bryant
- Collaborative for Maternal and Infant Health, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Alison M Stuebe
- Collaborative for Maternal and Infant Health, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| |
Collapse
|
3
|
Ciupitu-Plath C, Tietz F, Herzberg J. Parent needs assessment instruments in neonatal intensive care units: Implications for parent education interventions. PATIENT EDUCATION AND COUNSELING 2021; 104:2661-2669. [PMID: 33840550 DOI: 10.1016/j.pec.2021.03.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 02/09/2021] [Accepted: 03/16/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Psychosocial and educational interventions based on standardized needs assessment can help alleviate distress among parents of premature infants. This study aims to (1) provide an overview of standardized instruments used to assess parental needs in neonatal intensive care units (NICUs) and (2) discuss their potential to facilitate the provision of appropriate support to parents of premature babies. METHODS A systematic literature review was conducted. PubMed, CiNAHL, PsychARTICLES, PsychINFO, and Medline were searched for studies reporting on the use of validated parental needs assessment instruments in the NICU. RESULTS Following the analysis of 33 publications, 6 instruments designed to assess the needs of premature infants' parents were identified. Based on their good psychometric properties and practicality, the NICU Family Needs Inventory, the Critical Care Maternal Needs Inventory, and the Nurse Parent Support Tool were considered particularly relevant for use in clinical and research settings. CONCLUSIONS Validated parent needs assessment instruments are available for use in the NICU setting. Further research evaluating the benefits and usability of standardized parental needs assessment in the NICU is needed. PRACTICE IMPLICATIONS Validated needs assessment instruments should be consistently used to facilitate the development of targeted psychosocial and educational interventions for parents in the NICU.
Collapse
Affiliation(s)
| | - Franziska Tietz
- Education Center for Nursing Professions, DRK Hospitals, Berlin, Germany
| | - Jana Herzberg
- Clinical Nursing Science Unit, Charité Center 1 for Health and Human Sciences, Charité - Universitätsmedizin Berlin, Berlin, Germany
| |
Collapse
|
4
|
Khalesi ZB, Mirzaii S, Rad EH, Panjalipour S, Kazemi S. Determinants of maternal role adaptation in mothers with preterm neonates. JBRA Assist Reprod 2021; 25:434-438. [PMID: 33739799 PMCID: PMC8312292 DOI: 10.5935/1518-0557.20200108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 01/28/2021] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE Becoming a mother is an innate process, without any culture-dependent instruction. While it is a pleasant experience, it can sometimes be associated with problems resulted from baby caring. Preterm birth can be a challenge for the maternal role adaptation (MRA). Therefore, the present study was conducted to determine the maternal role adaptation in mothers with preterm neonates. METHODS The present study is cross-sectional, with a sample including 114 mothers of preterm infants in the NICU. We collected the data using a two-section questionnaire. The first section was a demographic questionnaire and the second section was a standardized questionnaire? "Maternal role adaptation scale in mothers with preterm neonates admitted to neonatal intensive care units" (MRAS: NICU). We ran the statistical analysis using descriptive and inferential statistical methods with the SPSS 21 software. RESULTS The total MRA score was strong in half of the participants. The participants had a university education, were employed and satisfied with their economic status, and had a high score on adaptation to the maternal role. There are different domains to the MRA, the highest score was allocated to the participation in care (56.24±0.13), and the lowest score was allocated to growth and development (3.12±0.28). CONCLUSIONS According to the results of this study, the most important factors associated with MRA are the mother's age, education, and economic satisfaction. Determining the factors related to the mothers' adoption of premature infants could increase the ability of mothers to cope with problems and negative emotions, and enhance the adoption of maternal roles.
Collapse
Affiliation(s)
- Zahra Bostani Khalesi
- Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Soheyla Mirzaii
- Student Research Committee, Guilan University of Medical Sciences, Rasht, Iran
| | - Enayatollah Homaei Rad
- Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Sepideh Panjalipour
- Student Research Committee, Guilan University of Medical Sciences, Rasht, Iran
| | - Sodabeh Kazemi
- Reproductive Health Research Center, Department of Obstetrics & Gynecology, Al-Zahra Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| |
Collapse
|
5
|
Abstract
Having a child admitted to the neonatal intensive care unit (NICU) is traumatic for both parents, but mothers and fathers may have different experiences, and thus, different needs. The purpose of this integrative review was to identify the needs of fathers of premature infants. A systematic review of 7 databases was conducted, and studies were evaluated by the Critical Appraisal Programme checklist. To provide structure for searching and reporting findings, the Whittemore and Knafle interpretive methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis methodology were used. A total of 19 articles were identified. The resulting themes included: need to be close to infant and involved in infant's care; need for information; need for a better NICU environment; need for emotional support; and need for a relationship with the NICU staff.
Collapse
Affiliation(s)
- Linda Merritt
- College of Nursing, Texas Woman's University, Dallas
| |
Collapse
|
6
|
Verbiest S, Ferrari R, Tucker C, McClain EK, Charles N, Stuebe AM. Health Needs of Mothers of Infants in a Neonatal Intensive Care Unit : A Mixed-Methods Study. Ann Intern Med 2020; 173:S37-S44. [PMID: 33253024 DOI: 10.7326/m19-3252] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Mothers with babies in the neonatal intensive care unit (NICU) face a host of challenges following childbirth. Limited information is available on these mothers' postpartum health needs and access to services. OBJECTIVE To identify health needs of NICU mothers, access to services, and potential service improvements. DESIGN A mixed-methods study including a retrospective cohort study, in-depth interviews, and focus groups. SETTING Large, Level IV, regional referral, university-affiliated hospital in the United States. PARTICIPANTS Mothers of live-born infants born from 1 July 2014 to 30 June 2016 (n = 6849). Interviews included 50 NICU mothers and 59 stakeholders who provide services to these mothers or their infants. MEASUREMENTS Severe maternal morbidity, chronic health conditions, health care encounters from discharge through 12 weeks postpartum, maternal health needs, care access, and system improvements. RESULTS Compared with mothers of well babies, NICU mothers had more chronic diseases, experienced more perinatal complications, and utilized more acute care postpartum. Qualitative analyses revealed the desire to be at the baby's bedside as a driver of maternal health-seeking behaviors, with women not seeking or delaying medical care so as to stay by their infant. Stakeholders acknowledged the unique needs of NICU mothers and cited system challenges, lack of clarity about provider roles, and reimbursement policies as barriers to meeting needs. LIMITATIONS The study was conducted within a single health care system, which may limit generalizability. Qualitative analyses did not explore the influence of fathers, other children in the home, or length of NICU stay. CONCLUSION Universal screening and convenient access to maternal health services for NICU mothers should be explored to reduce adverse maternal health outcomes. PRIMARY FUNDING SOURCE Maternal and Child Health Bureau, Health Resources and Services Administration, U.S. Department of Health and Human Services.
Collapse
Affiliation(s)
- Sarah Verbiest
- University of North Carolina at Chapel Hill School of Medicine and School of Social Work, Chapel Hill, North Carolina (S.V.)
| | - Renée Ferrari
- University of North Carolina at Chapel Hill Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina (R.F.)
| | - Christine Tucker
- University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina (C.T., N.C.)
| | - Erin K McClain
- University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina (E.K.M.)
| | - Nkechi Charles
- University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina (C.T., N.C.)
| | - Alison M Stuebe
- University of North Carolina at Chapel Hill School of Medicine and the Gillings School of Global Public Health, Chapel Hill, North Carolina (A.M.S.)
| |
Collapse
|
7
|
Brockway M, Benzies KM, Carr E, Aziz K. Does breastfeeding self-efficacy theory apply to mothers of moderate and late preterm infants? A qualitative exploration. J Clin Nurs 2020; 29:2872-2885. [PMID: 32421233 DOI: 10.1111/jocn.15304] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Revised: 03/16/2020] [Accepted: 03/29/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND Breastmilk feeding reduces morbidities and improves outcomes related to prematurity. However, breastmilk feeding rates in preterm infants are substantially lower than those in term infants. Breastfeeding self-efficacy theory is a social change theory, which is predictive of exclusive breastmilk feeding at 2 months postpartum in mothers of full-term infants. However, this theory has not been well explored in mothers of moderate and late preterm infants. AIMS AND OBJECTIVES To explore maternal experiences with feeding moderate (320/7 - 336/7 weeks' gestational age) and late preterm infants (340/7 - 366/7 weeks' GA) in neonatal intensive care units and assess applicability of breastfeeding self-efficacy theory. METHODS We conducted a qualitative descriptive exploration of maternal experiences with infant feeding in neonatal intensive care units. Using purposive, maximum variation sampling, we selected mothers of preterm infants born at 320/7 - 346/7 weeks, who experienced high mean differences in their BSE scores between admission and discharge. Fourteen mothers participated in semi-structured telephone interviews. Data were examined using thematic analysis. To explore and describe breastfeeding self-efficacy within the context of neonatal intensive care units, we super-imposed the four sources of information from breastfeeding self-efficacy theory onto the defined themes. RESULTS Three main themes emerged: (a) institutional influences, (b) relationship with the pump and (c) establishing breastfeeding, with an emphasis on the importance of direct breastfeeding at discharge. Overlaying the four sources of information from breastfeeding self-efficacy highlighted the presence of three sources of information: verbal persuasion, performance accomplishment and physiologic/affective responses. Vicarious experience was not identified in maternal experiences with infant feeding. CONCLUSION Our findings indicate that breastfeeding self-efficacy is an applicable theory for mothers of preterm infants. RELEVANCE TO CLINICAL PRACTICE Healthcare providers need to be aware of the influence that institutional culture and policies may have on maternal breastfeeding self-efficacy and breastfeeding outcomes.
