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Zhao Y, Liu J, Li M, Zhang H, Gong J, Zhang J, Zhu Y. The mediating effects of parenting self-efficacy between readiness for hospital discharge and post-discharge coping difficulty among mothers of preterm infants. Sci Rep 2024; 14:19404. [PMID: 39169155 PMCID: PMC11339403 DOI: 10.1038/s41598-024-70365-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 08/16/2024] [Indexed: 08/23/2024] Open
Abstract
Post-discharge coping difficulty presents a significant challenge for mothers of preterm infants. The readiness for hospital discharge and parenting self-efficacy are crucial factors influencing post-discharge coping difficulty. However, the pathways through which these factors impact post-discharge coping difficulty remain unclear. This study aims to investigate the impact of readiness for hospital discharge on post-discharge coping difficulty and the mediating role of parenting self-efficacy among mothers of preterm infants. A prospective study involving 462 mothers of preterm infants from six tertiary hospitals in Shandong Province was conducted. Mothers were evaluated on the day of discharge (using the Baseline characteristics and Readiness for Hospital Discharge Scale) and three weeks post-discharge (utilizing the Parenting Sense of Competence Scale-Efficacy subscale and Post-Discharge Coping Difficulty Scale). Structural equation modeling was employed to analyze the mediating effect. The results of this study revealed that readiness for hospital discharge significantly decreased post-discharge coping difficulty (β = - 0.533, P < 0.001), and parenting self-efficacy also significantly reduced post-discharge coping difficulty (β = - 0.419, P < 0.001). Furthermore, parenting self-efficacy partially mediated the relationship between readiness for hospital discharge and post-discharge coping difficulty, accounting for 25.35% of the total effect. Mothers reported a moderate level of post-discharge coping difficulty. In assisting mothers of premature infants to alleviate post-discharge coping difficulty, nurses could implement strategies focused on enhancing readiness for hospital discharge and parenting self-efficacy.
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Affiliation(s)
- Yarui Zhao
- Party Committee Office, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China
| | - Jin Liu
- Department of Neonatology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China
| | - Minmin Li
- Department of Neonatology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China
| | - Hong Zhang
- Department of Neonatology, Weifang Maternal and Child Health Hospital, Weifang, 261011, Shandong, China
| | - Jingjing Gong
- Department of Neonatology, Linyi People's Hospital, Linyi, 276000, Shandong, China
| | - Juan Zhang
- Department of Neonatology, Dongying People's Hospital, Dongying, 257091, Shandong, China
| | - Yun Zhu
- Party Committee Office, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China.
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Feeley N, Kabajaasi O, Kenya-Mugisha N, Tagoola A, O'Brien K, Duby J. Benefits and Challenges of Implementing an Adaptation of Family Integrated Care in a Ugandan Setting. Adv Neonatal Care 2024; 24:172-180. [PMID: 38547483 DOI: 10.1097/anc.0000000000001161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
BACKGROUND Family Integrated Care (FICare) integrates parents as partners in neonatal intensive care unit care. Our team adapted and implemented this approach in a Ugandan unit for hospitalized neonates. PURPOSE This qualitative descriptive study examined the perceptions of mothers and healthcare professionals (HCPs) of the benefits and challenges of this new approach to care. METHODS Fifty-one mothers of hospitalized neonates born weighing greater than 2000 g participated in the program. They were taught to assess neonate danger signs, feeding, and weight. After discharge, a subsample (n = 15) participated in focus groups to explore benefits and challenges of their participation in care. Interviews with 8 HCPs were also conducted for the same purpose. Transcripts from focus groups and interviews were analyzed using inductive content analysis to describe the benefits and challenges from the perspectives of mothers and HCPs. RESULTS For mothers a benefit was decreased stress. Both mothers and HCPs reported that the knowledge and skills mothers acquired were a benefit as was their ability to apply these to the care of their neonate. Improved relations between mothers and HCPs were described, characterized by greater exchange of information and HCPs' attentiveness to mothers' assessments. Mothers felt ready for discharge and used their knowledge at home. HCPs noted a decrease in their workload. Challenges included the need for mothers to overcome fears about performing the tasks, their own well-being and literacy skills, and access to equipment. IMPLICATIONS FOR PRACTICE Mothers' participation in their neonates' care can have benefits for them and their neonate.
