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Petersen M, Nordlund HL, Koreska M, Brødsgaard A. Bridging the gap between healthcare sectors: Facilitating the transition from NICU to the municipality and home for families with premature infants. J SPEC PEDIATR NURS 2024; 29:e12426. [PMID: 38615233 DOI: 10.1111/jspn.12426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 03/27/2024] [Indexed: 04/15/2024]
Abstract
PURPOSE The transition from hospital to home can be challenging for parents of prematurely born infants. The aim of this ethnographic study was to describe a multidisciplinary and cross-sectoral discharge conference for families with premature infants transitioning from a neonatal intensive care unit to municipal healthcare services. DESIGN AND METHODS An ethnographically/anthropologically inspired qualitative design was adopted. We conducted four participant observations of multidisciplinary and cross-sectoral discharge conferences and 12 semistructured interviews with four neonatologists, four nurses, and four health visitors who had attended one of the conferences. Salient themes were generated by two-part analysis consisting of a thematic analysis followed by Turner's ritual analysis. RESULTS This study illustrated how multidisciplinary and cross-sectoral discharge conferences improved the quality of care for premature infants and their families in their transition process which was perceived as complex. These conferences contributed to promoting a sense of coherence and continuity of care. The healthcare professionals experienced that this event may be characterized as a ritual, which created structures that promoted cross-sectoral cooperation and communication while increasing interdisciplinary knowledge sharing. Thus, the conferences triggered a sense that the participants were building bridges to unite healthcare sectors, ensuring a holistic and coordinated approach to meet the unique needs of the infants and their families. IMPLICATIONS FOR PRACTICE This study presented a unique holistic and family-centered approach to constructing multidisciplinary and cross-sectoral discharge conferences that seemed to underpin the quality of interdisciplinary and health-related knowledge sharing and establish a crucial starting point for early interventions, preventive measures, and health-promoting efforts. Hopefully, our findings will encourage others to rethink the discharge conference as a transitional ritual that may potentially bridge the gap between healthcare sectors. Specifically, our findings contribute to the mounting body of knowledge of family-centered care by showing how healthcare professionals may-in a meaningful and tangible manner-operate, develop, and implement this somewhat elusive theoretical foundation in their clinical practice.
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Affiliation(s)
- Mette Petersen
- Department of Paediatric and Adolescent Medicine, Neonatal Intensive Care Unit, Copenhagen University Hospital Amager Hvidovre, Copenhagen, Denmark
| | | | - Mai Koreska
- Department of Obstetrics and Gynaecology, Copenhagen University Hospital Amager Hvidovre, Copenhagen, Denmark
| | - Anne Brødsgaard
- Department of Paediatric and Adolescent Medicine, Neonatal Intensive Care Unit, Copenhagen University Hospital Amager Hvidovre, Copenhagen, Denmark
- Department of Obstetrics and Gynaecology, Copenhagen University Hospital Amager Hvidovre, Copenhagen, Denmark
- Department of Public Health, Nursing and Health Care, University of Aarhus, Aarhus, Denmark
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Bater ML, Gould JF, Collins CT, Anderson PJ, Stark MJ. Child development education in the Neonatal Unit: Understanding parent developmental literacy needs, priorities and preferences. PATIENT EDUCATION AND COUNSELING 2024; 119:108058. [PMID: 37976667 DOI: 10.1016/j.pec.2023.108058] [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: 11/06/2022] [Revised: 10/25/2023] [Accepted: 11/07/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVE To describe child development knowledge needs, priorities, and preferences for education to enhance developmental literacy among parents with children admitted to the neonatal unit (NNU). METHODS Two separate cohorts completed a survey; 1) Parents with children graduated from Australian NNUs (n = 316); 2) Parents with infants' inpatient at two South Australian NNUs (n = 209). RESULTS Parents considered it extremely important to understand child development (Graduates: 80%; Inpatients: 71%). Inpatient parents reported lower child development knowledge. Almost half (42%) of graduate parents described the child development education provided by neonatal staff as poor or inadequate. There was consistency in preferences for developmental literacy education provision. Parents desired education to commence during NNU and continue post discharge. Priorities included content specific to preterm birth and how to support child development over the first two years of life. Individualised education by a Neonatal Nurse/Midwife was most preferred. CONCLUSION Mothers and fathers value guidance to support their child's development during NNU admission and early childhood. Our study highlights the importance of improved early developmental literacy education for parents with children admitted to the neonatal unit. PRACTICE IMPLICATIONS Our findings can be used to inform the creation of future educational resources targeting improved parent developmental literacy.
