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Daliri DB, Laari TT, Ayine AA, Dei-Asamoa R, Volematome BG, Bogee G, Apo-Era MA, Oppong SA, Abagye N, Jarbaab M, Amoah MA, Afaya A. Psychosocial experiences of mothers of preterm babies admitted to the neonatal intensive care unit of the Upper East Regional Hospital, Bolgatanga: a descriptive phenomenological study. BMJ Open 2024; 14:e086277. [PMID: 39317505 PMCID: PMC11429351 DOI: 10.1136/bmjopen-2024-086277] [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] [Indexed: 09/26/2024] Open
Abstract
INTRODUCTION The postnatal period often presents significant psychological and social distress for mothers, a burden that is potentially heightened by having a preterm baby. Mothers of preterm babies face various psychosocial challenges that need to be explored. While some studies have explored the experiences of mothers of preterm babies, there is a need for more context-specific research to inform targeted interventions, especially in resource-constrained settings like northern Ghana. This study aimed to explore the psychosocial experiences of mothers of preterm babies admitted to the neonatal intensive care unit (NICU) of the Upper East Regional Hospital, Ghana. METHODS This descriptive phenomenological study was conducted in the NICU of the Upper East Regional Hospital in Ghana. Thirteen mothers of preterm babies were purposively sampled and interviewed using a semi-structured interview guide. The interviews were transcribed verbatim and analysed using Colaizzi's descriptive phenomenological method. RESULTS Three themes emerged namely, mothers' emotional experience, challenges encountered at the NICU and coping strategies. The mothers expressed a range of emotions, from indifference to profound sadness, disbelief, fear and worry, on realising their babies were preterm. Challenges within the NICU were financial constraints and poor NICU facilities while coping strategies included reliance on God, self-reliance and support from family and nurses. CONCLUSION Mothers of preterm babies in the NICU experience significant emotional distress and face numerous challenges. Comprehensive support programmes that address financial, emotional and practical needs are essential to improve outcomes for both mothers and their preterm babies.
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Affiliation(s)
| | | | | | - Richard Dei-Asamoa
- Department of Psychiatry, Korle Bu Teaching Hospital, Accra, Ghana
- Department of Psychiatric, University of Ghana Medical School, Accra, Ghana
| | | | - Gillian Bogee
- Department of Paediatrics, Upper East Regional Hospital, Bolgatanga, Ghana
| | | | | | - Nancy Abagye
- Department of Midwifery, University of Ghana, Legon, Ghana
| | | | | | - Agani Afaya
- Department of Nursing, University of Health and Allied Sciences, Ho, Ghana
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Guttmann KF, Raviv GN, Fortney CA, Ramirez M, Smith CB. Parent Perspectives on Communication Quality in the Neonatal Intensive Care Unit. Adv Neonatal Care 2024; 24:382-388. [PMID: 38975667 PMCID: PMC11334642 DOI: 10.1097/anc.0000000000001178] [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: 07/09/2024]
Abstract
BACKGROUND Though prior literature has demonstrated that communication in the Neonatal Intensive Care Unit (NICU) needs to be improved, in-depth descriptions of parents' views of NICU communication are lacking. PURPOSE We sought (1) to explore parent perceptions of communication in the NICU and (2) to understand parents' communication needs and preferences. METHODS We conducted in-depth semi-structured cognitive interviews utilizing concurrent probes with parents of 10 patients in our urban level IV Neonatal Intensive Care Unit over a period of 4 months (July 2021-October 2021). Interview questions were derived from the Quality of Communication scale. We conducted thematic analysis of interview transcripts modeled after work by Braun and Clarke. RESULTS Four overarching themes were identified: Strengths, Challenges, People, and Coping Strategies. Parents reported a range of communication quality in the NICU. Results revealed that the first 48 hours of NICU hospitalization represent a period of vulnerability and uncertainty for parents. Parents value clear yet hopeful communication about a baby's clinical status and expected course. IMPLICATIONS FOR PRACTICE AND RESEARCH We hope that the concrete findings from this study can both inform practice in the NICU now and influence practice guidelines to include such components as emphasis on the first 48 hours, desire for proactive information sharing, and the importance of including hope.