Collapse
|
8
|
Monaghan J, Kim T, Dol J, Orovec A, Campbell-Yeo M. Parents’ learning needs and preferences in a neonatal intensive care unit: A desire for enhanced communication and eHealth technology. ACTA ACUST UNITED AC 2020. [DOI: 10.1016/j.jnn.2019.09.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
|
9
|
Needs and stressors of parents of term and near-term infants in the NICU: A systematic review with best practice guidelines. Early Hum Dev 2019; 139:104839. [PMID: 31439386 DOI: 10.1016/j.earlhumdev.2019.104839] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Having a sick infant in the NICU can be quite stressful and overwhelming to parents. They require support and may have varied needs. A systematic review of qualitative and quantitative studies from 5 electronic databases (Ovid Medline, EMBASE, PsycINFO, CINAHL and Sociological Abstracts), covering January 2001 - March 2016 identified the needs and stressors of parents of term or near-term Infants in the NICU. Six articles addressed the needs and 14 identified the stressors of parents. Parents' most important need was for accurate and honest information. Needs focused around sensitive infant care and involvement in decision-making. The greatest stressor for parents was alteration to the parental role, followed by infant appearance. Fathers and parents of infants undergoing surgery are an under-researched population. Based on the evidence, enhancing staff-parent communication would better meet parental needs and reduce stressors. Our key recommendations highlight the need for family-centred and individualised care practices in the NICU.
Collapse
|
10
|
Obregon E, Litt JS, Patel P, Ziyeh T, McCormick MC. Health related quality of life (HRQoL) in mothers of premature infants at NICU discharge. J Perinatol 2019; 39:1356-1361. [PMID: 31417142 DOI: 10.1038/s41372-019-0463-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 06/21/2019] [Accepted: 07/01/2019] [Indexed: 11/09/2022]
Abstract
BACKGROUND Premature delivery and a potential Neonatal Intensive Care Unit admission may be associated with the risk of poor maternal health. We aimed to examine the mothers' health-related quality of life (HRQoL) at the time of infant discharge. STUDY DESIGN Fifty mothers completed the Medical Outcomes Study-Short Form 12. It has a Physical Component Score (PCS) and Mental Component Score (MCS), both with a mean of 50 and standard deviation of 10. Analysis included infant, maternal, and pregnancy-related characteristics. RESULTS In multivariable analyses, a household income of <150K lowered the PCS by 10 points (p = 0.003) compared to those with higher incomes. Marginal significance was noted in GA, for every week gained the PCS score was lower by 1.5 points. CONCLUSION Several risk factors are associated with lower physical health ratings in mothers of preterm infants at discharge. This information can be used to inform providers in their anticipatory guidance to the family and follow-up plans.
Collapse
Affiliation(s)
- Evelyn Obregon
- Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Jonathan S Litt
- Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, MA, USA.,Division of Newborn Medicine Harvard Medical School, Boston, MA, USA
| | - Palak Patel
- Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, USA
| | | | - Marie C McCormick
- Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, MA, USA. .,Division of Newborn Medicine Harvard Medical School, Boston, MA, USA. .,Department of Social Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| |
Collapse
|
11
|
Alinejad-Naeini M, Razavi N, Sohrabi S, Heidari-Beni F. The association between health literacy, social support and self-efficacy in mothers of preterm neonates. J Matern Fetal Neonatal Med 2019; 34:1703-1710. [PMID: 31307262 DOI: 10.1080/14767058.2019.1644620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Health literacy, social support and self-efficacy are important concepts in mothers of preterm neonates. The purpose of study was to determine the association between health literacy, social support and self-efficacy of mothers of preterm neonates admitted to the neonatal intensive care unit. METHODS This descriptive correlational study was conducted from November 2017 to January 2019 on 200 mothers of preterm neonates admitted to the neonatal intensive care unit of selected hospitals affiliated with Iran University of Medical Sciences, Tehran, Iran. Data were collected using demographic, maternal health literacy, maternal self-efficacy and multidimensional scale of perceived social support questionnaires. Data were analyzed by descriptive statistics (mean and standard deviation) and inferential tests (Pearson correlation coefficient) using SPSS-PC (v.23) and R software. RESULTS The data showed 23.5% of mothers had high likelihood of low health literacy, 45.5% had possibility of low health literacy and 31% had adequate with mean score 2.57 ± 1.28. Also, 9.5% of participants had low perceived social support, 62.5% moderate perceived social support and 28% high perceived social support. Maternal self-efficacy score was 52.54 ± 8.06. Pearson's correlation coefficient analyses revealed a statistically significant positive correlation between maternal health literacy and social support (r = 0.304, p < .001). Also maternal health literacy was positively correlated with the self-efficacy (r = 0.292, p < .001) and self-efficacy was positively correlated with social support (r = 0.440, p < .001). CONCLUSION Health literacy, social support and self-efficacy of mothers of preterm neonates admitted to the neonatal intensive care unit in Iran are related together. Therefore, neonatal care nurses need to note this in care of this clients and adopt strategies to enhance them.
Collapse
Affiliation(s)
- Mona Alinejad-Naeini
- Department of Neonatal Intensive Care Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Narjes Razavi
- Department of Health, Education and Health Promotion, Tehran University of Medical Sciences, Tehran, Iran
| | - Soroor Sohrabi
- Hazrat Ali Asghar Children's Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Farshad Heidari-Beni
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
12
|
Govindaswamy P, Laing S, Waters D, Walker K, Spence K, Badawi N. Needs of parents in a surgical neonatal intensive care unit. J Paediatr Child Health 2019; 55:567-573. [PMID: 30288834 DOI: 10.1111/jpc.14249] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 09/05/2018] [Accepted: 09/07/2018] [Indexed: 11/28/2022]
Abstract
AIM While there is evidence of parental needs in the neonatal intensive care unit (NICU), parents of newborns admitted for general surgery are an under-researched population. This study aimed to identify needs in parents of newborns admitted to the NICU for general surgery and whether health-care professionals meet these needs. METHODS This was a prospective cohort study of 111 parents (57% mothers) of newborns admitted to a surgical NICU for general surgery in Australia from January 2014 to September 2015. Parents completed the Neonatal Family Needs Inventory (NFNI), comprising 56 items in five subscales (Support, Comfort, Information, Proximity, Assurance) at admission and discharge, as well as the Social Desirability Scale (SDS). Data were analysed using parametric and non-parametric techniques. RESULTS At both admission and discharge, parents rated Assurance (M = 3.8, standard deviation (SD) = 0.24) needs as the most important, followed by Proximity (M = 3.6, SD = 0.32) and Information (M = 3.5, SD = 0.38). Mothers rated Assurance significantly more important than fathers (P < 0.02). Overall, parents' most important needs were having questions answered honestly (M = 3.96, SD = 0.19), seeing their infant frequently and knowing about the medical treatment (both M = 3.95, SD = 0.23). The 10 most important needs were met for more than 96% of parents, with no evidence of response bias. CONCLUSIONS Reassurance is a priority need for parents in the surgical NICU. Mothers' and fathers' needs may be best met by practices based on family-centred, individualised care principles.