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Affiliation(s)
- Megan L Bater
- Discipine of Paediatrics, Adelaide Medical School, the University of Adelaide, Adelaide, Australia; SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, Australia; Neonatal Unit, Women's and Children's Hospital, Adelaide, Australia; Robinson Research Institute, University of Adelaide, Adelaide, Australia.
| | - Jacqueline F Gould
- Discipine of Paediatrics, Adelaide Medical School, the University of Adelaide, Adelaide, Australia; SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, Australia; School of Psychology, the University of Adelaide, Adelaide, Australia
| | - Carmel T Collins
- Discipine of Paediatrics, Adelaide Medical School, the University of Adelaide, Adelaide, Australia; SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Peter J Anderson
- Turner Institute for Brain and Mental Health & School of Psychological Sciences, Monash University, Melbourne, Australia; Murdoch Children's Research Institute, Melbourne, Australia
| | - Michael J Stark
- Discipine of Paediatrics, Adelaide Medical School, the University of Adelaide, Adelaide, Australia; SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, Australia; Neonatal Unit, Women's and Children's Hospital, Adelaide, Australia; Robinson Research Institute, University of Adelaide, Adelaide, Australia
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Conceição TED, Souza MHDN, Esteves RB, Peres PLP, Valente D, Nespoli A. Maternal Concerns in Home Care for the Premature Newborn: An Integrative Review. Rev Bras Enferm 2023; 76:e20220769. [PMID: 38055478 DOI: 10.1590/0034-7167-2022-0769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 07/23/2023] [Indexed: 12/08/2023] Open
Abstract
OBJECTIVE To identify and analyze the scientific literature, both national and international, concerning the primary maternal concerns about caring for premature newborns at home. METHODS This integrative review is based on the guiding question: "What scientific publications from 2012 to 2021 address maternal concerns about the care of premature newborns at home?". Searches were conducted in the electronic databases: Embase, Medline, Web of Science, Lilacs, Scielo, and Cochrane Library. RESULTS A total of 21 articles were identified. The qualitative analysis showed that maternal concerns pertained to breastfeeding, hygiene, sunbathing practices, managing infant colic, identifying signs, symptoms, and clinical changes, temperature control, and the third phase of the kangaroo method. CONCLUSIONS Maternal uncertainties underscore the importance of enhancing strategies focused on supporting families and ensuring continued care for neonates at home.
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da Cunha AFS, de Brito Brandão M, Gontijo APB, de Miranda DM, de Melo Mambrini JV, Mancini MC. Parental priorities in the home care of preterm and full term newborns. Early Hum Dev 2022; 173:105658. [PMID: 36007454 DOI: 10.1016/j.earlhumdev.2022.105658] [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: 06/23/2022] [Revised: 08/16/2022] [Accepted: 08/17/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND The initial weeks after hospital discharge is a period of adaptation when parents assume great responsibility for the care of their child. Preterm birth may impact their demands of care. AIMS To compare parental priorities in the care of preterm and full-term newborns in the first two months after hospital discharge and to identify changes in priorities over time. METHODS Parents of 22 full-term and 19 preterm infants were followed for two months after hospital discharge, with three timepoint evaluations of the parental priorities. They reported on infant care demands in a semi-structured interview. RESULTS Despite prematurity, demands were similar between groups. Within-group changes occurred over time. Priorities related to bathing and caring for the navel showed significant reduction (p < 0.01); demands related to children's health care increased in the groups (p < 0.01). Feeding and sleep priorities were reduced in the full-term group (p < 0.02). Children's adaptation to routine increased significantly in the preterm group (p = 0.04). CONCLUSION Knowledge of parents' priorities in caring for preterm or full-term newborns at home helps health care teams develop appropriate support strategies and improve specialized assistance to the families.