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Affiliation(s)
- Katherine F Guttmann
- Division of Newborn Medicine, Department of Pediatrics, The Icahn School of Medicine at Mount Sinai, New York, New York, USA (Dr Guttmann and Ms Raviv); The Ohio State University College of Nursing Martha S. Pitzer Center for Women, Children, and Youth, Columbus, Ohio (Dr Fortney); Research Division, Hebrew Home at Riverdale, Riverdale, New York, USA (Dr Ramirez); Division of Hematology and Medical Oncology, Department of Medicine, The Icahn School of Medicine at Mount Sinai, New York, New York, USA (Dr Smith); Brookdale Department of Geriatrics and Palliative Medicine, The Icahn School of Medicine at Mount Sinai, New York, New York, USA (Dr Smith and Dr Guttmann)
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Merritt L, Verklan MT. A Feasibility Study to Test the NICU Paternal Needs Inventory. Adv Neonatal Care 2024; 24:86-93. [PMID: 38096431 DOI: 10.1097/anc.0000000000001121] [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: 01/26/2024]
Abstract
BACKGROUND There has been little research exploring paternal needs while experiencing a neonatal intensive care unit (NICU) stay. Some tools exist to measure paternal needs, but do not incorporate items to capture important information about how fathers cope with stress differently, and may have different needs. Therefore, an instrument is needed to measure and prioritize what needs are important to fathers to help facilitate the development of nursing interventions to help fathers cope with the NICU environment. PURPOSE The purpose of this study was to conduct a feasibility study before large-scale pilot testing the instrument, the NICU Paternal Needs Inventory (NPNI), so we could then determine what are the physical, emotional, and psychological needs of fathers. METHODS A nonexperimental, quantitative, and descriptive design was used to address the study's aims. Fathers were recruited from a level IV NICU and asked to complete an online survey (consisting of a demographic survey and the NPNI). RESULTS Needs rated 100% were knowing infant's progress, directions on caring for infant, flexible visitation, and assurance receiving the best care. The remainder showed a wide range of responses suggesting that needs of fathers are individual and varied. IMPLICATIONS FOR PRACTICE AND RESEARCH Use of the NPNI to evaluate a father's unique and individual needs would allow for the nurse to develop father-specific, individualized interventions. Findings support that the NPNI is feasible to accomplish measuring fathers' needs, but a larger study is needed to test the reliability and validity of this tool.
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Affiliation(s)
- Linda Merritt
- Quinnipiac University, North Haven, Connecticut (Dr Merritt); Texas Woman's University, Dallas (Dr Merritt); and The University of Texas Medical Branch, Galveston (Dr Verklan)
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Bertoncelli N, Lugli L, Bedetti L, Lucaccioni L, Bianchini A, Boncompagni A, Cipolli F, Cosimo AC, Cuomo G, Di Giuseppe M, Lelli T, Muzzi V, Paglia M, Pezzuti L, Sabbioni C, Salzone F, Sorgente MC, Ferrari F, Berardi A. Parents' Experience in an Italian NICU Implementing NIDCAP-Based Care: A Qualitative Study. CHILDREN (BASEL, SWITZERLAND) 2022; 9:1917. [PMID: 36553360 PMCID: PMC9776912 DOI: 10.3390/children9121917] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/21/2022] [Accepted: 12/04/2022] [Indexed: 12/13/2022]
Abstract
Background: The birth of a preterm infant and his/her immediate admittance to the Neonatal Intensive Care Unit (NICU) are sudden, unexpected, stressful and painful events for parents. In the last decade, in response to the increased awareness of the stressful experiences of parents, much attention has been paid to Family-Centered Care (FCC) and the implementation of the Newborn Individualized Developmental Care and Assessment Program (NIDCAP). According to the NIDCAP model, the infant-parents' dyad is the core of the care provided by the NICU professionals to reduce the stress experienced by parents. So far, the literature does not show a clear correlation between parental experiences and the NICU practices according NIDCAP principles. Aims: To explore how parents of preterm infants experienced the NIDCAP-based care from admission to discharge, in particular, their relationships with NICU professionals and with other parents, and the organization of the couple's daily activities during this process. Design: Qualitative exploratory study. Methods: Twelve parents of preterm infants born between January 2018 and December 2020 at the NICU of Modena, with a gestational age at birth of less than 30 weeks and/or a birth weight of less than 1250 g, were recruited. Three couples had twins, and the total number of infants was 15. All infants were followed for up to 24 months post-term age (PTA) for neurological outcomes. Each couple was given a semi-structured online interview about their experience during their infant's hospitalization in the NICU up to discharge. The interview was developed around three time points: birth, hospitalization and discharge. The data analysis was conducted according to the template analysis method. Results: The admission to the NICU was unexpected and extraordinary, and its impact was contained by the skilled staff who were capable of welcoming the parents and making them feel they were involved and active collaborators in the care of their infant. The emotional experience was compared to being in a blender; they were overwhelmed by changing emotions, ranging from terrible fear to extreme joy. The couple's activities of daily life were reorganized after the infant's birth and admission to the NICU. Fathers felt unbalanced and alone in taking care of their partners and their children. Conclusions: This is the first study in Italy to explore parental experience in an NICU implementing NIDCAP-based care. The NIDCAP approach in the NICU of Modena helps parents to be involved early, to develop parental skills, and to be prepared for the transition home; and it also facilitates and enhances the relationship between parents and NICU staff.
