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Franck LS, Magaña J, Bisgaard R, Lothe B, Sun Y, Morton CH. Mobile-enhanced Family Integrated Care for preterm infants: A qualitative study of parents' views. PEC INNOVATION 2024; 4:100284. [PMID: 38737891 PMCID: PMC11087992 DOI: 10.1016/j.pecinn.2024.100284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 04/25/2024] [Accepted: 04/26/2024] [Indexed: 05/14/2024]
Abstract
Objective The Family Integrated Care (FICare) model improves outcomes for preterm infants and parents compared with family-centered care (FCC). FICare with mobile technology (mFICare) may improve uptake and impact. Research on FICare in the United States (US) is scarce and little is known about parents' experience. Methods We conducted qualitative interviews with nine parents, exploring their NICU experiences, participation in and perceptions of the mFICare program. A directed content analysis approach was used, and common themes were derived from the data. Results Overall, parents had positive NICU experiences and found mFICare helpful in meeting three common parenting priorities: actively caring for their infant, learning how to care for their infant, and learning about the clinical status of their infant. They described alignment and misalignment with mFICare components relative to their personal parenting priorities and offered suggestions for improvement. Nurses were noted to play key roles in providing or facilitating parent support and encouragement to participate in mFICare and parenting activities. Conclusion The mFICare program showed potential for parental acceptance and participation in US NICUs. Innovation The mFICare model is an innovation in neonatal care that can advance the consistent delivery of NICU family-centered care planning and caregiving.Clinical Trial Registration:NCT03418870 01/02/2018.
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Affiliation(s)
- Linda S. Franck
- Department of Family Health Care Nursing, University of California San Francisco (UCSF), San Francisco, CA, USA
| | - Jazzelle Magaña
- Department of Pediatrics, Neonatal and Developmental Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Robin Bisgaard
- Intensive Care Nursery, UCSF Benioff Children's Hospital, San Francisco, CA, USA
| | | | - Yao Sun
- Division of Neonatology, University of California San Francisco, San Francisco, CA, USA
| | - Christine H. Morton
- Department of Pediatrics, Neonatal and Developmental Medicine, Stanford University School of Medicine, Stanford, CA, USA
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Weber A, Bakas T, Schulman-Green D, Voos KC, Rice JB, Bailey R, Reigel A, Oudat Q, Holmes M, Tubbs-Cooley HL, Kaplan HC. Family Management Skills Reported by Parents of Preterm Infants in the NICU Using the Self- and Family Management Framework (SFMF). Adv Neonatal Care 2024; 24:119-131. [PMID: 38127650 PMCID: PMC10978294 DOI: 10.1097/anc.0000000000001140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
BACKGROUND Across the globe, family-integrated care (FICare) has become an evidence-based standard in which parents deliver the majority of infant care in the neonatal intensive care unit (NICU). Because of extensive barriers to parent presence, adaptations to FICare may be required for successful implementation. Family management theory may provide structure to the Parent Education of FICare and help nurses guide parents' skill development as equal care members. PURPOSE To identify family management skills employed by NICU parents using the Self- and Family Management Framework (SFMF). METHODS We conducted secondary analyses of qualitative interview data from NICU parents (n = 17) who shared their experiences of using family management skills to care for their infant. We categorized skills according to 3 main self- and family management processes: Focusing on Infant Illness Needs; Activating Resources; and Living With Infant Illness. RESULTS Parents reported several family management skills currently identified in the SFMF, as well as new skills such as conflict management, power brokerage, and addressing resources related to social determinants of health. Parent activation of resources was critical to sustaining parent focus on the infant's illness needs. IMPLICATIONS FOR PRACTICE AND RESEARCH By teaching skills that parents reported as helping them manage infant care, neonatal nurses may better facilitate parent integration into the care team. Future researchers can incorporate the skills identified in this study into the design of family management interventions that facilitate FICare implementation in the United States.
