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Guez-Barber D, Pilon B. Parental impact during and after neonatal intensive care admission. Semin Perinatol 2024:151926. [PMID: 38964994 DOI: 10.1016/j.semperi.2024.151926] [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] [Indexed: 07/06/2024]
Abstract
Parents play a pivotal role in neurodevelopmental outcomes of their children in the neonatal intensive care unit (NICU) and beyond. Integration of parents in clinical care and research is synergistic. Engaged parents yield more comprehensive clinical care and more robust and meaningful research products. Subsequently, successful clinical and research efforts improve outcomes for children. We review strategies for parental integration into NICU clinical care and research, including parental involvement in therapeutic interventions and neurodevelopmental care, and effective communication strategies for clinicians and researchers. We discuss challenges in neonatal trials and emphasize the need for building a culture of research, collaborative partnerships with patient advocacy organizations, and ongoing support beyond the NICU. Overall, we call for recognizing and fostering the impactful role of parents as teammates with clinicians and researchers in optimizing neurodevelopmental outcomes in the NICU and beyond.
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Affiliation(s)
- Danielle Guez-Barber
- Instructor, Division of Neurology, Department of Pediatrics, The Children's Hospital of Philadelphia (CHOP), Philadelphia, PA 19104, USA; University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA.
| | - Betsy Pilon
- Executive Director, Hope for HIE, West Bloomfield, MI 48325, USA
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2
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Mooney S, Devagiri S, Puuri A, Naylor M, Bear K, Akpan US. Improving Parental Knowledge of Medically Complex Neonates Through Scheduled Conferences. Am J Med Qual 2024; 39:105-114. [PMID: 38683697 DOI: 10.1097/jmq.0000000000000180] [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: 05/02/2024]
Abstract
Reports of parental dissatisfaction from incomplete or inconsistent information led to a quality improvement (QI) project to establish planned family conferences at 10 days and 1 month of life, for 50% of the medically complex neonates admitted to a neonatal intensive care unit within 1 year. A QI team instituted a system in which social workers scheduled family conferences and a neonatologist conducted the conferences. Team members tracked measures using statistical process control charts over 21 months. The QI team scheduled conferences for greater than 80% of eligible families, with an 86% completion rate on days 10 and 30, exceeding project goals of 50%. The majority of the families surveyed were satisfied with the meetings. Only 2% of parents surveyed found meetings burdensome, compared to 14% of physicians. A sustainable method for scheduling meetings and preparation for conferences, including the use of a template led to success.
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Affiliation(s)
- Serena Mooney
- Department of Pediatrics, Brody School of Medicine at East Carolina University, Greenville, NC
| | - Sailaja Devagiri
- Department of Neonatology, East Carolina University Health Medical Center, Greenville, NC
| | - Angela Puuri
- Department of Neonatology, East Carolina University Health Medical Center, Greenville, NC
| | - Martha Naylor
- Department of Pediatrics, Brody School of Medicine at East Carolina University, Greenville, NC
| | - Kelly Bear
- Department of Pediatrics, Brody School of Medicine at East Carolina University, Greenville, NC
| | - Uduak S Akpan
- Department of Pediatrics, Brody School of Medicine at East Carolina University, Greenville, NC
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Bell EA, Rufrano GA, Traylor AM, Ohning BL, Salas E. Enhancing team success in the neonatal intensive care unit: challenges and opportunities for fluid teams. Front Psychol 2023; 14:1284606. [PMID: 38023000 PMCID: PMC10662301 DOI: 10.3389/fpsyg.2023.1284606] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 10/20/2023] [Indexed: 12/01/2023] Open
Abstract
Fluid teams, characterized by frequent changes in team membership, are vital in the neonatal intensive care unit (NICU) due to high patient acuity and the need for a wide range of specialized providers. However, many challenges can hinder effective teamwork in this setting. This article reviews the challenges related to fluid teamwork in the NICU and discusses recommendations from team science to address each challenge. Drawing from the current literature, this paper outlines three challenges that can hinder fluid teamwork in the NICU: incorporating patient families, managing hierarchy among team members, and facilitating effective patient handoffs. The review concludes with recommendations for managing NICU teamwork differently using strategies from team science.
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Affiliation(s)
| | | | | | - Bryan L. Ohning
- School of Medicine Greenville, University of South Carolina, Greenville, SC, United States
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Mernenko RK, Littlejohns A, Latchford G, Crouzen E, Moni-Nwinia W, Lakshminarayanan B, Chauhan H, Lawson E, McConachie D, McElwaine JG, Metcalfe F, Sagoo GS, McKechnie L, Sutcliffe J. Developing a method to capture parental experience in a neonatal surgical centre in the context of COVID-19: a qualitative study. BMJ Paediatr Open 2022; 6:10.1136/bmjpo-2022-001434. [PMID: 36053593 PMCID: PMC9288868 DOI: 10.1136/bmjpo-2022-001434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 05/19/2022] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Improved parental experience is related to improved mental and physical health outcomes for the infant. The COVID-19 pandemic abruptly impacted on healthcare delivery and services need information to shape how to manage the disruption and recovery. METHODS Our aim was to develop a systematic process to capture parents' experience of their neonatal surgical healthcare journey during the pandemic. We identified relevant stakeholders and using semistructured interviews, we explored three key themes.(1) How to recruit and collect data from representative parents?(2) What questions should be asked?(3) How to disseminate results for service development? RESULTS Responses indicated the need to involve 'difficult to access groups' (eg, first language not English, high social deprivation, low health literacy), defined the range of family and patient characteristics variables to be considered for representative responses (eg, antenatal diagnosis, disease complexity, number of siblings, single parent, parental health). The proposed questions were grouped into five main topics: information preadmission; in-patient experience; support during admission; the effect of COVID-19; discharge and posthospital experience. Recommendations for dissemination included local, regional and national fora as well as the need to feedback to participants about the changes made.Based on the analysis, we developed a semistructured interview which underwent cognitive testing, prepilot and pilot phase testing. DISCUSSION This protocol is grounded in the views of relevant stakeholders to ensure it captures relevant information in a pragmatic but methodologically sound way. It will next be used to assess parental experience in a large neonatal surgical unit. We hope that the protocol could be adapted and used by other groups.
