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Kocakabak C, van den Hoogen A, Rothfus M, Campbell-Yeo M, Kostenzer J, Axelin A, Schofield P, Latour JM. Identifying outcomes and outcome measures in neonatal family-centered care trials: a systematic review. Pediatr Res 2024:10.1038/s41390-024-03293-2. [PMID: 38849484 DOI: 10.1038/s41390-024-03293-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 04/16/2024] [Accepted: 05/15/2024] [Indexed: 06/09/2024]
Abstract
BACKGROUND A wide range of outcomes for infants and parents has been reported in clinical trials testing FCC interventions. This systematic review aimed to identify outcomes, outcome measures, and time-points reported in experimental studies testing FCC interventions in neonatal care units. METHODS This review included experimental studies investigating FCC interventions in neonatal settings. Database searches were conducted in MEDLINE, EMBASE, CINAHL, Cochrane, PsycINFO, Scopus, JBI, Lilacs, and SciELO, completed in December 2022 and updated in November 2023. Critical appraisal was performed using the JBI checklist for randomized controlled trials, and a narrative synthesis process was used. Outcomes were categorized into the Comet Taxonomy core areas. RESULTS The search identified 8787 papers; 42 studies were included in the analysis. Totally, 60 outcomes were identified: 42 infant and 18 parents' outcomes. Outcomes were clustered into 12 domains for infants and five domains for parents and measured by 97 outcome measures. The included studies reported 25 and 27 different time-points for infants and parents, respectively. CONCLUSION This review of studies testing FCC interventions identified heterogeneity and inconsistency of outcomes, outcome measures, and time-points measuring the outcomes. Developing a core outcome set for FCC studies is warranted to benchmark the evidence and identify best-practices. IMPACT This systematic review identified inconsistency of outcomes, outcome measures, and time-points reported in quantitative studies testing family-centered care interventions in neonatal care settings. The lack of standardized outcomes and outcome measures reported in clinical trials makes it difficult to synthesize data to provide conclusive recommendations. This systematic review will contribute to the development of a core outcome set for research testing family-centered care interventions in neonatal care settings.
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Affiliation(s)
- Cansel Kocakabak
- School of Nursing and Midwifery, Faculty of Health, University of Plymouth, Plymouth, UK.
| | - Agnes van den Hoogen
- Department Women and Baby, Neonatology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, The Netherlands, Utrecht University, Utrecht, The Netherlands
| | - Melissa Rothfus
- Dalhousie Libraries, Dalhousie University, Halifax, NS, Canada
| | - Marsha Campbell-Yeo
- School of Nursing, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Johanna Kostenzer
- European Foundation for the Care of Newborn Infants, Munich, Germany
| | - Anna Axelin
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Patricia Schofield
- School of Nursing and Midwifery, Faculty of Health, University of Plymouth, Plymouth, UK
| | - Jos M Latour
- School of Nursing and Midwifery, Faculty of Health, University of Plymouth, Plymouth, UK
- Department of Nursing, Zhongshan Hospital, Fudan University, Shanghai, China
- Curtin School of Nursing, Curtin University, Perth, WA, Australia
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Jeppesen E, Schmidt AA, Skjødt CK, Hybschmann J, Gjærde LK, Thestrup J, Hansson H, Sørensen JL. Educational programmes for paediatric healthcare professionals in patient- and family-centred care. A scoping review. Eur J Pediatr 2024; 183:2015-2028. [PMID: 38430279 PMCID: PMC11035470 DOI: 10.1007/s00431-024-05455-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 01/05/2024] [Accepted: 01/25/2024] [Indexed: 03/03/2024]
Abstract
To identify and describe educational programmes in patient- and family-centred care for paediatric healthcare professionals. This scoping review was conducted and reported according to the JBI Manual for Evidence Synthesis and the PRISMA guideline. The databases searched included MEDLINE (PubMed), PsycINFO, CINAHL, Scopus, Cochrane, and Embase. Inclusion criteria were experimental, observational and qualitative studies about educational programmes on patient- and family-centred care for paediatric healthcare professionals. Exclusion criteria were reviews and non-peer-reviewed literature. Two reviewers independently screened and extracted the data using Covidence. Of the 13922 records identified, 49 articles met the inclusion criteria. There was a large variety of educational programmes, half of which were interdisciplinary, that mainly targeted nurses and doctors. The median number of participants was 51 (range 7 to 1411). The predominant target population was children with chronic disabilities and neonatal intensive care units, and only one programme specifically targeted adolescents. The median duration was one day (range 5 min to 3.5 years). Development of competencies was the most common objective. We identified 12 different