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Ropero-Padilla C, Rodriguez-Arrastia M, Bernabé-Zuñiga JE, Alias Castillo AJ, Rueda-Ruzafa L, Del Mar Sánchez-Joya M. Experiences of parents with very premature-born children at risk of neurodevelopmental disorders: A qualitative study. Nurs Crit Care 2024. [PMID: 39385349 DOI: 10.1111/nicc.13182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Revised: 09/05/2024] [Accepted: 09/21/2024] [Indexed: 10/12/2024]
Abstract
BACKGROUND Premature birth is a traumatic and stressful situation for parents who are immediately separated from their infant because of the newborn's need for specialized care. The staff of these units are in charge of following the principles of family-centred care and practices for neonates at risk of neurodevelopmental disorders, including providing training to the family during their hospital stay and after being discharged. AIMS The aim of this study is to explore the perceptions of parents of premature children at risk of neurodevelopmental disorders in regard to care, interventions and assistance provided during the first months of their child's life. STUDY DESIGN A qualitative descriptive study was carried out through individual interviews. The data analysis was conducted through a thematic analysis. The methodology and results were reported following the standards for preparing qualitative research reports and recommendations. RESULTS Twenty-one parents of premature children were interviewed. From these interviews, three main themes emerged: (i) parents' perspectives on preterm birth risk communication, (ii) navigating parental support and early interventions in preterm birth and (iii) perceptions of preterm birth protective and challenging factors. CONCLUSIONS The parents of premature children need to receive better communication about the care and interventions for their child, and it is necessary that health personnel are better trained in terms of management and administration of public resources. Strategies must be implemented that continuously guide parents on the follow-up and care of their premature child not only during their first moments of life but also after being discharged from the hospital. RELEVANCE TO CLINICAL PRACTICE This study highlights the need to improve care for parents with premature infants at risk, emphasizing the necessity for health care system reforms and support structures, allowing health care professionals to enhance attention and care.
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Affiliation(s)
- Carmen Ropero-Padilla
- Department of Nursing Science, Physiotherapy and Medicine, Faculty of Health Sciences, University of Almeria, Almeria, Spain
- Research Group CTS-1114 Advances and Innovation in Health, University of Almeria, Almeria, Spain
- ScienceFlows, Universitat de València, Valencia, Spain
| | - Miguel Rodriguez-Arrastia
- Department of Nursing Science, Physiotherapy and Medicine, Faculty of Health Sciences, University of Almeria, Almeria, Spain
- Research Group CTS-1114 Advances and Innovation in Health, University of Almeria, Almeria, Spain
- ScienceFlows, Universitat de València, Valencia, Spain
| | - José Enrique Bernabé-Zuñiga
- Department of Nursing Science, Physiotherapy and Medicine, Faculty of Health Sciences, University of Almeria, Almeria, Spain
| | - Antonio Javier Alias Castillo
- Department of Nursing Science, Physiotherapy and Medicine, Faculty of Health Sciences, University of Almeria, Almeria, Spain
| | - Lola Rueda-Ruzafa
- Department of Nursing Science, Physiotherapy and Medicine, Faculty of Health Sciences, University of Almeria, Almeria, Spain
- Research Group CTS-1114 Advances and Innovation in Health, University of Almeria, Almeria, Spain
| | - María Del Mar Sánchez-Joya
- Department of Nursing Science, Physiotherapy and Medicine, Faculty of Health Sciences, University of Almeria, Almeria, Spain
- HUM-061 Experimental and Applied Neuropsychology, University of Almeria, Almeria, Spain
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Eriksson E, Lundqvist P, Jönsson L. Fathers' Experiences Six Months After their Preterm Infant's Discharge from the NICU. Compr Child Adolesc Nurs 2024:1-10. [PMID: 39320934 DOI: 10.1080/24694193.2024.2406209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 08/24/2024] [Indexed: 09/26/2024]
Abstract
Although fathers experience emotional stress both during the care period and after discharge, there is limited research focusing exclusively on fathers' experiences after their time in a neonatal intensive care unit. Their experiences are important for tailoring support to fathers based on their individual needs. This paper is part of a longitudinal study in which parents were followed by means of questionnaires and individual interviews during a two-year period after discharge from hospital-based neonatal home care. A qualitative content analysis with an inductive approach was used to elucidate the experiences of fathers six months after their preterm infant's discharge. Twelve fathers participated in the study. The following categories emerged and constituted the result: "Vivid memories from the NICU," "Struggling with new challenges in life" and "Transition to home still in their thoughts." The approach and attitude of health-care professionals may contribute to fathers' involvement during the care period, as fathers tend to set their own feelings aside.