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Affiliation(s)
- Ashley Weber
- Author Affiliations: University of Cincinnati College of Nursing, Cincinnati, Ohio (Drs Weber and Bakas and Mr Oudat); New York University Rory Meyers College of Nursing, New York City, New York (Dr Schulman-Green); Case Western Reserve University School of Medicine, Cleveland, Ohio (Dr Voos, Mr Bailey, and Mss Reigel and Holmes); Rainbow Babies and Children's Hospital, Cleveland, Ohio (Dr Rice); The Ohio State University, Columbus, Ohio (Dr Tubbs-Cooley); and Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio (Dr Kaplan)
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Cassidy CE, Flynn R, Campbell A, Dobson L, Langley J, McNeil D, Milne E, Zanoni P, Churchill M, Benzies KM. Knowledge translation strategies used for sustainability of an evidence-based intervention in child health: a multimethod qualitative study. BMC Nurs 2024; 23:125. [PMID: 38368328 PMCID: PMC10874067 DOI: 10.1186/s12912-024-01777-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 01/30/2024] [Indexed: 02/19/2024] Open
Abstract
BACKGROUND Sustainability of evidence-based interventions (EBIs) is suboptimal in healthcare. Evidence on how knowledge translation (KT) strategies are used for the sustainability of EBIs in practice is lacking. This study examined what and how KT strategies were used to facilitate the sustainability of Alberta Family Integrated Care (FICare)™, a psychoeducational model of care scaled and spread across 14 neonatal intensive care units, in Alberta, Canada. METHODS First, we conducted an environmental scan of relevant documents to determine the use of KT strategies to support the sustainability of Alberta FICare™. Second, we conducted semi-structured interviews with decision makers and operational leaders to explore what and how KT strategies were used for the sustainability of Alberta FICare™, as well as barriers and facilitators to using the KT strategies for sustainability. We used the Expert Recommendations for Implementation Change (ERIC) taxonomy to code the strategies. Lastly, we facilitated consultation meetings with the Alberta FICare™ leads to share and gain insights and clarification on our findings. RESULTS We identified nine KT strategies to facilitate the sustainability of Alberta FICare™: Conduct ongoing training; Identify and prepare local champions; Research co-production; Remind clinicians; Audit and provide feedback; Change record systems; Promote adaptability; Access new funding; and Involve patients/consumers and family members. A significant barrier to the sustainability of Alberta FICare™ was a lack of clarity on who was responsible for the ongoing maintenance of the intervention. A key facilitator to sustainability of Alberta FICare was its alignment with the Maternal, Newborn, Child & Youth Strategic Clinical Network (MNCY SCN) priorities. Co-production between researchers and health system partners in the design, implementation, and scale and spread of Alberta FICare™ was critical to sustainability. CONCLUSION This research highlights the importance of clearly articulating who is responsible for continued championing for the sustainability of EBIs. Additionally, our research demonstrates that the adaptation of interventions must be considered from the onset of implementation so interventions can be tailored to align with contextual barriers for sustainability. Clear guidance is needed to continually support researchers and health system leaders in co-producing strategies that facilitate the long-term sustainability of effective EBIs in practice.
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Affiliation(s)
- Christine E Cassidy
- School of Nursing, Faculty of Health, Dalhousie University, 5869 University Avenue, B3H 4R2, Halifax, NS, PO Box 15000, Canada.