Collapse
Affiliation(s)
- Priya Govindaswamy
- Grace Centre for Newborn Care, Children's Hospital at Westmead, Sydney, New South Wales, Australia.,Children's Hospital Westmead Clinical School, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Sharon Laing
- School of Social Sciences and Psychology, Western Sydney University, Sydney, New South Wales, Australia
| | - Donna Waters
- Children's Hospital Westmead Clinical School, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.,Sydney Nursing School, University of Sydney, Sydney, New South Wales, Australia
| | - Karen Walker
- Grace Centre for Newborn Care, Children's Hospital at Westmead, Sydney, New South Wales, Australia.,Children's Hospital Westmead Clinical School, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.,Sydney Nursing School, University of Sydney, Sydney, New South Wales, Australia
| | - Kaye Spence
- Grace Centre for Newborn Care, Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Nadia Badawi
- Grace Centre for Newborn Care, Children's Hospital at Westmead, Sydney, New South Wales, Australia.,Children's Hospital Westmead Clinical School, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| |
Collapse
|
13
|
Alsaiari EM, Magarey J, Rasmussen P. An Investigation of the Needs of Saudi Parents of Preterm Infants in the Neonatal Intensive Care Unit. Cureus 2019; 11:e3887. [PMID: 30911444 PMCID: PMC6424543 DOI: 10.7759/cureus.3887] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objective This study aimed to identify the needs of Saudi parents who had an infant in a neonatal intensive care unit (NICU) in one of five hospitals in Riyadh City, Saudi Arabia. Materials and methods Data were collected using a questionnaire that comprised questions about demographic characteristics and a modified version of the NICU Family Needs Inventory. A convenience sample of 36 Muslim Saudi mothers and fathers completed a self-reported questionnaire. Parents were asked to rate 52 statements in the NICU Family Needs Inventory as not important, somewhat important, important or very important. Results Saudi parents ranked the needs for assurance, proximity, and information as the most important needs. The comfort and support needs were ranked as the least important. Moreover, the highest top-ranked items were related to assurance of pain infant being treated for (86%), infant expected outcome (83%), and infant being handled gently (83%). Conclusion Nurses should create a relationship with parents and provide them with comprehensible and honest assurance and information. Likewise, it is imperative to provide a high-quality holistic care for parents that relies on their needs assessment.
Collapse
Affiliation(s)
- Eman M Alsaiari
- Pediatrics, Prince Sattam Bin Abdulaziz University, Riyadh, SAU
| | - Judy Magarey
- Pediatrics, The University of Adelaide, Adelaide, AUS
| | | |
Collapse
|
14
|
The Need for Support and Not Distress Evoking: A Meta-Synthesis of Experiences of Iranian Parents with Premature Infants. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2017. [DOI: 10.5812/ijpbs.5916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
15
|
Aftyka A, Rozalska-Walaszek I, Wróbel A, Bednarek A, Dąbek K, Zarzycka D. Support provided by nurses to parents of hospitalized children - cultural adaptation and validation of Nurse Parent Support Tool and initial research results. Scand J Caring Sci 2017; 31:1012-1021. [DOI: 10.1111/scs.12426] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Accepted: 12/09/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Anna Aftyka
- Department of Anaesthesiological and Intensive Care Nursing; Faculty of Health Sciences; Medical University of Lublin; Lublin Poland
| | - Ilona Rozalska-Walaszek
- Department of Anaesthesiological and Intensive Care Nursing; Faculty of Health Sciences; Medical University of Lublin; Lublin Poland
| | - Aleksandra Wróbel
- Department of Anaesthesiological and Intensive Care Nursing; Faculty of Health Sciences; Medical University of Lublin; Lublin Poland
| | - Anna Bednarek
- Chair and Department of Paediatric Nursing; Faculty of Health Sciences; Medical University of Lublin; Lublin Poland
| | - Katarzyna Dąbek
- Chair and Clinic of Obstetrics and Gynaecology; Medical University of Lublin; Lublin Poland
- Neonatal Department with Neonatal Intensive Care Unit; Friderick Chopin Clinical Provincial Hospital No 1 in Rzeszów
| | - Danuta Zarzycka
- Chair and Department of Paediatric Nursing; Faculty of Health Sciences; Medical University of Lublin; Lublin Poland
| |
Collapse
|
16
|
Epstein EG, Arechiga J, Dancy M, Simon J, Wilson D, Alhusen JL. Integrative Review of Technology to Support Communication With Parents of Infants in the NICU. J Obstet Gynecol Neonatal Nurs 2017; 46:357-366. [PMID: 28263727 DOI: 10.1016/j.jogn.2016.11.019] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2016] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To synthesize findings from the published literature on the use of technology in the NICU to improve communications and interactions among health care providers, parents, and infants. DATA SOURCES Electronic databases including Ovid MEDLINE, CINAHL, Web of Science, and Google Scholar were searched for related research published through May 2016. The reference lists of all studies were reviewed, and a hand search of key journals was also conducted to locate eligible studies. STUDY SELECTION Eleven studies (five quantitative, two qualitative, and four mixed methods) were identified that met the inclusion criteria. Only studies published in English were included. DATA EXTRACTION Whittemore and Knafl's methodology for conducting integrative reviews was used to guide data extraction, analysis, and synthesis. Data were extracted and organized according to the following headings: author, year, and location; study purpose and design; sample size and demographics; technology used; study findings; and limitations. DATA SYNTHESIS Various technologies were used, including videoconferencing, videophone, and commercially available modalities such as Skype, FaceTime, AngelEye, and NICView Webcams. In the 11 studies, three main outcomes were evaluated: parents' perception of technology use, health care providers' perceptions of technology use, and objective outcomes, such as parental anxiety or stress or infant length of stay. Overall, parents and health care providers perceived the varied interventions quite favorably, although a few significant differences were found for the objective measures. CONCLUSION Several interventions have been tested to improve communications and promote interactions among NICU health care team members, parents, and infants. Although initial findings are positive, research in this area is quite limited, and the reviewed studies had several limitations. There is a significant need for further rigorous research to be conducted with diverse samples.
Collapse
|
17
|
Delany C, Xafis V, Gillam L, Hughson JA, Hynson J, Wilkinson D. A good resource for parents, but will clinicians use it?: Evaluation of a resource for paediatric end-of-life decision making. BMC Palliat Care 2017; 16:12. [PMID: 28122549 PMCID: PMC5264290 DOI: 10.1186/s12904-016-0177-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 12/20/2016] [Indexed: 11/10/2022] Open
Abstract
Background Communication with parents about end-of-life care and decisions is a difficult and sensitive process. The objective of the present study was to ascertain clinicians’ views on the acceptability and usefulness of a handbook and web-based resource (Caring Decisions) that was designed as an aid for parents facing end-of-life decisions for their child. Methods Qualitative interviews were conducted with a range of health professionals who provide care to children facing life-limiting conditions. Results Data analysis confirmed the acceptability and usefulness of the resource. Two major themes were revealed: 1. Family empowerment, with sub-themes Giving words and clarity, Conversation starter, ‘I’m not alone in this’, and A resource to take away, highlighted how the resource filled a gap by supporting and enabling families in a multitude of ways; 2. Not just for families, with sub-themes A guide for staff, When to give the resource?, How to give the resource and Who should give the resource?, explored the significant finding that participants viewed the resource as a valuable tool for themselves, but its presence also brought into relief potential gaps in communication processes around end-of-life care. Conclusion The interview data indicated the positive reception and clear value and need for this type of resource. However, it is likely that successful resource uptake will be contingent on discussion and planning around dissemination and use within the health care team.
Collapse
Affiliation(s)
- Clare Delany
- Children's Bioethics Centre, Royal Children's Hospital Melbourne, 50 Flemington Rd, Parkville, VIC, 3052, Australia. .,University of Melbourne, Parkville, VIC, 3010, Australia.
| | - Vicki Xafis
- Sydney Children's Hospitals Network, Children's Hospital at Westmead, Locked Bag 4001, Westmead, NSW, 2145, Australia.,Centre for Values Ethics and the Law in Medicine, University of Sydney, Medical Foundation Building K25, Camperdown, NSW, 2006, Australia
| | - Lynn Gillam
- Children's Bioethics Centre, Royal Children's Hospital Melbourne, 50 Flemington Rd, Parkville, VIC, 3052, Australia
| | | | - Jenny Hynson
- Children's Bioethics Centre, Royal Children's Hospital Melbourne, 50 Flemington Rd, Parkville, VIC, 3052, Australia
| | - Dominic Wilkinson
- Oxford Uehiro Centre for Practical Ethics, Faculty of Philosophy, University of Oxford, Suite 8, Littlegate House, St Ebbes Street, Oxford, OX1 1PT, UK
| |
Collapse
|
18
|
Abstract
To investigate the needs of parents of premature infants hospitalized in a neonatal intensive care unit (NICU) and explore associated factors. This study includes a convenience sample of 198 parents of premature infants hospitalized in a NICU in Chenzhou, Hunan province, China. Parents completed a study-specific questionnaire and the Chinese version of Critical Care Family Need Inventory (CCFNI). Analysis was conducted by multiple linear regression. Parents rated 30 of 45 items on the Chinese version of the CCFNI as important or very important. Items on the assurance, information, and proximity subscales were perceived as the most important, while items on the comfort subscale were the least important. Gender of parents and experience of visiting a NICU were significantly associated with the total needs of the parents. These insights should be used to inform clinical practice in the NICU.