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Affiliation(s)
- Rebecca Kate Mernenko
- Department of Paediatric Surgery, Leeds Children's Hospital, Leeds, West Yorkshire, UK
| | - Anna Littlejohns
- Department of Anaesthetics, Leeds Teaching Hospitals NHS Trust, Leeds, West Yorkshire, UK
| | - Gary Latchford
- University of Leeds, Leeds Institute of Health Sciences, Leeds, West Yorkshire, UK
| | - Emile Crouzen
- Department of Paediatric Surgery, Leeds Children's Hospital, Leeds, West Yorkshire, UK
| | - Waaka Moni-Nwinia
- Department of Paediatric Surgery, Leeds Children's Hospital, Leeds, West Yorkshire, UK
| | | | - Hemma Chauhan
- Leeds Children's Hospital, Leeds Centre for Newborn Care, Leeds, West Yorkshire, UK
| | - Elizabeth Lawson
- University of Leeds School of Medicine, Leeds, West Yorkshire, UK
| | | | - John G McElwaine
- Department of Anaesthetics, Leeds Teaching Hospitals NHS Trust, Leeds, West Yorkshire, UK
| | - Fiona Metcalfe
- Department of Paediatric Surgery, Leeds Children's Hospital, Leeds, West Yorkshire, UK
| | - Gurdeep Singh Sagoo
- Academic Unit of Health Economics, University of Leeds, Leeds Institute of Health Sciences, Leeds, West Yorkshire, UK
| | - Liz McKechnie
- Leeds Children's Hospital, Leeds Centre for Newborn Care, Leeds, West Yorkshire, UK
| | - Jonathan Sutcliffe
- Department of Paediatric Surgery, Leeds Children's Hospital, Leeds, West Yorkshire, UK
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Zanoni P, Scime NV, Benzies K, McNeil DA, Mrklas K. Facilitators and barriers to implementation of Alberta family integrated care (FICare) in level II neonatal intensive care units: a qualitative process evaluation substudy of a multicentre cluster-randomised controlled trial using the consolidated framework for implementation research. BMJ Open 2021; 11:e054938. [PMID: 34663673 PMCID: PMC8524282 DOI: 10.1136/bmjopen-2021-054938] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To evaluate the barriers and facilitators to implementing Alberta Family Integrated Care (AB-FICare [2019 Benzies]), a model of care for integrating parents into level II neonatal intensive care units (NICUs) care teams, from the perspective of healthcare providers (HCP) and hospital administrators. DESIGN Qualitative process evaluation substudy. SETTING Ten level II NICUs in six cities across Alberta, Canada. PARTICIPANTS HCP and hospital administrators (n=32) who were involved in the cluster-randomised controlled trial of AB-FICare in level II NICUs. METHODS Post-implementation semi-structured interviews were conducted via phone or in-person. The Consolidated Framework for Implementation Research was used to develop interview guides, code transcripts and analyse data. RESULTS Key facilitators to implementation of AB-FICare included (1) a receptive implementation climate, (2) compatibility of the intervention with individual and organisational practices, (3) available resources and access to knowledge and information for HCP and hospital administrators, (4) engagement of key stakeholders across the organisation, (5) engagement of and outcomes for intervention participants, and (6) reflecting and evaluating on implementation progress and patient and family outcomes. Barriers were (1) design quality and packaging of the intervention, (2) relative priority of AB-FICare in relation to other initiatives, and (3) learning climate within the organisation. Mixed influences on implementation depending on contextual factors were coded to eight constructs: intervention source, cost, peer pressure, external policy and incentives, staff needs and resources, structural characteristics, organisational incentives and rewards, and knowledge, beliefs and attitudes. CONCLUSIONS The characteristics of an organisation and the implementation process had largely positive influences, which can be leveraged for implementation of AB-FICare in the NICU. We recommend site-specific consultations to mitigate barriers and assess how swing factors might impact implementation given the local context, with the goal that strategies can be put in place to manage their influence on implementation. TRIAL REGISTRATION NUMBER NCT02879799.
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Affiliation(s)
- Pilar Zanoni
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
| | - Natalie V Scime
- Community Health Sciences, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - Karen Benzies
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
- Community Health Sciences, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
- Paediatrics, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - Deborah A McNeil
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
- Community Health Sciences, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
- Maternal Newborn Child and Youth Strategic Clinical Network, Alberta Health Services, Calgary, Alberta, Canada
| | - Kelly Mrklas
- Community Health Sciences, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
- Provincial Clinical Excellence, Alberta Health Services, Calgary, Alberta, Canada
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Sánchez-Rubio L, Cleveland LM, Durán de Villalobos MM, McGrath JM. Parental Decision-Making in Pediatric Intensive Care: A Concept Analysis. J Pediatr Nurs 2021; 59:115-124. [PMID: 33848782 DOI: 10.1016/j.pedn.2021.03.018] [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: 07/09/2020] [Revised: 02/23/2021] [Accepted: 03/18/2021] [Indexed: 11/15/2022]
Abstract
The development of nursing knowledge requires a close relationship between theory, research, and practice. The purpose of the analysis of the concept of "parental decision-making in pediatric critical care" is to facilitate nurses' therapeutic care of critically ill children and their families. To construct, structure, and give meaning to the concept, we use our experience in the field, critical reading of the literature, and careful analysis of data that have emerged about parental decision-making in pediatric intensive care. Several factors affect parent's ability to act as decision-makers: the psychosocial and physical disorders they develop, the subordination of their parental roles by the health care team, and the child's critical state of health. While different disciplines, including nursing, have well described the decision-making concept, parental decision-making in the context of pediatric intensive care has not been as well delineated. Nursing science recognizes the importance of decision-making and has incorporated the concept as an essential domain of its philosophical and disciplinary interests. Following the method proposed by Walker and Avant, the concept was analyzed, attributes, background, and consequences described. A model case was presented and discussed. An operational definition emerges, providing knowledge for professional nursing practice and will be the basis for an essential theoretical development around this phenomenon. Parents' recognition, the promotion of family-centered care, and shared decisions are ideal for encouraging parental participation.
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Affiliation(s)
- Lorena Sánchez-Rubio
- Programa de Enfermería, Facultad de Ciencias de la Salud, Universidad del Tolima, Ibagué, Colombia.
| | - Lisa M Cleveland
- School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX.
| | | | - Jacqueline M McGrath
- School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX.
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Endah Purnamaningsih Maria Margaretha S, Mulatsih S, Effendy C, Kusnanto H. Qualitative Analysis of Family-centered Care for Children with Cancer in Palliative Wards: An Evaluation of Needs and Barriers in Resource-limited Settings. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Many children with cancer are faced with fatal diagnosis and unbearable pain, and palliative care is highly needed. In Indonesia, the provision of palliative care is only accessible in a few major cities where most cancer treatment facilities are located and development has been slow. While, the implementation of family center care identified a number of challenges related to family empowerment to be included in the development and implementation of interventions.
Objectives: This study aimed to assess the perspectives of nurses regarding family-centered treatment in Indonesia’s palliative wards for children with cancer.
Methods: A qualitative approach to content analysis was employed. The study participants were 10 primary nurses in pediatric units who worked with cancer patients regularly. These participants were purposefully chosen. The interview session included 10 study participants. Participants’ work experience ranged from 2 to 11 years, and their age ranged from 27 to 51 years. Data were collected via face-to-face, semi-structured interviews that lasted for an average of 30 to 45 minutes. The interviews were performed to explore the participants’ understanding about the definition of family-centered palliative care, including the needs and obstacles to implementation. These were analyzed using content analysis methodology that includes five main segments: introduction, coding, theme creation, thematic classification, and reporting.
Results: The themes from the study included an appreciation of palliative and family-centered care, palliative care capability and family-centered care, and multidisciplinary cooperation under three principles concerning needs and barriers.
Conclusion: Integrating family-centered care approaches in providing palliative care for children with cancer as well as the resources required for such programs to be implemented by hospital management in working toward improved quality care for patients. Communication and continuity of care remain a challenge; training and equipping clinicians with skills and confidence to carry out family-centered care approaches and palliative care for children with cancer can aid in this process.