| | - Rachel Flynn
- School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College of Cork, College Road, T12 AK54, Cork, Ireland
| | - Alyson Campbell
- Faculty of Nursing, University of Prince Edward Island, 550 University Avenue, HSB Room 116, C1A 4P3, Charlottetown, PE, Canada
| | - Lauren Dobson
- Faculty of Nursing, Edmonton Clinic Health Academy, University of Alberta, Level 3, 11405 87 Avenue, T6G 1C9, Edmonton, AB, Canada
| | - Jodi Langley
- Faculty of Health, Dalhousie University, 5790 University Avenue, B3H 1V7, Halifax, NS, Canada
| | - Deborah McNeil
- Strategic Clinical Networks, Alberta Health Services, 10101 Southport Road SW, T2W 3N2, Calgary, AB, Canada
- Faculty of Nursing, Departments of Pediatrics and Community Health Science, Cumming School of Medicine, University of Calgary, 2500 University Drive NW, T2N 1N4, Calgary, AB, Canada
| | - Ella Milne
- Faculty of Nursing, Edmonton Clinic Health Academy, University of Alberta, Level 3, 11405 87 Avenue, T6G 1C9, Edmonton, AB, Canada
| | - Pilar Zanoni
- Faculty of Nursing , University of Calgary, 2500 University Drive NW, T2N 1N4, Calgary, AB, Canada
| | - Megan Churchill
- Department of Pediatrics, IWK Health, 5980 University Ave #5850, B3K 6R8, Halifax, NS, Canada
| | - Karen M Benzies
- Faculty of Nursing, Departments of Pediatrics and Community Health Science, Cumming School of Medicine, University of Calgary, 2500 University Drive NW, T2N 1N4, Calgary, AB, Canada
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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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Ansari NS, Franck LS, Tomlinson C, Colucci A, O’Brien K. A Pilot Study of Family-Integrated Care (FICare) in Critically Ill Preterm and Term Infants in the NICU: FICare Plus. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1337. [PMID: 37628336 PMCID: PMC10453905 DOI: 10.3390/children10081337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/29/2023] [Accepted: 07/30/2023] [Indexed: 08/27/2023]
Abstract
Family-integrated care (FICare) is associated with improved developmental outcomes and decreased parental mental health risks in stable preterm infants. However, less is known about its application in critically ill infants who are at greater risk for adverse outcomes. The objective of this study was to assess the safety and feasibility of implementation of an augmented FICare program, FICare Plus, in critically ill infants in the first few weeks of life. Resources were specifically developed for staff and parents to support earlier parental engagement in infant care. Infant health outcomes and standardized measures of parental stress, anxiety and parenting self-efficacy were also collected using standardized questionnaires: State -Trait Anxiety Inventory (STAI), Parental Stressor Scale: NICU (PSS: NICU), Perceived Parenting Self-Efficacy Tool and Family Centered Care Survey. The t-test or Wilcoxon rank-sum test were used to compare continuous variables, while the Chi-square or Fisher exact test were used for categorical variables, respectively. In this prospective cohort study, 41 critically ill infants were enrolled: 17 in standard care (SC) and 24 in the FICare Plus group. The tools and procedures developed for FICare Plus successfully supported greater engagement in the care of their infants with no increase in adverse events and no increase in parental stress. Parents in the FICare Plus cohort felt confident to participate in their infant's care. The staff also found this model of care acceptable and well adopted. Preliminary measures of infant efficacy were similar in both groups. Total anxiety scores were high among all parents at enrollment (87 (67-94) vs. 70.5 (66-86); p-value 0.22). However, the scores prior to discharge were lower in FICare Plus group (78 (71-90) vs. 63 (52-74.5); p-value 0.02). This pilot study showed that it is feasible and safe to implement family-integrated care in critically ill infants.
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Affiliation(s)
- Najmus Sehr Ansari
- Department of Pediatrics, University of Toronto, Toronto, ON M5S 1A1, Canada; (C.T.); (K.O.)
- Division of Neonatology, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| | - Linda S. Franck
- School of Nursing, University of California, San Francisco, CA 94143, USA;
| | - Christopher Tomlinson
- Department of Pediatrics, University of Toronto, Toronto, ON M5S 1A1, Canada; (C.T.); (K.O.)
- Division of Neonatology, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| | - Anna Colucci
- Department of Pediatrics, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada;
| | - Karel O’Brien
- Department of Pediatrics, University of Toronto, Toronto, ON M5S 1A1, Canada; (C.T.); (K.O.)
