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Kim ES, Min HG, Lee JY, Lee JY, Yi YH. Development of a Protocol for the Direct Breastfeeding of Premature Infants in Neonatal Intensive Care Units. J Perinat Neonatal Nurs 2024; 38:73-87. [PMID: 38197807 DOI: 10.1097/jpn.0000000000000791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
PURPOSE This study aimed to develop a direct breastfeeding protocol for premature infants admitted to neonatal intensive care units (NICUs) and investigate its efficacy. BACKGROUND Direct breastfeeding increases the amount and duration of breastfeeding. However, NICUs have low direct feeding rates owing to medical staff anxiety, lack of knowledge and experience, and fear of overwork. Accordingly, this study developed a protocol for direct breastfeeding in the NICU and evaluated its effect. METHODS The protocol was developed through a literature review, expert validation, and preliminary investigation. Its application effects were identified using a nonexperimental, evidence-based research design targeting premature infants, their mothers, and NICU nurses. RESULTS The protocol comprised 5 areas and 23 items. Application of the protocol resulted in continuous weight gain of the infants and increased self-efficacy in the mothers' direct breastfeeding ( t = 3.219, P = .004). Significant increases were noted in NICU nurses' direct breastfeeding activities ( t = 3.93, P < .001), breastfeeding rates in the NICU ( P = .037), and direct breastfeeding rates ( P = .007). CONCLUSIONS Results underscore the value of an evidence-based protocol for improving breastfeeding rates in premature infants. This study highlights the need for continuous nursing education on protocol applications and human resource support.
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Affiliation(s)
- Eun Sook Kim
- Cicely Saunders Institute, King's College London, London, United Kingdom (Dr Kim); Neonatal Intensive Care Unit, Samsung Medical Center, Gangnam-Gu, Seoul, South Korea (Dr Kim and Ms Min, Ji Yeon Lee, and Ji Yoon Lee); and Graduate School of Clinical Nursing Science, Sungkyunkwan University, Gangnam-gu, Seoul, South Korea (Dr Yi)
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van de Riet L, Alsem MW, Beijneveld RSI, van Woensel JBM, van Karnebeek CD. Delineating family needs in the transition from hospital to home for children with medical complexity: part 2, a phenomenological study. Orphanet J Rare Dis 2023; 18:387. [PMID: 38082332 PMCID: PMC10714565 DOI: 10.1186/s13023-023-02747-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 05/18/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND A systematic literature review on the transition from hospital-to-home (H2H) of families with a child with medical complexity (CMC), resulted in nine overarching themes. These demonstrated common needs and experiences despite the widely differing CMC diagnoses and family characteristics. However, none of the reported studies was conducted in the Netherlands, which hampers the creation of a tailored H2H care pathway, deemed essential for our recently established Transitional Care Unit in the Netherlands: the 'Jeroen Pit Huis'. Therefore, the aim of this study was to gain a deeper understanding of the needs and experiences of Dutch CMC parents on H2H transition and integrate these insights with the literature review into an evidence-based H2H care pathway for CMC and their families. METHODS A descriptive phenomenological approach was applied. Heterogeneous purposeful sampling methods were used to recruit participants according to the following criteria: parents of CMC from various regions in the Netherlands, who spoke Dutch fluently and who had been discharged home from a tertiary hospital within the previous five years. Semi-structured, open-ended interviews were conducted via video call by two researchers, who transcribed the audio recordings verbatim. Thematic analysis methods were used to identify emerging themes from the individual transcripts, involving a third and fourth researcher to reach consensus. RESULTS Between March and August 2021, 14 mothers and 7 fathers participated in 14 interviews. They elaborated on the H2H transition of 14 CMC with a wide range of underlying diseases: 7 male, 7 female, aged 6 months to 10 years. Eight overarching themes, consistent with the results of the systematic review, represent CMC parental needs and experiences during the H2H process in the Netherlands: (1) autonomy, (2) division of tasks and roles, (3) family emotions, (4) impact on family life, (5) communication, (6) coordination of care, (7) support system and (8) adaptation. CONCLUSIONS The H2H needs and experiences reported by the CMC families in this study align with the results of our systematic review. The H2H transition process is not linear but continuous, and should extend beyond the specific medical needs of the CMC to holistic care for the family as a whole. The overarching care needs and experiences, expressed by all CMC families, regardless of underlying symptoms and diagnoses, inform the H2H care pathway and its future evaluation. Our studies highlight the necessity to focus on the family needs rather than on the specific illness of the child, as well as the value of our interdisciplinary care team partnering with parents in the 'Jeroen Pit Huis' towards a safe and sustainable transition home.
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Affiliation(s)
- L van de Riet
- Department of Pediatric Intensive Care, Amsterdam UMC, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Reproduction & Development Research Institute, Amsterdam, The Netherlands
- On Behalf of the Transitional Care Unit Consortium, Amsterdam, The Netherlands
| | - M W Alsem
- On Behalf of the Transitional Care Unit Consortium, Amsterdam, The Netherlands
- Department of Rehabilitation, Amsterdam Movement Sciences, Amsterdam UMC, Meibergdreef 9, Amsterdam, The Netherlands
| | - R S I Beijneveld
- Department of Pediatric Intensive Care, Amsterdam UMC, Meibergdreef 9, Amsterdam, The Netherlands
| | - J B M van Woensel
- Department of Pediatric Intensive Care, Amsterdam UMC, Meibergdreef 9, Amsterdam, The Netherlands
- On Behalf of the Transitional Care Unit Consortium, Amsterdam, The Netherlands
| | - C D van Karnebeek
- On Behalf of the Transitional Care Unit Consortium, Amsterdam, The Netherlands.
- Emma Center for Personalized Medicine, Departments of Pediatrics and Human Genetics, Amsterdam Gastro-Enterology Endocrinology and Metabolism, Amsterdam UMC, Meibergdreef 9, Amsterdam, The Netherlands.
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Hurt L, Odd D, Mann M, Beetham H, Dorgeat E, Isaac TC, Ashman A, Wood F. What matters to families about the healthcare of preterm or low birth weight infants: A qualitative evidence synthesis. PATIENT EDUCATION AND COUNSELING 2023; 115:107893. [PMID: 37473603 DOI: 10.1016/j.pec.2023.107893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 07/06/2023] [Accepted: 07/07/2023] [Indexed: 07/22/2023]
Abstract
OBJECTIVE We examined what matters to families about the healthcare provided to preterm or LBW infants in hospital and the community, to ensure that care meets the needs of infants and parents. METHODS We searched databases to identify eligible studies examining the views and expectations of families. Study quality was assessed using the CASP checklist for qualitative studies. The GRADE-CERQual approach was used to assess confidence in review findings. Studies were sampled and data analysed using thematic synthesis. RESULTS 222 studies (227 papers) were eligible for inclusion. 54 studies (57 papers) were sampled based on data richness, methodological quality, and representation across settings. Eight analytical themes were identified. Confidence in results was moderate to high. What mattered was a positive outcome for the child; active involvement in care; being supported to cope at home after discharge; emotional support; the healthcare environment; information needs met; logistical support available; and positive relationships with staff. CONCLUSION Although parents and family members reported a variety of experiences in the care of their infant, we found high consistency in what matters to families. PRACTICE IMPLICATIONS This review identifies approaches to improve experiences of parents which are consistent with the Family Centred Care model of healthcare.
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Affiliation(s)
- Lisa Hurt
- Division of Population Medicine, Cardiff University School of Medicine, Cardiff, UK.
| | - David Odd
- Division of Population Medicine, Cardiff University School of Medicine, Cardiff, UK
| | - Mala Mann
- Specialist Unit for Review Evidence, Cardiff University, Cardiff, UK
| | | | - Emma Dorgeat
- Cardiff University School of Medicine, Cardiff, UK
| | | | | | - Fiona Wood
- Division of Population Medicine, Cardiff University School of Medicine, Cardiff, UK
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Reimer A, Mause L, Hoffmann J, Hagemeier A, Dresbach T, Scholten N. How does stress affect maternal and paternal perceptions of relationship strain after a preterm birth? Results of a retrospective survey study. Acta Paediatr 2023; 112:762-769. [PMID: 36627542 DOI: 10.1111/apa.16664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/29/2022] [Accepted: 01/09/2023] [Indexed: 01/12/2023]
Abstract
AIM Strain on couple relationships is associated with a lower well-being. As premature birth is known to pose stress to parents, this study explores whether interparental relationship strain comes to pass within mothers and fathers during their infant's stay in a neonatal intensive care unit. METHODS A retrospective cross-sectional survey was conducted with parents who experienced a preterm birth (September to December 2020). Linear regression was used to analyse associations between stress and relationship strain. RESULTS The study included 437 mothers and 301 fathers. Fathers experienced lower relationship strain (M = 2.49, SD = 1.00) than mothers (M = 3.37, SD = 1.04). Overall, a significant association between relationship strain and stress due to the infant's behaviour and appearance was found for mothers (β = 0.16, p = 0.02) and fathers, with a significantly higher association for fathers (β = 0.27, p ≤ 0.002). With regard to parental role alterations, only mothers showed a significant association (β = 0.21, p ≤ 0.001). CONCLUSION Although mothers showed higher levels of stress and relationship strain, stress may also have an impact on fathers. Therefore, research should focus on stress prevention measures to meet both maternal and paternal needs.
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Affiliation(s)
- Alinda Reimer
- Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Human Sciences and Faculty of Medicine, University of Cologne and University Hospital Cologne, Cologne, Germany
| | - Laura Mause
- Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Human Sciences and Faculty of Medicine, University of Cologne and University Hospital Cologne, Cologne, Germany
| | - Jan Hoffmann
- Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Human Sciences and Faculty of Medicine, University of Cologne and University Hospital Cologne, Cologne, Germany
| | - Anna Hagemeier
- Medical Faculty and University Hospital Cologne, Institute of Medical Statistics and Computational Biology, University of Cologne, Cologne, Germany
| | - Till Dresbach
- Department of Neonatology and Paediatric Intensive Care Medicine, University Hospital Bonn, Bonn, Germany
| | - Nadine Scholten
- Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Human Sciences and Faculty of Medicine, University of Cologne and University Hospital Cologne, Cologne, Germany
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Friedrich AB. Ethical Consequences of Technological Mediation on Parental Decision-Making Experiences in the Neonatal Intensive Care Unit. QUALITATIVE HEALTH RESEARCH 2023; 33:259-269. [PMID: 36704925 DOI: 10.1177/10497323231151816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
The neonatal intensive care unit (NICU) is a morally charged space in which parents may be confronted with difficult decisions about the treatment of their newborns, decisions often complicated and created by the increasing use of technologies. This paper adopts a postphenomenological approach to explore the ethical consequences of technological mediation on parental treatment decision-making in the NICU. Semi-structured interviews were conducted with parents of children who received invasive technological support in the NICU to better understand how they made treatment decisions or decisions about specific interventions during their child's hospitalization. The findings suggest that technological mediation-or the various ways in which humans can interact with their world via technologies-contributes to experiences of ambiguity, ambivalence, and alienation in parental decision-making. The ambiguity of invasive NICU technologies can create uncertainty in a decision, which can then lead to internal ambivalence about which decision to make. Ultimately, this ambiguity and ambivalence may lead to alienation from one's child, as parents are disconnected physically and emotionally from the decision and thus their child. Articulating the effects of technological mediation on parental decision-making is a key step in addressing decisional conflict in neonatal intensive care settings and better supporting parents in their decision-making roles.