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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] [Track Full Text] [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.
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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)
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Merritt L, Verklan MT. A Feasibility Study to Test the NICU Paternal Needs Inventory. Adv Neonatal Care 2024; 24:86-93. [PMID: 38096431 DOI: 10.1097/anc.0000000000001121] [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: 01/26/2024]
Abstract
BACKGROUND There has been little research exploring paternal needs while experiencing a neonatal intensive care unit (NICU) stay. Some tools exist to measure paternal needs, but do not incorporate items to capture important information about how fathers cope with stress differently, and may have different needs. Therefore, an instrument is needed to measure and prioritize what needs are important to fathers to help facilitate the development of nursing interventions to help fathers cope with the NICU environment. PURPOSE The purpose of this study was to conduct a feasibility study before large-scale pilot testing the instrument, the NICU Paternal Needs Inventory (NPNI), so we could then determine what are the physical, emotional, and psychological needs of fathers. METHODS A nonexperimental, quantitative, and descriptive design was used to address the study's aims. Fathers were recruited from a level IV NICU and asked to complete an online survey (consisting of a demographic survey and the NPNI). RESULTS Needs rated 100% were knowing infant's progress, directions on caring for infant, flexible visitation, and assurance receiving the best care. The remainder showed a wide range of responses suggesting that needs of fathers are individual and varied. IMPLICATIONS FOR PRACTICE AND RESEARCH Use of the NPNI to evaluate a father's unique and individual needs would allow for the nurse to develop father-specific, individualized interventions. Findings support that the NPNI is feasible to accomplish measuring fathers' needs, but a larger study is needed to test the reliability and validity of this tool.
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Affiliation(s)
- Linda Merritt
- Quinnipiac University, North Haven, Connecticut (Dr Merritt); Texas Woman's University, Dallas (Dr Merritt); and The University of Texas Medical Branch, Galveston (Dr Verklan)
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Ettenberger M, Bieleninik Ł, Stordal AS, Ghetti C. The effect of paternal anxiety on mother-infant bonding in neonatal intensive care. BMC Pregnancy Childbirth 2024; 24:55. [PMID: 38212696 PMCID: PMC10782755 DOI: 10.1186/s12884-023-06179-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 12/06/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND The hospitalization of a preterm infant in the NICU can lead to mental health difficulties in parents, but not much is known how paternal anxiety might affect the mother-infant relationship. METHODS This prospective cohort study is a secondary analysis investigating how paternal anxiety levels might affect maternal bonding in the NICU using the dataset of the multinational pragmatic randomized controlled trial LongSTEP. A linear mixed-effects model was used for correlations of paternal anxiety (GAD-7) and maternal bonding (PBQ) at NICU discharge, and at 6 and 12 months infant corrected age. Secondary analyses examined effects on paternal anxiety related to: site (Argentina, Colombia, Israel, Norway, and Poland), maternal depression (EPDS), infant gestational age at birth, paternal age, and type of pregnancy. RESULTS Paternal anxiety did not predict maternal bonding at NICU discharge (p = 0.096), at 6 months (p = 0.316), or at 12 months infant corrected age (p = 0.473). Secondary outcomes showed a statistically significant site effect, with higher paternal anxiety levels at the two Colombian sites at baseline (p = 0.014 and p = 0.020) and for one site at discharge (p = 0.012), but not for paternal age (p = 0.925 and p = 0.793), infant gestational age at birth (p = 0.974 and p = 0.686 and p = 0.340), or type of pregnancy (p = 0.381). Maternal depression predicted paternal anxiety at baseline (p < 0.001) and at discharge (p = 0.003). CONCLUSIONS In this study, paternal anxiety did not predict maternal bonding. Paternal anxiety varied by site, indicating a need for research on potential cultural differences in manifestation of paternal anxiety. Maternal depression predicted paternal anxiety, confirming a previously reported correlation. Further research on variations in paternal mental health in the neonatal period is warranted, as well as exploration of the social contagion of mental health in preterm parents. TRIAL REGISTRATION ClinicalTrials.gov NCT03564184.
