1
|
Lee J. Neonatal family-centered care: evidence and practice models. Clin Exp Pediatr 2024; 67:171-177. [PMID: 37321589 PMCID: PMC10990654 DOI: 10.3345/cep.2023.00367] [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: 02/20/2023] [Revised: 05/16/2023] [Accepted: 06/07/2023] [Indexed: 06/17/2023] Open
Abstract
Although advances in neonatology have reduced the mortality rate of high-risk infants, sick newborns or pre-mature infants undergo more intensive monitoring, pain-ful procedures, and lengthy hospitalization, leading to pro-longed separation from their parents. In recent decades, the importance of parent-infant closeness early in life has become more apparent, especially in preterm infants who are prone to neurodevelopmental deficits. There is an increasing body of evidence regarding the benefits of family-centered care (FCC) in neonatal intensive care units. Key aspects related to neonatal FCC include the parents' presence in the ward and their participation in infants' daily care and decision-making processes. In addition, an environment that supports a private and comfortable space for each family member and infant, such as a single-family room, should be provided. To successfully implement FCC in neonatal intensive care units, the culture of care and hospital policies should be changed to successfully implement FCC in neonatal intensive care units, and appropriate training for medical staff is also required.
Collapse
Affiliation(s)
- Juyoung Lee
- Department of Pediatrics, Inha University Hospital, Inha University College of Medicine, Incheon, Korea
| |
Collapse
|
2
|
Brelsford GM, Doheny KK, Stoner J. A Systematic Review of Psycho-Spiritual Interventions in the NICU: Supporting Parents' Mental Health and Psychological Well-Being. Adv Neonatal Care 2024; 24:141-150. [PMID: 38547481 DOI: 10.1097/anc.0000000000001160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
BACKGROUND The presence of psychospiritual supports and interventions for neonatal intensive care unit (NICU) parents is unclear. PURPOSE This systematic review examines the psychological and medical literature for psychospiritual interventions designed to support parents' mental health and psychological well-being during or after the NICU experience. DATA SOURCES Data sources include PubMed, PsycINFO, and Cochrane Library (Cochrane Database of Systemic Reviews, Cochrane Central Register of Controlled Trials) with peer-reviewed studies published between 2013 and 2023. STUDY SELECTION Peer-reviewed studies that included spiritual and psychological intervention components focused on supporting parents during or after the NICU were included for this systematic review. There were 42 records located in 3 databases ultimately yielding 4 peer-reviewed studies that met inclusion criteria. Articles must have been written in English and evaluate parents'/caregivers' mental health/psychological well-being in relation to a psychospiritual intervention. DATA EXTRACTION Because of the small number of studies, article summaries are provided within the results section and were written by the first author with approval by the second and third authors. RESULTS Results indicated that when psychological (focus on coping) and spiritual components were included psychological and well-being outcomes were better for NICU parents. IMPLICATIONS FOR PRACTICE AND RESEARCH The inclusion of psychological and spiritual aspects of coping and supportive care is necessary for the best family-centered NICU care. More work needs to be done to develop psychospiritual supports and include fathers in these endeavors as most work occurs with mothers. Nurses need support and training to facilitate family-centered care with a focus on parents' psychospiritual needs.
Collapse
Affiliation(s)
- Gina M Brelsford
- Author Affiliations: Penn State Harrisburg, Middletown, Pennsylvania (Dr Brelsford); Penn State College of Medicine, Hershey, Pennsylvania (Dr Doheny); and Penn State Children's Hospital, Hershey, Pennsylvania (Ms Stoner)
| | | | | |
Collapse
|
3
|
Carew M, Redley B, Bloomer MJ. Competing Tensions: Nurse Perceptions of Family-Centered Care and Parents' Needs in Neonatal Care. Adv Neonatal Care 2024; 24:35-42. [PMID: 38193725 DOI: 10.1097/anc.0000000000001136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
BACKGROUND Family-centered care is founded upon collaboration between parents and healthcare professionals, caring for a child and parents as one entity. The unfamiliar neonatal environment and complexity of care can make family-centered care challenging. PURPOSE To explore neonatal nurses' perceptions of family-centered care and parents' cultural needs. METHODS This was a qualitative descriptive study using interviews to gather data from registered nurses, and analyzed using inductive content analysis. RESULTS Ten neonatal nurses participated in online interviews, lasting an average of 25 minutes. Parents' cultural needs were poorly understood and assumed synonymous with family-centered care. While all acknowledged the importance of family-centered care, most described tasks to parent-infant bonding, rather than a broader embodiment of family-centered care. In time of uncertainty, emergent clinical priorities took priority over a family-centered approach to care. Cultural care was poorly understood, and care tasks associated with supporting parent-infant bonding suggest further work is necessary to promote embodiment of family-centered care beyond individual tasks. While emergent clinical priorities and neonate well-being will always be the priority, finding a way to respond that concords with the ethos of family-centered care is also essential. IMPLICATIONS FOR PRACTICE AND RESEARCH Clear and consistent leadership is needed to demonstrate greater embodiment of family-centered care, which includes cultural care for parents. Strong leadership and targeted education are key to supporting this change. Further research is warranted to examine and observe practice, in particular how parents' cultural needs are assessed and integrated into family-centered care in neonatal settings.