educational content areas. Content mainly focused on communication and relational competencies, including partnership, which involved shared decision-making, mutual agenda setting, and negotiation of a plan. Many kinds of educational strategies were found but experiential learning through simulation and roleplay was used most. Conclusion: A large variety of educational programmes in paediatric patient- and family-centred care exist. Educational content mainly focused on communication and relational competencies. Experiential learning including roleplay and simulation was the most used educational strategy. What is Known: • Delivery of patient- and family-centred care improves parental satisfaction of care but requires clinicians have a certain attitude towards involving the child and parents in a healthcare partnership as well as advanced triadic communication skills. Little is known about how this attitude, and more broadly, patient- and family-centred care, can be facilitated through education and training. What is New: • This scoping review found a wide array of programmes.. Workshops with simulation or roleplay was the most frequent educational strategy. The programmes, which typically targeted nurses and doctors, chiefly focused on basic and advanced communication and relational competencies, including partnership, which involved shared decision-making and negotiation of plans.
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Affiliation(s)
- Elisabeth Jeppesen
- Mary Elizabeth's Hospital - Rigshospitalet for Children, Teens and Expecting Families, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.
- Juliane Marie Centre, Copenhagen University Hospital -Rigshospitalet, Copenhagen, Denmark.
- Department of Respiratory Medicine, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark.
| | - Anne Aarslev Schmidt
- Juliane Marie Centre, Copenhagen University Hospital -Rigshospitalet, Copenhagen, Denmark
- Department of Pediatric Surgery, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Camilla Kriegbaum Skjødt
- Juliane Marie Centre, Copenhagen University Hospital -Rigshospitalet, Copenhagen, Denmark
- Department of Pediatric Surgery, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Jane Hybschmann
- Mary Elizabeth's Hospital - Rigshospitalet for Children, Teens and Expecting Families, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Line Klingen Gjærde
- Mary Elizabeth's Hospital - Rigshospitalet for Children, Teens and Expecting Families, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
- Juliane Marie Centre, Copenhagen University Hospital -Rigshospitalet, Copenhagen, Denmark
| | - Jakob Thestrup
- Mary Elizabeth's Hospital - Rigshospitalet for Children, Teens and Expecting Families, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Helena Hansson
- Juliane Marie Centre, Copenhagen University Hospital -Rigshospitalet, Copenhagen, Denmark
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jette Led Sørensen
- Mary Elizabeth's Hospital - Rigshospitalet for Children, Teens and Expecting Families, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
- Juliane Marie Centre, Copenhagen University Hospital -Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Deribe L, Addissie A, Girma E, Gidey A, Teferra S, Lindström NB. Level of Family centered care and associated factors among parents of children with cancer at tertiary level hospital, Ethiopia. J Pediatr Nurs 2024; 76:e69-e76. [PMID: 38307760 DOI: 10.1016/j.pedn.2024.01.020] [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: 05/27/2023] [Revised: 01/16/2024] [Accepted: 01/20/2024] [Indexed: 02/04/2024]
Abstract
OBJECTIVE To determining level and factors affecting Family Centered Care (FCC) in pediatric oncology unit of Tikur Anbessa Specialized hospital (TASH), Ethiopia. METHOD A cross sectional study was conducted from June to December 2022. Three hundred ninety-three parents of children with cancer were consecutively interviewed using Measure of Processes of Care (MPOC-20). Multivariable linear regression was used to identify independent predictors of FCC. RESULT The total MPOC 20 means was 3.71(SD = 1.04). The mean score for respectful and supportive care, coordinated and comprehensive care, enabling and partnership, providing specific information and providing general information were found to be 4.8, 4.6, 3.7, 2.3 and 2.6, respectively. Family employment (-0.33(95% CI = -0.63, -0.03; P = .029)), low family education (-0.40 (95% CI = -0.70, -0.11; P = .008)), referral cases (-0.37(95% CI = -0.59, -0.14; P = .001)), shorter time spent in hospital (-0.49(95% CI = -0.85, -0.12; P = .010)) and psychological distress (-0.01(95% CI = -0.026, -0.001; P = .028)) were associated with lower mean score of FCC. CONCLUSION The total FCC mean score was found to be low. From the five FCC components providing general and specific information scored the lowest mean level. PRACTICE IMPLICATIONS Mechanism to improve information delivery that address parents from different background and referred from other health facility should be in place in order to improve FCC level. In addition, the FCC should be designed to address parents of children with different lengths of stay.