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Affiliation(s)
- Annie B Friedrich
- Center for Bioethics and Medical Humanities, Institute for Health & Equity, 5506Medical College of Wisconsin, Milwaukee, WI, USA
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Tenfelde K, Antheunis M, Krahmer E, Bunt JE. Using Digital Communication Technology to Improve Neonatal Care: Two-Part Explorative Needs Assessment. JMIR Pediatr Parent 2023; 6:e38435. [PMID: 36749606 PMCID: PMC9944133 DOI: 10.2196/38435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 09/23/2022] [Accepted: 10/17/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The birth of a premature infant and subsequent hospitalization are stressful events for parents. Therefore, accurate and easy-to-understand communication between parents and health care professionals is crucial during this period. Mobile health (mHealth) technologies have the potential to improve communication with parents at any time and place and possibly reduce their stress. OBJECTIVE We aimed to conduct a 2-part explorative needs assessment in which the interaction between the pediatrician and parents was examined along with their digital communication technology needs and interest in an mHealth app with the aim of improving interpersonal communication and information exchange. METHODS Overall, 19 consultations between parents of preterm infants and pediatricians were observed to determine which themes are discussed the most and the number of questions asked. Afterward, the parents and the pediatrician were interviewed to evaluate the process of communication and gauge their ideas about a neonatal communication mHealth app. RESULTS The observations revealed the following most prevalent themes: breastfeeding, criteria for discharge, medication, and parents' personal life. Interview data showed that the parents were satisfied with the communication with their pediatrician. Furthermore, both parents and pediatricians expected that a neonatal mHealth app could further improve the communication process and the hospital stay. Parents valued app features such as asking questions, growth graphs, a diary function, hospital-specific information, and medical rounds reports. CONCLUSIONS Both parents of hospitalized preterm infants and pediatricians expect that the hypothetical mHealth app has the potential to cater to the most prevalent themes and improve communication and information exchange. Recommendations for developing such an app and its possible features are also discussed. On the basis of these promising results, it is suggested to further develop and study the effects of the mHealth app together with all stakeholders.
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Affiliation(s)
- Kim Tenfelde
- Department of Communication and Cognition, Tilburg University, Tilburg, Netherlands
| | - Marjolijn Antheunis
- Department of Communication and Cognition, Tilburg University, Tilburg, Netherlands
| | - Emiel Krahmer
- Department of Communication and Cognition, Tilburg University, Tilburg, Netherlands
| | - Jan Erik Bunt
- Department of Pediatrics, Elisabeth-Tweesteden Ziekenhuis, Tilburg, Netherlands
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Taştekin E, Bayhan P. Living with a birthmark: Phenomenology of prematurity for mothers in Turkey. J Pediatr Nurs 2023; 69:77-85. [PMID: 36682260 DOI: 10.1016/j.pedn.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 01/13/2023] [Accepted: 01/13/2023] [Indexed: 01/22/2023]
Abstract
BACKGROUND Mothers of premature infants are in the risk group for having psychological symptoms and attachment-interaction difficulties. Preventing these maternal risks is essential for providing optimal care and health opportunities for infants, consequently improving developmental outcomes. METHODS In this study, we aimed to understand how mothers experienced prematurity within four processes retrospectively: (a) the mother's hospitalization after birth, (b) the infant's hospitalization in the Neonatal Intensive Care Unit (NICU), (c) after discharge, and (d) in early childhood. We adopted Max van Manen's phenomenology of practice and interviewed nine mothers whose children were born premature and reached early childhood. FINDINGS The themes were as follows: (a) incomplete mother; (b) facing prematurity, uncertainty, natural touch barrier, facing reductive social response, and NICU friendship; (c) being on the alert, a period of complete closure, and fighting with the reductive social response; (d) association to prematurity and (cannot) overcome the difficulties. We expressed the mothers' overall experiences through the metaphor "living with a birthmark." This metaphor represents the longitudinal effects of prematurity. As much as it is apparent and painful at first, it fades over time, and the pain lessens, but the effects of the birthmark remain in early childhood. The birthmark becomes a part of the mother-baby relationship. CONCLUSIONS AND PRACTICE IMPLICATIONS Our study contributes to premature infant care and health literature by highlighting the longitudinal experiences of mothers on prematurity.
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Affiliation(s)
- Ezgi Taştekin
- Department of Child Development, Hacettepe University, Turkey.
| | - Pınar Bayhan
- Department of Child Development, Hacettepe University, Turkey
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Ebersjö C, Berggren Broström E, Kull I, Lindholm Olinder A. Home Immunization with Palivizumab-A Randomized Pilot Study Describing Safety Aspects and Parents' Preferences. CHILDREN (BASEL, SWITZERLAND) 2023; 10:198. [PMID: 36832327 PMCID: PMC9955059 DOI: 10.3390/children10020198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 01/16/2023] [Accepted: 01/18/2023] [Indexed: 01/22/2023]
Abstract
Among prematurely born infants and newborns with chronic conditions, a respiratory syncytial virus (RSV) infection may cause (re-)admission and later respiratory complications. Therapeutic protection is possible with monthly injections of a specific monoclonal antibody, palivizumab, during RSV season. Standard care is giving up to five injections in clinic-based settings. Immunization at home could be an alternative to standard care for vulnerable infants to reduce the number of revisits and associated risk of RSV infection. The aim of this randomized pilot trial was to evaluate safety aspects and explore parents' preferences of home versus hospital immunization with palivizumab during one RSV season. Immediate adverse events (AEs) were observed and registered by a pediatric specialist nurse. Late-onset AEs were reported by parents. Parents' perceptions were collected through a questionnaire and analyzed using content analysis. The study population consisted of 43 infants in 38 families. No immediate AEs occurred. Three late-onset AEs were reported in two infants in the intervention group. Three categories emerged in the content analysis: (1) protect and watch over the infant, (2) optimal health and well-being for the whole family, and (3) avoid suffering for the infant. The study results show that home immunization with palivizumab is feasible if safety aspects are considered and that parental involvement in the choice of place for immunization after a neonatal intensive care experience can be important.
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Affiliation(s)
- Christina Ebersjö
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institute, 171 77 Stockholm, Sweden
- Sach’s Children and Youth Hospital, Södersjukhuset AB, 118 83 Stockholm, Sweden
| | - Eva Berggren Broström
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institute, 171 77 Stockholm, Sweden
| | - Inger Kull
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institute, 171 77 Stockholm, Sweden
- Sach’s Children and Youth Hospital, Södersjukhuset AB, 118 83 Stockholm, Sweden
| | - Anna Lindholm Olinder
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institute, 171 77 Stockholm, Sweden
- Sach’s Children and Youth Hospital, Södersjukhuset AB, 118 83 Stockholm, Sweden
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‘They said, let’s teach you how you are going to care for the child at home…’: caregivers’ and healthcare worker’s perceptions and experiences of post-discharge preterm care in eastern Uganda. BMC Health Serv Res 2022; 22:1521. [PMCID: PMC9749343 DOI: 10.1186/s12913-022-08894-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 11/28/2022] [Indexed: 12/15/2022] Open
Abstract
Abstract
Background
Complications of prematurity are the leading cause of neonatal mortality, and the majority of these deaths occur in low and middle-income countries. Research in these settings has focused on improved outcomes for preterm infants in hospital settings, however, research into the continuation of preterm care in the home after discharge from a neonatal unit is limited. This study examines the experiences and perceptions of caregivers of preterm infants during the initial weeks following discharge from a neonatal unit in Uganda, and the views of healthcare workers (HCWs) on the ability of caregivers to cope.
Methods
This qualitative study used multiple data collection approaches, namely focus group discussions (FGDs), in-depth interviews (IDIs), field observations, and case studies to explore the perceptions and experiences of providing care to preterm infants post-discharge from a neonatal unit in eastern Uganda from the perspectives of caregivers and HCWs.
Results
We recruited 39 participants with a total of 35 separate sessions including 18 IDIs (12 caregivers and 6 HCWs), 3 FGDs (17 caregivers), and 4 case studies (14 separate IDIs over 5 weeks after discharge, three mothers, and one grandmother). IDIs and FGDs took place at the Mbale Regional Referral Hospital or in participants’ homes.
Key themes emerged; preparation for continuing care in the home, psychosocial challenges to providing preterm care in the home, barriers to continuing preterm care in the home, and suggestions for improvement of preterm care in the home. Caregivers had good knowledge and awareness about different aspects of preterm care. Following discharge, caregivers struggled to maintain quality care due to loss of continuous support from the neonatal team, feelings of anxiety and isolation, financial issues, and home responsibilities.
Conclusion
This study highlights multiple challenges to continuing preterm care in this Ugandan setting. Improved training and education for caregivers, especially in neonatal resuscitation, enhanced and continued support of the caregiver and infant in the home, and increased community involvement following discharge may all be key solutions. These findings are fundamental to improving care in the home for preterm infants in eastern Uganda and similar settings.