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Affiliation(s)
- Agnes Flórida Santos da Cunha
- Universidade Federal de Minas Gerais, Av. Antônio Carlos 6627, Campus Pampulha, Belo Horizonte 31270-901, MG, Brazil
| | - Marina de Brito Brandão
- Department of Occupational Therapy, Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Av. Antônio Carlos 6627, Campus Pampulha, Belo Horizonte 31270-901, MG, Brazil
| | - Ana Paula Bensemann Gontijo
- Department of Physical Therapy, Universidade Federal de Minas Gerais, Av. Antônio Carlos 6627, Campus Pampulha, Belo Horizonte 31270-901, MG, Brazil
| | - Débora Marques de Miranda
- Departament of Medicine, Universidade Federal de Minas Gerais, , Av. Antônio Carlos 6627, Campus Pampulha, Belo Horizonte 31270-901, MG, Brazil
| | | | - Marisa Cotta Mancini
- Department of Occupational Therapy, Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Av. Antônio Carlos 6627, Campus Pampulha, Belo Horizonte 31270-901, MG, Brazil.
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Howden A, McFerran KS, Thompson GA. Reflective Lullaby Writing with two mother--infant dyads who recently experienced an admission to a neonatal intensive care unit. NORDIC JOURNAL OF MUSIC THERAPY 2022. [DOI: 10.1080/08098131.2022.2115531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Amy Howden
- The Faculty of Fine Arts and Music, University of Melbourne, Melbourne, Australia
| | | | - Grace Anne Thompson
- The Faculty of Fine Arts and Music, University of Melbourne, Melbourne, Australia
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Epstein S, Elefant C, Ghetti C. Israeli Parents' Lived Experiences of Music Therapy With Their Preterm Infants Post-Hospitalization. J Music Ther 2022; 59:239-268. [PMID: 35661217 DOI: 10.1093/jmt/thac006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
In the current study, we aimed to explore the lived experience of Israeli parents who engaged in musical dialogues with their preterm infants during music therapy (MT) after being discharged from the neonatal intensive care unit (NICU), as a part of the multinational LongSTEP RCT. Seven participants of the main trial were invited to engage in semi-structured in-depth interviews intertwining listening to audio recordings from their music therapy sessions in an adapted interpersonal process recall (IPR) procedure. The interviews were transcribed and analyzed using interpretative phenomenological analysis (IPA). We understood the participants' experiences to reflect two main themes: 1) Music therapy as a potential means of transformation in communication skills, resourcefulness and sense of agency; and 2) emotional and musical preconditions for parental engagement in MT. The findings illustrate how a specific group of Israeli parents experienced MT as offering them a means of expanding their relationship with their preterm infants after discharge. Based on our findings, we recommend that music therapists consider parents' musical and emotional resources during post-discharge MT to meet the individual needs of families.