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Affiliation(s)
- Leul Deribe
- School of Nursing and Midwifery, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Adamu Addissie
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Eshetu Girma
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Abdulkadir Gidey
- School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Solomon Teferra
- School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
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Carew M, Redley B, Bloomer MJ. Competing Tensions: Nurse Perceptions of Family-Centered Care and Parents' Needs in Neonatal Care. Adv Neonatal Care 2024; 24:35-42. [PMID: 38193725 DOI: 10.1097/anc.0000000000001136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
BACKGROUND Family-centered care is founded upon collaboration between parents and healthcare professionals, caring for a child and parents as one entity. The unfamiliar neonatal environment and complexity of care can make family-centered care challenging. PURPOSE To explore neonatal nurses' perceptions of family-centered care and parents' cultural needs. METHODS This was a qualitative descriptive study using interviews to gather data from registered nurses, and analyzed using inductive content analysis. RESULTS Ten neonatal nurses participated in online interviews, lasting an average of 25 minutes. Parents' cultural needs were poorly understood and assumed synonymous with family-centered care. While all acknowledged the importance of family-centered care, most described tasks to parent-infant bonding, rather than a broader embodiment of family-centered care. In time of uncertainty, emergent clinical priorities took priority over a family-centered approach to care. Cultural care was poorly understood, and care tasks associated with supporting parent-infant bonding suggest further work is necessary to promote embodiment of family-centered care beyond individual tasks. While emergent clinical priorities and neonate well-being will always be the priority, finding a way to respond that concords with the ethos of family-centered care is also essential. IMPLICATIONS FOR PRACTICE AND RESEARCH Clear and consistent leadership is needed to demonstrate greater embodiment of family-centered care, which includes cultural care for parents. Strong leadership and targeted education are key to supporting this change. Further research is warranted to examine and observe practice, in particular how parents' cultural needs are assessed and integrated into family-centered care in neonatal settings.
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Affiliation(s)
- Maddison Carew
- Maternity Unit, Bass Coast Health, Wonthaggi, Victoria, Australia (Ms Carew); School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia (Ms Carew and Prof Redley); Health Complaints Commissioner, Melbourne, Victoria, 3000, Australia (Prof Redley); and School of Nursing and Midwifery, Griffith University, Nathan, Queensland, and Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, and Intensive Care Unit, Princess Alexandra Hospital, Metro South Health, Woolloongabba, Queensland, Australia (Prof Bloomer)
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Pricoco R, Mayer-Huber S, Paulick J, Benstetter F, Zeller M, Keller M. Impact of a family-centred clinical care programme on short-term outcomes of very low-birth weight infants. Acta Paediatr 2023; 112:2368-2377. [PMID: 37551158 DOI: 10.1111/apa.16944] [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: 04/19/2023] [Revised: 08/01/2023] [Accepted: 08/07/2023] [Indexed: 08/09/2023]
Abstract
AIM We evaluated the effects of a family-centred clinical care pathway and case management programme on short-term clinical outcome in a cohort of very low-birth weight (VLBW) infants. METHODS The programme, named NeoPAss, was developed at the Department of Neonatology Children's hospital Passau in 2013. Short-term outcomes of infants were compared to matched controls from the Bavarian neonatology surveillance database before (n = 111; 2008-2012) and after implementation (n = 170; 2014-2017). RESULTS After implementation the rate of late-onset sepsis was significantly lower (2.5% vs. 10.7%, p = 0.005) and the length of stay was significantly shorter (VLBW 28 to 31 weeks' gestational age (GA) 47.5 vs. 53.1 days, p = 0.047; <28 weeks' GA 79.4 vs. 91.9 days, p = 0.007) in the intervention group compared to controls. Infants were discharged with significantly lower weight (mean 2351 vs. 2539 g, p = 0.013). There was no statistically significant difference in the rate of intraventricular haemorrhage (3.7% vs. 8.2%), necrotizing enterocolitis (0.6% vs. 1.9%) and bronchopulmonary dysplasia (0% vs. 6.9%). CONCLUSION Our data confirm that of other studies demonstrating a beneficial effect of family-centred care programmes and provides evidence that structured parental involvement is not associated with increased risk of infection in a VLBW cohort.