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A Multisite Survey of NICU Healthcare Professionals' Perceptions About Family-Centered Care. Adv Neonatal Care 2021; 21:205-213. [PMID: 33417328 DOI: 10.1097/anc.0000000000000805] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Family-centered care contributes to improved outcomes for preterm and ill infants. Little is known about the perceptions of neonatal intensive care unit (NICU) healthcare professionals regarding the degree to which their NICU practices or values family-centered care. PURPOSE The aims of this study were to describe attitudes and beliefs of NICU healthcare professionals about family-centered care and to explore professional characteristics that might influence those views. METHODS Data were derived from the baseline phase of a multicenter quasi-experimental study comparing usual family-centered NICU care with mobile-enhanced family-integrated care. Neonatal intensive care unit healthcare professionals completed the Family-Centered Care Questionnaire-Revised (FCCQ-R), a 45-item measure of 9 core dimensions of Current Practice and Necessary Practice for family-centered care. RESULTS A total of 382 (43%) NICU healthcare professionals from 6 NICUs completed 1 or more of the FCCQ-R subscales, 83% were registered nurses. Total and subscale scores on the Necessary Practice scale were consistently higher than those on the Current Practice scale for all dimensions of family-centered care (mean: 4.40 [0.46] vs 3.61 [0.53], P < .001). Only years of hospital experience and NICU site were significantly associated with Current Practice and Necessary Practice total scores. IMPLICATIONS FOR PRACTICE Ongoing assessment of the perceptions of NICU healthcare professionals regarding their current practice and beliefs about what is necessary for the delivery of high-quality family-centered care can inform NICU education, quality improvement, and maintenance of family-centered care during the COVID-19 pandemic. IMPLICATIONS FOR RESEARCH Further research is needed to identify additional factors that predict family-centered care perceptions and behaviors.
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Inpatient Unit Leaders' Perspectives on Parent Engagement in Neonatal and Pediatric Intensive Care: A Secondary, Qualitative Analysis. Adv Neonatal Care 2021; 21:77-86. [PMID: 32366807 DOI: 10.1097/anc.0000000000000736] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Hospital unit leaders help set the unit's priorities and are responsible for guiding the unit mission and philosophy of care; however, the perspective of leaders in facilitating parent engagement within intensive care units is limited. PURPOSE The purpose of this study was to explore how medical and nursing unit leaders facilitate parent engagement in intensive care settings. METHODS Qualitative secondary analysis of 16 semistructured interviews of unit leadership (medical directors and nurse managers). Directed content analysis explored themes within the interviews using systematic strategies to ensure rigor. FINDINGS Unit leadership described 3 main features of care delivery necessary for supporting parent engagement: (1) culture of care, (2) relationships in care, and (3) environment of care. Communication among providers and parents and timing of decision-making were key areas addressed, along with concerns about physical space limiting parent engagement. Unit leaders discussed how the 3 main features (unit culture, relationships, and physical space) of care delivery were interconnected to optimize parent engagement. IMPLICATIONS FOR PRACTICE Overall, unit leaders recognized the importance of each feature of care delivery in facilitating engagement. Parent engagement is ultimately influenced by the optimization of delivering inclusive care: the physical space, the policies surrounding medical and nursing care, and the overall culture of the unit. IMPLICATIONS FOR RESEARCH Future research needs to explore best practices around relationship building and managing space limitations. Further clarification of the needs and expectations of both parents and providers surrounding parent engagement in intensive care settings is needed.
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Griffiths N, Spence K, Galea C, Psaila K, Foureur M, Sinclair L. The effects of education levels of developmental care in Australia: Perceptions and challenges. Aust Crit Care 2020; 34:370-377. [PMID: 33221131 DOI: 10.1016/j.aucc.2020.10.003] [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: 04/12/2020] [Revised: 09/28/2020] [Accepted: 10/09/2020] [Indexed: 10/22/2022] Open
Abstract
BACKGROUND Developmental care consists of a range of clinical, infant-focused, and family-focused interventions designed to modify the neonatal intensive care environment and caregiving practices to reduce stressors on the developing brain. Since the inception of developmental care in the early 1980s, it has been recommended and adopted globally as a component of routine practice for neonatal care. Despite its application for almost 40 y, little is known of the attitude of neonatal nurses in Australia towards the intervention. AIMS AND OBJECTIVES The objective of this study was to establish Australian neonatal nurse perceptions of developmental care and explore associations between developmental care education levels of the nurses and personal beliefs in the application of developmental care. DESIGN This involves a cross-sectional survey design. METHODS An online questionnaire was completed by 171 neonatal nurses. Participants were members of the Australian College of Neonatal Nursing (n = 783). Covariate associations between key components of developmental care and respondents' geographical location, place of employment, professional qualifications, and developmental care education level were analysed. The reporting of this study is in accordance with the Enhancing the Quality and Transparency of Health Research Checklist for Reporting Results of Internet E-Surveys. RESULTS Differences were observed between groups for geographical location, place of employment, and professional qualification level. Rural nurses were less likely to support the provision of skin-to-skin care (odds ratio [OR]: 0.6, 95% confidence interval [CI]: 0.2-1.8) than nurses in a metropolitsan unit. Nurses working in a neonatal intensive care unit and nurses with postgraduate qualifications were more likely to support parental involvement in care ([OR: 2.3, 95% CI: 0.9-6.2] and [OR: 2.1, 95% CI: 0.6-7.4], respectively). Rural respondents were more likely to have attended off-site education (OR: 3.6, 95% CI: 1.3-9.9) than metropolitan respondents. CONCLUSION The application of developmental care in Australia may be influenced by inadequate resources and inequitable access to educational resources, and similar challenges have been reported in other countries. Overcoming the challenges requires a focused education strategy and support within and beyond the neonatal intensive care unit.
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Affiliation(s)
- Nadine Griffiths
- Grace Centre for Newborn Intensive Care, The Children's Hospital at Westmead, Locked Bag 4001, Westmead 2145, NSW, Australia; University of Technology Sydney, Centre of Midwifery, Child and Family Health, 15 Broadway, Ultimo, NSW 2007, Australia.
| | - Kaye Spence
- Grace Centre for Newborn Intensive Care, The Children's Hospital at Westmead, Locked Bag 4001, Westmead 2145, NSW, Australia; School of Nursing and Midwifery, Western Sydney University, Parramatta, NSW, Australia
| | - Claire Galea
- Cerebral Palsy Alliance Research Institute, Discipline of Child & Adolescent Health, Faculty of Medicine & Health, The University of Sydney, PO Box 6427, Frenchs Forest, Sydney, NSW 2086, Australia
| | - Kim Psaila
- School of Nursing and Midwifery, Western Sydney University, Parramatta, NSW, Australia
| | - Maralyn Foureur
- University of Technology Sydney, Centre of Midwifery, Child and Family Health, 15 Broadway, Ultimo, NSW 2007, Australia; Nursing and Midwifery Research Centre Hunter New England Local Health District, James Fletcher Hospital Campus, 77 Scott Street, Newcastle 2300, NSW, Australia; Faculty of Health and Medicine, University of Newcastle, Callaghan Campus, 2308 NSW, Australia
| | - Lynn Sinclair
- University of Technology Sydney, Centre of Midwifery, Child and Family Health, 15 Broadway, Ultimo, NSW 2007, Australia; University of New South Wales, School of Women's and Children's Health, Faculty of Medicine, Randwick, NSW 2052, Australia
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Kim AR. Addressing the Needs of Mothers with Infants in the Neonatal Intensive Care Unit: A Qualitative Secondary Analysis. Asian Nurs Res (Korean Soc Nurs Sci) 2020; 14:327-337. [PMID: 32937202 DOI: 10.1016/j.anr.2020.09.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 09/07/2020] [Accepted: 09/08/2020] [Indexed: 11/27/2022] Open
Abstract
PURPOSE Mothers of infants hospitalized in neonatal intensive care units (NICUs) need to be recognized as essential partners of the care team as their presence and involvement are key to infants' health and developmental outcomes. Addressing mothers' perceived needs is beneficial for the improvement of supportive nursing care; however, little qualitative research on their unmet needs has been conducted in South Korea. This study assessed mothers' perspectives on their NICU experiences and their unmet needs within the South Korean cultural context. METHOD A cross-sectional, multicentered, secondary analysis study was conducted using the written responses to an open-ended questionnaire. Of the 344 NICU-experienced mothers, 232 throughout South Korea (seven cities and five provinces) voluntarily completed the questionnaire via smartphone-based or web-based surveys. Their narrative responses were analyzed using thematic content analysis guided by the critical incident technique. RESULTS Four themes emerged. NICU-experienced mothers of preterm infants referred to the "family-friendly environment" (16.4%) as a positive experience. The greatest unmet need was "relationship-based support" (58.2%), followed by "information and education-based support" (20.0%) and "system-level challenges" (5.4%). CONCLUSION The importance of creating a family-friendly NICU environment should be emphasized by ensuring 24-hour unrestricted access and encouraging active parental involvement in infant care, as well as actively supporting NICU families through supportive words and actions. The assurance of antiinfection management and better staffing levels should be fundamentally guaranteed to NICU staff.