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Affiliation(s)
- Nancy Feeley
- Centre for Nursing Research, Jewish General Hospital & Lady Davis Institute for Medical Research, CIUSSS West-Central Montreal & Ingram School of Nursing, McGill University, Montreal, Québec, Canada (Dr Feeley); Walimu, Kampala, Uganda (Ms Kabajaasi and Dr Kenya-Mugisha); Department of Pediatrics, Jinja Regional Referral Hospital, Jinja, Uganda (Dr Tagoola); Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada (Dr O'Brien); and Department of Pediatrics, McGill University, Montreal, Québec, Canada (Dr Duby)
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Arwehed S, Axelin A, Björklund LJ, Thernström Blomqvist Y, Heiring C, Jonsson B, Klingenberg C, Metsäranta M, Ågren J, Lehtonen L. Nordic survey showed wide variation in discharge practices for very preterm infants. Acta Paediatr 2024; 113:48-55. [PMID: 37540833 DOI: 10.1111/apa.16934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 08/01/2023] [Accepted: 08/02/2023] [Indexed: 08/06/2023]
Abstract
AIM We aimed to describe clinical practices and criteria for discharge of very preterm infants in Nordic neonatal units. METHODS Medical directors of all 89 level-2 and level-3 units in Denmark, Finland, Iceland, Norway and Sweden were invited by e-mail to complete a web-based multiple-choice survey with the option to make additional free-text comments. RESULTS We received responses from 83/89 units (93%). In all responding units, discharge readiness was based mainly on clinical assessment with varying criteria. In addition, 36% used formal tests of cardiorespiratory stability and 59% used criteria related to infant weight or growth. For discharge with feeding tube, parental ability to speak the national language or English was mandatory in 45% of units, with large variation among countries. Post-discharge home visits and video-consultations were provided by 59% and 51%, respectively. In 54% of units, parental preparation for discharge were not initiated until the last two weeks of hospital stay. CONCLUSION Discharge readiness was based mainly on clinical assessment, with criteria varying among units despite similar population characteristics and care structures. This variation indicates a lack of evidence base and may unnecessarily delay discharge; further studies of this matter are needed. Earlier parental preparation and use of interpreters might facilitate earlier discharge.
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Affiliation(s)
- Sofia Arwehed
- Department of Women's and Children's Health, Uppsala University and Uppsala University Hospital, Uppsala, Sweden
| | - Anna Axelin
- Department of Women's and Children's Health, Uppsala University and Uppsala University Hospital, Uppsala, Sweden
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Lars J Björklund
- Department of Clinical Sciences, Lund, Paediatrics, Lund University and Skåne University Hospital, Lund, Sweden
| | - Ylva Thernström Blomqvist
- Department of Women's and Children's Health, Uppsala University and Uppsala University Hospital, Uppsala, Sweden
| | - Christian Heiring
- Department of Neonatology, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Baldvin Jonsson
- Department of Women's and Children's Health, Karolinska Institute and Karolinska University Hospital, Stockholm, Sweden
| | - Claus Klingenberg
- Paediatric Research Group, Faculty of Health Sciences, UiT-The Arctic University of Norway, Tromsø, Norway
- Department of Pediatrics and Adolescence Medicine, University Hospital of North Norway, Tromsø, Norway
| | - Marjo Metsäranta
- Department of Pediatrics, University of Helsinki and Helsinki University Hospital (HUH), Helsinki, Finland
| | - Johan Ågren
- Department of Women's and Children's Health, Uppsala University and Uppsala University Hospital, Uppsala, Sweden
| | - Liisa Lehtonen