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Adcock A, Cram F, Edmonds L, Lawton B. He Tamariki Kokoti Tau: Whānau of preterm Māori infants (pēpi) reflect on their journeys from birth to first birthday. J R Soc N Z 2022. [DOI: 10.1080/03036758.2022.2090390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Anna Adcock
- Te Tātai Hauora o Hine National Centre for Women’s Health Research Aotearoa, Te Herenga Waka Victoria University of Wellington, Wellington, Aotearoa New Zealand
| | | | - Liza Edmonds
- Kōhatu Centre for Hauora Māori, Division of Health Sciences, University of Otago, Dunedin, New Zealand
- Department of Women’s and Children’s, Otago School of Medicine, University of Otago, Dunedin, New Zealand
| | - Beverley Lawton
- Te Tātai Hauora o Hine National Centre for Women’s Health Research Aotearoa, Te Herenga Waka Victoria University of Wellington, Wellington, Aotearoa New Zealand
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Personalized support of parents of extremely preterm infants before, during and after birth. Semin Fetal Neonatal Med 2022; 27:101335. [PMID: 35780043 DOI: 10.1016/j.siny.2022.101335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The emotional turmoil associated with extremely preterm birth is inescapable parents. How each parent handles the unexpected, makes sense of the unknown and learns to parent their child is uniquely personal. A rigid standardized approach to support families through their journey before and during neonatal intensive care disregards this individuality. This article reviews general concepts and practices that can be learned and applied by clinicians to promote resiliency and help parents cope adaptively. This review will describe how to personalize parenting support during the antenatal consultation and hospitalization for parents of extremely premature infants. To facilitate this, mindsets and care delivery models need to shift from inflexible standardized protocols to flexible guidelines that enable personalized communications, support structures and care delivery models tailored to each person's characteristics, preferences, and values.
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Suarez C, Adair P, Doherty N, McCormack D. Exploring Adjustment and Parent-Infant Relations in Mothers of Premature Infants: Thematic Analysis Using a Multisensory Approach. J Pediatr Psychol 2022; 47:827-839. [PMID: 35286395 PMCID: PMC9297088 DOI: 10.1093/jpepsy/jsac007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 01/26/2022] [Accepted: 01/28/2022] [Indexed: 11/13/2022] Open
Abstract
Objective The aim of the study was to explore mothers’ experiences of having an infant born prematurely (28–32 weeks gestation). In particular, the study aimed to explore the developing parent–infant relationship 12–30 months since birth and the developing parental identity during hospitalization and discharge. Methods Twelve mothers, aged between 22 and 43, participated in the semi-structured interviews. The mean age of infants was 19 months. Interviews comprised open-ended questions and visual stimuli consisting of photographs brought by participants, word selection, and card sorting techniques. Data were analyzed using Braun and Clarke’s thematic analysis (Braun & Clarke, 2013). Results Three themes arose from a clustering of 10 subthemes: (a) Emotional Impact, (b) Searching for Parent Identity, and (c) Moving Beyond Adversity. Participants expressed experiencing heightened emotional distress during the time of their infants’ birth and hospitalization and initially not feeling like parents. Their parental identity strengthened as they became more involved in the care of their infant and began to accept the situation. Participants described parenting their premature infants differently compared with parents of full-term infants, and described adjusting to this difference over time. Conclusions The findings highlight the emotional experience and adjustment of mothers of premature infants, from hospital and postdischarge. The need for psycho-educational interventions postdischarge and parent-partnered models during hospitalization is discussed. In addition, the study demonstrates the use of integrating visual stimuli in qualitative data collection procedures, to elicit further meaning and interaction from participants with the interview process.
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Affiliation(s)
- Catalina Suarez
- Department of Psychology, Queen's University Belfast, Belfast, Northern Ireland
| | - Pauline Adair
- Department of Psychology, Queen's University Belfast, Belfast, Northern Ireland
| | - Nicola Doherty
- Western Health and Social Care Trust, Londonderry, Northern Ireland
| | - David McCormack
- Department of Psychology, Queen's University Belfast, Belfast, Northern Ireland
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Former Neonatal Intensive Care Unit Fathers' Involvement 4 Years Later: A Qualitative Study. J Pediatr Nurs 2021; 60:31-39. [PMID: 33607536 DOI: 10.1016/j.pedn.2021.02.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 02/02/2021] [Accepted: 02/02/2021] [Indexed: 11/23/2022]
Abstract
PURPOSE To explore the experience of fathering a previous Newborn Intensive Care Unit (NICU) infant four years after hospitalization. DESIGN AND METHODS Nineteen fathers of former NICU infants were interviewed using a semi-structured schedule. RESULTS Most of the fathers had children with ongoing health issues (84%). The median age of the fathers was 38 years old. Racial demographics included 12 white fathers (63%), 5 black fathers (26%), and 2 Hispanic fathers (11%). Themes that emerged included adjustments, prepared for anything, closeness, ambivalent normalcy, and vigilance. These fathers of former infants with health issues made 'adjustments' in their lives to be available and better fathers for their children. They familiarized themselves with their children's ongoing health issues so they could be better protectors and be 'prepared for anything', but considered their children 'normal kids' while still maintaining 'vigilance' for future health needs. Fathers described that the experience of having an infant with health issues helped them to develop 'closeness' with the child and boosted their confidence as fathers. CONCLUSION This involvement/confidence pattern is critically important to establishing and maintaining fathering, especially for fathers of children with disabilities. PRACTICE IMPLICATIONS Pediatric practitioners can continue to encourage this pattern after the initial hospital stay.
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Adama EA, Adua E, Bayes S, Mörelius E. Support needs of parents in neonatal intensive care unit: An integrative review. J Clin Nurs 2021; 31:532-547. [PMID: 34312923 DOI: 10.1111/jocn.15972] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 06/09/2021] [Accepted: 06/22/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Having an infant in the neonatal intensive care unit (NICU) is associated with intense emotional stress for both mothers and fathers. However, with the right support from staff, this stress can be reduced significantly. Although evidence on needs of parents in the neonatal unit exists, there is lack of a systematic integrative review on the support needs of parents in the neonatal unit. Current review evidence is needed to support busy neonatal unit clinicians in their practice. AIM AND OBJECTIVES The purpose of this integrative review is to explore the current available evidence to describe and understand the support needs of parents of infants in the NICU. METHODS The integrative review process of Whittemore and Knafl (2005) was used to guide this study. Six databases-MEDLINE, CINHAL, PubMed, Scopus, Google Scholar and PsycINFO-were searched for eligible studies using relevant keywords. Primary studies published in English language from 2010 to 2021 were reviewed following a pre-determined inclusion criteria. Studies that met the inclusion criteria were critically appraised using the Mixed Methods Appraisal Tool (MMAT). The review report is guided by the PRISMA 2020 checklist for systematic reviews. RESULTS Overall, 24 primary qualitative, quantitative and mixed methods studies were included in the review. Analysis of included studies resulted in six themes that demonstrate the support needs of parents in the NICU; 1. Information needs; 2. Emotionally intelligent staff; 3. Hands-on support; 4. Targeted support; 5. Emotional needs; and 6. Practical needs. CONCLUSION This review has presented the current evidence on the needs of parents from their own perspective. Healthcare workers' understanding and supporting these needs in the NICU is likely to increase parental satisfaction and improve health outcomes for parents, infants and their family. RELEVANCE TO CLINICAL PRACTICE Parents of infants in the NICU require staff support to enhance their experiences, well-being, caring and parenting confidence during admission and post-discharge. As parents are in constant need for informational, emotional and practical support, continuing professional development for NICU staff should place emphasis on effective communication strategies, enhancing emotional intelligence and empathy among staff. NICU staff should build positive ongoing relationships with parents and provide targetted support for mothers and fathers.
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Affiliation(s)
- Esther Abena Adama
- School of Nursing and Midwifery, Edith Cowan University, Perth, Western Australia, Australia
| | - Eric Adua
- School of Nursing and Midwifery, Edith Cowan University, Perth, Western Australia, Australia.,Department of Biochemistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Sara Bayes
- School of Nursing and Midwifery, Edith Cowan University, Perth, Western Australia, Australia.,Faculty of Health Sciences, School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, Victoria, Australia
| | - Evalotte Mörelius
- School of Nursing and Midwifery, Edith Cowan University, Perth, Western Australia, Australia.,Perth Children's Hospital, Perth, Western Australia, Australia
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15
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Alnuaimi N, Tluczek A. Father's Bonding With an Infant Born Prematurely: A Qualitative Meta-synthesis. West J Nurs Res 2021; 44:493-505. [PMID: 33834922 DOI: 10.1177/01939459211002909] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
There is no current theory that explains the process of a fathers' bonding with their infants born prematurely. Through meta-synthesis of 19 qualitative studies, we developed a conceptual framework to illustrate how fathers perceive the relationship with their premature infant formed over the first 18 months of life. It details the contextual factors that contribute to that process. Findings reveal a complex process comprised of five stages, derived from five core themes and related subthemes. Fathers progress through five sequential stages to establish their role as fathers and form emotional connections with their child. Stages include: (a) feeling alien and lacking emotional connection to the infant, (b) caregiving engagement and claiming the role as a father, (c) claiming the infant as their own, (d) adjusting to having the infant home, and (5) normalizing family life. This conceptual framework can inform future research and clinical interventions designed to foster father-infant bonding.
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Affiliation(s)
- Nisreen Alnuaimi
- School of Nursing, University of Wisconsin-Madison, Madison, WI, USA
| | - Audrey Tluczek
- School of Nursing, University of Wisconsin-Madison, Madison, WI, USA
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16
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Livingston JD, Youssef GJ, StGeorge J, Wynter K, Dowse E, Francis LM, Di Manno L, Teague S, Demmer D, Collins S, Wilford E, Leach L, Melvin GA, Macdonald JA. Paternal coping and psychopathology during the perinatal period: A mixed studies systematic review and meta-analysis. Clin Psychol Rev 2021; 86:102028. [PMID: 33975226 DOI: 10.1016/j.cpr.2021.102028] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 03/10/2021] [Accepted: 03/30/2021] [Indexed: 12/25/2022]
Abstract
How fathers cope with stress may be critical to their mental health during the perinatal period. Using a sequential explanatory design for systematic review and meta-analysis, we aimed to identify associations and causal relations between higher- and lower-order avoidant and approach coping strategies and paternal psychopathology. We searched five electronic databases and grey literature, and used random-effects models to calculate pooled effects from 11 quantitative studies. Meta-analytic results were integrated with findings from 18 qualitative studies. Fathers' avoidant coping was positively associated with global psychopathology and depression. Approach-oriented coping, particularly problem-solving, was associated with positive affect but not psychopathology. Qualitative findings indicate distressed fathers employ avoidant coping strategies such as suppression, distraction, and social withdrawal. Approach-oriented coping strategies such as problem-solving and cognitive reappraisals appeared to be constructive components of men's coping repertoires supporting adaptation to fatherhood. Different coping strategies and approaches may reflect enactment of constrictive, moderate, or reinterpreted masculine norms. Study designs did not allow conclusions about causal relations between coping and psychopathology. Screening for, and targeting of, high avoidant coping among expectant and new fathers may help detect men at risk of or experiencing mental health difficulties and inform clinical response to psychopathology. Research examining whether different patterns of avoidant and approach coping are associated with psychopathology over time could inform interventions to support men's mental health and adaptation to fatherhood.