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Affiliation(s)
- Rafael Pricoco
- Department of Pediatrics, Technical University of Munich, School of Medicine, Munich, Germany
| | | | - Johannes Paulick
- Department of Pediatrics, Technical University of Munich, School of Medicine, Munich, Germany
| | | | - Michael Zeller
- Department of Pediatrics, Technical University of Munich, School of Medicine, Munich, Germany
- Kinderklinik Dritter Orden, Passau, Germany
| | - Matthias Keller
- Department of Pediatrics, Technical University of Munich, School of Medicine, Munich, Germany
- Kinderklinik Dritter Orden, Passau, Germany
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North K, Whelan R, Folger LV, Lawford H, Olson I, Driker S, Bass MB, Edmond K, Lee ACC. Family Involvement in the Routine Care of Hospitalized Preterm or Low Birth Weight Infants: A Systematic Review and Meta-analysis. Pediatrics 2022; 150:188641. [PMID: 35921672 DOI: 10.1542/peds.2022-057092o] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/16/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Preterm and low birth weight (LBW) infants are often separated from parents during hospitalization. Our objective was to assess effects of interventions to increase family involvement in the routine newborn care of preterm or LBW infants compared with standard NICU care on infant and parental outcomes. METHODS Data sources include Medline, Embase, CINAHL, and World Health Organization Global Index Medicus to August 2021. The study selection included randomized controlled trials (RCTs) of family involvement intervention packages. Data were extracted and pooled with random-effects models. RESULTS We included 15 RCTs with 5240 participants. All interventions included direct parental bedside care; packages varied with respect to additional components. Family involvement interventions decreased retinopathy of prematurity (odds ratio 0.52, 95% confidence interval [CI]: 0.34, 0.80; 8 RCTs), length of hospital stay (mean difference [MD] -2.91 days; 95% CI: -5.15,-0.82; 11 RCTs), and parental stress and anxiety (Parental Stress Scale: MD -0.29 points, 95% CI: -0.56,-0.01, 2 RCTs; Anxiety State-Trait scale: MD -1.79, 95% CI: -3.11,-0.48; 2 RCTs). Family involvement increased weight gain velocity (MD 2.09 g/day; 95% CI: 1.27, 2.91; 3 RCTs), neurobehavioral exam scores (MD: 1.11; 95% CI: 0.21, 2.01; 2 RCTs) and predominant or exclusive breastmilk intake (odds ratio 1.34; 95% CI: 1.01, 1.65; 3 RCTs). It may decrease rates of bronchopulmonary dysplasia, infection, and intraventricular hemorrhage. There were no effects on mortality or necrotizing enterocolitis. Certainty of evidence ranged from low to moderate. CONCLUSIONS Family involvement has a beneficial role on several infant and parental outcomes.