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Affiliation(s)
- Shulamit Epstein
- School for Creative Arts Therapies, University of Haifa, Haifa, Israel
| | - Cochavit Elefant
- School for Creative Arts Therapies, University of Haifa, Haifa, Israel
| | - Claire Ghetti
- The Grieg Academy-Department of Music, University of Bergen, GAMUT, Bergen, Norway
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Gralton KS, Doering J, Ngui E, Pan A, Schiffman R. Family resiliency and family functioning in Non-Hispanic Black and Non-Hispanic White families of preterm infants. J Pediatr Nurs 2022; 64:102-110. [PMID: 35248955 DOI: 10.1016/j.pedn.2022.02.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 02/06/2022] [Accepted: 02/17/2022] [Indexed: 11/15/2022]
Abstract
PURPOSE The purpose of this study was to examine the relationship between resiliency factors and family functioning in families of preterm infants (< 37 weeks gestation) from two different racial groups hospitalized in a neonatal intensive care unit (NICU). DESIGN AND METHODS A cross-sectional design was used at five Level III/IV NICUs in a Midwestern city/suburbs. Seventy-nine family units (24 Non-Hispanic Black and 55 Non-Hispanic White) completed four instruments that assessed families' use of specific resiliency factors and a measure of family functioning. Demographic data were also collected. RESULTS Using linear mixed modeling, the significant predictors of family functioning for both Non-Hispanic Black and Non-Hispanic White, even after adjusting for education, income and race, were the protective factors "hardiness" (coefficient = -0.021) and "resources" (coefficient = -0.0052). The fixed effects in the model accounted for 48% (Marginal R2 = 0.48) of the variance on family functioning and the fixed and random effects accounted for 59% (Conditional R2, 0.59) of the variance on family functioning. Sixteen percent of the total sample rated their family as dysfunctional. CONCLUSIONS Findings from this study suggest that assessment of protective factors related to hardiness and resources individualize nursing interventions to support the resiliency of both Non-Hispanic Black and Non-Hispanic White families, regardless of differences in income and education. Further research studying resiliency in families of preterm infants is needed to understand the impact on long-term family functioning. PRACTICE IMPLICATIONS Understandingindividual family strengths,through the identification of resiliency (protective and recovery) factors could predict at-risk families before discharge. In collaboration with other health care professionals, nurses can assess individual family needs and strengths, within the context of their socioeconomic environment, and the racial and cultural influences that are important to the family.
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Affiliation(s)
| | - Jennifer Doering
- College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Emmanuel Ngui
- School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Amy Pan
- Medical College of Wisconsin, WI, USA
| | - Rachel Schiffman
- College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
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Development and validation of a self-reported questionnaire to assess occupational balance in parents of preterm infants. PLoS One 2021; 16:e0259648. [PMID: 34780508 PMCID: PMC8592439 DOI: 10.1371/journal.pone.0259648] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 10/23/2021] [Indexed: 12/30/2022] Open
Abstract
Background Parents’ meaningful activities (occupations) and occupational balance are relevant to neonatal care. Valid and reliable self-reported measurement instruments are needed to assess parents’ occupational balance and to evaluate occupational balance interventions in neonatal care. The aims of this study were to develop a self-reported questionnaire on occupational balance in informal caregivers (OBI-Care) and to examine its measurement properties including construct validity and internal consistency. Methods and findings A mixed method multicenter study design was employed. Items of the OBI-Care were created with parents of preterm infants based on qualitative research methods. Measurement properties were analyzed with quantitative data of parents of preterm infants. Construct validity was assessed by determining dimensionality, overall and item fit to a Rasch model, differential item functioning and threshold ordering. Internal consistency was examined by determining inter-item and item-total correlations, Cronbach’s alpha and Rasch’s person separation index. Fourteen parents participated in item creation. Measurement properties were explored in data of 304 parents. Twenty-two items, summarized in three subscales were compiled to the OBI-Care. Items showed an overall fit and except one item, an item fit to the Rasch model. There was no evidence of differential item functioning and all items displayed ordered thresholds. Each subscale had good values of person separation indices and Cronbach’s alpha. Conclusions The OBI-Care demonstrates construct validity and internal consistency and is thus a suitable measurement instrument to assess occupational balance of parents of preterm infants in neonatal care. OBI-Care is generic and can be applied in various health care settings.