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Affiliation(s)
- Natascia Bertoncelli
- Neonatal Intensive Care Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University Hospital of Modena, 41125 Modena, Italy
| | - Licia Lugli
- Neonatal Intensive Care Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University Hospital of Modena, 41125 Modena, Italy
| | - Luca Bedetti
- Neonatal Intensive Care Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University Hospital of Modena, 41125 Modena, Italy
- PhD Program in Clinical and Experimental Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Laura Lucaccioni
- Pediatric Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Arianna Bianchini
- Neonatal Intensive Care Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University Hospital of Modena, 41125 Modena, Italy
| | - Alessandra Boncompagni
- Neonatal Intensive Care Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University Hospital of Modena, 41125 Modena, Italy
| | - Federica Cipolli
- Neonatal Intensive Care Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University Hospital of Modena, 41125 Modena, Italy
| | - Anna Cinzia Cosimo
- Neonatal Intensive Care Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University Hospital of Modena, 41125 Modena, Italy
| | - Giovanna Cuomo
- Neonatal Intensive Care Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University Hospital of Modena, 41125 Modena, Italy
| | - Michela Di Giuseppe
- Neonatal Intensive Care Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University Hospital of Modena, 41125 Modena, Italy
| | - Tamara Lelli
- Neonatal Intensive Care Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University Hospital of Modena, 41125 Modena, Italy
| | - Veronica Muzzi
- Neonatal Intensive Care Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University Hospital of Modena, 41125 Modena, Italy
| | - Martina Paglia
- Neonatal Intensive Care Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University Hospital of Modena, 41125 Modena, Italy
| | - Lucia Pezzuti
- Neonatal Intensive Care Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University Hospital of Modena, 41125 Modena, Italy
| | - Claudia Sabbioni
- Neonatal Intensive Care Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University Hospital of Modena, 41125 Modena, Italy
| | - Francesca Salzone
- Neonatal Intensive Care Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University Hospital of Modena, 41125 Modena, Italy
| | - Maria Cristina Sorgente
- Neonatal Intensive Care Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University Hospital of Modena, 41125 Modena, Italy
| | - Fabrizio Ferrari
- Neonatal Intensive Care Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University Hospital of Modena, 41125 Modena, Italy
| | - Alberto Berardi
- Neonatal Intensive Care Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University Hospital of Modena, 41125 Modena, Italy
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Nelson JL, Winston K, Bloch E, Craig JW. What is the lived experience of mothers in a Level-IV neonatal intensive care unit? Br J Occup Ther 2022. [DOI: 10.1177/03080226221097302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Rationale Occupation-based practice in the neonatal intensive care unit may be impacted by a plethora of contextual factors. There is limited literature of the lived experience mothers have with mothering occupations for the care of premature infants in a Level-IV neonatal intensive care unit. Methodology A phenomenological design was used to interview mothers of premature infants in a Level-IV neonatal intensive care unit. The eight participants were mothers who had been in the neonatal intensive care unit for at least 1 month. Data was obtained via demographic form, two individual semi-structured interviews for each mother, and fieldnotes. Results Thematic analysis yielded five themes and two subthemes which were: unanticipated journey to becoming a mother, emotional rollercoaster, mother’s lost voice, subtheme cultural influences, roadblocks to mothering, unexpected layer to mothering occupations and subtheme support for mothering occupations. Each theme described a mother’s experience with mothering. Conclusion There is an importance for neonatal occupational therapists to provide support for mothering occupations for mothers from a variety of demographic and cultural backgrounds. Occupation-based practice in the neonatal intensive care unit continues to need attention for inclusion of all mothers. The findings showed that cultural humility should be practiced in family-centred care in the neonatal intensive care unit.