Collapse
Affiliation(s)
- Li Wang
- 1 The First People's Hospital of Chenzhou, P. R. China
| | - Jun Li He
- 1 The First People's Hospital of Chenzhou, P. R. China
| | - Shu Lan Fei
- 1 The First People's Hospital of Chenzhou, P. R. China
| |
Collapse
|
19
|
Verbiest S, McClain E, Stuebe A, Menard MK. Postpartum Health Services Requested by Mothers with Newborns Receiving Intensive Care. Matern Child Health J 2016; 20:125-131. [PMID: 27357697 PMCID: PMC5118385 DOI: 10.1007/s10995-016-2045-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Objectives Our pilot study aimed to build knowledge of the postpartum health needs of mothers with infants in a newborn intensive care unit (NICU). Methods Between May 2008 and December 2009, a Certified Nurse Midwife was available during workday hours to provide health care services to mothers visiting their infants in the NICU at a large tertiary care center. Results A total of 424 health service encounters were recorded. Maternal requests for services covered a wide variety of needs, with primary care being the most common. Key health concerns included blood pressure monitoring, colds, coughs, sore throats, insomnia and migraines. Mothers also expressed a need for mental health assessment and support, obstetric care, treatment for sexually transmitted infections, tobacco cessation, breastfeeding assistance, postpartum visits, and provision of contraception. Conclusions Our study suggests that mothers with babies in the NICU have a host of health needs. We also found that women were receptive to receiving health services in a critical care pediatric setting. Intensive care nurseries could feasibly partner with in-patient mother-baby units and/or on-site obstetric clinics to increase access to health care for the mothers of the high-risk newborns in their units. Modifications should be made within health care systems that serve high-risk infants to better address the many needs of the mother/baby dyad in the postpartum period.
Collapse
Affiliation(s)
- Sarah Verbiest
- Center for Maternal and Infant Health, University of North Carolina at Chapel Hill, Campus Box 7181, Room 3018 Old Clinic Building, Chapel Hill, NC, 27599-7181, USA.
- School of Social Work, University of North Carolina at Chapel Hill, Campus Box 3550, 325 Pittsboro Street, Chapel Hill, NC, 27599-3550, USA.
| | - Erin McClain
- Center for Maternal and Infant Health, University of North Carolina at Chapel Hill, Campus Box 7181, Room 3018 Old Clinic Building, Chapel Hill, NC, 27599-7181, USA
| | - Alison Stuebe
- Center for Maternal and Infant Health, University of North Carolina at Chapel Hill, Campus Box 7181, Room 3018 Old Clinic Building, Chapel Hill, NC, 27599-7181, USA
- Division of Maternal Fetal Medicine, Obstetrics and Gynecology Department, University of North Carolina at Chapel Hill School of Medicine, Campus Box 7516, Chapel Hill, NC, 27599-7516, USA
| | - M Kathryn Menard
- Center for Maternal and Infant Health, University of North Carolina at Chapel Hill, Campus Box 7181, Room 3018 Old Clinic Building, Chapel Hill, NC, 27599-7181, USA
- Division of Maternal Fetal Medicine, Obstetrics and Gynecology Department, University of North Carolina at Chapel Hill School of Medicine, Campus Box 7516, Chapel Hill, NC, 27599-7516, USA
| |
Collapse
|
20
|
Harvey ME, Redshaw ME. Qualitative study of the clinician-parent interface in discussing prognosis following MRI and US imaging of preterm infants in the UK. BMJ Open 2016; 6:e011472. [PMID: 27678531 PMCID: PMC5051465 DOI: 10.1136/bmjopen-2016-011472] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To explore communication and interaction between parents and clinicians following neonatal ultrasound (US) and MRI of the brain of babies born preterm. SETTING This qualitative study was undertaken as part of a larger UK study of neonatal brain imaging. 511 infants were cared for in 14 London neonatal units with MR and cerebral US imaging in a specialist centre. PARTICIPANTS Parents with infants born at <33 weeks gestation were randomised to receive prognostic information based on either MRI or US findings on their infants at term-corrected age. METHODS Discussions between parents and clinicians about the MRI or US result were audio recorded. Parents were told about the findings and their baby's predicted outcome. A topic guide ensured essential aspects were covered. Recordings were fully transcribed. Discussion of the scan results, the content and style of the interaction and parental response were analysed qualitatively in 36 recordings using NVivo V.10. OUTCOMES Key themes and subthemes were identified in the clinician-parent discussions. RESULTS The overarching theme of 'the communication interface' was identified with three key themes: 'giving information', 'managing the conversation' and 'getting it right' and further subthemes. A range of approaches were used to facilitate parental understanding and engagement. There were differences in the exchanges when information about an abnormal scan was given. The overall structure of the discussions was largely similar, though the language used varied. In all of the discussions, the clinicians talked more than the parents. CONCLUSIONS The discussions represent a difficult situation in which the challenge is to give and receive complex prognostic information in the context of considerable uncertainty. The study highlights the importance of being able to re-visit specific issues and any potential areas of misunderstanding, of making time to talk to parents appreciating their perspective and level of knowledge. TRIAL REGISTRATION NUMBER EudraCT 2009-013888-19; Pre-results.
Collapse
Affiliation(s)
- M E Harvey
- Department of Perinatal Imaging and Health, Division of Imaging and Biomedical Engineering, King's College, London, UK
- National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK
- Faculty of Health, Education and Life Sciences, Birmingham City University, Birmingham, UK
| | - M E Redshaw
- National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK
| |
Collapse
|
21
|
Maternal Health Risk Assessment and Behavioral Intervention in the NICU Setting Following Very Low Birth Weight Delivery. Matern Child Health J 2016; 20:28-38. [DOI: 10.1007/s10995-016-2183-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
22
|
Abstract
Family-centered care in neonatal intensive care changed over the last decades. Initially, parents and infants were separated and parents were even being blamed for cau-sing infections in their infants. The importance, though, of the parents being the constant in the infant's life emerged and with that the importance of early bonding and attachment for the parents to take on their role and responsibi-lities as primary caregivers. Facilitation of family-centered care includes involving the parents in daily care activities, kangaroo care, developmental care, interaction and communication with the infant, as well as involving grandparents and siblings. Implementation of family-centered care requires appropriate policies, facilities and resources, education of all involved, and a positive attitude.
Collapse
Affiliation(s)
- Carin Maree
- Department of Nursing Science, University of Pretoria, Pretoria, South Africa (Dr Maree and Ms Downes); and Nursetech, Midrand, South Africa (Ms Downes)
| | | |
Collapse
|
23
|
Mousavi SS, Chaman R, Khosravi A, Mohagheghi P, Mousavi SA, Keramat A. The Needs of Parents of Preterm Infants in Iran and a Comparison With Those in Other Countries: A Systematic Review and Meta-Analysis. IRANIAN JOURNAL OF PEDIATRICS 2016; 26:e4396. [PMID: 28203326 PMCID: PMC5294933 DOI: 10.5812/ijp.4396] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Revised: 03/06/2016] [Accepted: 03/27/2016] [Indexed: 11/24/2022]
Abstract
Context Proper accountability to needs of preterm infants’ parents requires recognition of these needs and how they change in different conditions. The aim of this study was to assess the needs of parents of preterm infants in Iran, as compared to those in other regions in the world. Evidence Acquisition A search of Iranian databases (Iran Medex, Magiran, and SID) and international resources (PubMed, Scopus, and Google Scholar) was conducted, with no time limitations, to 5 October 2014. Using standard tools, all quantitative studies that considering the parental needs of preterm infants and parental support were extracted. The STROBE checklist was used for the evaluation of the studies. Thirty-one studies were extracted in the qualitative evaluation, of which 17 were included in the meta-analysis. The variance between the studies was analyzed using tau-squared (Tau2) and review manager 5 software. Results The results obtained using the nurse-parent support tool (NPST) showed that mothers considered that all the fields of support were of great importance. The parental needs in Iran were similar to those of parents in other regions worldwide. However, the mean score for Iranian parents’ assessment of the support they received was 2.20 ± 0.06, whereas it was 3.84 ± 0.72 for other countries. The mean scores for parents’ assessment of the provision of emotional, informational appraisal, and instrumental support in Iran were 1.73 ± 0.06, 2.1 ± 0.06, 1.54 ± 0.6, and 3.44 ± 0.04, respectively, compared to 3.18 ± 1.34, 4.11 ± 0.5, 4.26 ± 0.18, and 4.51 ± 0.14, respectively, in other countries. Conclusions Parents always prefer the priorities of their babies to their individual needs. Given the lower scores for the parental assessment of received support in Iran, it is important to focus on these specific items in providing interventions to meet the needs of Iranian parents.