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Affiliation(s)
- Julianne D Livingston
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia
| | - George J Youssef
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia; Murdoch Children's Research Institute, Centre for Adolescent Health, Melbourne, Australia
| | | | - Karen Wynter
- Deakin University, School of Nursing and Midwifery, Faculty of Health, Geelong, Australia; Deakin University, Centre for Quality and Patient Safety Research - Western Health Partnership, St Albans, Australia
| | - Eileen Dowse
- University of Newcastle, School of Nursing and Midwifery, Newcastle, Australia
| | - Lauren M Francis
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia
| | - Laura Di Manno
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia
| | - Samantha Teague
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia
| | - David Demmer
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia
| | - Sam Collins
- Deakin University, Food & Mood Centre, IMPACT SRC, School of Medicine, Faculty of Health, Geelong, Australia
| | - Emily Wilford
- Australian National University, National Centre for Epidemiology and Population Health, Canberra, Australia
| | - Liana Leach
- Australian National University, National Centre for Epidemiology and Population Health, Canberra, Australia
| | - Glenn A Melvin
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia; Centre for Educational Development, Appraisal & Research, University of Warwick, Coventry, UK
| | - Jacqui A Macdonald
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia; Murdoch Children's Research Institute, Centre for Adolescent Health, Melbourne, Australia; University of Melbourne, Department of Paediatrics, Royal Children's Hospital, Melbourne, Australia.
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17
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Baraldi E, Allodi MW, Smedler AC, Westrup B, Löwing K, Ådén U. Parents' Experiences of the First Year at Home with an Infant Born Extremely Preterm with and without Post-Discharge Intervention: Ambivalence, Loneliness, and Relationship Impact. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E9326. [PMID: 33322234 PMCID: PMC7764273 DOI: 10.3390/ijerph17249326] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/04/2020] [Accepted: 12/11/2020] [Indexed: 12/29/2022]
Abstract
With increasing survival rates of children born extremely preterm (EPT), before gestational week 28, the post-discharge life of these families has gained significant research interest. Quantitative studies of parental experiences post-discharge have previously reported elevated levels depressive symptoms, posttraumatic stress-disorder and anxiety among the parents. The current investigation aims to qualitatively explore the situation for parents of children born EPT in Sweden during the first year at home. Semi-structured interviews were performed with 17 parents of 14 children born EPT; eight parents were from an early intervention group and nine parents from a group that received treatment as usual, with extended follow-up procedures. Three main themes were identified using a thematic analytic approach: child-related concerns, the inner state of the parent, and changed family dynamics. Parents in the intervention group also expressed themes related to the intervention, as a sense of security and knowledgeable interventionists. The results are discussed in relation to different concepts of health, parent-child interaction and attachment, and models of the recovery processes. In conclusion, parents describe the first year at home as a time of prolonged parental worries for the child as well as concerns regarding the parent's own emotional state.
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Affiliation(s)
- Erika Baraldi
- Department of Special Education, Stockholm University, 106 91 Stockholm, Sweden;
| | - Mara Westling Allodi
- Department of Special Education, Stockholm University, 106 91 Stockholm, Sweden;
| | | | - Björn Westrup
- Department of Women’s and Children’s Health, Karolinska Institutet, 171 77 Stockholm, Sweden; (B.W.); (K.L.); (U.Å.)
| | - Kristina Löwing
- Department of Women’s and Children’s Health, Karolinska Institutet, 171 77 Stockholm, Sweden; (B.W.); (K.L.); (U.Å.)
- Karolinska University Hospital Functional Area Occupational Therapy and Physiotherapy, Allied Health Professionals Function, 171 76 Stockholm, Sweden
| | - Ulrika Ådén
- Department of Women’s and Children’s Health, Karolinska Institutet, 171 77 Stockholm, Sweden; (B.W.); (K.L.); (U.Å.)
- Karolinska University Hospital Neonatal Unit, 171 76 Stockholm, Sweden
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18
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Soghier LM, Kritikos KI, Carty CL, Glass P, Tuchman LK, Streisand R, Fratantoni KR. Parental Depression Symptoms at Neonatal Intensive Care Unit Discharge and Associated Risk Factors. J Pediatr 2020; 227:163-169.e1. [PMID: 32681990 DOI: 10.1016/j.jpeds.2020.07.040] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 07/09/2020] [Accepted: 07/10/2020] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To investigate the prevalence and risk factors associated with parental depressive symptoms at neonatal intensive care unit (NICU) discharge and determine the relationships among depressive symptoms, stress, and social support. STUDY DESIGN Parents participating in the Giving Parents Support trial (n = 300) were surveyed before NICU discharge. Depressive symptoms, stress, and social support were assessed using the Center for Epidemiological Studies Depression Scale (CESD-10), Parental Stressor Scale: Neonatal Intensive Care Unit (PSS:NICU), Perceived Stress Scale (PSS-10), and Multidimensional Scale of Perceived Social Support (MSPSS). Regression analyses examined relationships among depressive symptoms, stress, social support, and parent/infant factors. RESULTS At NICU discharge, 45% of parents reported depressive symptoms and 43% reported elevated perceived stress. Increased odds of elevated depressive symptoms were associated with older gestational age (P = .02), female infant (P = .02), and longer length of stay (P = .045). Odds of depression were 7.87 (95% CI, 2.15-28.75) for parents of infants with gestational age ≥37 weeks compared with gestational age <28 weeks. Parental NICU stress was higher in younger parents (P < .01). Depressive symptoms were positively associated with parental stress. Each 1-point increase in PSS:NICU score was associated with a 2.1-point (95% CI, 1.6-2.9; P < .001) increase in CESD-10 score. Social support was inversely associated with depressive symptoms. CONCLUSION The prevalence of depressive symptoms in parents at NICU discharge was high, even among parents of term infants. Older gestational age, greater parental stress, and lower levels of social support were strong correlates of depressive symptoms. Strategies to support parents, including depression screening, stress reduction strategies, and mental health referrals, are needed.
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Affiliation(s)
- Lamia M Soghier
- Department of Neonatology, Children's National Hospital, Washington, DC; Center for Translational Science, Children's Research Institute, Children's National Hospital, Washington, DC.
| | - Katherine I Kritikos
- Center for Translational Science, Children's Research Institute, Children's National Hospital, Washington, DC
| | - Cara L Carty
- Center for Translational Science, Children's Research Institute, Children's National Hospital, Washington, DC
| | - Penny Glass
- Department of Neonatology, Children's National Hospital, Washington, DC; Center for Translational Science, Children's Research Institute, Children's National Hospital, Washington, DC; Department of Psychology and Behavioral Health, Children's National Hospital, Washington, DC
| | - Lisa K Tuchman
- Center for Translational Science, Children's Research Institute, Children's National Hospital, Washington, DC; Department of Adolescent and Young Adult Medicine, Children's National Hospital, Washington, DC
| | - Randi Streisand
- Center for Translational Science, Children's Research Institute, Children's National Hospital, Washington, DC; Department of Psychology and Behavioral Health, Children's National Hospital, Washington, DC
| | - Karen R Fratantoni
- Center for Translational Science, Children's Research Institute, Children's National Hospital, Washington, DC; Division of General and Community Pediatrics, Children's National Hospital, Washington, DC
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19
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Savanh P, Aita M, Héon M, Charbonneau L. Case study of an educational intervention to favor siblings’ adaptation during the hospitalization of a preterm infant in the neonatal intensive care unit. ACTA ACUST UNITED AC 2020. [DOI: 10.1016/j.jnn.2020.04.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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20
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Sunkwa-Mills G, Rawal L, Enweronu-Laryea C, Aberese-Ako M, Senah K, Tersbøl BP. Perspectives and practices of healthcare providers and caregivers on healthcare-associated infections in the neonatal intensive care units of two hospitals in Ghana. Health Policy Plan 2020; 35:i38-i50. [PMID: 33165583 PMCID: PMC7649666 DOI: 10.1093/heapol/czaa102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2020] [Indexed: 12/17/2022] Open
Abstract
Healthcare-associated infections (HAIs) remain a serious threat to patient safety worldwide, particularly in low- and middle-income countries. Reducing the burden of HAIs through the observation and enforcement of infection prevention and control (IPC) practices remains a priority. Despite growing emphasis on HAI prevention in low- and middle-income countries, limited evidence is available to improve IPC practices to reduce HAIs. This study examined the perspectives of healthcare providers (HPs) and mothers in the neonatal intensive care unit on HAIs and determined the major barriers and facilitators to promoting standard IPC practices. This study draws on data from an ethnographic study using 38 in-depth interviews, four focus group discussions and participant observation conducted among HPs and mothers in neonatal intensive care units of a secondary- and tertiary-level hospital in Ghana. The qualitative data were analysed using a grounded theory approach, and NVivo 12 to facilitate coding. HPs and mothers demonstrated a modest level of understanding about HAIs. Personal, interpersonal, community, organizational and policy-level factors interacted in complex ways to influence IPC practices. HPs sometimes considered HAI concerns to be secondary in the face of a heavy clinical workload, a lack of structured systems and the quest to protect professional authority. The positive attitudes of some HPs, and peer interactions promoted standard IPC practices. Mothers expressed interest in participation in IPC activities. It however requires systematic efforts by HPs to partner with mothers in IPC. Training and capacity building of HPs, provision of adequate resources and improving communication between HPs and mothers were recommended to improve standard IPC practices. We conclude that there is a need for institutionalizing IPC policies and strengthening strategies that acknowledge and value mothers' roles as caregivers and partners in IPC. To ensure this, HPs should be better equipped to prioritize communication and collaboration with mothers to reduce the burden of HAIs.