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Affiliation(s)
- Ah Rim Kim
- Department of Nursing, Far East University, Chungbuk, Republic of Korea.
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12
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Pellikka HK, Pölkki T, Sankilampi U, Kangasniemi M. Finnish Parents' Responsibilities for Their Infant's Care When They Stayed in a Single Family Room in a Neonatal Intensive Care Unit. J Pediatr Nurs 2020; 53:e28-e34. [PMID: 32081527 DOI: 10.1016/j.pedn.2020.01.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 01/30/2020] [Accepted: 01/31/2020] [Indexed: 11/17/2022]
Abstract
PURPOSE To describe parents' perceptions of their responsibilities for their infant's care during admission to a single family room in a neonatal intensive care unit (NICU). DESIGN AND METHODS A qualitative study with semi-structured individual interviews conducted at a family-centered level III Finnish NICU in late 2016 and early 2017. The participants were 10 mothers and nine fathers of infants aged from six days to eight months. The data were analyzed with inductive content analysis. RESULTS The parents wanted to take responsibility for their infant's care during their stay in a single family room in the NICU, because it prepared them for their infant's discharge. The mothers and fathers reported that their responsibilities supported them as they grew into parenthood and enabled their infants' rights. On the other hand, the parents needed nurses to empower them to commit to, and take, responsibility for their infant's care and share decision making. The nurses also taught the parents caring skills. CONCLUSIONS Empowering parents to take responsibility enabled their infant's rights during their stay in a single family room in the NICU. More research is needed about how nurses transfer these responsibilities to parents and how those are connected to the infant's rights and well-being. PRACTICE IMPLICATIONS Organizations who provide single family rooms in NICUs need to develop guidelines that facilitate the responsibilities that parents and nurses have to care for the infants. Although parents are the infant's primary caregivers, they depend on nurses to ensure their infant is safely cared for.
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Affiliation(s)
| | - Tarja Pölkki
- Department of Children and Women, Oulu University Hospital, Oulu, Finland.
| | - Ulla Sankilampi
- Kuopio University Hospital, Department of Paediatrics, KYS, Finland
| | - Mari Kangasniemi
- Department of Nursing Science, Faculty of Medicine, University of Turku, Finland
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Naef R, Kläusler-Troxler M, Ernst J, Huber S, Dinten-Schmid B, Karen T, Petry H. Translating family systems care into neonatology practice: A mixed method study of practitioners’ attitudes, practice skills and implementation experience. Int J Nurs Stud 2020; 102:103448. [DOI: 10.1016/j.ijnurstu.2019.103448] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 10/03/2019] [Accepted: 10/03/2019] [Indexed: 10/25/2022]
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Hall EM, Shahidullah JD, Lassen SR. Development of postpartum depression interventions for mothers of premature infants: a call to target low-SES NICU families. J Perinatol 2020; 40:1-9. [PMID: 31439918 DOI: 10.1038/s41372-019-0473-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 05/29/2019] [Accepted: 07/10/2019] [Indexed: 12/31/2022]
Abstract
In the United States, ethnic minority status and low socioeconomic status both confer greater risk of premature birth. These sociodemographic factors also contribute to a greater risk of postpartum depression, as does giving birth prematurely. Considering the known adverse effects of postpartum depression on children's development, NICU-based mental health services for these high-risk mothers is an important public health intervention. Although counseling and educational interventions in the NICU have been shown to decrease maternal depressive symptoms, these interventions require parental presence on the unit. Mothers of both low socioeconomic and ethnic minority status face systemic barriers that may prevent them from visiting their infants, such as lack of paid leave, transportation, and childcare. We propose directions for future research with the aim of increasing access to services. Directions include brief individual therapy, telehealth, and increasing the psychosocial support skills of other health professionals. Potential barriers to implementation are discussed.
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Affiliation(s)
- Eleanore M Hall
- Department of Clinical Psychology, Rutgers University, New Brunswick, NJ, USA.
| | - Jeffrey D Shahidullah
- Department of Psychiatry, The University of Texas at Austin Dell Medical School, Austin, TX, USA
| | - Stephen R Lassen
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS, USA
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Brødsgaard A, Pedersen JT, Larsen P, Weis J. Parents' and nurses' experiences of partnership in neonatal intensive care units: A qualitative review and meta‐synthesis. J Clin Nurs 2019; 28:3117-3139. [DOI: 10.1111/jocn.14920] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 02/22/2019] [Accepted: 04/14/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Anne Brødsgaard
- Department of Pediatrics and Adolecent Medicine Copenhagen University Hospital Hvidovre Copenhagen Denmark
- Department of Public Health, Section for Nursing University of Aarhus Aarhus Denmark
| | | | - Palle Larsen
- Department of Nursing University College Lillebaelt Svendborg Denmark
| | - Janne Weis
- Department of Neonatology Copenhagen University Hospital Rigshospitalet Copenhagen Denmark
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16
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Franck LS, O'Brien K. The evolution of family-centered care: From supporting parent-delivered interventions to a model of family integrated care. Birth Defects Res 2019; 111:1044-1059. [PMID: 31115181 DOI: 10.1002/bdr2.1521] [Citation(s) in RCA: 136] [Impact Index Per Article: 27.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 05/06/2019] [Indexed: 12/18/2022]
Abstract
There is increasing recognition that parents play a critical role in promoting the health outcomes of low birthweight and preterm infants. Despite a large body of literature on interventions and models to support family engagement in infant care, parent involvement in the delivery of care for such infants is still restricted in many neonatal intensive care units (NICUs). In this article, we propose a taxonomy for classifying parent-focused NICU interventions and parent-partnered care models to aid researchers, clinical teams, and health systems to evaluate existing and future approaches to care. The proposed framework has three levels: interventions to support parents, parent-delivered interventions, and multidimensional models of NICU care that explicitly incorporate parents and partners in the care of their preterm or low birthweight infant. We briefly review the available evidence for interventions at each level and highlight the strong level of research evidence to support the parent-delivered intervention of skin-to-skin contact (also known as the Kangaroo Care position) and for the Kangaroo mother care and family integrated care models of NICU care. We suggest directions for future research and model implementation to improve and scale-up parent partnership in the care of NICU infants.