- Department of Paediatrics and Adolescent Medicine, Turku University, Hospital and University of Turku, Turku, Finland
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Brito S, Williams A, Fox J, Mohammed T, Chahin N, McCarthy K, Nubayaat L, Nunlist S, Brannon M, Xu J, Hendricks-Muñoz KD. Lactation Support as a Proxy Measure of Family-Centered Care Quality in Neonates with Life-Limiting Conditions-A Comparative Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1635. [PMID: 37892298 PMCID: PMC10605637 DOI: 10.3390/children10101635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 09/17/2023] [Accepted: 09/27/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Lactation support is an important measure of Family-Centered Care (FCC) in the Neonatal Intensive Care Unit (NICU). Life-limiting conditions (LLCs) raise complex ethical care issues for providers and parents in the NICU and represent a key and often overlooked population for whom FCC is particularly important. We investigated healthcare disparities in FCC lactation support quality in infants with LLCs. METHODS A retrospective cohort of inborn infants with or without LLCs admitted to the NICU between 2015-2023 included 395 infants with 219 LLC infants and 176 matched non-LLC infants and were compared on LLC supports. RESULTS The LLC cohort experienced greater skin-to-skin support, but less lactation specialist visits, breast pumps provided, and human milk oral care use. LLC infants also experienced less maternal visitation, use of donor milk (LLC: 15.5%, non-LLC: 33.5%), and breastfeeds (LLC: 24.2%, non-LLC: 43.2%), with lower mean human milk provision (LLC: 36.6%, non-LLC: 67.1%). LLC infants who survived to discharge had similar human milk use as non-LLC infants (LLC: 49.8%, non-LLC: 50.6%). CONCLUSION Lactation support was significantly absent for families and infants who presented with LLCs in the NICU, suggesting that policies can be altered to increase lactation support FCC quality for this population.
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Affiliation(s)
- Suneeta Brito
- Division of Neonatal Medicine, Department of Pediatrics, Children's Hospital of Richmond at VCU, Virginia Commonwealth University School of Medicine, P.O. Box 980646, Richmond, VA 23298-0646, USA
| | - Allison Williams
- Department of Psychology, Virginia Commonwealth University School of Medicine, P.O. Box 980646, Richmond, VA 23298-0646, USA
| | - Jenny Fox
- Division of Neonatal Medicine, Department of Pediatrics, Children's Hospital of Richmond at VCU, Virginia Commonwealth University School of Medicine, P.O. Box 980646, Richmond, VA 23298-0646, USA
| | - Tazuddin Mohammed
- Division of Neonatal Medicine, Department of Pediatrics, Children's Hospital of Richmond at VCU, Virginia Commonwealth University School of Medicine, P.O. Box 980646, Richmond, VA 23298-0646, USA
| | - Nayef Chahin
- Division of Neonatal Medicine, Department of Pediatrics, Children's Hospital of Richmond at VCU, Virginia Commonwealth University School of Medicine, P.O. Box 980646, Richmond, VA 23298-0646, USA
| | - Kaitlin McCarthy
- Eastern Virginia School of Medicine, P.O. Box 1980, Norfolk, VA 23501-1980, USA
| | | | - Shirley Nunlist
- Virginia Commonwealth University School of Medicine, P.O. Box 980646, Richmond, VA 23298-0646, USA
| | - Mason Brannon
- Virginia Commonwealth University School of Medicine, P.O. Box 980646, Richmond, VA 23298-0646, USA
| | - Jie Xu
- Division of Neonatal Medicine, Department of Pediatrics, Children's Hospital of Richmond at VCU, Virginia Commonwealth University School of Medicine, P.O. Box 980646, Richmond, VA 23298-0646, USA
| | - Karen D Hendricks-Muñoz
- Division of Neonatal Medicine, Department of Pediatrics, Children's Hospital of Richmond at VCU, Virginia Commonwealth University School of Medicine, P.O. Box 980646, Richmond, VA 23298-0646, USA
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