- Department of Pediatrics, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada;
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Obigbesan O, Hayden KA, Benzies KM. Scoping Review of Education for Women About Return to Driving After Abdominal Surgery. J Obstet Gynecol Neonatal Nurs 2023; 52:106-116. [PMID: 36463949 DOI: 10.1016/j.jogn.2022.11.002] [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: 07/06/2022] [Revised: 11/03/2022] [Accepted: 11/03/2022] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE To conduct a scoping review to examine the evidence on education provided to women about when to return to driving after abdominal surgery and to assess variation in this education by type of abdominal surgery and source of education. DATA SOURCES We searched MEDLINE, Cochrane Central Register of Controlled Trials, Embase, Scopus, and CINAHL for peer-reviewed articles. We searched the publications of professional associations, clinical guidelines, driver's licensing agencies, and clinical trial registries for gray literature. Searches generated 2,908 peer-reviewed titles and abstracts and 20 documents in the gray literature. STUDY SELECTION We included articles and documents published in English in which authors reported education, advice, counseling, or recommendations about return to driving after abdominal surgery for women ages 16 to 50 years. DATA EXTRACTION We identified 16 peer-reviewed articles and eight documents in the gray literature. We extracted data including the title, authors, country of origin, study design, study purpose, sample size, type of abdominal surgery, education about return to driving, source of evidence to support the education, source of education, outcomes, and relevance to the review question. DATA SYNTHESIS We found that recommendations about when to return to driving after abdominal surgery ranged from 1 to 10 weeks after surgery, and 6 weeks after surgery was the most common. Recommended times were shorter for laparoscopic surgeries and longer for nonlaparoscopic surgeries, including cesarean. Most recommendations were provided by health care providers, and some recommendations were provided in leaflets. Evidence to support these recommendations was limited, and they were based on common sense, traditional practice, perceptions of insurance policies, a women's comfort level, or her ability to deploy the emergency brake. CONCLUSION Education provided to women about return to driving after abdominal surgery varies substantially and has a weak evidence base.
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Wasylak T, Benzies K, McNeil D, Zanoni P, Osiowy K, Mullie T, Chuck A. Creating Value Through Learning Health Systems: The Alberta Strategic Clinical Network Experience. Nurs Adm Q 2023; 47:20-30. [PMID: 36469371 PMCID: PMC9746610 DOI: 10.1097/naq.0000000000000552] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Design, implementation, and evaluation of effective multicomponent interventions typically take decades before value is realized even when value can be measured. Value-based health care, an approach to improving patient and health system outcomes, is a way of organizing health systems to transform outcomes and achieve the highest quality of care and the best possible outcomes with the lowest cost. We describe 2 case studies of value-based health care optimized through a learning health system framework that includes Strategic Clinical Networks. Both cases demonstrate the acceleration of evidence to practice through scientific, financial, structural administrative supports and partnerships. Clinical practice interventions in both cases, one in perioperative services and the other in neonatal intensive care, were implemented across multiple hospital sites. The practical application of using an innovation pipeline as a structural process is described and applied to these cases. A value for money improvement calculator using a benefits realization approach is presented as a mechanism/tool for attributing value to improvement initiatives that takes advantage of available system data, customizing and making the data usable for frontline managers and decision makers. Health care leaders will find value in the descriptions and practical information provided.
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Affiliation(s)
- Tracy Wasylak
- Alberta Health Services, Edmonton, Alberta, Canada (Ms Wasylak, Dr McNeil, and Messrs Osiowy and Mullie); Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada (Mss Wasylak and Zanoni and Drs Benzies and McNeil); and Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada (Dr Chuck)
| | - Karen Benzies
- Alberta Health Services, Edmonton, Alberta, Canada (Ms Wasylak, Dr McNeil, and Messrs Osiowy and Mullie); Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada (Mss Wasylak and Zanoni and Drs Benzies and McNeil); and Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada (Dr Chuck)
| | - Deborah McNeil
- Alberta Health Services, Edmonton, Alberta, Canada (Ms Wasylak, Dr McNeil, and Messrs Osiowy and Mullie); Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada (Mss Wasylak and Zanoni and Drs Benzies and McNeil); and Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada (Dr Chuck)
| | - Pilar Zanoni
- Alberta Health Services, Edmonton, Alberta, Canada (Ms Wasylak, Dr McNeil, and Messrs Osiowy and Mullie); Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada (Mss Wasylak and Zanoni and Drs Benzies and McNeil); and Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada (Dr Chuck)
| | - Kevin Osiowy
- Alberta Health Services, Edmonton, Alberta, Canada (Ms Wasylak, Dr McNeil, and Messrs Osiowy and Mullie); Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada (Mss Wasylak and Zanoni and Drs Benzies and McNeil); and Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada (Dr Chuck)
| | - Thomas Mullie
