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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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Astuti DD, Rohsiswatmo R, Wanda D, Utari DM. Experiences of Indonesian nurses in improving preterm oral feeding readiness in special care units: A qualitative descriptive study. BELITUNG NURSING JOURNAL 2023; 9:478-488. [PMID: 37901376 PMCID: PMC10600710 DOI: 10.33546/bnj.2772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 07/15/2023] [Accepted: 09/19/2023] [Indexed: 10/31/2023] Open
Abstract
Background Many preterm infants face feeding difficulties during the transition from enteral to oral feeding due to organ immaturity, resulting in aspiration, airway instability, and oral feeding intolerance. These challenges can increase morbidity and mortality among preterm infants. Nurses play a vital role in providing interventions to minimize negative impacts and enhance the safety of preterm oral feeding. Objective This study aimed to explore the experiences of Indonesian nurses in improving preterm oral feeding readiness. Methods A qualitative descriptive study was conducted involving ten nurses working in intensive care units as participants through purposive sampling. Data were collected through semi-structured, in-depth interviews conducted from January to March 2023. Thematic analysis was applied for data analysis. Results Four key themes developed in this study: 1) comprehensive and holistic nursing assessment, 2) challenging and complex nursing issues, 3) the need for nutritional management skills, and 4) the necessity of collaborative support. Conclusion Nurses play a pivotal role in enhancing oral feeding readiness among premature infants. Their responsibilities include assessing oral feeding readiness, addressing nursing challenges, and implementing multidisciplinary stimulation involving parents. This study provides a foundational framework for developing interventions to improve preterm oral feeding readiness.
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Affiliation(s)
- Dyah Dwi Astuti
- Postgraduate Program, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
- Department of Pediatric Nursing, Poltekkes Kemenkes Surakarta, Mojosongo, Surakarta, Indonesia
| | - Rinawati Rohsiswatmo
- Department of Child Health, Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo Hospital, DKI Jakarta, Indonesia
| | - Dessie Wanda
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
| | - Diah Mulyawati Utari
- Department of Public Health Nutrition, Faculty of Public Health, Universitas Indonesia, Depok, Indonesia
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Yang X, Zhang J, Cao M, Pan Y, Zhang Y. Application of e-health on neonatal intensive care unit discharged preterm infants and their parents: Protocol for systematic review and meta-analysis. Digit Health 2023; 9:20552076231205271. [PMID: 37822959 PMCID: PMC10563470 DOI: 10.1177/20552076231205271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 09/15/2023] [Indexed: 10/13/2023] Open
Abstract
Background After preterm birth, parents often conformed with difficulties such as negative emotions, lack of care knowledge and skills, and insufficient professional support. As a remote health guidance method, e-health can provide a series of support for premature infants and their parents during the transition period from neonatal intensive care unit (NICU) to home care. Objectives To determine the efficacy of e-health interventions in discharged preterm infants as well as their parents, and to describe the process outcomes and elements of these e-health interventions to inform the effective design of future interventions. Methods The systematic review of the randomized and non-randomized controlled trials on the follow-up effect of e-health on preterm infants and their parents discharged from NICU between the inception to May 2023 will be electronically searched in the following nine databases: Web of Science, CINAHL Complete (EBSCO), PubMed, Embase, the Cochrane Library, Ovid MEDLINE, China National Knowledge Infrastructure, WANFANG DATA, and SinoMed. Quality will be appraised, respectively, via the revised tool to assess risk of bias (RoB 2) and the tool for risk of bias in non-randomized studies of interventions (ROBINS-I). The main outcome indicators of preterm infants are breastfeeding rate, readmission rate, neurobehavioral development, and premature infant's body mass. The outcome indicators for parents of premature infants are anxiety, depression scale, and parenting competency scale. The RevMan 5.4 software provided by the Cochrane Collaboration will be used for statistical analysis of the data. Conclusion The results of this study may provide future development opportunities for e-health follow-up prevention in preterm infants and may support evidence-based decision-making for e-health interventions of post-discharge developmental support in preterm infants. PROSPERO registration number CRD42023410334.