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Abstract
BACKGROUND A successful transition from the neonatal intensive care unit to home is fundamental for the long-term health and well-being of preterm infants; however, the process parents' experience during their transition home is poorly understood. An improved understanding of this concept will allow nurses to offer families comprehensive and collaborative discharge preparation. PURPOSE To describe the defining attributes, antecedents, and consequences for the concept of transition in the context of the neonatal intensive care unit to home. METHODS Databases, MEDLINE, CINAHL, PsycINFO, and EMBASE were searched for articles containing "transition" in combination with "neonatal intensive care unit" or variants of these terms. The Walker and Avant method was used for this concept analysis. RESULTS The defining attributes of transition in the context of the neonatal intensive care unit to home are "mix of emotions," "uncertainty," and "coming into parenthood." The principal antecedent is "hospital discharge preparation" and consequences include "feeding and medical needs," "family life changes," and "parental confidence." IMPLICATIONS FOR PRACTICE Gradually increasing parents' participation in their infant's care and forming a partnership and collaborative plan with families will help ease the uncertainty parents experience during their transition home. IMPLICATIONS FOR RESEARCH Further investigation is needed to determine how best to provide emotional support for parents during their transition home and to explore a feasible option for neonatal nurses to follow up with parents after hospital discharge.
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Mothers' experiences of caring for preterm babies at home: qualitative insights from an urban setting in a middle-income country. BMC Pregnancy Childbirth 2021; 21:395. [PMID: 34016064 PMCID: PMC8136128 DOI: 10.1186/s12884-021-03872-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 05/10/2021] [Indexed: 12/18/2022] Open
Abstract
Background Preterm delivery is the birth of a baby before 37 weeks of gestation. This global phenomenon is a critical issue of concern especially in developing countries that are resource-constrained when it comes to the management of preterm babies. Complications associated with prematurity contribute significantly to under-five mortality and are linked with feelings of despair, grief, and anxiety among mothers. Methods This was a qualitative descriptive study in an urban setting in the Greater Accra region of Ghana. Eleven mothers whose babies had been discharged from the neonatal intensive care unit in a major hospital and resided in Accra were interviewed in their homes using a semi-structured interview guide. Data were audiotaped, transcribed verbatim, and analyzed inductively by content analysis. Results All the mothers had formal education and the mean maternal age was 27.9 years. The majority of the mothers were multiparous. The gestational age at birth ranged from 32 to 34 weeks and the average birth weight of their babies was 1.61 kg. Four major themes emerged which included: Around the clock care; mothers’ self-perceptions and attitudes of significant others; mothers’ health and wellbeing; and support. Most of the mothers experienced physical exhaustion from the extra demands involved with care, had negative emotions, and unmet social needs. Conclusions The findings indicate that home management of preterm babies poses multiple stressors and is associated with poor psychological and physical wellbeing among mothers. Hence, the need for extensive education and identification of other social support systems to augment facility-based care for mothers and their preterm babies. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-03872-9.
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Green J, Fowler C, Petty J, Whiting L. The transition home of extremely premature babies: An integrative review. ACTA ACUST UNITED AC 2021. [DOI: 10.1016/j.jnn.2020.09.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Mathiolli C, Ferrari RAP, Parada CMGDL, Zani AV. O cuidado paterno ao filho prematuro no ambiente domiciliar: representações maternas. ESCOLA ANNA NERY 2021. [DOI: 10.1590/2177-9465-ean-2020-0298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumo Objetivo Apreender as representações maternas frente à participação dos pais, que foram capacitados ou não por meio de um protocolo de cuidados na unidade neonatal, em relação aos cuidados com o filho prematuro no ambiente domiciliar. Método Pesquisa qualitativa realizada com mães de prematuros em que os companheiros participaram ou não do protocolo de cuidados ao filho no ambiente hospitalar. A análise foi realizada por meio do Discurso do Sujeito Coletivo. Resultados Participaram 24 mães, cujos companheiros de 13 realizaram cuidados e 11 não. Surgiram seis ideias centrais e duas ancoragens que foram agrupadas em dois temas: Cuidado paterno no ambiente hospitalar e suas repercussões no cuidado domiciliar; Barreiras para o cuidado paterno. Conclusão e Implicações para a Prática As mães representam a participação paterna como positiva, principalmente aquelas cujos companheiros participaram do protocolo. Porém, observou-se que em algumas situações a não participação paterna estava relacionada com influências culturais e/ou barreiras maternas. Além disso, referiram que o retorno ao trabalho e o medo paterno foram barreiras para o cuidado, independentemente da participação ou não do pai no protocolo. A inserção paterna no cuidado ao filho prematuro no ambiente hospitalar é essencial para a melhoria do cuidado ao bebê e sua família.