Collapse
Affiliation(s)
| | - Reza Chaman
- Associate Professor, Epidemiology, Department of Community Medicine, Yasuj University Of Medical Sciences, Yasuj, IR Iran
| | - Ahmad Khosravi
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, IR Iran
| | - Parisa Mohagheghi
- Associate Professor, Iran University of Medical Sciences, Tehran, IR Iran
| | - Seyed Abbas Mousavi
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, IR Iran
| | - Afsaneh Keramat
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, IR Iran
- Corresponding author: Afsaneh Keramat, Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, IR Iran. Tel: +98-2332395054, Fax: +98-2332394800, E-mail:
| |
Collapse
|
24
|
Alves E, Severo M, Amorim M, Grande C, Silva S. A short form of the neonatal intensive care unit family needs inventory. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2016. [DOI: 10.1016/j.jpedp.2015.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
25
|
Alves E, Severo M, Amorim M, Grande C, Silva S. A short form of the neonatal intensive care unit family needs inventory. J Pediatr (Rio J) 2016; 92:73-80. [PMID: 26453515 DOI: 10.1016/j.jped.2015.04.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2014] [Revised: 03/28/2015] [Accepted: 04/15/2015] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE The identification of parental needs in Neonatal Intensive Care Units is essential to design and implement family-centered care. This article aims to validate the Neonatal Intensive Care Units Family Needs Inventory for the Portuguese population, and to propose a Short Form. METHODS A linguistic adaptation of the Neonatal Intensive Care Units Family Needs Inventory, a self-report scale with 56-items, was performed. The instrument was administered to 211 parents of infants hospitalized in all level III Neonatal Intensive Care Units in the North of Portugal, 15-22 days after admission (July of 2013-June of 2014). The number of items needed to achieve reliability close to 0.8 was calculated using by the Spearman-Brown formula. The global goodness of fit of the scale was evaluated using the comparative fit index. Construct validity was assessed through association of each dimension score with socio-demographic and obstetric characteristics. RESULTS Exploratory factor analysis revealed two dimensions, one focused on parents' needs and another on the infant's needs. To compose the Short Form Inventory, items with ceiling effect were eliminated and 22 items were submitted to confirmatory analysis, which supported the existence of two dimensions (CFI=0.925). The Short Form showed a high degree of reliability (alpha≥0.76). Less educated and older parents more frequently attributed a significantly higher importance to parent-centered needs, while parents of multiples revealed a tendency to value infant-centered needs. CONCLUSIONS The Short Form of the Neonatal Intensive Care Units Family Needs Inventory is a brief, simple, and valid instrument with a high degree of reliability. Further studies are needed to explore associations with practices of family-centered care.
Collapse
Affiliation(s)
- Elisabete Alves
- EpiUnit - Institute of Public Health, Universidade do Porto, Porto, Portugal.
| | - Milton Severo
- EpiUnit - Institute of Public Health, Universidade do Porto, Porto, Portugal; Department of Clinical Epidemiology, Predictive Medicine and Public Health, Medical School, Universidade do Porto, Porto, Portugal
| | - Mariana Amorim
- EpiUnit - Institute of Public Health, Universidade do Porto, Porto, Portugal; Global Public Health Doctoral Programme, Institute of Public Health, Universidade do Porto, Portugal
| | - Catarina Grande
- Faculty of Psychology and Education Sciences, Universidade do Porto, Porto, Portugal
| | - Susana Silva
- EpiUnit - Institute of Public Health, Universidade do Porto, Porto, Portugal
| |
Collapse
|
26
|
Xafis V, Wilkinson D, Sullivan J. What information do parents need when facing end-of-life decisions for their child? A meta-synthesis of parental feedback. BMC Palliat Care 2015; 14:19. [PMID: 25924893 PMCID: PMC4424961 DOI: 10.1186/s12904-015-0024-0] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 04/23/2015] [Indexed: 11/17/2022] Open
Abstract
Background The information needs of parents facing end-of-life decisions for their child are complex due to the wide-ranging dimensions within which such significant events unfold. While parents acknowledge that healthcare professionals are their main source of information, they also turn to a variety of additional sources of written information in an attempt to source facts, discover solutions, and find hope. Much has been written about the needs of parents faced with end-of-life decisions for their child but little is known about the written information needs such parents have. Research in the adult intensive care context has shown that written resources impact positively on the understanding of medical facts, including diagnoses and prognoses, communication between families and healthcare professionals, and the emotional wellbeing of families after their relative’s death. Methods A meta-synthesis of predominantly empirical research pertaining to features which assist or impede parental end-of-life decisions was undertaken to provide insight and guidance in our development of written resources (short print and online comprehensive version) for parents. Results The most prominently cited needs in the literature related to numerous aspects of information provision; the quantity, quality, delivery, and timing of information and its provision impacted not only on parents’ ability to make end-of-life decisions but also on their emotional wellbeing. The meta-synthesis supports the value of written materials, as these provide guidance for both parents and healthcare professionals in pertinent content areas. Conclusions Further research is required to determine the impact that written resources have on parental end-of-life decision-making and on parents’ wellbeing during and after their experience and time in the hospital environment. Electronic supplementary material The online version of this article (doi:10.1186/s12904-015-0024-0) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Vicki Xafis
- Discipline of Obstetrics and Gynaecology, The University of Adelaide, Adelaide, Australia.
| | - Dominic Wilkinson
- Discipline of Obstetrics and Gynaecology, The University of Adelaide, Adelaide, Australia. .,John Radcliffe Hospital Oxford, Director of Medical Ethics, Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK.
| | - Jane Sullivan
- Children's Bioethics Centre, The Royal Children's Hospital, Melbourne, Australia. .,The Centre for Health Equity, The University of Melbourne, Melbourne, Australia.
| |
Collapse
|
27
|
Bastani F, Abadi TA, Haghani H. Effect of Family-centered Care on Improving Parental Satisfaction and Reducing Readmission among Premature Infants: A Randomized Controlled Trial. J Clin Diagn Res 2015; 9:SC04-8. [PMID: 25738051 PMCID: PMC4347142 DOI: 10.7860/jcdr/2015/10356.5444] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 09/05/2014] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Healthcare quality is usually evaluated through analysing medical outcomes including neonatal readmission and patient and family satisfaction. Parental involvement in neonatal care is considered as one of the most important factors, which directly affects these outcomes. The aim of the present study was to determine the effect of family-centered care including maternal participation, presence, and information about neonatal care, on maternal satisfaction and neonatal readmission; the care services were provided by the primiparous mothers of preterm infants. MATERIALS AND METHODS One hundred and ten primiparous mothers with preterm infants participated in this clinical trial. All samples were randomly divided into family-centered care (FCC) and control groups, through simple random sampling. The FCC program, which consisted of information about neonatal care, maternal presence, and participation in the care process, was implemented in the FCC group, while the control group was provided with routine care. Data were obtained using demographic and satisfaction questionnaires and readmission checklist. RESULTS In the FCC group, the mean score of satisfaction increased after the implementation of the program (22.36 and 59.28 before and after the program, respectively) (p<0.001); however, this increase in the control group was not significant. The obtained results regarding the different aspects of satisfaction indicated that mothers in the FCC group were more satisfied with maternal presence in the neonatal intensive care unit (NICU), compared with aspects of information and participation. In addition, the number of neonatal readmission was less in the FCC group compared with the control group, and the mean duration of hospitalization was 6.96 and 12.96 days in the FCC and control groups, respectively (p<0.001). CONCLUSION FCC program seems to be effective in increasing maternal satisfaction and decreasing neonatal readmission. Therefore, it seems necessary that healthcare authorities of the departments of obstetrics and gynecology in Iran provide the opportunity for the implementation of such programs in clinical environments, which follow the policy of parental absence and participation in the intensive care units.