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Affiliation(s)
- Xinyi Yang
- School of Nursing, Wuhan University, Wuhan, PR China
| | - Jun Zhang
- School of Nursing, Wuhan University, Wuhan, PR China
| | - Mi Cao
- School of Nursing, Hubei Polytechnic Institute, Xiaogan, PR China
| | - Yujie Pan
- School of Nursing, Wuhan University, Wuhan, PR China
| | - Yijia Zhang
- School of Nursing, Wuhan University, Wuhan, PR China
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Howden A, McFerran KS, Thompson GA. Reflective Lullaby Writing with two mother--infant dyads who recently experienced an admission to a neonatal intensive care unit. NORDIC JOURNAL OF MUSIC THERAPY 2022. [DOI: 10.1080/08098131.2022.2115531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Amy Howden
- The Faculty of Fine Arts and Music, University of Melbourne, Melbourne, Australia
| | | | - Grace Anne Thompson
- The Faculty of Fine Arts and Music, University of Melbourne, Melbourne, Australia
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Kaap-Fröhlich S, Ulrich G, Wershofen B, Ahles J, Behrend R, Handgraaf M, Herinek D, Mitzkat A, Oberhauser H, Scherer T, Schlicker A, Straub C, Waury Eichler R, Wesselborg B, Witti M, Huber M, Bode SFN. Position paper of the GMA Committee Interprofessional Education in the Health Professions - current status and outlook. GMS JOURNAL FOR MEDICAL EDUCATION 2022; 39:Doc17. [PMID: 35692364 PMCID: PMC9174072 DOI: 10.3205/zma001538] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/31/2022] [Accepted: 02/16/2022] [Indexed: 05/19/2023]
Abstract
In the wake of local initiatives and developmental funding programs, interprofessionality is now included in national curricula in the German-speaking countries. Based on the 3P model (presage, process, product), this position paper presents the development of interprofessional education in recent years in Germany, Austria and Switzerland and places it in an international context. Core aspects as legal frameworks, including amendments to occupational regulations as well as the formation of networks and faculty development are basic requirements for interprofessional education. New topics and educational settings take shape in the process of interprofessional education: patient perspectives and teaching formats, such as online courses, become more important or are newly established. The influence of the COVID-19 pandemic on interprofessional education is explored as well. Among many new interprofessional courses, particularly the implementation of interprofessional training wards in Germany and Switzerland are positive examples of successful interprofessional education. The objective of interprofessional education continues to be the acquisition of interprofessional competencies. The main focus is now centered on evaluating this educational format and testing for the corresponding competencies. In the future, more capacities will be required for interprofessional continuing education and post-graduate education. Structured research programs are essential to ascertain the effects of interprofessional education in the German-speaking countries. In this position paper the GMA committee on interprofessional education encourages further advancement of this topic and expresses the aim to continue cooperating with other networks to strengthen and intensify interprofessional education and collaboration in healthcare.
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Affiliation(s)
- Sylvia Kaap-Fröhlich
- Careum Foundation, Zurich, Switzerland
- Zurich University of Applied Sciences, Bachelor "Biomedical Laboratory Diagnostics", Wädenswil, Switzerland
| | | | - Birgit Wershofen
- Institute of Medical Education, University Hospital, LMU Munich, Munich, Germany
| | - Jonathan Ahles
- Albert-Ludwigs-University Freiburg, Medical Faculty, Office of the Dean of Studies, Freiburg, Germany
| | - Ronja Behrend
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Deans Office of Study Affairs, Semester Coordination, Berlin, Germany
| | - Marietta Handgraaf
- University of Applied Sciences, Department of Applied Health Sciences, Division of Physiotherapy, Bochum, Germany
| | - Doreen Herinek
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Health and Nursing Science, Berlin, Germany
| | - Anika Mitzkat
- Heidelberg University Hospital, Department of General Medicine and Health Services Research, Heidelberg, Germany
| | - Heidi Oberhauser
- fh gesundheit, fhg - Health University of Applied Sciences Tyrol, Innsbruck, Austria
| | - Theresa Scherer
- Bern University of Applied Sciences, Department of Health, Office for Interprofessional Teaching, Bern, Switzerland
| | - Andrea Schlicker
- Witten/Herdecke University, Faculty of Health, Department of Human Medicine, Witten, Germany
| | - Christine Straub
- University of Freiburg, Faculty of Medicine, Department of General Pediatrics, Adolescent Medicine and Neonatology, Medical Centre, Teaching and Teaching Research/Teaching Development Working Group, Freiburg, Germany
| | - Regina Waury Eichler
- Protestant University of Applied Sciences Berlin, Bachelor of Nursing degree program, Berlin, Germany
| | - Bärbel Wesselborg
- Fliedner Fachhochschule Düsseldorf, University of Applied Sciences, Nursing Education, Düsseldorf, Germany
| | - Matthias Witti
- Institute of Medical Education, University Hospital, LMU Munich, Munich, Germany
| | - Marion Huber