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Affiliation(s)
- Krysten North
- Global Advancement of Infants and Mothers (AIM), Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Rachel Whelan
- Global Advancement of Infants and Mothers (AIM), Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Lian V Folger
- Global Advancement of Infants and Mothers (AIM), Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Harriet Lawford
- Mater Research Institute, The University of Queensland, NHMRC Centre of Research Excellence in Stillbirth (Stillbirth CRE), South Brisbane, Australia
| | - Ingrid Olson
- Global Advancement of Infants and Mothers (AIM), Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Sophie Driker
- Global Advancement of Infants and Mothers (AIM), Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Michelle B Bass
- Countway Medical Library, Harvard Medical School, Boston, Massachusetts
| | | | - Anne C C Lee
- Global Advancement of Infants and Mothers (AIM), Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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Tajalli S, Ebadi A, Parvizy S, Kenner C. Maternal caring ability with the preterm infant: A Rogerian concept analysis. Nurs Forum 2022; 57:920-931. [PMID: 35716151 DOI: 10.1111/nuf.12756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 04/23/2022] [Accepted: 05/10/2022] [Indexed: 11/29/2022]
Abstract
AIM To analyze the concept of maternal caring ability for a preterm infant to develop an operational definition. BACKGROUND Each year, many newborns are born preterm and admitted to the neonatal intensive care unit (NICU). Although their mothers are prepared for discharge home by the staff, it is difficult to identify an operational definition of their maternal caring ability for the preterm infant. DESIGN Concept analysis. DATA SOURCES Searches used PubMed, as the primary health-related literature, ProQuest, Science Direct, CINHAL, web of science, Scopus, and Google Scholar. Keywords caring ability, mother, and preterm infant were used to analyze the development of the concept from 1965 to 2020. METHODS Rogers' and Knafl's evolutionary approach has been used to explain the concept of maternal caring ability for the preterm infant. RESULTS The combined searches yielded 23,291 documents published in English. After the screening process, 43 documents were selected. The Graneheim and Lundman analysis method was used to identify the themes related to the attributes of maternal caring ability. Findings showed the caring ability to have four antecedents (maternal characteristics, support systems, infant characteristics, and the illness severity), four attributes (knowledge and skill in neonatal care, self-efficacy, sensitivity, responsibility, and problem-solving), and three consequences (parental adjustment, improving infant growth and development, and improving parent-infant relationships). CONCLUSION The caring ability of the mother of a preterm infant is grounded in an adequate knowledge of caregiving needs of a preterm infant, high caregiving skills, a sense of self-efficacy, problem-solving, sensitivity, and responsibility.
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Affiliation(s)
- Saleheh Tajalli
- School of Nursing and Midwifery, Nursing Care Research Center (NCRC), Iran University of Medical Sciences, Tehran, Iran
| | - Abbas Ebadi
- Behavioral Sciences Research Center, Life Style Institute, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Soroor Parvizy
- Department of Medical Education, Center for Educational Research in Medical Sciences (CERMS), School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Carole Kenner
- School of Nursing, Health, and Exercise Science, The College of New Jersey, Ewing, New Jersey, USA
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Abstract
With improving survival at the lowest gestations an increasing number of tiny and vulnerable infants are being cared for, and optimal outcomes require an approach to care that takes their specific characteristics into account. These include immature organ function and a risk for iatrogenic injury, and parental/familial strain due to the high degree of uncertainty, infant-mother separation, and long hospital stay. While the challenges in providing nursing care to these infants are obvious it is also clear that this field has tremendous potential to influence both short and long-term outcomes of this population. This mini-review discusses aspects of the nursing care provided to infants born at the very lowest gestations and their families, with focus on doing less harm by establishing an adequate care environment, actively promoting parental closeness and care-giving, and conservative skin care.
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Soni R, Tscherning Wel-Wel C, Robertson NJ. Neuroscience meets nurture: challenges of prematurity and the critical role of family-centred and developmental care as a key part of the neuroprotection care bundle. Arch Dis Child Fetal Neonatal Ed 2022; 107:242-249. [PMID: 33972264 DOI: 10.1136/archdischild-2020-319450] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 04/01/2021] [Accepted: 04/13/2021] [Indexed: 02/06/2023]
Abstract
Advances in neonatal-perinatal medicine have resulted in increased survival at lower gestations. Although the incidence of germinal matrix haemorrhage-intraventricular haemorrhage and cystic periventricular leucomalacia is reducing, a new phenotype of preterm brain injury has emerged consisting of a combination of destructive and dysmaturational effects. Consequently, severe neurological disability is reported at a lower rate than previously, but the overall morbidity associated with premature birth continues to present a large global burden and contributes significantly to increased financial costs to health systems and families. In this review, we examine the developmental milestones of fetal brain development and how preterm birth can disrupt this trajectory. We review common morbidities associated with premature birth today. Although drug-based and cell-based neuroprotective therapies for the preterm brain are under intense study, we outline basic, sustainable and effective non-medical, family-centred and developmental care strategies which have the potential to improve neurodevelopmental outcomes for this population and need to be considered part of the future neuroprotection care bundle.