Collapse
Affiliation(s)
- Farideh Bastani
- Associate Professor, Departments of Community Health Nursing and Geriatrics Nursing, School of Management and Information, Iran University of Medical Sciences, Tehran, Iran
| | - Tayebe Ali Abadi
- Faculty, Department of Nursing, Neyshabur Science and Research Branch, Islamic Azad University, Neyshabur, Iran
| | - Hamid Haghani
- Assistant Professor, Department of Biostatistics, School of Management and Information, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
28
|
|
29
|
Paternal and maternal concerns for their very low-birth-weight infants transitioning from the NICU to home. J Perinat Neonatal Nurs 2014; 28:305-12. [PMID: 24927295 DOI: 10.1097/jpn.0000000000000021] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This study examines qualitatively the concerns and coping mechanisms of fathers and mothers of very low-birth-weight (VLBW; <1500 g) neonatal intensive care unit (NICU) infants as they transition to home from the NICU. In-depth, semistructured phone interviews were conducted with a sample of fathers and mothers of VLBW NICU infants in the Chicago area who had transitioned home, and parental concerns were examined during the transition to home. Phone interviews lasting 30 to 60 minutes were transcribed verbatim, and all interviews were coded using content and narrative analysis. Twenty-five parents (10 fathers, 15 mothers) of 16 VLBW infants who had an average gestational age of 29.5 weeks and an average NICU stay of 58.38 days completed the interview. Overriding concerns included pervasive uncertainty, lingering medical concerns, and partner-related adjustment concerns that differed by gender. A variety of resilient coping methods during this stressful transition are also described. Fathers and mothers of VLBW NICU graduates have evolving but often differing concerns as they transition from the NICU to home. Many of these concerns can be addressed with improved discharge information exchanges and anticipatory guidance. Supporting parents during this stressful and often difficult transition may lead to decreased family stress, improved care, and better infant outcomes.
Collapse
|
30
|
Dellenmark-Blom M, Wigert H. Parents' experiences with neonatal home care following initial care in the neonatal intensive care unit: a phenomenological hermeneutical interview study. J Adv Nurs 2013; 70:575-86. [DOI: 10.1111/jan.12218] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Michaela Dellenmark-Blom
- Division of Paediatric Emergency Care and Paediatric Surgery; The Queen Silvia Children's Hospital; Sahlgrenska University Hospital; Gothenburg Sweden
| | - Helena Wigert
- Institute of Health and Care Sciences; The Sahlgrenska Academy at the University of Gothenburg; Sweden
- Division of Neonatology; Sahlgrenska University Hospital; Gothenburg Sweden
| |
Collapse
|
31
|
Wigert H, Dellenmark MB, Bry K. Strengths and weaknesses of parent-staff communication in the NICU: a survey assessment. BMC Pediatr 2013; 13:71. [PMID: 23651578 PMCID: PMC3651269 DOI: 10.1186/1471-2431-13-71] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Accepted: 05/02/2013] [Indexed: 01/01/2023] Open
Abstract
Background Parents of infants hospitalized in the neonatal intensive care unit (NICU) find themselves in a situation of emotional strain. Communication in the NICU presents special challenges due to parental stress and the complexity of the highly technologized environment. Parents’ need for communication may not always be met by the NICU staff. This study aimed to describe strengths and weaknesses of parent–nurse and parent–doctor communication in a large level III NICU in Sweden in order to improve our understanding of parents’ communication needs. Methods Parents were asked to complete a survey consisting of sixteen questions about their experiences of communication with nurses and doctors in the NICU. In each question the parents evaluated some aspect of communication on a five- or six-point Likert scale. They also had the opportunity on each question to comment on their experiences in their own words. Data were analyzed using IBM SPSS Statistics 20.0 and qualitative manifest content analysis. Results 270 parents (71.4%) completed the survey. Parents generally rated communication with the staff in the NICU positively and appreciated having received emotional support and regular information about their child´s care. Although a large majority of the parents were satisfied with their communication with doctors and nurses, only about half of the parents felt the nurses and doctors understood their emotional situation very well. Some parents would have desired easier access to conversations with doctors and wanted medical information to be given directly by doctors rather than by nurses. Parents’ communication with the staff was hampered when many different nurses were involved in caring for the infant or when the transfer of information in connection with shift changes or between the maternity ward and NICU was poor. Parents also desired to be present during doctors’ rounds on their infant. Conclusions Training both doctors and nurses in communication skills, especially in how to meet parents’ emotional needs better, could make communication at the NICU more effective and improve parental well-being. Creating a framework for the parents of what to expect from NICU communication might also be helpful. In addition, our results support the use of primary nurse teams to improve continuity of care and thereby promote successful communication.
Collapse
Affiliation(s)
- Helena Wigert
- Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Box 457, Gothenburg, SE 405 30, Sweden.
| | | | | |
Collapse
|
32
|
Harvey ME, Nongena P, Gonzalez-Cinca N, Edwards AD, Redshaw ME. Parents' experiences of information and communication in the neonatal unit about brain imaging and neurological prognosis: a qualitative study. Acta Paediatr 2013; 102:360-5. [PMID: 23298288 DOI: 10.1111/apa.12154] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Revised: 10/19/2012] [Accepted: 01/03/2013] [Indexed: 11/27/2022]
Abstract
AIM To explore parental information and communication needs during their baby's care in the neonatal unit with a focus on brain imaging and neurological prognosis. METHODS Eighteen parents recruited from one neonatal unit in the United Kingdom participated in semi-structured qualitative interviews using a grounded theory approach. The topic guide focused on information received about neonatal brain imaging, diagnosis and prognosis, emotional impact and support. RESULTS Parents expressed different information needs influenced by their history, expectations, coping strategies and experiences. Most felt they initially were passive recipients of information and attempted to gain control of the information flow. Nurses were the main providers of information; doctors and other parents were also valuable. Attending ward rounds was important. Some parents felt accessing specific information such as the results of brain imaging could be difficult. Concerns about long-term developmental outcomes and the need for information did not diminish over time. The emotional impact of having a preterm baby had a negative effect on parents' ability to retain information, and all had an ongoing need for reassurance. CONCLUSION The findings provide insights about the needs and experiences of parents who have a continuing requirement for information about their infant's care, development and prognosis.
Collapse
Affiliation(s)
- Merryl E Harvey
- Centre for the Developing Brain; Imperial College London and MRC Clinical Sciences Centre; Hammersmith Hospital; London UK
| | - Phumza Nongena
- Centre for the Developing Brain; Imperial College London and MRC Clinical Sciences Centre; Hammersmith Hospital; London UK
| | - Nuria Gonzalez-Cinca
- Centre for the Developing Brain; Imperial College London and MRC Clinical Sciences Centre; Hammersmith Hospital; London UK
| | - A David Edwards
- Centre for the Developing Brain; Imperial College London and MRC Clinical Sciences Centre; Hammersmith Hospital; London UK
| | - Maggie E. Redshaw
- National Perinatal Epidemiology Unit; University of Oxford; Oxford UK
| | | |
Collapse
|
33
|
Obeisat SM, Hweidi IM. Jordanian parental needs of critically ill infants in neonatal intensive care units. J Res Nurs 2012. [DOI: 10.1177/1744987112468444] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This descriptive correlational study was conducted to identify perceived parental needs of critically ill infants in Neonatal Intensive Care Units (NICUs). Jordanian parents who were visiting their infants admitted in NICU ( N = 170) composed the study sample. Participants completed the demographic data sheet and the NICU Family Needs Inventory. Findings showed that parents ranked assurance, information and proximity as the most important needs, while comfort and support were ranked the lowest. The primary concern of parents was to be assured and informed about the progress of their infant. In addition, the results indicated that the mother’s perceived needs for support, information and proximity were significantly more important than the father's. Accordingly, nurses should establish a rapport with family members and provide them with understandable and honest information. Furthermore, the provision of quality, holistic, family-centered nursing care that relies primarily on early and comprehensive needs assessment, which correlates with infants’ outcomes, is imperative.