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Affiliation(s)
- Gifty Sunkwa-Mills
- Ghana Health Service, Central Region, Ghana
- Global Health Section, Department of Public Health, University of Copenhagen, Denmark
| | - Lal Rawal
- School of Health Medical and Applied Sciences, CQUniversity, Sydney, Australia
- Translational Health Research Institute, Western Sydney University, Sydney, Australia
| | | | - Matilda Aberese-Ako
- Institute of Health Research, University of Health and Allied Sciences, Ghana
| | - Kodjo Senah
- Department of Sociology, University of Ghana, Accra, Ghana
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21
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Carton AM, Cordwell J, Steinhardt K. A framework synthesis reviewing the impact of neonatal care unit admission on early caregiver-infant relationships. J Adv Nurs 2020; 76:3258-3272. [PMID: 33058269 DOI: 10.1111/jan.14538] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 06/29/2020] [Accepted: 07/23/2020] [Indexed: 11/30/2022]
Abstract
AIMS To critically review and synthesize qualitative research pertaining to the establishment of early caregiver-infant relationships in the neonatal care unit (NCU). BACKGROUND It is well-established that bonding and attachment, established across the prenatal and early childhood periods, affect child cognitive and behavioural development. Proximity, reciprocity, and commitment are key to the formation of these early relationships. It is intuitively likely that an admission to the NCU may affect early reciprocal caregiver-infant relationships. DESIGN A qualitative best-fit framework synthesis. DATA SOURCES A systematic search of four databases (PsycINFO, MEDLINE, British Nursing Index and CINAHL) was conducted, from January 2000-December 2018. REVIEW METHODS The RATS quality appraisal tool was used to evaluate study quality. To ensure reliability, 20% of studies were randomly selected for independent rating. A "best-fit" synthesis approach using an existing framework of early parent-infant attachment and bonding was adopted to synthesize the review findings. FINDINGS Twenty studies, from an original 3,526 unique articles, were included in the review. Studies varied in the extent to which they demonstrated transparency of procedures and in the quality of recruitment information provided. The meta-synthesis demonstrated that proximity, reciprocity, and commitment were affected by admission to a NCU and identified that parental reflections on bonding and the role of staff in this process, were important factors to consider. CONCLUSIONS Caregiver-infant relationships are affected by admission to the NCU. The review theoretically supports moves to Family Integrated Care. Units should evaluate caregiver emotional state and consider the role of peer support. IMPACT The synthesis revealed that areas typically implicated in the formation of attachment and bonds were affected by admission to a NCU. Results have implications on the clinical care delivered as part of neonatal care.
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Affiliation(s)
- Amelia Myri Carton
- Oxford Institute for Clinical Psychology Training, Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Jacinta Cordwell
- Oxford Children's Hospital, The John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Karen Steinhardt
- Oxford Children's Hospital, The John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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22
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van Veenendaal NR, van der Schoor SRD, Heideman WH, Rijnhart JJM, Heymans MW, Twisk JWR, van Goudoever JB, van Kempen AAMW. Family integrated care in single family rooms for preterm infants and late-onset sepsis: a retrospective study and mediation analysis. Pediatr Res 2020; 88:593-600. [PMID: 32241017 DOI: 10.1038/s41390-020-0875-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 02/24/2020] [Accepted: 02/26/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND During hospital stay after birth, preterm infants are susceptible to late-onset sepsis (LOS). OBJECTIVE To study the effect of family integrated care in single family rooms (SFRs) compared to standard care in open bay units (OBUs) on LOS. Peripheral or central venous catheters (PVCs/CVCs) and parenteral nutrition (PN) were investigated as potential mediators. Secondary outcomes were length of stay, exclusive breastfeeding at discharge, and weight gain during hospital stay. METHODS Single-center retrospective before-after study with preterm infants admitted ≥3 days. RESULTS We studied 1,046 infants (468 in SFRs, 578 in OBUs, median gestational age 35 weeks). SFRs were associated with less LOS (adjusted odds ratio (OR) 0.486, 95% confidence interval (CI): 0.293; 0.807, p = 0.005). PVCs (indirect effect -1.757, 95% CI: -2.738; -1.068), CVCs (indirect effect -1.002, 95% CI: -2.481; 0.092), and PN (indirect effect -1.784, 95% CI: -2.688; -1.114) were possible mediators of the effect. PN was the main mediator of the effect of SFRs on LOS. We found shorter length of stay (median length of stay in SFRs 10 days and in OBUs 12 days, adjusted β -0.088, 95% CI: -0.159; -0.016, p = 0.016), but no differences in weight gain or exclusive breastfeeding at discharge. CONCLUSIONS SFRs were associated with decreased incidences of LOS and shorter length of hospital stay. The positive effect of SFRs on LOS was mainly mediated through a decreased use of PN in SFRs. IMPACT Family integrated care (FICare) in single family rooms for preterm infants was associated with less late-onset sepsis events during hospital stay and a shorter length of hospital stay after birth. FICare in single family rooms was associated with less use of peripheral or central venous catheters and parenteral nutrition. Mediation analysis provided insights into the mechanisms underlying the effect of FICare in single family rooms on late-onset sepsis and helped explain the differences observed in late-onset sepsis between FICare in single family rooms and open bay units. The reduction in late-onset sepsis in FICare in single family rooms was mediated by a reduced use of intravenous catheters and parenteral nutrition.
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Affiliation(s)
- Nicole R van Veenendaal
- Department of Neonatology, OLVG, Amsterdam, The Netherlands.,Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Vrije Universiteit, Amsterdam, The Netherlands
| | | | - Wieke H Heideman
- Department of Research and Epidemiology, OLVG, Amsterdam, The Netherlands
| | - Judith J M Rijnhart
- Department of Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Martijn W Heymans
- Department of Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Jos W R Twisk
- Department of Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Johannes B van Goudoever
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Vrije Universiteit, Amsterdam, The Netherlands
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23
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Alinejad-Naeini M, Peyrovi H, Shoghi M. Emotional disorganization: The prominent experience of Iranian mothers with preterm neonate: A qualitative study. Health Care Women Int 2020; 42:815-835. [PMID: 32886578 DOI: 10.1080/07399332.2020.1797040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
When a preterm neonate is born and needs to be taken care of in the neonatal intensive care unit (NICU), the mother experiences a different process of mothering. A grounded theory study was conducted to explore the maternal role attainment in mothers of preterm infants. The authors of this paper report the most prominent experience of Iranian mothers with preterm neonates during their stay in the NICU that emerged as part of the process of maternal role attainment. Data were collected through in-depth semi-structured interviews with mothers in the NICU. We found four categories as emerged from experiences that formed the concept of "emotional disorganization". We argue that these findings can help caregivers and nurses to provide sensitive and supportive care to mothers of preterm neonates.
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Affiliation(s)
- Mona Alinejad-Naeini
- Nursing Care Research Center, Pediatric and intensive Neonatal Nursing Department, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Hamid Peyrovi
- Nursing Care Research Center and Department of Critical Care Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Mahnaz Shoghi
- Nursing Care Research Center, Pediatric and intensive Neonatal Nursing Department, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
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24
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Widding U, Hägglöf B, Adamsson M, Farooqi A. Parents of extremely and moderately preterm children reported long-lasting impressions of medical care and the hospital environment. Acta Paediatr 2020; 109:1772-1777. [PMID: 31876043 DOI: 10.1111/apa.15149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 12/19/2019] [Accepted: 12/20/2019] [Indexed: 11/25/2022]
Abstract
AIM Few studies have examined the parents of moderately preterm children. The aim of this study was to investigate the experiences of parents of both extremely and moderately preterm children. METHODS Qualitative telephone interviews were conducted in 2013-2014 with 13 mothers and 10 fathers of extremely preterm children and with 11 mothers and seven fathers of moderately preterm children. The children were born between 2000 and 2003. Data were analysed with a narrative approach. RESULTS Parents of extremely preterm children recounted dramatic birth stories that, for most, ended positively. Parents of moderately preterm children presented more neutral birth stories, and most recounted that their children did not receive attention for prematurity from medical staff. Parents from both groups described staff members' treatment in terms of long-lasting impressions, and they were deeply affected by the hospital environment and the other parents and children admitted. Parents whose children died or were disabled recounted dramatic stories and endless fights for support. CONCLUSION Parents from both groups reported long-lasting impressions of the medical staff and the hospital environment, which they found important to talk about, even a decade after the birth of their child/children.
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Affiliation(s)
| | - Bruno Hägglöf
- Umeå University Umeå Sweden
- Umeå University Hospital Umeå Sweden
| | - Marie Adamsson
- Umeå University Umeå Sweden
- Umeå University Hospital Umeå Sweden
| | - Aijaz Farooqi
- Umeå University Umeå Sweden
- Umeå University Hospital Umeå Sweden
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25
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Comparative Evaluation of Parental Stress Experiences Up to 2 to 3 Years After Preterm and Term Birth. Adv Neonatal Care 2020; 20:301-313. [PMID: 32108660 PMCID: PMC7379044 DOI: 10.1097/anc.0000000000000714] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Parenting stress after preterm birth (PTB) has negative long-term effects on parenting. Research about parental experiences after PTB and on parenting stress in early childhood has focused on mothers.
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26
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Shani-Sherman T, Dolgin MJ, Leibovitch L, Mazkereth R. Internal and External Resources and the Adjustment of Parents of Premature Infants. J Clin Psychol Med Settings 2020; 26:339-352. [PMID: 30259301 DOI: 10.1007/s10880-018-9583-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Studies have shown premature birth and infant hospitalization to be associated with increased levels of parental distress. Internal and external psychological resources have been found to mitigate distress among persons coping with stressful medical events. The current study evaluated psychological resources and distress in 87 parents (57 mothers and 30 fathers) to whom an infant was born prematurely and hospitalized in the NICU of a large tertiary medical center. Parents were administered standardized measures of internal (problem-solving skills) and external (total spousal support, adequacy of spousal support) psychological resources and of psychological distress (depression, posttraumatic symptoms, and mood). Findings indicated that higher levels of problem-solving skills and more adequate spousal support, but not total spousal support, were related to lower levels of parental distress. Adequacy of spousal support and parents' problem-solving skills accounted for 18% of the variance in overall mood and 13.8% of the variance in posttraumatic stress symptoms. A significant two-way interaction was found between adequacy of spousal support and problem-solving skills such that individuals with better problem-solving skills reported better overall mood independent of the adequacy of spousal support they receive. However, for individuals with poor problem-solving skills, the adequacy of the spousal support they receive was a significant factor in determining their overall mood. The theoretical and clinical implications of these findings are discussed in terms of the accessibility of these resources to assessment and their potential for change via existing intervention approaches.