- Alberta Health Services, Edmonton, Alberta, Canada (Ms Wasylak, Dr McNeil, and Messrs Osiowy and Mullie); Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada (Mss Wasylak and Zanoni and Drs Benzies and McNeil); and Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada (Dr Chuck)
| | - Anderson Chuck
- Alberta Health Services, Edmonton, Alberta, Canada (Ms Wasylak, Dr McNeil, and Messrs Osiowy and Mullie); Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada (Mss Wasylak and Zanoni and Drs Benzies and McNeil); and Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada (Dr Chuck)
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Zwicky A, Thaqi Q, Hediger H, Naef R. The influence of nurse characteristics on practice skills and attitudes towards working with families in critical care: A regression analysis. Intensive Crit Care Nurs 2022; 72:103261. [PMID: 35672213 DOI: 10.1016/j.iccn.2022.103261] [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: 03/11/2022] [Revised: 05/01/2022] [Accepted: 05/07/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The study aimed to identify nurse characteristics that influence their self-perceived practice skills in working with families and their attitudes towards engaging families in adult and neonatal intensive care units. RESEARCH METHODOLOGY/DESIGN Secondary data analysis using a descriptive, cross-sectional design. SETTING An online survey was completed by 256 nurses from six adult intensive (73% response rate) and two neonatal intensive and one intermediate care unit (27% response rate) in a Swiss, university affiliated hospital. MAIN OUTCOME MEASURES Nurses' self-perceived practice skills in working with families were assessed with the "Family Nursing Practice Scale". Attitudes towards families were measured with the "Families' Importance in Nursing Care - Nurses' Attitudes Scale". Data were analysed with multiple linear regression models. RESULTS Prior education in family nursing significantly influenced nurses' self-perceived practice skills in working with families. Nurses' clinical speciality had a significant influence on their attitudes towards overall, and on the subscale "family as a burden". Neonatal intensive care nurses showed more open attitudes towards families overall, but perceived family more often as a burden than nurses in adult intensive care. Nurses' perceived skills and attitudes in family engagement significantly influenced each other. CONCLUSION The results suggest that nurses' prior education in family nursing and clinical speciality determine their ability to work with and engage families in critical care. Our study suggests that integration of family nursing engagement practices in critical care requires educational implementation strategies combined with culture change efforts.
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Affiliation(s)
- Anja Zwicky
- Cantonal Hospital Winterthur, Department of Medicine, Brauerstrasse 15, 8400 Winterthur, Switzerland.
| | - Qendresa Thaqi
- Centre of Clinical Nursing Science, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland; Institute for Implementation Science in Health Care, Faculty of Medicine, University of Zurich, Universitaetstrasse 84, 8006 Zurich, Switzerland.
| | - Hannele Hediger
- Institute of Nursing, School of Health Professions, Zurich University of Applied Sciences, Katharina-Sulzer-Platz 9, 8400 Winterthur, Switzerland.
| | - Rahel Naef
- Centre of Clinical Nursing Science, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland; Institute for Implementation Science in Health Care, Faculty of Medicine, University of Zurich, Universitaetstrasse 84, 8006 Zurich, Switzerland.
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van Veenendaal NR, Labrie NH, Mader S, van Kempen AAMW, van der Schoor SRD, van Goudoever JB. An international study on implementation and facilitators and barriers for parent-infant closeness in neonatal units. Pediatr Investig 2022; 6:179-188. [PMID: 36203512 PMCID: PMC9523817 DOI: 10.1002/ped4.12339] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 05/31/2022] [Indexed: 11/11/2022] Open
Abstract
Importance Parent-infant closeness and active parent participation in neonatal care are important for parent and infant health. Objective To give an overview of current neonatal settings and gain an in-depth understanding of facilitators and barriers to parent-infant closeness, zero-separation, in 19 countries. Methods Neonatal intensive care unit (NICU) professionals, representing 45 NICUs from a range of geographic regions in Europe and Canada, were purposefully selected and interviewed June-December 2018. Thematic analysis was conducted to identify, analyze and report patterns (themes) for parent-infant closeness across the entire series of interviews. Results Parent-infant separation during infant and/or maternity care is very common (42/45 units, 93%), despite the implementation of family integrated care (FICare) practices, including parent participation in medical rounds (17/45, 38%), structured education sessions for parents (16/45, 36%) and structured training for healthcare professionals (22/45, 49%). NICU professionals encountered four main themes with facilitators and barriers for parent-infant closeness on and between the hospital, unit, staff, and family level: Culture (jointly held characteristics, values, thinking and behaviors about parental presence and participation in the unit), Collaboration (the act of working together between and within different levels), Capacities (resources and policies), and Coaching (education to acquire and transfer knowledge and skills). Interpretation Implementing parent-infant closeness in the NICU is still challenging for healthcare professionals. Further optimization in neonatal care towards zero-separation and parent-infant closeness can be achieved by enforcing the 'four Cs for Closeness': Culture, Collaboration, Capacities, and Coaching.