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Affiliation(s)
- Linda S Franck
- Department of Family Health Care Nursing, University of California, San Francisco, California
| | - Karel O'Brien
- Department of Paediatrics, Sinai Health System, Toronto, Canada.,Department of Paediatrics, University of Toronto, Toronto, Canada
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Bruton C, Meckley J, Nelson L. NICU Nurses and Families Partnering to Provide Neuroprotective, Family-Centered, Developmental Care. Neonatal Netw 2019; 37:351-357. [PMID: 30567884 DOI: 10.1891/0730-0832.37.6.351] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The aim of this project was to determine how implementing neuroprotective, family-centered, developmental care interventions would impact the satisfaction of nurses and families compared with traditional care in a NICU. Neuroprotective, family-centered, developmental care is grounded in the principle that optimal health outcomes are accomplished when patients' family members play an active role in contributing emotional, social, and developmental support for their babies. To accomplish this, nurses needed an understanding of the developmental problems associated with high-risk premature infants, fundamentals of neurosensory growth, and how the intrauterine environment protects the infant from the fluctuation of an unstable extrauterine environment. The model we chose to use was the Neonatal Integrative Developmental Care Model. Pre- and post-surveys showing an increase in knowledge and benefits of these interventions were collected from nurses. Pre- and post-Press Ganey reports showed families had a strong satisfaction with neuroprotective, family-centered, developmental care in our NICU.
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18
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Rubio-Grillo MH. Performance of an occupational therapist in a neonatal intensive care unit. Colomb Med (Cali) 2019; 50:30-39. [PMID: 31168167 PMCID: PMC6536043 DOI: 10.25100/cm.v50i1.2600] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Revised: 02/03/2017] [Accepted: 01/28/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The following article constitutes an effort to make explicit an experience in neonatology within the framework of the exercise of occupational therapy, a discipline belonging to the health sciences. The occupational therapist (OT) in the Neonatal Intensive Care Unit in which he participates in an interdisciplinary health group. Exalts the interaction of person-environment-occupation-performance. Encourage self-regulation of the baby. Encourages family participation in co-participation in routine activities. OBJECTIVE To determine the realities and knowledge about the practice of OT in the Neonatal Intensive Care Unit (NICU) by the occupational therapist in the interaction between the baby, the occupation, the caregivers and the environment of the NICU. METHODS A systematic exploratory review of the performance of the OT in the NICU was made. RESULTS The results transcended the thematic variables, the theories, the methods, the approaches, the characteristics of the baby, the occupations, and the contexts of the management of the premature baby. CONCLUSION The education in concepts concerning the occupation of the baby, the interaction with her/his environment and her/his caregivers, the procedures, the guide for the stimulation as the modification of the physical, temporal and social environment facilitate the self-regulation of the baby and we will all be working in pro of your recovery.
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Affiliation(s)
- María Helena Rubio-Grillo
- Universidad del Valle, Facultad de Salud, Escuela de Rehabilitación Humana, Grupo SINERGIA, Cali, Colombia
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The health care system is making ‘too much noise’ to provide family-centred care in neonatal intensive care units: Perspectives of health care providers and hospital administrators. Intensive Crit Care Nurs 2019; 50:44-53. [DOI: 10.1016/j.iccn.2018.05.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 03/19/2018] [Accepted: 05/02/2018] [Indexed: 01/08/2023]
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Yu X, Zhang J. Family-centred care for hospitalized preterm infants: A systematic review and meta-analysis. Int J Nurs Pract 2018; 25:e12705. [PMID: 30378217 DOI: 10.1111/ijn.12705] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 09/21/2018] [Accepted: 09/30/2018] [Indexed: 11/29/2022]
Abstract
AIM To evaluate the effects of family-centred care on hospitalized preterm infants. BACKGROUND With an increase in published reports on family-centred care for preterm infants, there is a need for an up-to-date review and meta-analysis of rigorously designed studies to measure the effects of family-centred care on preterm infants. DESIGN A systematic review and meta-analysis. DATA SOURCES The Cochrane Library (Issue 12, 2017), PubMed (1966 to December 2017), CINAHL (1982 to December 2017), EMBASE (1974 to December 2017), and Web of Science (1975 to December 2017) databases were searched. REVIEW METHODS Relevant terms were used to search for randomized controlled trials of family-centred care versus standard care. A modified rating scale was utilized to assess studies for the degree of family-centredness of the intervention. RESULTS Four studies involving 1026 preterm infants were included. Compared with standard care, family-centred care shortened the total length of hospital stay and length of neonatal intensive care unit stay. There was inadequate evidence to demonstrate any effects of family-centred care on infant morbidity, feeding, growth, or neurobehavioural performance. CONCLUSION Family-centred care is an effective and safe intervention to shorten the length of stay in the hospital and improve survival quality among hospitalized preterm infants.
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Affiliation(s)
- Xiaoyan Yu
- School of Health Sciences, Wuhan University, Wuhan, China
| | - Jun Zhang
- School of Health Sciences, Wuhan University, Wuhan, China
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21
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Clinical rounds with parental involvement in a neonatal unit. Early Hum Dev 2018; 120:21-25. [PMID: 29604487 DOI: 10.1016/j.earlhumdev.2018.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Accepted: 03/20/2018] [Indexed: 11/22/2022]
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Hall SL, Hynan MT, Phillips R, Lassen S, Craig JW, Goyer E, Hatfield RF, Cohen H. The neonatal intensive parenting unit: an introduction. J Perinatol 2017; 37:1259-1264. [PMID: 28796241 PMCID: PMC5718987 DOI: 10.1038/jp.2017.108] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 05/23/2017] [Accepted: 05/26/2017] [Indexed: 01/06/2023]
Abstract
This paper describes a paradigm shift occurring in neonatal intensive care. Care teams are moving from a focus limited to healing the baby's medical problems towards a focus that also requires effective partnerships with families. These partnerships encourage extensive participation of mothers and fathers in their baby's care and ongoing bi-directional communication with the care team. The term Newborn Intensive Parenting Unit (NIPU) was derived to capture this concept. One component of the NIPU is family-integrated care, where parents are intimately involved in a baby's care for as many hours a day as possible. We describe six areas of potentially better practices (PBPs) for the NIPU along with descriptions of NIPU physical characteristics, operations, and a relationship-based culture. Research indicates the PBPs should lead to improved outcomes for NIPU babies, better mental health outcomes for their parents, and enhanced well-being of staff.
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Affiliation(s)
- S L Hall
- St. John’s Regional Medical Center, Oxnard, CA, USA
| | - M T Hynan
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - R Phillips
- Division of Neonatology, Department of Pediatrics, Loma Linda University Children’s Hospital, Loma Linda, CA, USA
| | - S Lassen
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS, USA
| | - J W Craig
- School of Occupational Therapy, Brenau University, Gainesville, GA, USA
| | - E Goyer
- Family Advocacy Network, National Perinatal Association, Austin, TX, USA
| | - R F Hatfield
- Newborn Intensive Care Unit, University of Utah Medical Center, Salt Lake City, UT, USA
| | - H Cohen
- Neonatal Intensive Care Unit, Salem Hospital, Salem, OR, USA
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Trujillo JA, Fernandez Y, Ghafoori L, Lok K, Valencia A. Interdisciplinary Family Conferences to Improve Patient Experience in the Neonatal Intensive Care Unit. HEALTH & SOCIAL WORK 2017; 42:241-246. [PMID: 29025070 DOI: 10.1093/hsw/hlx039] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 12/16/2016] [Indexed: 06/07/2023]
Abstract
Parents play a significant role in the development of their neonate. They can affect the length of stay in a neonatal intensive care unit (NICU) and are seen as an integral part of the team. Parents are often put in positions where difficult decision making is required of them in the care of their critically ill child. Studies suggest that one way to improve the family's experience and to encourage their involvement is by establishing a formal and focused family conference. Therefore, the NICU social workers and the interdisciplinary team collaborated to formulate strategies to improve communication that would enhance current practice. As a new initiative, the team decided that holding an interdisciplinary family conference (IFC) within the first two weeks of a baby's NICU admission is critical for parental involvement of infants less than 32 weeks gestation and those with congenital birth anomalies. The team determined that the primary outcome measure would be family satisfaction scores from hospital surveys. Since the implementation of IFCs, satisfaction scores showed steady improvement. This quality improvement project demonstrated that IFCs are an integral part of the family-centered care approach in the NICU. IFCs foster partnerships with families to ensure their involvement in all aspects of patient care and improve their experience in the NICU.