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Affiliation(s)
| | | | - Leah Leibovitch
- Department of Neonatology, The Edmond and Lili Safra Children's Hospital, Sheba Medical Center, Tel Hashomer and Sackler Faculty of Medicine, Tel Aviv University, Ariel, Israel
| | - Ram Mazkereth
- Department of Neonatology, The Edmond and Lili Safra Children's Hospital, Sheba Medical Center, Tel Hashomer and Sackler Faculty of Medicine, Tel Aviv University, Ariel, Israel
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Tan A, Pelone F, Arnold S, Anderson J, Kennedy G, Goodman J. Support and information needs of parents and carers of preterm babies requiring respiratory support on the neonatal unit: A qualitative systematic review. ACTA ACUST UNITED AC 2020. [DOI: 10.1016/j.jnn.2019.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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28
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Premji SS, Reilly S, Currie G, Dosani A, Oliver LM, Lodha AK, Young M, Hall M, Williamson T. Experiences, mental well-being and community-based care needs of fathers of late preterm infants: A mixed-methods pilot study. Nurs Open 2020; 7:127-136. [PMID: 31871696 PMCID: PMC6917944 DOI: 10.1002/nop2.370] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 07/14/2019] [Accepted: 08/19/2019] [Indexed: 01/21/2023] Open
Abstract
Aims We explore fathers' experience of caring for a late preterm infant including their stressors, needs and corresponding interventions proffered by public health nurses. Design Pilot mixed-methods exploratory sequential design. Methods We collected (a) qualitative data from semi-structured interviews (N = 5) and (b) quantitative data (N = 31) about fathers' levels of stress (Parenting Stress Index), anxiety (Speilberger State-Trait Anxiety) and depression (Edinburgh Postnatal Depression Scale) at 6-8 weeks after birth of their infant. Results Fathers appreciated their infant was born 'early', however, discovered through experience the demands of their infant, which appeared as stress (child and parent domains) and anxiety. Themes: hypervigilance in care explained the fathers' sense of competency and role restriction; infant fatigue and parental feeding elucidated the stressful aspect of father-infant interaction. Unscientific advice from healthcare providers was confusing and frustrating while uncertainty of rehospitalization caused worries, fears or stress. One father experienced depressive symptoms.
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Affiliation(s)
| | - Sandra Reilly
- Faculty of NursingUniversity of CalgaryCalgaryABCanada
| | - Genevieve Currie
- School of Nursing and MidwiferyHealth, Community & Education, Mount Royal UniversityCalgaryABCanada
| | - Aliyah Dosani
- School of Nursing and MidwiferyHealth, Community & Education, Mount Royal UniversityCalgaryABCanada
| | | | - Abhay K. Lodha
- Department of Community Health SciencesCumming School of MedicineUniversity of CalgaryCalgaryABCanada
- Division of NeonatologyDepartment of PaediatricsAlberta Health ServicesFoothills Medical CentreCalgaryABCanada
| | - Marilyn Young
- Division of NeonatologyDepartment of PaediatricsAlberta Health ServicesFoothills Medical CentreCalgaryABCanada
- Prenatal & Postpartum ServicesPublic Health Calgary ZoneAlberta Health ServicesCalgaryABCanada
| | - Marc Hall
- Faculty of NursingUniversity of CalgaryCalgaryABCanada
| | - Tyler Williamson
- Department of Community Health SciencesCumming School of MedicineUniversity of CalgaryCalgaryABCanada
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Benscoter D, Borschuk A, Hart C, Voos K. Preparing families to care for ventilated infants at home. Semin Fetal Neonatal Med 2019; 24:101042. [PMID: 31648918 DOI: 10.1016/j.siny.2019.101042] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Advances in neonatal care have led to increased survival of infants with complex medical needs and technology dependence. Transition of the ventilator-dependent infant from hospital to home is a complex process that requires extensive coordination between the medical team and family. Home caregivers must be prepared to provide routine care for the ventilator-dependent child and respond to life-threatening emergencies. Families should be counseled on the need for home nursing, medical equipment and an adequate home environment to ensure a safe transition to home. Throughout the process, the family may require financial, social and psychological support. A structured education and transition process that is clearly communicated to parents is necessary to have an effective partnership with families.
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Affiliation(s)
- Dan Benscoter
- Department of Pediatrics, University of Cincinnati, College of Medicine, 3333 Burnet Ave, Cincinnati, 45229, OH, USA; Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, 45229, OH, USA.
| | - Adrienne Borschuk
- Department of Pediatrics, University of Cincinnati, College of Medicine, 3333 Burnet Ave, Cincinnati, 45229, OH, USA; Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, 45229, OH, USA.
| | - Catherine Hart
- Department of Otolaryngology, University of Cincinnati, College of Medicine, 231 Albert Sabin Way, Cincinnati, 45267, OH, USA.
| | - Kristin Voos
- Department of Pediatrics, Case Western Reserve University School of Medicine, 11100 Euclid Ave, Cleveland, 44106, OH, USA; Division of Neonatology, University Hospitals Cleveland Medical Center Rainbow Babies and Children's Hospital, 11100 Euclid Ave, Cleveland, 44106, OH, USA.
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30
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Transferring preterm infants into an open cot using a heated mattress at ≤ 1400 g. J Perinatol 2019; 39:1399-1405. [PMID: 31388119 DOI: 10.1038/s41372-019-0453-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 04/19/2019] [Accepted: 06/25/2019] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The objective of this study is to evaluate the corrected age and weight that infants were transferred into an open cot using a heated mattress, in overall and within the subgroups of early (weight ≤ 1400 g) and standard transfer (weight > 1400 g). DESIGN Retrospective cohort study in a tertiary neonatal unit RESULTS: One hundred and thirty-five preterm infants were analysed. The mean weight of moving into an open cot was 1370 ± 167 g at a corrected age 33 ± 1.8 weeks. Eighty-three infants (61%) were transferred early at a mean weight 1276 ± 98 g compared with 52 infants of standard transfer with a mean weight 1522 ± 141 g. Infants of the early group had higher weight gain, were discharged earlier and had shorter length of stay. CONCLUSIONS Stable preterm infants can be safely moved to an open cot at < 33 weeks and weight ≤ 1400 g.
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31
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Fletcher R, Knight T, Macdonald JA, StGeorge J. Process evaluation of text-based support for fathers during the transition to fatherhood (SMS4dads): mechanisms of impact. BMC Psychol 2019; 7:63. [PMID: 31519207 PMCID: PMC6796445 DOI: 10.1186/s40359-019-0338-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 08/30/2019] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND There is growing evidence for the value of technology-based programs to support fathers to make positive transitions across the perinatal period. However, past research has focused on program outcomes with little attention to the mechanisms of impact. Knowledge of why a program works increases potential for replication across contexts. METHODS Participants were 40 Australian fathers enrolled in the SMS4dads text-based perinatal support program (Mean age 35.11 (5.87). From a starting point between 16 weeks gestation and 12 weeks postpartum, they were sent a maximum of 184 text messages. An inductive approach was used to analyse post-program semi-structured interviews. The aim was to identify mechanisms of impact aligned to previously identified program outcomes, which were that SMS4dads: 1) is helpful/useful; 2) lessens a sense of isolation; 3) promotes the father-infant relationship; and 4) supports the father-partner relationship. RESULTS We identified two types of mechanisms: four were structural within the program messages and five were psychological within the participant. The structural mechanisms included: syncing information to needs; normalisation; prompts to interact; and, the provision of a safety net. The psychological mechanisms were: increase in knowledge; feelings of confidence; ability to cope; role orientation; and, the feeling of being connected. These mechanisms interacted with each other to produce the pre-identified program outcomes. CONCLUSIONS If the current findings are generalisable then, future mobile health program design and evaluation would benefit from explicit consideration to how both program components and individual cognitive and behavioural processes combine to elicit targeted outcomes.
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Affiliation(s)
- Richard Fletcher
- Family Action Centre, School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, NSW University Drive, Callaghan, NSW, Australia.
| | - Tess Knight
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Australia
| | - Jacqui A Macdonald
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Australia.,Murdoch Children's Research Institute, Melbourne, Australia
| | - Jennifer StGeorge
- Family Action Centre, School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, NSW University Drive, Callaghan, NSW, Australia
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McGowan EC, Vohr BR. Impact of Nonmedical Factors on Neurobehavior and Language Outcomes of Preterm Infants. Neoreviews 2019; 20:e372-e384. [PMID: 31261104 DOI: 10.1542/neo.20-7-e372] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Preterm infants are at increased risk for adverse neurodevelopmental outcomes. The impact of maternal, NICU, and social environmental factors on early neurobehavior and language outcomes of preterm infants is recognized. There is a need for health care professionals to have a clear understanding of the importance of facilitating positive mother-infant relationships, and to address not only the infant's sensory and language environment, but also focus on adverse maternal mental health and social adversities to optimize infant outcomes.
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Affiliation(s)
- Elisabeth C McGowan
- Warren Alpert Medical School of Brown University, and Department of Pediatrics, Women & Infants Hospital of Rhode Island, Providence, RI
| | - Betty R Vohr
- Warren Alpert Medical School of Brown University, and Department of Pediatrics, Women & Infants Hospital of Rhode Island, Providence, RI
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33
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Widding U, Hägglöf B, Farooqi A. Parents of preterm children narrate constructive aspects of their experiences. J Clin Nurs 2019; 28:4110-4118. [DOI: 10.1111/jocn.14948] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 04/24/2019] [Accepted: 05/26/2019] [Indexed: 11/30/2022]
Affiliation(s)
| | - Bruno Hägglöf
- Department of Clinical Sciences: Child and Adolescent Psychiatry Umeå University Hospital Umeå Sweden
| | - Aijaz Farooqi
- Department of Neonatology: Child and Adolescent Medicine Umeå University Hospital Umeå Sweden
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34
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Stress and feelings in mothers and fathers in NICU: identifying risk factors for early interventions. Prim Health Care Res Dev 2019; 20:e81. [PMID: 32799977 PMCID: PMC6567892 DOI: 10.1017/s1463423619000021] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
AIMS The aims of this study were to explore parents' stress levels and negative feelings after premature births and to identify the risk factors related to parents' stress and negative feelings during their children's neonatal intensive care unit (NICU) stay. BACKGROUND Preterm birth is a multi-problematic event that may put the babies in danger for both their medical and neurophysiological conditions and could have a negative impact on both the mother-father relationship and the parent-child interactions. METHODS The study involved 43 mothers and 38 fathers of preterm infants. All participants filled out the Parental Stressor Scale: Neonatal Intensive Care Unit and the Profile of Mood States. FINDINGS The results revealed significant differences between mothers' and fathers' responses to preterm births in terms of both stress and negative feelings. We found that, for mothers, their own young age and the baby's need for respiratory support were significant predictors of stress; for fathers, their own young age and the baby's lower gestational age and worse condition at birth were significant predictors of stress and negative feelings. The NICU may be a stressful place both for mothers and fathers. Identifying which mothers and fathers are at risk immediately after their children are born could help to direct specific interventions that can reduce these parents' stress and prevent them from negative feelings.