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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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Lee JY, Lee JH, Yeon GM, Jung YJ. Parental anxiety regarding premature infants and factors affecting parental concern. J SPEC PEDIATR NURS 2019; 24:e12266. [PMID: 31513350 DOI: 10.1111/jspn.12266] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 06/25/2019] [Accepted: 07/12/2019] [Indexed: 01/22/2023]
Abstract
PURPOSE Premature births have a great impact on the parents. The purpose of this study was to investigate the anxieties of parents of premature infants regarding infantile diseases and to help medical staff better communicate with parents of premature infants. DESIGN AND METHODS This study included premature infants <37 weeks of age who were admitted to the Neonatal Intensive Care Unit of Kosin University Gospel Hospital between August 1, 2017, and December 31, 2017. The eligible subjects included 51 premature infants with their 75 parents (45 mothers and 30 fathers) listed in the children's medical records. Parental anxieties regarding the infants were determined by retrospective interviews at various time points as follows: before and after the birth, on postnatal Days 3 and 7, before discharge, in the first week after discharge, and at "whenever" time point. RESULTS The highest parental anxiety during all time points was regarding the respiratory system of the premature infants. Parental concerns regarding the metabolic-endocrine system of their infants significantly correlated with the presence of maternal diabetes mellitus. Parental anxiety significantly differed depending on the use of resuscitation after birth. A statistically significant difference in parental anxiety was observed in relation to the birth weight before discharge. The premature infants with bronchopulmonary dysplasia showed a significant difference in the level of parental anxiety concerning the infant's illness in the first week after discharge. CONCLUSIONS The parents of the premature infants were greatly concerned about their infants' respiratory system. Careful prenatal counseling and support are needed for mothers with diabetes.
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Affiliation(s)
- Ju Yun Lee
- Department of Pediatrics, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Korea
| | - Jung Hyun Lee
- Department of Pediatrics, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Korea
| | - Gyu Min Yeon
- Department of Pediatrics, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Korea
| | - Yu Jin Jung
- Department of Pediatrics, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Korea
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Abstract
BACKGROUND Few understand the experience of having an infant in the neonatal intensive care unit (NICU). This article provides a discussion about the importance of an annual reunion for former NICU infants, their families, and neonatal staff. PURPOSE The purpose of this article is to explain the impact of the NICU reunion on families and neonatal healthcare providers and describe the experience of organizing this reunion over the past 20 years. METHODS This is a description of how a NICU reunion was organized at a regional neonatal center. Graphic-designed invitations were e-mailed to NICU graduates, who previously agreed to being contacted, 2 months prior to the reunion date. Social media were utilized to publicize the event on the hospital's Web site. RESULTS At the reunion, parents and families introduced their NICU graduate to the neonatal staff who cared for them while hospitalized. Sometimes staff found it difficult to recognize the NICU graduates, who were toddlers or older. Parents were relaxed, expressing their appreciation for care received. IMPLICATIONS FOR PRACTICE The impact of seeing an infant, born at 24 weeks, now walking, talking, and running cultivates pride in the NICU healthcare team. The reunion adds a positive dimension to the work of NICU caregivers. Parents look forward to attending the reunion to reconnect with NICU staff and other NICU parents. IMPLICATIONS FOR RESEARCH Directions for future study include a comparison of staff and families who attend the NICU reunion and those who do not, by using a survey or online evaluation tool, to improve future reunions.