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Affiliation(s)
- Jennifer A Trujillo
- Department of Social Work Services, Miller Children's & Women's Hospital Long Beach, Long Beach, CA. Neonatal Intensive Care Unit, Henderson Hospital, Las Vegas, NV
| | - Yesenia Fernandez
- Department of Social Work Services, Miller Children's & Women's Hospital Long Beach, Long Beach, CA. Neonatal Intensive Care Unit, Henderson Hospital, Las Vegas, NV
| | - Lyla Ghafoori
- Department of Social Work Services, Miller Children's & Women's Hospital Long Beach, Long Beach, CA. Neonatal Intensive Care Unit, Henderson Hospital, Las Vegas, NV
| | - Kristina Lok
- Department of Social Work Services, Miller Children's & Women's Hospital Long Beach, Long Beach, CA. Neonatal Intensive Care Unit, Henderson Hospital, Las Vegas, NV
| | - Arwin Valencia
- Department of Social Work Services, Miller Children's & Women's Hospital Long Beach, Long Beach, CA. Neonatal Intensive Care Unit, Henderson Hospital, Las Vegas, NV
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Schrauwen L, Kommers DR, Oetomo SB. Viewpoints of Parents and Nurses on How to Design Products to Enhance Parent-Infant Bonding at Neonatal Intensive Care Units: A Qualitative Study Based on Existing Designs. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2017; 11:20-31. [PMID: 28994322 PMCID: PMC5985569 DOI: 10.1177/1937586717728483] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIM To investigate how product design can be used to improve parent-infant bonding in a neonatal intensive care unit. BACKGROUND Impaired parent-infant bonding is an inevitable consequence of premature birth, which negatively influences development. Products, systems, or services that support the bonding process might counter these negative influences. METHOD The first step was to trace existing products by performing a literature search in PubMed, the university library, and Google. The identified existing designs were then used in semistructured interviews with nurses and parents to get insights into their desires and recommendations for product design to enhance bonding. Interviews contained open questions and a multiple-choice questionnaire based on the literature search. RESULTS In total, 17 existing design types were used in interviews with 11 parents and 23 nurses. All nurses explicitly stated that practicality was the first criterion designs aimed at enhancing bonding definitely had to meet. All parents indicated that they would like to use a design to enhance bonding if that would contribute to their child's health and development. For both parents and nurses, the most valuable way to enhance bonding seemed to be products to improve Kangaroo care; however, their specific desires varied substantially. Therefore, seven recurring themes were defined, resulting in nine general recommendations and six opportunities intended to enhance parent-infant bonding. CONCLUSION This study provides design recommendations and opportunities based on parents' and nurses' expert opinions. Designing to enhance bonding is considered valuable; however, designs should match the stakeholders' desires and conditions.
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Affiliation(s)
- Laura Schrauwen
- 1 Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Deedee R Kommers
- 2 Máxima Medical Center, Veldhoven, the Netherlands.,3 Department of Industrial Design, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Sidarto Bambang Oetomo
- 2 Máxima Medical Center, Veldhoven, the Netherlands.,3 Department of Industrial Design, Eindhoven University of Technology, Eindhoven, the Netherlands
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26
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Miyagishima S, Himuro N, Kozuka N, Mori M, Tsutsumi H. Family-centered care for preterm infants: Parent and physical therapist perceptions. Pediatr Int 2017; 59:698-703. [PMID: 28218813 DOI: 10.1111/ped.13266] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2016] [Revised: 01/30/2017] [Accepted: 02/15/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND The aim of this study was to compare perceptions between physical therapists and parents about family-centered care for preterm infants. METHODS Translated versions of the Measure of Processes of Care-20 and Measures of Processes of Care for Service Providers were used to evaluate the family-centered care for preterm infants. RESULTS A total of 42 parents of 44 preterm infants and nine physical therapists completed questionnaires. Parent perceptions of the family-centered care were generally positive. The highest rating was in the domain Enable and Partnership. Physical therapists gave lower scores in all information domains. There were some gaps between parent and physical therapist perceptions of information domains. CONCLUSIONS Strengths and weaknesses in family-centered care for preterm infants have been identified. Parents viewed the role of physical therapists in family-centered care for preterm infants as positive.
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Affiliation(s)
- Saori Miyagishima
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo Medical University, Sapporo, Japan
| | - Nobuaki Himuro
- Department of Public Health, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Naoki Kozuka
- Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Mitsuru Mori
- Department of Public Health, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Hiroyuki Tsutsumi
- Department of Pediatrics, School of Medicine, Sapporo Medical University, Sapporo, Japan
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Smartphone and Internet Preferences of Parents: Information Needs and Desired Involvement in Infant Care and Pain Management in the NICU. Adv Neonatal Care 2017; 17:131-138. [PMID: 27759567 DOI: 10.1097/anc.0000000000000349] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Despite an abundance of research that identifies the benefits for both parent and child when parents are actively involved in their infant's care, challenges related to the best methods to engage families persist. PURPOSE To conduct a feasibility study that aims to understand the preferences of smartphone and Internet use by parents of infants admitted to the neonatal intensive care unit (NICU) related to information seeking and active participation in infant care, with a focus on pain management interventions. METHODS A paper-based survey was distributed to 90 parents in a tertiary-level NICU from September to November 2013. RESULTS Response rate was 80% (72 of the 90). Ninety-seven percent accessed the Internet daily, 87% using their smartphone, and ranked it as an important source of NICU information (81%), more than books (56%) and brochures (33%). Participants reported a desire to have more information on how they could provide general comfort (96%), as well as greater participation in comforting their baby during painful procedures (94%). IMPLICATIONS FOR PRACTICE Parents in the NICU want more information and greater involvement in their infant's care and pain management and place a higher value on the Internet compared with traditional resources. IMPLICATIONS FOR RESEARCH Researchers and clinicians should work together to determine the quality of online resources to better support and evaluate parent use of the Internet as a health information resource. Future studies should examine parental preference regarding the optimal balance between online sources and face-to-face interactions.