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35
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Ireland S, Ray RA, Larkins S, Woodward L. Perspectives of time: a qualitative study of the experiences of parents of critically ill newborns in the neonatal nursery in North Queensland interviewed several years after the admission. BMJ Open 2019; 9:e026344. [PMID: 31092655 PMCID: PMC6530444 DOI: 10.1136/bmjopen-2018-026344] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
DESIGN A qualitative study informed by grounded theory principles to explore the experiences of parents who had extremely preterm or babies with antenatally diagnosed life-threatening diagnoses who were cared for in a regional tertiary neonatal unit. The study was conducted when the child was old enough to be diagnosed with long-term neurodevelopmental or medical sequelae. SETTING North Queensland is a large area in Eastern Australia of 500 000 km2, which is served by one tertiary neonatal unit. PARTICIPANTS Seventeen families representing 21 extremely preterm babies and one baby with congenital malformations who was not expected to survive prior to delivery (but did) were interviewed using grounded theory principles. Interviews were coded and themes derived. RESULTS Parents who recollect their neonatal experiences from 3 to 7 years after the baby was cared for in the neonatal intensive care described negative themes of grief and loss, guilt and disempowerment. Positive enhancers of care included parental strengths, religion and culture, family supports and neonatal unit practices. Novel findings included that prior pregnancy loss and infertility formed part of the narrative for parents, and hope was engendered by religion for parents who did not usually have a religious faith. CONCLUSIONS An understanding of both the negative aspects of neonatal care and the positive enhancers is necessary to improve the neonatal experience for parents. Parents are able to contextualise their previous neonatal experiences within both the long-term outcome for the child and their own life history.
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Affiliation(s)
- Susan Ireland
- James Cook University College of Medicine and Dentistry, Townsville, Queensland, Australia
- Townsville Hospital and Health Service, Townsville, Queensland, Australia
| | - Robin A Ray
- James Cook University College of Medicine and Dentistry, Townsville, Queensland, Australia
| | - Sarah Larkins
- James Cook University College of Medicine and Dentistry, Townsville, Queensland, Australia
| | - Lynn Woodward
- James Cook University College of Medicine and Dentistry, Townsville, Queensland, Australia
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36
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Lundqvist P, Weis J, Sivberg B. Parents’ journey caring for a preterm infant until discharge from hospital‐based neonatal home care—A challenging process to cope with. J Clin Nurs 2019; 28:2966-2978. [DOI: 10.1111/jocn.14891] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 03/16/2019] [Accepted: 04/14/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Pia Lundqvist
- Department of Health Sciences, Faculty of Medicine Lund University Lund Sweden
| | - Janne Weis
- Neonatal Department and the Research Unit for Women’s and Children’s Health Copenhagen University Hospital Copenhagen Denmark
| | - Bengt Sivberg
- Department of Health Sciences, Faculty of Medicine Lund University Lund Sweden
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37
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Månsson C, Sivberg B, Selander B, Lundqvist P. The impact of an individualised neonatal parent support programme on parental stress: a quasi‐experimental study. Scand J Caring Sci 2019; 33:677-687. [DOI: 10.1111/scs.12663] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 01/08/2019] [Indexed: 01/30/2023]
Affiliation(s)
- Catrin Månsson
- Department of Health Sciences Faculty of Medicine Lund University Lund Sweden
- Department of Neonatology Skåne University Hospital Lund Sweden
| | - Bengt Sivberg
- Department of Health Sciences Faculty of Medicine Lund University Lund Sweden
| | - Bo Selander
- Department of Pediatrics Central Hospital Kristianstad Sweden
| | - Pia Lundqvist
- Department of Health Sciences Faculty of Medicine Lund University Lund Sweden
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38
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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.
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Affiliation(s)
- Eman M Alsaiari
- Pediatrics, Prince Sattam Bin Abdulaziz University, Riyadh, SAU
| | - Judy Magarey
- Pediatrics, The University of Adelaide, Adelaide, AUS
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Trumello C, Candelori C, Cofini M, Cimino S, Cerniglia L, Paciello M, Babore A. Mothers' Depression, Anxiety, and Mental Representations After Preterm Birth: A Study During the Infant's Hospitalization in a Neonatal Intensive Care Unit. Front Public Health 2018; 6:359. [PMID: 30581812 PMCID: PMC6293875 DOI: 10.3389/fpubh.2018.00359] [Citation(s) in RCA: 93] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 11/22/2018] [Indexed: 12/04/2022] Open
Abstract
Aim: This paper aimed to explore psychological functioning and mental representations in mothers of preterm infants during the child's hospitalization in a Neonatal intensive care unit (NICU). Methods: A sample including 62 mothers of premature infants (gestational age < 37 weeks) was recruited in a NICU. According to the gestational age at the time of delivery, we considered two groups: Group A included mothers whose children were born before 32 weeks of pregnancy; Group B included mothers whose children were born at or after 32 weeks of pregnancy. Within one week of childbirth, mothers were administered two self-report questionnaires: the Edinburgh Postnatal Depression Scale (EPDS) and the State-Trait Anxiety Inventory (STAI). When their infants' medical conditions became stable, the Clinical Interview for Parents of High-Risk Infants (CLIP) was administered to mothers. Results: The results showed high levels of depression and anxiety in both groups of mothers, with higher state anxiety scores in Group A than Group B. Besides, a series of hierarchical regression analyses were conducted with STAI, EPDS, and gestational age as predictors on the CLIP scores. Results indicated that EPDS scores predicted CLIP scores on parental self-image, support system, and readiness for discharge (p < 0.001); moreover, the interaction among depression, anxiety, and gestational age predicted the CLIP dimension of feeling of mutual recognition (p < 0.005). Conclusions: These findings suggested that a premature birth and the child's hospitalization might exert a negative effect on the mothers' emotional state, their perception of parental self-image and, consequently, the early bond with the child—independent from the infants' gestational age at the time of the preterm delivery. The data underlined the importance of involving NICU nurses and clinicians in order to optimize the care for mothers immediately after the preterm birth and during the infant's hospitalization, taking into account psychological needs of mothers of both very preterm and moderately preterm infants.
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Affiliation(s)
- Carmen Trumello
- Department of Psychological, Health and Territorial Sciences, Università degli studi G.D'Annunzio Chieti Pescara, Chieti, Italy
| | - Carla Candelori
- Department of Psychological, Health and Territorial Sciences, Università degli studi G.D'Annunzio Chieti Pescara, Chieti, Italy
| | - Marika Cofini
- Department of Psychological, Health and Territorial Sciences, Università degli studi G.D'Annunzio Chieti Pescara, Chieti, Italy
| | - Silvia Cimino
- Department of Dynamic and Clinical Psychology, Faculty of Psychology, Sapienza University of Rome, Rome, Italy
| | - Luca Cerniglia
- Università Telematica Internazionale Uninettuno, Rome, Italy
| | | | - Alessandra Babore
- Department of Psychological, Health and Territorial Sciences, Università degli studi G.D'Annunzio Chieti Pescara, Chieti, Italy
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Ong SL, Abdullah KL, Danaee M, Soh KL, Soh KG, Lee DSK, Hussin EOD. The effectiveness of a structured nursing intervention program on maternal stress and ability among mothers of premature infants in a neonatal intensive care unit. J Clin Nurs 2018; 28:641-649. [PMID: 30182455 DOI: 10.1111/jocn.14659] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 06/22/2018] [Accepted: 08/29/2018] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES To investigate the effectiveness of a structured nursing intervention program on maternal stress and NICU-related maternal ability after the admission of premature infants to a neonatal intensive care unit (NICU). BACKGROUND Mothers of premature infants may face stress having premature infants, and their infants may be admitted to the NICU for a few weeks or months. The mothers' experience of stress would be worse if they have low knowledge and poor NICU-related maternal ability. Mothers of infants admitted to the NICU require well-planned interventions to cope with psychological matters arising after an infant hospitalisation. DESIGN Quasi-experimental design. METHODS A total of 216 mothers were consecutively assigned to control and intervention groups. Each group consisted of 108 mothers. The mothers in both groups received questionnaire concerning maternal stress and NICU-related ability during their first visit to NICU (within 48 hr of admission). A structured nursing intervention was implemented for 10 days on mothers in the intervention group. The control group continued to receive existing practice nursing care. Mothers of both groups were again given the questionnaire on maternal stress and NICU-related ability after 14 days of admission. RESULTS In the intervention group, the difference between the mean total score of maternal stress and parental role and relationship subscale decreased significantly, compared to the control group (p = 0.04; p = 0.01) respectively. Maternal ability improved significantly in mothers in the intervention group 2 weeks postintervention, p < 0.001. CONCLUSION A structured nursing intervention for mothers could significantly reduce maternal stress and promote maternal NICU-related abilities. RELEVANCE TO CLINICAL PRACTICE The results of the study could help neonatal nurses to develop an appropriate nursing intervention for parents with premature infants in the NICU.
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Affiliation(s)
- Swee Leong Ong
- Department of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,School of Nursing, Faculty of Medicine, Universiti Sultan Zainal Abidin, Terengganu, Malaysia
| | - Khatijah Lim Abdullah
- Department of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Faculty of Nursing, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Mahmoud Danaee
- Academic Enhancement And Leadership Development Centre (ADeC), Deputy Vice Chancellor (academic & International) Office, Kuala Lumpur, Malaysia
| | - Kim Lam Soh
- Department of Nursing and Rehabilitation, Faculty of Medicine and Health Sciences, UPM, Serdang, Malaysia
| | - Kim Geok Soh
- Department of Sports Studies, Faculty of Education, UPM, Serdang, Malaysia
| | - Daphne Siew Kee Lee
- Department of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Emni Omar Daw Hussin
- Department of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Effectiveness of the Neonatal Discharge Program for Very Low-Birth-Weight Infants on Parental Efficacy and Psychological Distress. J Perinat Neonatal Nurs 2018; 32:E11-E21. [PMID: 29782436 DOI: 10.1097/jpn.0000000000000337] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This pilot study aimed to (i) evaluate the effectiveness of a neonatal discharge program, (ii) identify relationships between parent and infant factors and parental efficacy and psychological distress, and (iii) identify ways to improve the neonatal discharge program. A quasiexperimental 1-group pretest/posttest design was used. Through consecutive sampling, 42 participants were recruited. Data were collected using self-report questionnaires. Self-administering instruments gathered data on parental efficacy and psychological distress as well as feedback and recommendations on the intervention. A significant increase in parental efficacy and a reduction in psychological distress were observed from pre- to postdischarge intervention. Significant relationships were found between parental efficacy and infants' gestational age, birth weight, gender, and participants' level of education, and a significant relationship was found between psychological distress and number of children from previous pregnancies. Moreover, an Internet-based program, in addition to the face-to-face teaching, was identified as a preferred option to aid in information retention. It is important to evaluate and enhance the neonatal discharge program to suit the parents of today while providing them with informational and emotional support. Future studies should explore parental coping and the long-term effects of their infant's birth and the intervention.