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Affiliation(s)
- Roopali Soni
- Neonatology, Sidra Medical and Research Center, Doha, Ad Dawhah, Qatar .,Department of Neonatology, Mediclinic Parkview Hospital, Dubai, UAE
| | - Charlotte Tscherning Wel-Wel
- Neonatology, Sidra Medical and Research Center, Doha, Ad Dawhah, Qatar.,Center of Physiopathology Toulouse-Purpan(CPTP), University of Toulouse, Toulouse, France
| | - Nicola J Robertson
- Institute for Women's Health, University College London, London, UK.,Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
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Albayrak S, Büyükgönenç LA. The impact of family-centered care interventions on neonatal and parental outcomes in a Turkish hospital. Collegian 2022. [DOI: 10.1016/j.colegn.2022.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Jerofke-Owen TA, McAndrew NS, Gralton KS, Totka JP, Weiss ME, Fial AV, Sawin KJ. Engagement of Families in the Care of Hospitalized Pediatric Patients: A Scoping Review. JOURNAL OF FAMILY NURSING 2022; 28:151-171. [PMID: 34605283 DOI: 10.1177/10748407211048894] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This scoping review was conducted to examine the range, nature, and extent of the published family engagement literature specific to the pediatric acute care setting to highlight future research and practice development opportunities. Included studies (N = 247) revealed global relevance. Engagement strategies ranged from more passive such as allowing/encouraging families to be present at the bedside to more active strategies aimed at promoting mutual and reciprocal nurse-patient interactions. Family engagement is distinguished by a mutually beneficial partnership of families with health care team members and care organizations. Future research in the area of family engagement in pediatric nursing should focus on determining the core engaging health professional behaviors and engaged parent outcomes; extending the knowledge base related to mutually beneficial partnerships between families and health care teams; developing effectiveness studies to determine the optimal engaging actions by teams to achieve parent engagement; and measuring the influence of engagement on parent and infant/child outcomes.
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Affiliation(s)
| | - Natalie S McAndrew
- University of Wisconsin-Milwaukee, USA
- Froedtert Hospital & the Medical College of Wisconsin, Milwaukee, USA
| | | | - Joan P Totka
- Marquette University, Milwaukee, WI, USA
- Children's Wisconsin, Milwaukee, USA
| | | | | | - Kathleen J Sawin
- University of Wisconsin-Milwaukee, USA
- Children's Wisconsin, Milwaukee, USA
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Factors That Influence NICU Health Care Professionals' Decision Making to Implement Family-Centered Care. Adv Neonatal Care 2022; 22:87-94. [PMID: 33675305 DOI: 10.1097/anc.0000000000000846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Neonatal intensive care unit (NICU) is a multifaceted, technology-driven high stress environment for professionals, infants and families. PURPOSE Examine healthcare professionals' beliefs and perceptions regarding providing FCC within the context of NICU. METHODS This exploratory descriptive study used an online-survey format. The survey comprised several instruments including the Perceived Stress Scale, symptoms of burnout subscale from the Professional Quality of Life scale, and the Family Nurse Caring Belief Scale (FNCBS). Demographic and open-ended items were also included. RESULTS Sample consisted of 115 multidisciplinary participants working in a level IV neonatal intensive care unit. Participants report strong levels of FCC beliefs. Participants strongly agreed (82%) or agreed (18%) that no matter how sick the infant is, he or she needs to be treated as an individual. A significant correlation (r=-0.343, P < .001) exists between participant's stress composite score and FNCBS composite score. There were significant relationships between participant's years of experience (F = 5.35, P < .002) and education levels (F = 2.60, P < .05) and higher FNCBS composite scores. There were also significant relationships between participant's years of experience (F = 4.77, P < .004) and education (F = 2.89, P < .039) with higher Perceived Stress Scale composite scores. IMPLICATIONS FOR PRACTICE Results suggest that while participants agreed that FCC is important, they also believed that inadequate staffing and inappropriate assignments may lead to rationing of care. IMPLICATIONS FOR RESEARCH Further research is needed to explore factors that lead to rationing of FCC.