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Neonatal Nurses NICU Quality Improvement: Embracing EBP Recommendations to Provide Parent Psychosocial Support. Adv Neonatal Care 2017; 17:33-44. [PMID: 27763909 DOI: 10.1097/anc.0000000000000352] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The neonatal intensive care unit (NICU) can be a stressful environment for infants, their families, and the healthcare team. There is an immediate need for neonatal nurses to embrace and translate the new National Perinatal Association recommendations for psychosocial support of NICU parents into clinical practice to demonstrate best practices for infants, their families, and the whole team. PURPOSE To summarize the current evidence-based practice recommendations and to provide suggestions for team members to develop strategies to adopt and implement them through quality improvement (QI) projects. METHODS Literature reviews were conducted by the original 6 National Perinatal Association workgroup teams and covered all levels of available evidence (eg, qualitative, quantitative, and clinical research, guidelines, and clinical and parental expertise). Evidence was synthesized to formulate this set of recommendations published in December 2015. We describe their applicability to the vital role of neonatal nurses, while elucidating QI projects that track measurements of change to translate these recommendations into practice. RESULTS Neonatal nurses are in an ideal position to transform systems of support for NICU parents through the adoption of these recommendations at the bedside, and further to identify areas for QI to enhance implementation. IMPLICATIONS FOR PRACTICE Neonatal nurses are integral to problem solving and identifying QI strategies for translating these recommendations into NICU clinical practice to improve parent psychosocial support. IMPLICATIONS FOR RESEARCH This article disseminates evidence and encourages scientific investigation into various methods of supporting emotional health of NICU parents to create better health outcomes.
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Parent and nurse perceptions on the quality of family-centred care in 11 European NICUs. Aust Crit Care 2016; 29:201-209. [DOI: 10.1016/j.aucc.2016.09.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 09/12/2016] [Accepted: 09/19/2016] [Indexed: 11/20/2022] Open
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Brødsgaard A, Larsen P, Weis J, Pedersen PU. The perception of partnership between parents of premature infants and nurses in neonatal intensive care units. ACTA ACUST UNITED AC 2016; 14:40-46. [DOI: 10.11124/jbisrir-2016-003073] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Abstract
Family-centered care in neonatal intensive care changed over the last decades. Initially, parents and infants were separated and parents were even being blamed for cau-sing infections in their infants. The importance, though, of the parents being the constant in the infant's life emerged and with that the importance of early bonding and attachment for the parents to take on their role and responsibi-lities as primary caregivers. Facilitation of family-centered care includes involving the parents in daily care activities, kangaroo care, developmental care, interaction and communication with the infant, as well as involving grandparents and siblings. Implementation of family-centered care requires appropriate policies, facilities and resources, education of all involved, and a positive attitude.
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Affiliation(s)
- Carin Maree
- Department of Nursing Science, University of Pretoria, Pretoria, South Africa (Dr Maree and Ms Downes); and Nursetech, Midrand, South Africa (Ms Downes)
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Abstract
The philosophical framework of family-centered care (FCC) has been promoted consistently since the 1980s in perinatal and neonatal settings as a gold standard approach for developing programs and providing care that supports the meaningful involvement of parents in the care of their infants and children. Recent literature suggests that despite years of promotion, FCC remains an elusive practice. Sources frequently state that FCC is based on principles of communication and empowerment, but the literature overall does not suggest substantial underlying philosophical or theoretical underpinnings. There have been theoretical advances in nursing and other disciplines that hold potential for moving our practice of FCC forward. In this article, we describe the informed advocacy framework and apply the framework to FCC.
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Abstract
The philosophy of family-centered care in neonatal intensive care units is intended to facilitate parental involvement, shared decision-making, and improved outcomes for infants and families. To support family-centered care, there are multiple interventions with different components and associated outcomes that have been described in the research literature. This evidence leaves many unanswered questions about how best to implement and evaluate strategies to enhance family-centered care. This article provides a brief overview of interventions designed to support family-centered care in neonatal intensive care units and offers an evidence-informed staff education strategy to enhance family-centered care. The evidence-informed relational communications strategies of circular pattern diagrams, questioning, and commendations are described, along with specific examples of how nurses can use them in in their day-to-day practice in neonatal intensive care units.
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Kenner C, Press J, Ryan D. Recommendations for palliative and bereavement care in the NICU: a family-centered integrative approach. J Perinatol 2015; 35 Suppl 1:S19-23. [PMID: 26597801 PMCID: PMC4660047 DOI: 10.1038/jp.2015.145] [Citation(s) in RCA: 92] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 09/18/2015] [Indexed: 11/09/2022]
Abstract
Technological advances have increased our ability to detect a life-threatening, life-limiting or lethal problem early in pregnancy, leaving parents months to anticipate a death or a prematurely born infant. Babies can also be born with unanticipated problems that could lead to death. In either scenario, perinatal palliative care should be offered as a strategy for family support. Since the preponderance of professional training focuses on saving lives, many health professionals are uncomfortable with palliative care. This article's purpose is to define best practices for the provision of family-centered perinatal and neonatal palliative care and provision of support to bereaved families experiencing anticipated and unanticipated life-limiting conditions or death of their infant. An overview of core concepts and values is presented, followed by intervention strategies to promote an integrated family-centered approach to palliative and bereavement care. The concluding section presents evidence-based recommendations.
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Affiliation(s)
- C Kenner
- School of Nursing, Health and Exercise Science, The College of New Jersey, Ewing, NJ, USA
- Council of International Neonatal Nurses, Yardley, PA, USA
| | - J Press
- Perinatal Bereavement Services, Crouse Hospital, Syracuse, NY, USA
| | - D Ryan
- Nurse Education Program, Elmira College, Elmira, NY, USA
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Recommendations for involving the family in developmental care of the NICU baby. J Perinatol 2015; 35 Suppl 1:S5-8. [PMID: 26597804 PMCID: PMC4660048 DOI: 10.1038/jp.2015.142] [Citation(s) in RCA: 136] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Revised: 09/27/2015] [Accepted: 09/29/2015] [Indexed: 11/13/2022]
Abstract
Family involvement is a key to realize the potential for long-lasting positive effects on physical, cognitive and psychosocial development of all babies, including those in the neonatal intensive care unit (NICU). Family-centered developmental care (FCDC) recognizes the family as vital members of the NICU health-care team. As such, families are integrated into decision-making processes and are collaborators in their baby's care. Through standardized use of FCDC principles in the NICU, a foundation is constructed to enhance the family's lifelong relationship with their child and optimize development of the baby. Recommendations are made for supporting parental roles as caregivers of their babies in the NICU, supporting NICU staff participation in FCDC and creating NICU policies that support this type of care. These recommendations are designed to meet the basic human needs of all babies, the special needs of hospitalized babies and the needs of families who are coping with the crisis of having a baby in the NICU.
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36
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Himuro N, Miyagishima S, Kozuka N, Tsutsumi H, Mori M. Measurement of family-centered care in the neonatal intensive care unit and professional background. J Perinatol 2015; 35:284-9. [PMID: 25429382 DOI: 10.1038/jp.2014.204] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Revised: 10/06/2014] [Accepted: 10/09/2014] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The aims of this study were to examine the validity and reliability of the Measure of Processes of Care for Service Providers (MPOC-SP) for multidisciplinary teams in neonatal intensive care units (NICUs) and to examine differences among professions. STUDY DESIGN A Japanese language version of the MPOC-SP questionnaire was distributed among the professionals employed at three perinatal medical centers. RESULT A total of 83 multidisciplinary team members completed the questionnaire. The construct validity was examined by a confirmative analysis of each scale structure. The MPOC-SP showed adequate internal consistency. The test-retest analysis showed that the MPOC-SP, except the 'providing general information' scale, is a reliable tool. The results suggest that professional background affects the attitude and behavior of professionals involved in family-centered care. CONCLUSION The MPOC-SP has good psychometric properties and can be used to identify areas for improvement in the family-centered care provided by multidisciplinary teams in the NICUs.