- Zurich University of Applied Sciences, Department of Interprofessional Teaching and Practice, Winterthur, Switzerland
| | - Sebastin F N Bode
- University of Freiburg, Faculty of Medicine, Department of General Pediatrics, Adolescent Medicine and Neonatology, Medical Centre, Teaching and Teaching Research/Teaching Development Working Group, Freiburg, Germany
- Ulm University, Ulm University Medical Center, Department of Pediatrics and Adolescent Medicine, Ulm, Germany
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Schuetz Haemmerli N, Stoffel L, Schmitt KU, Khan J, Humpl T, Nelle M, Cignacco E. Enhancing Parents' Well-Being after Preterm Birth-A Qualitative Evaluation of the "Transition to Home" Model of Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074309. [PMID: 35409993 PMCID: PMC8998674 DOI: 10.3390/ijerph19074309] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 03/31/2022] [Accepted: 04/01/2022] [Indexed: 01/03/2023]
Abstract
There are few programs available aimed at preventing short- and long-term negative consequences after preterm birth and covering the entire care continuum. The “Transition to Home (TtH)” model is such a program, offering structured, individual support for families with preterm infants before and after hospital discharge. This study gathers and examines the parents’ views of receiving support from an interprofessional team under the TtH model of care during hospitalization and after discharge. Using a qualitative explorative design, 39 semi-structured interviews with parents were analyzed thematically. From this analysis, three main themes were identified: (1) TtH and the relevance of continuity of care; (2) Enhancement of parents’ autonomy and self-confidence; (3) Perception of interprofessional collaboration. Within these themes, the most relevant aspects identified were continuity of care and the appointment of a designated health care professional to anchor the entire care continuum. Emotional support complemented by non-medical approaches, along with strength-based and family resource-oriented communication, also emerged as key aspects. Continuous, family-centered care and well-organized interprofessional collaboration promote the well-being of the family after a premature birth. If the aspects identified in this study are applied, the transition from hospital to home will be smoothened for the benefit of affected families.
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Affiliation(s)
- Natascha Schuetz Haemmerli
- Department of Health Professions, Bern University of Applied Sciences, 3008 Bern, Switzerland; (K.-U.S.); (E.C.)
- Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland;
- Correspondence:
| | - Liliane Stoffel
- Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland;
| | - Kai-Uwe Schmitt
- Department of Health Professions, Bern University of Applied Sciences, 3008 Bern, Switzerland; (K.-U.S.); (E.C.)
- Insel Gruppe, Bern University Hospital, 3010 Bern, Switzerland
| | - Jeannine Khan
- Kantonale Schule für Berufsbildung, 5001 Aarau, Switzerland;
| | - Tilman Humpl
- Tilman Humpl, Department of Paediatrics, St. Elisabethen-Krankenhaus, Kliniken des Landeskreises Lörrach, 79539 Lörrach, Germany;
| | - Mathias Nelle
- Mathias Nelle, Children’s Hospital, Kreiskliniken Böblingen, 71302 Böblingen, Germany;
| | - Eva Cignacco
- Department of Health Professions, Bern University of Applied Sciences, 3008 Bern, Switzerland; (K.-U.S.); (E.C.)
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Haslbeck FB, Schmidli L, Bucher HU, Bassler D. Music Is Life-Follow-Up Qualitative Study on Parental Experiences of Creative Music Therapy in the Neonatal Period. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126678. [PMID: 34205787 PMCID: PMC8296508 DOI: 10.3390/ijerph18126678] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 06/15/2021] [Accepted: 06/16/2021] [Indexed: 11/16/2022]
Abstract
Developmental problems in extremely preterm (EP) infants and the associated longitudinal burden for their families are major health issues worldwide. Approaches to social-emotional support such as family-integrating Creative Music Therapy (CMT) are warranted. We aimed: (1) to explore parental perspectives on the use of CMT with EP infants in the neonatal hospitalization period and (2) to examine the possible longitudinal influence of CMT. A qualitative design was used to examine the perspective of six families from various backgrounds. Semi-structured interviews were carried out when the infants reached school age. We used an inductive-deductive thematic analysis to identify three main themes, each with three sub-themes: (1) the positive impact of CMT on the infants, the parents, and bonding; (2) the attitude toward CMT, from being open-minded to recommending it as complementary therapy; and (3) the experience of overall healthy infant development despite unique developmental delay issues. The findings elucidate the positive and formative impact of CMT on both infants and parents in the stressful NICU setting and beyond. CMT may empower positive transformation in the parents through individualized early nurturing musical interactions, capacity building, and positive reinforcement. Further research may help to identify and implement potentially modifiable factors for improving health care in this vulnerable group through early family-integrating, resource-based approaches such as CMT.
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