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Affiliation(s)
| | | | - Elise Bloch
- Nova Southeastern University, Fort Lauderdale, FL, USA
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Gralton KS, Doering J, Ngui E, Pan A, Schiffman R. Family resiliency and family functioning in Non-Hispanic Black and Non-Hispanic White families of preterm infants. J Pediatr Nurs 2022; 64:102-110. [PMID: 35248955 DOI: 10.1016/j.pedn.2022.02.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 02/06/2022] [Accepted: 02/17/2022] [Indexed: 11/15/2022]
Abstract
PURPOSE The purpose of this study was to examine the relationship between resiliency factors and family functioning in families of preterm infants (< 37 weeks gestation) from two different racial groups hospitalized in a neonatal intensive care unit (NICU). DESIGN AND METHODS A cross-sectional design was used at five Level III/IV NICUs in a Midwestern city/suburbs. Seventy-nine family units (24 Non-Hispanic Black and 55 Non-Hispanic White) completed four instruments that assessed families' use of specific resiliency factors and a measure of family functioning. Demographic data were also collected. RESULTS Using linear mixed modeling, the significant predictors of family functioning for both Non-Hispanic Black and Non-Hispanic White, even after adjusting for education, income and race, were the protective factors "hardiness" (coefficient = -0.021) and "resources" (coefficient = -0.0052). The fixed effects in the model accounted for 48% (Marginal R2 = 0.48) of the variance on family functioning and the fixed and random effects accounted for 59% (Conditional R2, 0.59) of the variance on family functioning. Sixteen percent of the total sample rated their family as dysfunctional. CONCLUSIONS Findings from this study suggest that assessment of protective factors related to hardiness and resources individualize nursing interventions to support the resiliency of both Non-Hispanic Black and Non-Hispanic White families, regardless of differences in income and education. Further research studying resiliency in families of preterm infants is needed to understand the impact on long-term family functioning. PRACTICE IMPLICATIONS Understandingindividual family strengths,through the identification of resiliency (protective and recovery) factors could predict at-risk families before discharge. In collaboration with other health care professionals, nurses can assess individual family needs and strengths, within the context of their socioeconomic environment, and the racial and cultural influences that are important to the family.
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Affiliation(s)
| | - Jennifer Doering
- College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Emmanuel Ngui
- School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Amy Pan
- Medical College of Wisconsin, WI, USA
| | - Rachel Schiffman
- College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
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Nickbakht M, Meyer C, Beswick R, Scarinci N. Minimum Data Set for Families of Children With Hearing Loss: An eDelphi Study. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:1615-1629. [PMID: 35201846 DOI: 10.1044/2021_jslhr-21-00356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE Assessing the unique needs of each family following the diagnosis of a hearing loss is central to the delivery of family-centered hearing health care. Therefore, the aim of this study was to develop a Minimum Data Set (MDS) that could be used in the design of a needs assessment tool for families of children with hearing loss transitioning to early intervention. METHOD A list of potential items for the MDS was prepared. In a two-round electronic Delphi study in Australia, hearing researchers (N = 15 in Round 1; N = 9 in Round 2), clinicians, and professionals working in early intervention for children with hearing loss (N = 85) were asked to review the potential items and to rate the importance of items using a Likert scale. RESULTS Consensus was reached on 32 main items to be included in the MDS across six categories, including informational support (13 items), professional support (five items), peer support (one item), skills and knowledge (seven items), financial support (three items), and methods of information provision (three items). Eight optional items that could be considered for inclusion in the MDS were also identified. CONCLUSIONS The proposed MDS could support hearing professionals in identifying families' needs in order to provide individualized information and support. Future research is needed to conduct a pilot study to evaluate the needs assessment tool in terms of usability, feasibility, and therapeutic effects.