Collapse
Affiliation(s)
- Salwa M. Obeisat
- Assistant Professor, Faculty of Nursing, Maternal Child Health Nursing Department, Jordan University of Science and Technology, Jordan
| | - Issa M. Hweidi
- Associate Professor, Faculty of Nursing, Adult Health Nursing Department, Jordan University of Science and Technology, Jordan
| |
Collapse
|
34
|
Abstract
There is much research about the negative effect of serious and chronic childhood illness on the parent's partner relationship. It is generally assumed that parents of newborns admitted to the neonatal intensive care unit (NICU) also share this risk of relationship strain. However, little research specific to the effects of the NICU on the parent's relationship exists. The focus of most research examining parents of NICU infants is the mother's emotional well-being. The effect on the father is rarely studied. Drawing from studies of other childhood illnesses, it is reasonable to hypothesize that the experience of a NICU hospitalization may also strain the parents' relationship, possibly to the point of dissolution. The implementation of family-centered care in the NICU has had promising outcomes, and it is hypothesized that family-centered care will minimize the emotional stressors that may lead to the dissolution of the parent's partner relationship.
Collapse
|
35
|
Cockcroft S. How can family centred care be improved to meet the needs of parents with a premature baby in neonatal intensive care? ACTA ACUST UNITED AC 2012. [DOI: 10.1016/j.jnn.2011.07.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
36
|
Cleveland LM, Horner SD. Normative cultural values and the experiences of Mexican-American mothers in the neonatal intensive care unit. Adv Neonatal Care 2012; 12:120-5. [PMID: 22469967 DOI: 10.1097/anc.0b013e31824d9a00] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To explore the experiences of Mexican-American mothers who have had infants in the neonatal intensive care unit (NICU). PARTICIPANTS A convenience sample of 15 English-speaking, Mexican-American women was interviewed. DESIGN The study used an exploratory qualitative approach. METHODS Data collection was conducted through audiotaped, transcribed, semistructured, individual interviews and field notes. The 5 normative cultural values for Latino families-(1) simpatia, (2) personalismo, (3) respeto, (4) familismo, and (5) fatalismo-were used as a sensitizing framework to guide data interpretation. RESULTS The women's discussions of their NICU experiences clearly reflect the 5 normative Latino cultural values. Positive and negative exemplars of these values are provided as evidence. CONCLUSIONS These findings can be used to inform nursing care provided for Mexican-American mothers and their infants by assisting nurses to customize care to meet the cultural needs of this population.
Collapse
|
37
|
Lee J, Bang KS. The Effects of Kangaroo Care on Maternal Self-esteem and Premature Infants' Physiological Stability. KOREAN JOURNAL OF WOMEN HEALTH NURSING 2011; 17:454-462. [PMID: 37697531 DOI: 10.4069/kjwhn.2011.17.5.454] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023] Open
Abstract
PURPOSE This paper identified the effects of kangaroo care (KC) on maternal self-esteem and the growth and physiological stability of premature infants hospitalized in the neonatal intensive care unit. METHODS The experiment was conducted with an experimental group of 17 infants, and a control group of 17 infants selected by convenience sampling. KC was given to the infants one time a day for 30 minutes after feeding for two weeks. Their weight was measured every morning, and their physiological stability was measured in terms of their body temperature, respiratory rate, heart rate, oxygen saturation, and stability of the cardio-respiratory system in premature infants (SCRIP) score, as physiological responses at every 10 minutes during the intervention. Maternal self-esteem was assessed by a maternal self-report inventory. RESULTS The experimental group showed significant increase in the self-esteem of mothers. Also, KC was effective on physiological stabilization of preterm infants. CONCLUSION This study suggests that KC can be provided in clinical settings more widely in Korea as one of the nursing interventions aimed at promoting maternal self-esteem as well as infants' physiological stabilization.
Collapse
Affiliation(s)
- Jihye Lee
- College of Nursing, Seoul National University, Korea
| | | |
Collapse
|
38
|
Schlittenhart JM, Smart D, Miller K, Severtson B. Preparing parents for NICU discharge: an evidence-based teaching tool. Nurs Womens Health 2011; 15:484-494. [PMID: 22900689 DOI: 10.1111/j.1751-486x.2011.01676.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Preparation for discharge and transition to parents' care of infants hospitalized in the neonatal intensive care unit (NICU) is a process that begins on admission. Identifying parents' educational needs requires thoughtful assessment by experienced nurses. Caring for these infants can be daunting to parents, and participating in a discharge class can be very helpful in easing the transition to home. This article describes a NICU discharge informational DVD/video that was developed to deliver parent education and promote informed and safe transition from hospital to home.
Collapse
|
39
|
De Rouck S, Leys M. Information behaviour of parents of children admitted to a neonatal intensive care unit: Constructing a conceptual framework. Health (London) 2011; 15:54-77. [PMID: 21212114 DOI: 10.1177/1363459309360785] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This article explores the concepts 'information behaviour' and 'illness trajectory' at the neonatal intensive care unit (NICU). On the basis of literature review and exploratory interviews with neonatologists and head nurses of Belgian NICUs a conceptual framework is presented. The 'information behaviour' of parents of infants admitted to a NICU is analytically divided into five dimensions: ways of getting information; interpersonal information sources; time-related issues; location of information transfer; and content of information. The conceptual framework equally takes the 'illness trajectory' into account. Following Corbin and Strauss the illness trajectory at a NICU is analysed in three sub-trajectories: disease course; healthcare trajectory; and sickness trajectory. By combining the respective categories of information behaviour and illness trajectory, an analytical tool is presented under the form of a classification matrix for scrutinizing the mediating role of the illness trajectory on the information behaviour of parents of infants admitted to a NICU.
Collapse
|
40
|
Reis MD, Rempel GR, Scott SD, Brady-Fryer BA, Van Aerde J. Developing nurse/parent relationships in the NICU through negotiated partnership. J Obstet Gynecol Neonatal Nurs 2010; 39:675-83. [PMID: 21039850 DOI: 10.1111/j.1552-6909.2010.01189.x] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To explore parents' experience and satisfaction with care in the Neonatal Intensive Care Unit (NICU). DESIGN Qualitative design using an interpretive description method. SETTING A tertiary-level care 69-bed NICU. PARTICIPANTS Ten parents (nine mothers and one father) were interviewed. METHOD Parents were interviewed in person or via telephone, either following or close to discharge. Interviews were recorded, transcribed, and then analyzed using an evolving coding guide. RESULTS All parents indicated that the relationship they developed with the bedside nurse was the most significant factor affecting their satisfaction with their NICU experience. All parents described nursing actions of perceptive engagement, cautious guidance, and subtle presence, which facilitated the development of this relationship. Further analysis of the data revealed that parents portrayed nurses in ideal nurse/parent interactions as fulfilling the roles of teacher, guardian, and facilitator. CONCLUSION Developing a collaborative and effective nurse/parent relationship is the most significant factor affecting parents' satisfaction with their NICU experience. Providing nursing care in a manner that optimizes consistency and continuity of care facilitates the ability of both parties to develop this relationship.
Collapse
Affiliation(s)
- Misty D Reis
- Department, School of Nursing, University of North Carolina, Greensboro, NC, USA
| | | | | | | | | |
Collapse
|
41
|
Abstract
BACKGROUND Limited research has been conducted to assess family needs in neonatal intensive care units. Health care providers often make assumptions about what families need, but these assumptions are unfounded and can lead to inappropriate conclusions. When assessed appropriately, family needs can be incorporated into individualized plans of care, enhancing family-centered care. OBJECTIVE To assess the needs of parents in neonatal intensive care units, we asked the following 3 questions: What are the most and least important needs of families in a level III neonatal intensive care unit? Do parents' needs differ at admission and discharge? Do the needs of mothers and fathers differ? METHODS Parents were interviewed by using the Neonatal Intensive Care Unit Family Needs Inventory. Participants rated statements as not important (1), slightly important (2), important (3), very important (4), or not applicable (5). RESULTS Fifty-two (93%) of the 56 items were rated as important or very important, and parents rated assurance-type needs highest. Parents at admission rated support needs higher than parents at discharge rated those needs. Needs of mothers and fathers did not differ significantly. CONCLUSIONS Identifying the needs of parents in neonatal intensive care units can enhance nursing communication and allow nurses to incorporate parents' needs into families' plans of care. The family needs inventory can help identify those needs and allows the integration of individualized nursing care to fulfill those needs, providing a positive family-centered experience in the unit for patients and their families.