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Affiliation(s)
- Mark Ettenberger
- Music Therapy Service, Department of Social Management, Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Music Therapy Service, Clínica de la Mujer, Bogotá, Colombia
- SONO - Centro de Musicoterapia, Bogotá, Colombia
| | - Łucja Bieleninik
- Institute of Psychology, Faculty of Social Sciences, University of Gdańsk, Gdańsk, Poland
- GAMUT - The Grieg Academy Music Therapy Research Centre, NORCE Norwegian Research Centre AS, Bergen, Norway
- Institute of Pedagogy and Languages, University of Applied Sciences, Elbląg, Poland
| | - Andreas Størksen Stordal
- NORCE Technology, NORCE Norwegian Research Centre AS, Bergen, Norway
- Department of Mathematics, University of Bergen, Bergen, Norway
| | - Claire Ghetti
- GAMUT - The Grieg Academy Music Therapy Research Centre, NORCE Norwegian Research Centre AS, Bergen, Norway.
- Dept. of Music, GAMUT - The Grieg Academy Music Therapy Research Centre, The Grieg Academy, University of Bergen, Bergen, Norway.
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Horner S, Benbrook K, Hoffman M, Libutti L. Implementing Guidelines for NICU Parent Presence: Effects on Parent and Infant Stress. J Perinat Neonatal Nurs 2023:00005237-990000000-00024. [PMID: 37967272 DOI: 10.1097/jpn.0000000000000776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
BACKGROUND Relationships between parents and infants are essential for mitigating stressors encountered in neonatal intensive care units (NICUs) and are supported by parent presence and engagement. PURPOSE The purpose of this study was to compare NICU parent and infant outcomes pre- and postimplementation of an intervention aimed at increasing parent presence and engagement in the NICU. This family-centered care intervention consisted of communicating specific guidelines for parent presence. METHODS Data related to parent presence, skin-to-skin care, and breastfeeding; parental stress; infant outcomes including weight gain, length of stay, feeding status at discharge, and stress; and unit-level outcomes were collected from a convenience sample of 40 NICU families recruited preimplementation and compared with data for 38 NICU families recruited postimplementation of specific guidelines for parent presence. To establish comparability of groups, infants were assigned scores using the Neonatal Medical Index. RESULTS Parent presence, engagement in skin-to-skin care, and breastfeeding rates were not significantly different between groups. Stress-related outcomes were significantly decreased in NICU mothers, fathers, and infants, and infant feeding outcomes were improved in the postintervention group. CONCLUSIONS Specific guidelines for parent presence may represent an invitation for parents to engage with their NICU infants and may positively impact parent and infant stress.
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Affiliation(s)
- Susan Horner
- Neonatal Intensive Care Unit, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
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Risanger LI, Kofoed PE, Noergaard B, Vahlkvist S. Parents’ Perception of Staff Support in a Father-Friendly Neonatal Intensive Care Unit. CHILDREN 2023; 10:children10040673. [PMID: 37189922 DOI: 10.3390/children10040673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/30/2023] [Accepted: 03/30/2023] [Indexed: 04/05/2023]
Abstract
Healthcare professionals, especially nurses, play a central role in supporting parents during their stay in neonatal intensive care units (NICUs). Fathers often have their own support needs; however, studies have shown that these needs are rarely met to the same degree as those of the mothers. We developed a “father-friendly NICU” with the aim of providing good-quality care to the entire family. To evaluate the impact of this concept, we adopted a quasi-experimental design; using the Nurse Parent Support Tool (NPST), we investigated the differences in the fathers’ (n = 497) and mothers’ (n = 562) perception of the nursing support received on admission and discharge between before and after the intervention. In the historical control and intervention groups, the fathers’ median NPST scores at admission were 4.3 (range, 1.9–5.0) and 4.0 (range, 2.5–4.8), respectively (p < 0.0001); at discharge, these scores were 4.3 (range, 1.6–5.0) and 4.4 (range, 2.3–5.0), respectively (difference not significant). In the historical control and intervention groups, the mothers median NPST scores at admission were 4.5 (range, 1.9–5.0) and 4.1 (range, 1.0–4.8), respectively (p < 0.001); at discharge, these scores were 4.4 (range, 2.7–5.0) and 4.4 (range, 2.6–5), respectively (difference not significant). The parental perception of support did not increase after the intervention; however, the parents reported a high level of staff support both before and after the intervention. Further studies should focus on parental support needs during the different phases of hospitalization (i.e., admission, stabilization, and discharge).