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Gaden TS, Ghetti C, Kvestad I, Gold C. The LongSTEP approach: Theoretical framework and intervention protocol for using parent-driven infant-directed singing as resource-oriented music therapy. NORDIC JOURNAL OF MUSIC THERAPY 2021. [DOI: 10.1080/08098131.2021.1921014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Tora Söderström Gaden
- GAMUT – The Grieg Academy Music Therapy Research Centre, NORCE Norwegian Research Centre AS, Bergen, Norway
| | - Claire Ghetti
- GAMUT – The Grieg Academy Music Therapy Research Centre, NORCE Norwegian Research Centre AS, Bergen, Norway
- GAMUT – the Grieg Academy Music Therapy Research Centre, the Grieg Academy – Department of Music, University of Bergen, Bergen, Norway
| | - Ingrid Kvestad
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre AS, Bergen, Norway
| | - Christian Gold
- GAMUT – The Grieg Academy Music Therapy Research Centre, NORCE Norwegian Research Centre AS, Bergen, Norway
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Care of hospitalized infants and their families during the COVID-19 pandemic: an international survey. J Perinatol 2021; 41:981-987. [PMID: 33758385 PMCID: PMC7985585 DOI: 10.1038/s41372-021-00960-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 01/19/2021] [Accepted: 01/22/2021] [Indexed: 11/20/2022]
Abstract
This research study explored changes in family-centered care practices for hospitalized infants and families due to the COVID-19 pandemic. This exploratory descriptive study used a 49-item online survey, distributed to health care professionals working with hospitalized infants and families. The sample consisted of 96 participants from 22 countries. Prior to the COVID-19 pandemic, 87% of units welcomed families and 92% encouraged skin-to-skin care. During the pandemic, family presence was restricted in 83% of units, while participation in infant care was restricted in 32%. Medium-sized (20-40 beds) units applied less restriction than small (<20 beds) units (p = 0.03). Units with single-family rooms that did not restrict parental presence, implemented fewer restrictions regarding parents' active participation in care (p = 0.02). Restrictions to families were not affected by geographic infection rates or developmental care education of health care professionals. Restrictions during the pandemic increased separation between the infant and family.
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Goals of Parents Whose Infant Is in the Neonatal Intensive Care Unit: An Explorative Study. Adv Neonatal Care 2020; 20:499-505. [PMID: 32243323 DOI: 10.1097/anc.0000000000000725] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The aim of many neonatal intensive care units (NICU) today is to promote a family-centered practice that addresses parental concerns and needs. However, the specific goals of parents are often unaddressed by the healthcare team. The aim of this study was to understand the goals of parents whose infant was in the NICU to enhance collaboration and communication between parents and health professionals. METHODS A written questionnaire was disseminated to parents whose infant was in the NICU at the Kingston Health Sciences Centre. A thematic analysis of the goals was completed to identify key emergent themes and their implications. RESULTS A total of 23 questionnaires were disseminated to parents and 13 (57%) were returned. Returned questionnaires were most often completed by the mother (n = 9, 70%), and a total of 40 goals were recorded. Three key emergent themes were identified, which included feeding and weight gain, eliminating medical equipment, and successful hospital discharge. IMPLICATIONS FOR PRACTICE Understanding the goals of parents whose infant was in the NICU can enhance communication between parents and their healthcare team, thus aiding the implementation of a family-centered practice. IMPLICATIONS FOR RESEARCH Future larger sample sizes studies across several NICUs would increase the generalizability of results and garner a larger volume of data to establish significant trends between specific infant and parent demographic data and the associated goals.
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Bovbjerg ML. Current Resources for Evidence-Based Practice, January 2020. J Obstet Gynecol Neonatal Nurs 2020; 49:116-124. [DOI: 10.1016/j.jogn.2019.11.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
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