Collapse
Affiliation(s)
- Cynthia A. Mundy
- Cynthia A. Mundy is a neonatal nurse practitioner in the neonatal intensive care unit at the Medical College of Georgia in Augusta. When this study was done, she was an assistant professor and director of the clinical nurse leader program in the School of Nursing at the Medical College of Georgia
| |
Collapse
|
42
|
Including parents in the evaluation of clinical microsystems in the neonatal intensive care unit. Adv Neonatal Care 2009; 9:174-9. [PMID: 19696572 DOI: 10.1097/anc.0b013e3181afab3c] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Neonatal intensive care is an area of healthcare that has experienced significant growth in recent years. As a result, "megaunits" of more than 60 beds are not uncommon. Delivering care in units of this size that incorporates the principles of family-centered care and that is satisfying to both staff and parents is challenging. One proposed method to enhance delivery of care in the megaunit NICU has been to implement a clinical microsystem approach. Up to now, research to evaluate the efficacy of a clinical microsystem has focused primarily on staff satisfaction and perception. However, implementing the clinical microsystem within the NICU requires that careful attention be paid to the parents and their experience and perception of their infant's care in the NICU. This article reviews the basic principles of family-centered care, identifies components of care that affect parents' satisfaction with NICU care, reviews the theoretical underpinnings of the clinical microsystem, and discusses areas for future research.
Collapse
|
43
|
De Rouck S, Leys M. Information needs of parents of children admitted to a neonatal intensive care unit: a review of the literature (1990-2008). PATIENT EDUCATION AND COUNSELING 2009; 76:159-173. [PMID: 19321288 DOI: 10.1016/j.pec.2009.01.014] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2008] [Revised: 01/28/2009] [Accepted: 01/31/2009] [Indexed: 05/27/2023]
Abstract
OBJECTIVE This literature review focuses on information and communication needs of parents of children admitted to the NICU and on their use of information sources in the illness trajectories at NICU. METHODS Literature search in 4 electronic databases (Ovid Medline, PsycINFO, CINAHL and Sociological Abstracts), covering 1990-March 2008. RESULTS The seventy-eight included articles revealed that NICU parents have high information needs. The illness trajectory mediates parental information needs and induces a changing pattern in information use and information needs. Most attention is paid to the prenatal and acute phases, while information behaviour in sudden events and later phases receives limited attention. CONCLUSIONS In-depth studies on information needs and corresponding use of information sources are lacking. More longitudinal studies are needed, taking the illness trajectory into account and investigating the determinants and outcomes of the information and communication needs of NICU parents. PRACTICE IMPLICATIONS Healthcare professionals should adapt their information provision along the illness trajectory. The development of guidelines of information provision during the illness trajectory at NICU would support all professionals.
Collapse
Affiliation(s)
- Sofie De Rouck
- Vrije Universiteit Brussel, Department of Medical Sociology and Health Sciences (MESO), Brussels, Belgium.
| | | |
Collapse
|
44
|
Sargent AN. Predictors of needs in mothers with infants in the neonatal intensive care unit. J Reprod Infant Psychol 2009. [DOI: 10.1080/02646830802350849] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
45
|
Abstract
OBJECTIVE A systematic review of the literature was conducted to answer the following 2 questions: (a) What are the needs of parents who have infants in the neonatal intensive care unit? (b) What behaviors support parents with an infant in the neonatal intensive care unit? DATA SOURCES Using the search terms "parents or parenting" and the "neonatal intensive care unit," computer library databases including Medline and CINAHL were searched for qualitative and quantitative studies. Only research published in English between 1998 and 2008 was included in the review. STUDY SELECTION Based on the inclusion criteria, 60 studies were selected. DATA EXTRACTION Study contents were analyzed with the 2 research questions in mind. DATA SYNTHESIS Existing research was organized into 1 of 3 tables based on the question answered. Nineteen articles addressed the first question, 24 addressed the second, and 17 addressed both. CONCLUSIONS Six needs were identified for parents who had an infant in the neonatal intensive care unit: (a) accurate information and inclusion in the infant's care, (b) vigilant watching-over and protecting the infant, (c) contact with the infant, (d) being positively perceived by the nursery staff, (e) individualized care, and (f) a therapeutic relationship with the nursing staff. Four nursing behaviors were identified to assist parents in meeting these needs: (a) emotional support, (b) parent empowerment, (c) a welcoming environment with supportive unit policies, and (d) parent education with an opportunity to practice new skills through guided participation.
Collapse
Affiliation(s)
- Lisa M Cleveland
- University of Texas Health Science Center San Antonio, School of Nursing, University of Texas, Austin, TX 78229-3900, USA.
| |
Collapse
|
46
|
Lindberg B, Ohrling K. Experiences of having a prematurely born infant from the perspective of mothers in northern Sweden. Int J Circumpolar Health 2009; 67:461-71. [PMID: 19186767 DOI: 10.3402/ijch.v67i5.18353] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES The aim of this study was to describe the mothers' experience of having a prematurely born infant, with the focus on the birth itself and during the time immediately following the birth. STUDY DESIGN A qualitative design was chosen to achieve the aim of this study. METHODS Six mothers, whose infants were born prematurely and thereby needed care on a neonatal intensive care unit (NICU), participated in the study. Narrative interviews were conducted and the mothers were encouraged to freely narrate their experiences of having an infant born preterm. A qualitative content analysis was used to analyse the interviews. RESULTS The results show that mothers were not prepared for having prematurely born infants and that initially they had difficulties feeling like a mother. Having an infant born preterm was dominated by feelings of anxiety. Feeling closeness to the child was important, and separation from the child was a very stressful experience. Family life was affected, but mothers felt they were able to handle the situation if they received support from their partner and hospital staff, and if they were equipped with knowledge regarding the birth and care of a premature infant. Furthermore, it was important for the mothers to be involved in their infants' care. CONCLUSIONS Support and knowledge made it possible for mothers to handle having a premature infant. Mothers' situations could be facilitated if nurses had increased knowledge and understanding about how mothers experience this situation.
Collapse
Affiliation(s)
- Birgitta Lindberg
- Department of Health Sciences, Luleå University of Technology, Luleå, Sweden.
| | | |
Collapse
|
47
|
Nurses' understanding about the delivery of family centred care in the neonatal unit. ACTA ACUST UNITED AC 2008. [DOI: 10.1016/j.jnn.2008.07.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
48
|
Sloan K, Rowe J, Jones L. Stress and coping in fathers following the birth of a preterm infant. ACTA ACUST UNITED AC 2008. [DOI: 10.1016/j.jnn.2007.12.009] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
49
|
Johnson AN. Promoting maternal confidence in the NICU. J Pediatr Health Care 2008; 22:254-7. [PMID: 18590871 DOI: 10.1016/j.pedhc.2007.12.012] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2007] [Revised: 12/18/2007] [Accepted: 12/18/2007] [Indexed: 11/16/2022]
Abstract
The technological intensive care environment of the neonatal intensive care unit (NICU) presents a challenge for nurses to integrate care that supports the development of premature and critically ill term infants while supporting mothers as collaborators in the care of their infant. The purpose of this article is to discuss the attributes of maternal-infant attachment, examine the challenges the NICU environment presents, and propose nursing interventions that facilitate and support the development of maternal confidence in the NICU. These interventions create an environment that facilitates maternal-infant attachment by offering mothers meaningful, positive experiences with their infants.
Collapse
|
50
|
Rüdiger M, Iffländer S, Reichert J, Bätzel C, Reiter G, Wauer RR. Which information will be given to parents of preterm infants--a comparison of estimates and local data. J Perinat Med 2007; 35:436-42. [PMID: 17605600 DOI: 10.1515/jpm.2007.074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Parents of preterm infants require information on morbidity and duration of common interventions performed in the NICU. Since locally achieved data are often not available, information is mainly based on educated guesses of health care professionals. The present study compares estimates of neonatal nurses or medical doctors (MDs) in two separate NICUs with local data. METHODS Health care professionals were asked to estimate morbidity and duration of medical interventions of two groups of very low birth weight infants. For comparison, local data were obtained from infant charts and the Vermont Oxford Neonatal Network data base. RESULTS Incidence of BPD was underestimated by MDs and overestimated by nurses for low birth weight group (500-750 g) and overestimated by nurses for 1250- 1500 g infants. Incidence of IVH was significantly overestimated by nurses for both groups. Duration of ventilatory support was underestimated for infants of a gestational age of 24-27 weeks and overestimated for the age group of 31-32 weeks. Length of stay in NICU was underestimated for infants at gestational age of 24-27 weeks, but not for the 32-33 weeks group. CONCLUSIONS Information based on estimates made by health care professionals may be misleading. Data differ significantly among different NICUs, thus, local data should be obtained by each NICU and used to inform parents appropriately.
Collapse
Affiliation(s)
- Mario Rüdiger
- Department for Pediatrics, Medical University Innsbruck, Pädiatrie IV-Neonatologie, Austria.
| | | | | | | | | | | |
Collapse
|