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Affiliation(s)
- Linn Iren Risanger
- Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital, University Hospital of Southern Denmark, Sygehusvej 24, 6000 Kolding, Denmark
- H.C. Andersens Children’s Hospital, Odense University Hospital, 5000 Odense, Denmark
| | - Poul-Erik Kofoed
- Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital, University Hospital of Southern Denmark, Sygehusvej 24, 6000 Kolding, Denmark
- Department of Regional Health Research, University of Southern Denmark, 5000 Odense, Denmark
| | - Betty Noergaard
- Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital, University Hospital of Southern Denmark, Sygehusvej 24, 6000 Kolding, Denmark
| | - Signe Vahlkvist
- Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital, University Hospital of Southern Denmark, Sygehusvej 24, 6000 Kolding, Denmark
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Akgül Gündoğdu N, Temel Mert Z, Gündüz ES. Not being able to hug our baby before the cables: Early experiences of parents with premature babies. Nurs Forum 2022; 57:1193-1203. [PMID: 36308316 DOI: 10.1111/nuf.12822] [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: 02/23/2022] [Revised: 10/10/2022] [Accepted: 10/10/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The nursing care provided after the intensive care period and discharge can contribute to the optimal growth and development of the baby while protecting the mental health of the parents. OBJECTIVE The aim of this study is to examine in detail the experiences of parents with premature babies about having a premature baby and their experiences with the hospitalization process of their babies in the neonatal intensive care unit (NICU). DESIGN The methodological approach was informed by Van Manen's hermeneutic phenomenological methodology. The sample consisted of 15 parents who had a preterm baby in the NICU of a state hospital in Turkey. RESULTS The data obtained from this study were categorized under four themes: having a preterm baby, perception of intensive care, feelings toward nurses, emotions about discharge and home care. CONCLUSIONS Health professionals should know what the parents' perception of being a parent and having a premature baby is.
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Affiliation(s)
- Nurcan Akgül Gündoğdu
- Department of Public Health Nursing, Faculty of Health Science, Bandirma Onyedi Eylul University, Bandirma, Balıkesir, Turkey
| | - Zeynep Temel Mert
- Department of Child Health and Disease Nursing, School of Suşehri Health, University of Sivas Cumhuriyet, Sivas, Turkey
| | - Emine Selda Gündüz
- Department of Medical Services and Techniques, Vocational School of Health Services, First and Emergency Aid Programme, Akdeniz University, Antalya, Turkey
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Abstract
BACKGROUND Neonatal intensive care unit (NICU) nurses need a better understanding of fathers' needs and perceptions in order to provide more family holistic care. Previous research aimed at exploring fathers' experiences in the NICU resulted in identifying some needs; however, these studies mostly occurred outside the United States where practices may differ. Therefore, research is needed to explore NICU fathers' needs within the United States. PURPOSE The purpose of this study was to explore the needs of fathers who previously had a premature infant in the NICU. METHODS This qualitative descriptive study used semistructured interviews collected to obtain in-depth knowl-edge of fathers' needs in the NICU. Twenty-eight fathers were recruited through 3 parent support organizations: Hand to Hold, NICU Parent Support Network, and March of Dimes. RESULTS Results revealed 3 themes: need for support, clarity and to be recognized. IMPLICATIONS FOR PRACTICE Fathers have specific needs in the NICU that need to be addressed and that may differ from mothers. Awareness of addressing fathers' needs promotes more holistic care to fathers, supports coping within the NICU environment and the multifaceted impact of the experience, and helps them engage in the care of their infant. IMPLICATIONS FOR RESEARCH Further research is needed to explore the needs of fathers from diverse backgrounds and those who perceive to be or are less involved in their infant's care as well as their experiences and needs related to the recent COVID-19 pandemic. Comparative research is also needed to identify differences between mothers' and fathers' needs in order to determine interventions that promoting more holistic, family-centered care.
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