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Affiliation(s)
- Nicole R. van Veenendaal
- Department of Pediatrics and NeonatologyOLVGAmsterdamThe Netherlands
- Amsterdam UMC, location Vrije Universiteit and location University of AmsterdamDepartment of Pediatrics, Emma Children's HospitalAmsterdamThe Netherlands
| | - Nanon H.M. Labrie
- Department of Pediatrics and NeonatologyOLVGAmsterdamThe Netherlands
- Department of Language, Literature and CommunicationVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Silke Mader
- European Foundation for Care of Newborn InfantsMunichGermany
| | | | | | - Johannes B. van Goudoever
- Amsterdam UMC, location Vrije Universiteit and location University of AmsterdamDepartment of Pediatrics, Emma Children's HospitalAmsterdamThe Netherlands
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Liang X, Miao A, Zhang W, Li M, Xing Y. Effect of family integrated care on physical growth and language development of premature infants: a retrospective study. Transl Pediatr 2022; 11:965-977. [PMID: 35800279 PMCID: PMC9253945 DOI: 10.21037/tp-22-210] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 05/27/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Premature birth (PTB) increases the long-term risk of diseases such as hypertension, heart disease, and diabetes in adulthood. It is an independent disease with the largest global burden in terms of high mortality and lifelong negative health impacts. The purpose of this study was to analyze the physical growth and language development of premature infants (PIs) at the age of 18 months, and to explore the impact of family integrated care (FIcare) on PI. METHODS This study retrospectively included mothers and their PIs born in the Neonatal Pediatrics Department, Affiliated Hospital of Nantong University from January 2018 to September 2020 and hospitalized in the neonatal intensive care unit (NICU) within 24 hours after birth. The weight, head circumference, body length, and language development of each child were followed up at the age of 1, 3, 6, 12, and 18 months and recorded, and the relationship between FIcare and physical growth and language development of PIs was evaluated. RESULTS The development quotient (DQ) score and language development score of the FIcare group were always higher than those of the control group from 6 to 18 months, and the difference was statistically significant (P<0.05). Multiple regression analysis showed that the body length of the FIcare group participants was longer than that of control group participants. The head circumference of infants was positively correlated with gestational age, birth head circumference, and family average monthly income. The head circumference of FIcare group participants was longer than that of control group participants. The DQ score was positively correlated with gestational age, and the FIcare group participants scored higher than control group participants. Logistic regression analysis showed that early language milestone (ELM) scale score and gestational age were positively correlated with mother's education, and the score of FIcare group participants was higher than that of control group participants (P<0.05). CONCLUSIONS Compared with the traditional nursing model, the implementation of FIcare for the hospitalized PIs in the NICU can actively promote the physical growth and language development of infants.
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Affiliation(s)
- Xiangyan Liang
- Department of Neonatal Pediatrics, Affiliated Hospital of Nantong University, Nantong, China
| | - Aimei Miao
- Department of Neonatal Pediatrics, Affiliated Hospital of Nantong University, Nantong, China
| | - Wei Zhang
- Department of Neonatal Pediatrics, Affiliated Hospital of Nantong University, Nantong, China
| | - Min Li
- Department of Neonatal Pediatrics, Affiliated Hospital of Nantong University, Nantong, China
| | - Yan Xing
- Department of Neonatal Pediatrics, Affiliated Hospital of Nantong University, Nantong, China
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