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42
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Ghanaian fathers' experiences of caring for preterm infants; a journey of exclusion. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.jnn.2017.05.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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43
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Ahnert L, Teufl L, Ruiz N, Piskernik B, Supper B, Remiorz S, Gesing A, Nowacki K. FATHER-CHILD PLAY DURING THE PRESCHOOL YEARS AND CHILD INTERNALIZING BEHAVIORS: BETWEEN ROBUSTNESS AND VULNERABILITY. Infant Ment Health J 2017; 38:743-756. [DOI: 10.1002/imhj.21679] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
| | | | | | | | | | - Silke Remiorz
- University of Applied Sciences and Arts; Dortmund Germany
| | | | - Katja Nowacki
- University of Applied Sciences and Arts; Dortmund Germany
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Koliouli F, Zaouche Gaudron C, Casper C, Berdot-Talmier L, Raynaud JP. Soutien social et expérience paternelle des pères de nouveau-nés prématurés. ENFANCES, FAMILLES, GÉNÉRATIONS 2017. [DOI: 10.7202/1041063ar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Cadre de la recherche : Plusieurs études ont montré que le vécu parental lors d’une naissance prématurée peut être de nature traumatique avec un impact sur la qualité de la relation parent-enfant (Lindberg, Axelsson et Ohrling, 2008). Cependant, force est de constater que les processus en jeu chez le père restent relativement inexplorés.
Objectifs : L’objectif de cette étude exploratoire est de développer un modèle de compréhension de l’expérience paternelle de nouveau-nés prématurés. Celle-ci est appréhendée par la relation avec le nourrisson (Blomqvist et al., 2012 ; Helth et Jarden, 2013) et l’expérience du devenir père (Zaouche Gaudron et al., 2003 ; Zaouche Gaudron et al., 2005) mais également par la relation avec l’équipe soignante (Fegran et Helseth, 2009). La gravité de la prématurité est également examinée (Ibanez et al., 2006).
Méthodologie : L’échantillon se compose de 48 pères de bébés prématurés. Un entretien semi-directif basé sur le Clinical Interview for Parents of High Risk Infants (Meyer et al., 1993) a été adapté et utilisé pour le recueil de données. Les axes réfèrent à la grossesse de la conjointe, à l’accouchement, à la relation avec le nourrisson et au soutien social.
Résultats : Nos principaux résultats indiquent que les pères construisent un premier lien avec leur bébé par le contact du peau-à-peau et par l’accordage du regard. Ils témoignent, par ailleurs, d’un vécu traumatique lié à la prématurité décrit par des sentiments ambivalents, comme la peur, le stress mais également le bonheur. La source la plus importante de soutien social, hormis la famille, est l’équipe soignante et les autres parents dans le service.
Conclusions : Les principales conclusions permettent d’amener des propositions quant aux pratiques professionnelles afin de soutenir le processus de paternalisation dans ce contexte particulier de prématurité.
Contribution : Dans une approche qualitative, cette étude apporte un éclairage concernant l’expérience paternelle dans le contexte particulier qu'est la prématurité du nouveau-né.
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Affiliation(s)
- Flora Koliouli
- Docteur en Psychologie, Attachée Temporaire d’Enseignement et de Recherche, UMR LISST-CERS (UMR 5193) – Université de Toulouse 2 – Jean Jaurès,
| | - Chantal Zaouche Gaudron
- Professeur en Psychologie de l’enfant, UMR LISST-CERS (UMR 5193) – Université de Toulouse 2 – Jean Jaurès
| | - Charlotte Casper
- Professeur en Pédiatrie et Néonatologie, UMR 1043 Centre de Physiopathologie de Toulouse Purpan (CPTP). INSERM CHU Toulouse/ Université Paul Sabatier
| | - Laurence Berdot-Talmier
- Doctorante en Psychologie, UMR LISST-CERS (UMR 5193) – Université de Toulouse 2 – Jean Jaurès
| | - Jean-Philippe Raynaud
- Professeur de Psychiatrie de l’enfant et de l’adolescent, UMR 1027 Épidémiologie et analyses en santé publique : risques, maladies chroniques, handicaps. INSERM CHU Toulouse/Université Paul Sabatier
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45
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Abstract
OBJECTIVE To study stress in fathers of preterm infants admitted in a neonatal intensive care unit. METHODS Questionnaire-based study. Questionnaire included domains on infants health, maternal illness, staff behavior, parental role, home affairs and finances. Eligible fathers were repeatedly interviewed on day 7 (n=80), day 17 (n=59) and day 27 (n=28). Raw and standardized stress scores were calculated. RESULTS Financial burden was the main stressor at all times. Stress related to staff behavior and altered parental role reduced with time. Birthweight and fathers age, occupation and education independently predicted stress. CONCLUSION Fathers of preterm infants admitted in hospital are stressed, primarily due to financial burden.
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Lakshmanan A, Agni M, Lieu T, Fleegler E, Kipke M, Friedlich PS, McCormick MC, Belfort MB. The impact of preterm birth <37 weeks on parents and families: a cross-sectional study in the 2 years after discharge from the neonatal intensive care unit. Health Qual Life Outcomes 2017; 15:38. [PMID: 28209168 PMCID: PMC5312577 DOI: 10.1186/s12955-017-0602-3] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 01/24/2017] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Little is known about the quality of life of parents and families of preterm infants after discharge from the neonatal intensive care unit (NICU). Our aims were (1) to describe the impact of preterm birth on parents and families and (2) and to identify potentially modifiable determinants of parent and family impact. METHODS We surveyed 196 parents of preterm infants <24 months corrected age in 3 specialty clinics (82% response rate). Primary outcomes were: (1) the Impact on Family Scale total score; and (2) the Infant Toddler Quality of Life parent emotion and (3) time limitations scores. Potentially modifiable factors were use of community-based services, financial burdens, and health-related social problems. We estimated associations of potentially modifiable factors with outcomes, adjusting for socio-demographic and infant characteristics using linear regression. RESULTS Median (inter-quartile range) infant gestational age was 28 (26-31) weeks. Higher Impact on Family scores (indicating worse effects on family functioning) were associated with taking ≥3 unpaid hours/week off from work, increased debt, financial worry, unsafe home environment and social isolation. Lower parent emotion scores (indicating greater impact on the parent) were also associated with social isolation and unpaid time off from work. Lower parent time limitations scores were associated with social isolation, unpaid time off from work, financial worry, and an unsafe home environment. In contrast, higher parent time limitations scores (indicating less impact) were associated with enrollment in early intervention and Medicaid. CONCLUSIONS Interventions to reduce social isolation, lessen financial burden, improve home safety, and increase enrollment in early intervention and Medicaid all have the potential to lessen the impact of preterm birth on parents and families.
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Affiliation(s)
- Ashwini Lakshmanan
- Center for Fetal and Neonatal Medicine, USC Division of Neonatal Medicine, Children's Hospital Los Angeles; Keck School of Medicine, University of Southern California, 4650 Sunset Boulevard, MS #31, CA, 90027, Los Angeles, USA.
- Newborn and Infant Critical Care Unit, Children's Hospital Los Angeles, 4650 Sunset Boulevard, MS #31, CA, 90027, Los Angeles, USA.
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
- Center for Health Policy and Economics, University of Southern California, Los Angeles, CA, USA.
| | - Meghana Agni
- Drexel School of Medicine, Philadelphia, PA, USA
| | - Tracy Lieu
- Division of Research, Kaiser Permanente, Oakland, CA, USA
| | - Eric Fleegler
- Division of Emergency Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Michele Kipke
- Saban Research Institute, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Philippe S Friedlich
- Center for Fetal and Neonatal Medicine, USC Division of Neonatal Medicine, Children's Hospital Los Angeles; Keck School of Medicine, University of Southern California, 4650 Sunset Boulevard, MS #31, CA, 90027, Los Angeles, USA
| | - Marie C McCormick
- Division of Newborn Medicine, Boston Children's Hospital, Boston, MA, USA
- Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Social and Behavioral Sciences, The Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Mandy B Belfort
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, MA, USA
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47
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Park JE, Lee BS. Experience of Becoming a Father of a High Risk Premature Infant. J Korean Acad Nurs 2017; 47:277-288. [DOI: 10.4040/jkan.2017.47.2.277] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 01/11/2017] [Accepted: 03/13/2017] [Indexed: 11/09/2022]
Affiliation(s)
- Jeong Eon Park
- Department of Nursing, Uiduk University, Gyeongju, Korea
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48
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Perceptions of Parents With Preterm Infants Hospitalized in Singaporean Neonatal Intensive Care Unit. J Perinat Neonatal Nurs 2017; 31:263-273. [PMID: 28234668 DOI: 10.1097/jpn.0000000000000239] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Perceptions of parents with preterm infants who were hospitalized in a Singapore-based neonatal intensive care unit were observed. Convenience sampling method was used to recruit 8 parents of preterm infants. Semistructured face-to-face in-depth interviews were used to collect data between November 2013 and February 2014. Data were analyzed using thematic analysis. Four themes were identified: "negative emotions versus positive emotions," "finding ways forward," "nature of support received from various sources," and "need more informational and professional support." Parents of preterm infants experienced a multitude of emotions that varied from shock and sadness to excitement and anticipation through their babies' birth, hospitalization, and impending discharge. These parents adopted several strategies to cope with their birth and subsequent infant hospitalization. While their neonatal intensive care unit (NICU) experience was perceived as positive for most parents, some suggestions were made to improve on the information provided and professional care. This study provides evidence to health care professionals in addressing parents' negative emotions and coping abilities in practice. Emotional and informational support for parents is important for them to be more competent in coping with the hospitalization of their newborn in the NICU.
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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.
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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
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Provenzi L, Fumagalli M, Bernasconi F, Sirgiovanni I, Morandi F, Borgatti R, Montirosso R. Very Preterm and Full-Term Infants’ Response to Socio-Emotional Stress: The Role of Postnatal Maternal Bonding. INFANCY 2016; 22:695-712. [DOI: 10.1111/infa.12175] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 10/05/2016] [Accepted: 11/17/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Livio Provenzi
- 0-3 Centre for the at-Risk Infant; Scientific Institute IRCCS Eugenio Medea
| | - Monica Fumagalli
- NICU, Department of Maternal and Pediatric Sciences; University of Milan; Fondazione IRCCS Ca’ Granda
| | | | - Ida Sirgiovanni
- NICU, Department of Maternal and Pediatric Sciences; University of Milan; Fondazione IRCCS Ca’ Granda
| | | | - Renato Borgatti
- Neuropsychiatry and Neurorehabilitation Unit; Scientific Institute IRCCS Eugenio Medea
| | - Rosario Montirosso
- 0-3 Centre for the at-Risk Infant; Scientific Institute IRCCS Eugenio Medea
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