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Affiliation(s)
- N Himuro
- Department of Public Health, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - S Miyagishima
- 1] Department of Pediatrics, Graduate School, Sapporo Medical University, Sapporo, Japan [2] Division of Rehabilitation Medicine, Sapporo Medical University Hospital, Sapporo, Japan
| | - N Kozuka
- Department of First Division of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - H Tsutsumi
- Department of Pediatrics, Sapporo Medical University, Sapporo, Japan
| | - M Mori
- Department of Public Health, School of Medicine, Sapporo Medical University, Sapporo, Japan
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Altimier L. Compassionate Family Care Framework: A New Collaborative Compassionate Care Model for NICU Families and Caregivers. ACTA ACUST UNITED AC 2015. [DOI: 10.1053/j.nainr.2015.01.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Taiwanese parents' perceptions of their very low-birth-weight infant with developmental disabilities. J Perinat Neonatal Nurs 2013; 27:345-52. [PMID: 24164817 DOI: 10.1097/jpn.0b013e3182a98408] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study explores the perceptions and experiences of Taiwanese parents in coping with the unfolding evidence of a disability, their response to the official diagnosis, and their views about their child's developmental disability. This descriptive qualitative study is a partial analysis of data from a larger study including 19 Taiwanese parents of very low-birth-weight infants with developmental disability at 6 and 12 months of corrected age. Four themes were generated: uncertainty and worry about developmental progress, search for meaning and supernatural will, desire for normality and attitude toward services, and finding a balance point in family life and relationships. The parents of very low-birth-weight infants face uncertainty about developmental and other potential problems in the infant's early age. Adequate information related to infant development needs to be integrated into follow-up clinic and early intervention services. Early intervention programs should not only focus on the needs of these infants but also provide support and care to the whole family. Understanding parental beliefs and values toward developmental disabilities can help neonatal and pediatric professionals to provide optimal early intervention to these families.
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Butt ML, McGrath JM, Samra HA, Gupta R. An integrative review of parent satisfaction with care provided in the neonatal intensive care unit. J Obstet Gynecol Neonatal Nurs 2013; 42:105-20. [PMID: 23316895 DOI: 10.1111/1552-6909.12002] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To synthesize findings from the published empirical literature on parent satisfaction with care provided in the neonatal intensive care unit (NICU). DATA SOURCES Electronic databases including CINAHL, Medline, Embase, PsycInfo, Sociological Abstracts, the Cochrane Library, and the Campbell Library were searched for relevant research dating from January 1990 to the beginning of October 2011. The reference lists of all studies were reviewed and the personal files of the authors were also searched for relevant studies. STUDY SELECTION Twelve studies (nine quantitative descriptive, two qualitative descriptive, and one mixed methods) were identified that met the review inclusion criteria. Only studies written in English were selected. DATA EXTRACTION Whittemore and Knafl's methodology for integrative reviews guided the data extraction and subsequent analysis. Studies meeting the review inclusion criteria were analyzed sequentially. Data were extracted and organized under the following headings: author, year, and country; study purpose and design; sample size and setting; study variables and data collection; study findings; and limitations. DATA SYNTHESIS Studies examining parent satisfaction with the care provided in the NICU were synthesized under four main themes: (a) parents' degree of satisfaction with care, (b) factors associated with parents' satisfaction with care, (c) elements of care parents view as important, and (d) discrepancies between parent expectations and actual ratings of care. CONCLUSIONS The vast majority of parents were highly satisfied with the care they and their infants received in the NICU. However, other evidence points to less-than-optimal NICU care that is not meeting parents' expectations. These findings provide some direction as to what is important and satisfying to parents whose children must reside in the NICU. However, given the quality and dearth of the evidence, gaps remain in our understanding, and additional, more rigorous research is needed.
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Affiliation(s)
- Michelle L Butt
- School of Nursing, McMaster University, Hamilton, ON L8S 4K1 Canada.
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Franck LS, Axelin A. Differences in parents', nurses' and physicians' views of NICU parent support. Acta Paediatr 2013; 102:590-6. [PMID: 23463946 DOI: 10.1111/apa.12227] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Revised: 02/28/2013] [Accepted: 03/01/2013] [Indexed: 12/31/2022]
Abstract
AIM To measure the perceptions of parent support by parents, nurses and physicians. METHODS Perceptions were compared among parents (n = 227), nurses (n = 178) and physicians (n = 43) in four neonatal intensive care units (NICU) using two versions of the Nurse Parent Support Tool (NPST and NPSTpro). RESULTS Overall, parents reported receiving support from nurses some or most of the time and their perceptions were correlated with aspects of their NICU experience. Nurses reported giving support to parents almost all of the time. The mean difference between parent and nurse ratings was smallest for instrumental support (0.26, 0.16-0.36; p < 0.001) and greatest for emotional support (0.82, 0.67-0.97; p < 0.001). Physicians overall reported that they gave support to parents most of the time, significantly less frequently than nurses (mean difference 0.58, 0.45-0.71; p < 0.001). They rated their support as most frequent on answering parents' questions satisfactorily and as least frequent on teaching parents how to give care to their baby. CONCLUSION NICU nurses and physicians should be encouraged to critically reflect on whether the type and consistency of support they provide to parents is in line with parents' perceptions and needs. Further research is needed on effective methods for health professionals to support parents of NICU infants.
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Affiliation(s)
- Linda S Franck
- Department of Family Health Care Nursing; University of California; San Francisco CA USA
| | - Anna Axelin
- Department of Family Health Care Nursing; University of California; San Francisco CA USA
- Department of Nursing Science; University of Turku; Turku Finland
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Trajkovski S, Schmied V, Vickers M, Jackson D. Neonatal nurses' perspectives of family-centred care: a qualitative study. J Clin Nurs 2012; 21:2477-87. [PMID: 22889445 DOI: 10.1111/j.1365-2702.2012.04138.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES The aim of this study is to explore neonatal nurses' perspectives of their role in facilitating family centred care in the neonatal intensive care unit. BACKGROUND The philosophy of family centred care focuses on the health and wellbeing of the newborn and their family, through the development of a respectful partnership between the health care professional and the infant's parents. Many studies report family centred care in the context of paediatric care; however, few studies explore neonatal nurses' perspective of family centred care in the context of neonatal care. DESIGN Qualitative interpretative approach. METHODS Four focus groups and five individual face-to-face interviews were conducted with neonatal intensive care nurses (total n=33) currently practicing in a tertiary Neonatal Intensive Care Unit in Australia. Each focus group and face to face interview was audio-taped and transcribed. Data was analysed using thematic analysis. RESULTS Four dominant themes emerged from the data: (1) Getting to know parents and their wishes (2) Involving family in the day to day care (3) Finding a 'happy' medium (4) Transitioning support across the continuum. CONCLUSION These findings revealed a general understanding of family centred care principles. Nurses reported the potential benefits and challenges of adopting a family centred care approach to deliver optimal care for neonates and their families. The study highlighted that nurses need ongoing organisation support, guidance and further education to assist them in delivering family centred care effectively. RELEVANCE TO CLINICAL PRACTICE Family centred care is a central tenet underpinning neonatal care. Understanding neonatal nurses' perspectives will be useful when developing strategies to strengthen family centred care in the neonatal intensive care unit, and potentially improve neonatal care and family outcomes.
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Affiliation(s)
- Suza Trajkovski
- Family and Community Health Research Group (FaCH), School of Nursing & Midwifery, College of Health Science, University of Western Sydney, Sydney, Australia.
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