Collapse
Affiliation(s)
- Maddison Carew
- Maternity Unit, Bass Coast Health, Wonthaggi, Victoria, Australia (Ms Carew); School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia (Ms Carew and Prof Redley); Health Complaints Commissioner, Melbourne, Victoria, 3000, Australia (Prof Redley); and School of Nursing and Midwifery, Griffith University, Nathan, Queensland, and Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, and Intensive Care Unit, Princess Alexandra Hospital, Metro South Health, Woolloongabba, Queensland, Australia (Prof Bloomer)
| | | | | |
Collapse
|
4
|
Cuervo S, Creaghead N, Vannest J, Hunter L, Ionio C, Altaye M, Parikh NA. Language Outcomes of Children Born Very Preterm in Relation to Early Maternal Depression and Anxiety. Brain Sci 2023; 13:1355. [PMID: 37891724 PMCID: PMC10605035 DOI: 10.3390/brainsci13101355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/15/2023] [Accepted: 09/20/2023] [Indexed: 10/29/2023] Open
Abstract
Unaddressed maternal psychological distress within the first year postpartum is known to have numerous negative consequences on the child's developmental outcomes, including language acquisition. This study examined the relationship between early maternal psychosocial factors and the language outcomes of children born very preterm (VPT; ≤32 weeks gestational age). It used data from the Cincinnati Infant Neurodevelopment Early Prediction Study, an ongoing National-Institutes-of-Health-funded prospective, multicenter cohort investigation of VPT infants. A total of 243 (125 boys; 118 girls) children born VPT (M = 29.03 weeks of gestation; SD = 2.47) and their corresponding 207 mothers (34 with multiple infants) were included in this study. We did not find an association between maternal depression or anxiety and Bayley-III (M = 92.3, SD = 18.9) language scores. Additionally, maternal grit and self-efficacy did not modify the relationship between depression and anxiety and language scores. A higher level of maternal education and infant female sex were significantly associated with higher language scores. While preterm birth typically results in higher rates of depression and anxiety for parents, the findings suggest that maternal depression, anxiety, and grit and the self-efficacy of the mothers in this sample did not relate to the language development of their children, independent of maternal education and infant female sex.
Collapse
Affiliation(s)
- Sisan Cuervo
- Department of Communication Sciences and Disorders, University of Cincinnati, Cincinnati, OH 45267, USA; (S.C.); (N.C.); (J.V.)
- Communication Sciences Research Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Nancy Creaghead
- Department of Communication Sciences and Disorders, University of Cincinnati, Cincinnati, OH 45267, USA; (S.C.); (N.C.); (J.V.)
| | - Jennifer Vannest
- Department of Communication Sciences and Disorders, University of Cincinnati, Cincinnati, OH 45267, USA; (S.C.); (N.C.); (J.V.)
- Communication Sciences Research Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
- Center for Prevention of Neurodevelopmental Disorder, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA; (M.A.); (N.A.P.)
| | - Lisa Hunter
- Department of Communication Sciences and Disorders, University of Cincinnati, Cincinnati, OH 45267, USA; (S.C.); (N.C.); (J.V.)
- Communication Sciences Research Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
- Center for Prevention of Neurodevelopmental Disorder, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA; (M.A.); (N.A.P.)
| | - Chiara Ionio
- Department of Psychology, Catholic University of the Sacred Heart, 00168 Milano, Italy;
| | - Mekibib Altaye
- Center for Prevention of Neurodevelopmental Disorder, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA; (M.A.); (N.A.P.)
- Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Nehal A. Parikh
- Center for Prevention of Neurodevelopmental Disorder, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA; (M.A.); (N.A.P.)
- Perinatal Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA
| |
Collapse
|
5
|
Akkaş N, Geçkil E. Family-Centered Care Scale in Neonatal Intensive Care Unit (FCCS-NICU): Development and psychometrics evaluation. J Pediatr Nurs 2023; 72:168-176. [PMID: 36517315 DOI: 10.1016/j.pedn.2022.11.031] [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: 05/25/2022] [Revised: 11/29/2022] [Accepted: 11/29/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE The study was conducted to develop FCC Scale in Neonatal Intensive Care Units (FCCS-NICU) and to test its validity and reliability. METHODS This methodological study was conducted with 484 mothers whose neonates were hospitalized in the NICU of four different hospitals in Konya, Turkey. Data were collected with the mother and neonate information form and FCCS-NICU, and analyzed with Items Analysis, Cronbach's alpha, Exploratory Factor Analysis, and Confirmatory Factor Analysis tests. RESULTS A 48-item pool was created for the draft FCCS-NICU based on the family-centered care model. The Content Validity Index of the scale was found to be popular opinion 0.95. In the Exploratory Factor Analysis, a four-factor structure with 29 items emerged. These four factors explained 53.23% of the total variance. The subscales were named dignity and respect (7 items), information sharing (9 items), participation in care (5 items), and collaboration with the family (8 items). The parallel form correlation coefficient was 0.80, the test-retest correlation coefficient was 0.76 (p < .001). The Cronbach's Alpha was found 0.94 for a total scale. The Confirmatory factor analysis confirmed the four-factor structure. CONCLUSIONS We provide a valid and reliable scale to evaluate FCC and associated factors in NICU. FCCS-NICU can be used as a tool in descriptive research to assess FCC and identify associated factors. PRACTICE IMPLICATION It can be used as a tool in experimental studies to develop FCC.
Collapse
Affiliation(s)
- Neslihan Akkaş
- Neonatal Intensive Care Unit of Konya City Hospital, Konya, Turkey
| | - Emine Geçkil
- Department of Pediatric Nursing, Nursing Faculty, Necmettin Erbakan University, Konya, Turkey.
| |
Collapse
|