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O'Donovan A, Nixon E. "Weathering the storm:" Mothers' and fathers' experiences of parenting a preterm infant. Infant Ment Health J 2019; 40:573-587. [PMID: 31044448 DOI: 10.1002/imhj.21788] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Parenting preterm infants is a unique experience distinct from parenting full-term infants, characterized by a delayed transition to parenthood and limited caregiving opportunities. This study explored mothers' and fathers' lived experiences of parenting during infancy in the context of preterm birth. Semistructured qualitative interviews were conducted with 13 parents (6 fathers, 7 mothers) of preterm infants. Data were analyzed using interpretative phenomenological analysis. Four superordinate themes emerged: (a) An unnatural disaster: The traumatic nature of preterm birth, (b) The immediate aftermath: Disconnected and displaced, (c) Breaking the ice: Moving from frozen to melted, and (d) Aftershocks: Transitioning home. Both parents experienced preterm birth as traumatic. Similarities and differences in mothers' and fathers' experiences were identified. Preterm birth posed challenges for nurturant and social caregiving and resulted in anxiety, hypervigilance, and overprotective parenting behavior. The results highlight the need for trauma-informed care and further research developing and testing empirically based interventions.
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Affiliation(s)
| | - Elizabeth Nixon
- School of Psychology, Trinity College Dublin, Dublin, Ireland
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Transition From Hospital to Home in Parents of Preterm Infants: Revision, Modification, and Psychometric Testing of the Questionnaire. J Nurs Meas 2018; 26:296-310. [PMID: 30567946 DOI: 10.1891/1061-3749.26.2.296] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE Transition from hospital to home in parents of prematurely born infants can be challenging. This methodological study aimed to develop an instrument to measure transitional problems in parents after hospital discharge. METHODS Kenner's Transition Questionnaire was modified based on findings of the literature review and a qualitative study. Content validity of the revised tool was determined by a panel of experts, and field testing was conducted via an online survey of parents of preterm infants (N = 704). Exploratory factor analysis (principal axis factoring and direct oblimin rotation) was performed. RESULTS Results showed four correlated factors in parental transition from hospital to home: Isolation, Worry, Confidence, and Professional Support (17 items total). Factor loadings ranged from .59 to .87, and reliability estimates ranged from .77 to .87. CONCLUSION The revised instrument demonstrated adequate psychometric characteristics; further testingand validation of the instrument is warranted.
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Petty J, Whiting L, Green J, Fowler C. Parents' views on preparation to care for extremely premature infants at home. Nurs Child Young People 2018; 30:e1084. [PMID: 29975481 DOI: 10.7748/ncyp.2018.e1084] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2018] [Indexed: 11/09/2022]
Abstract
AIM To gain insight into the post-discharge experiences of parents in relation to the adequacy of preparation for caring for extremely premature infants at home. METHOD A narrative approach was drawn on to facilitate data collection, through face-to-face semi-structured interviews with 14 parents of extremely premature infants. FINDINGS Constant comparative analysis was used to allow the emergence of five key research themes - emotional and mental health of parents, uncertain outcomes, ongoing health needs of the baby, educational needs of health professionals, and parental support and preparation for transition home. CONCLUSION Parental experience of being discharged home with a premature baby can be emotionally challenging and necessitates a range of support mechanisms to help them to cope with this period of transition. Health professionals can direct parents to appropriate counselling services, resources and peer support groups. Tailored education is needed for community-based health professionals, such as health visitors, to equip them to support parents practically and emotionally during the transition home and beyond. In addition, health professionals can learn much from parents about what is needed to support them.
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Affiliation(s)
- Julia Petty
- Department of nursing and social work, University of Hertfordshire, England
| | - Lisa Whiting
- University of Hertfordshire, Hertfordshire, England
| | - Janet Green
- University of Technology Sydney, New South Wales, Australia
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