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Affiliation(s)
- Mansoureh Nickbakht
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Carly Meyer
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Rachael Beswick
- Healthy Hearing Program, Children's Health Queensland Hospital and Health Service, Brisbane, Australia
| | - Nerina Scarinci
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
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Wyles C, Gephart SM, Nunez F. Engaging Parents of Fragile Infants in the Design and Appraisal of Health Literature: An Español Toolkit for Necrotizing Enterocolitis. J Perinat Neonatal Nurs 2022; 36:198-208. [PMID: 35476774 DOI: 10.1097/jpn.0000000000000644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
WHAT WAS OBSERVED OR INVESTIGATED The increased morbidity of diverse infants is unacceptable, and methods to reduce necrotizing enterocolitis (NEC) in their communities are needed. This article discusses the importance of the Español toolkit; provides a backstory of how the Español toolkit came about and how it was verified and validated; and concludes with impressions from involving parents in the research process. SUBJECTS AND METHODS After research evidence was translated from English into Spanish, a cross-sectional exploratory, descriptive, mixed-methods study was conducted, guided by the knowledge translation into practice (Translating Research Into Practice [TRIP]) framework. Twenty bilingual English-Spanish parents of fragile infants evaluated the NEC-Zero Español toolkit from a single neonatal intensive care unit. RESULTS AND CONCLUSIONS The NEC-Zero Español toolkit was found to be easy-to-use and useful and provided information that can be used to augment information sharing. Having access to health information offers a meaningful way to start a conversation and may even impact positive behaviors such as breastfeeding promotion. To lessen Spanish speakers' linguistic barriers, providing materials in Spanish can help meet their information needs and initiate conversations with healthcare providers. This is particularly important because Hispanic infants are at high risk for NEC.
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Ciupitu-Plath C, Tietz F, Herzberg J. Parent needs assessment instruments in neonatal intensive care units: Implications for parent education interventions. PATIENT EDUCATION AND COUNSELING 2021; 104:2661-2669. [PMID: 33840550 DOI: 10.1016/j.pec.2021.03.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 02/09/2021] [Accepted: 03/16/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Psychosocial and educational interventions based on standardized needs assessment can help alleviate distress among parents of premature infants. This study aims to (1) provide an overview of standardized instruments used to assess parental needs in neonatal intensive care units (NICUs) and (2) discuss their potential to facilitate the provision of appropriate support to parents of premature babies. METHODS A systematic literature review was conducted. PubMed, CiNAHL, PsychARTICLES, PsychINFO, and Medline were searched for studies reporting on the use of validated parental needs assessment instruments in the NICU. RESULTS Following the analysis of 33 publications, 6 instruments designed to assess the needs of premature infants' parents were identified. Based on their good psychometric properties and practicality, the NICU Family Needs Inventory, the Critical Care Maternal Needs Inventory, and the Nurse Parent Support Tool were considered particularly relevant for use in clinical and research settings. CONCLUSIONS Validated parent needs assessment instruments are available for use in the NICU setting. Further research evaluating the benefits and usability of standardized parental needs assessment in the NICU is needed. PRACTICE IMPLICATIONS Validated needs assessment instruments should be consistently used to facilitate the development of targeted psychosocial and educational interventions for parents in the NICU.
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Affiliation(s)
| | - Franziska Tietz
- Education Center for Nursing Professions, DRK Hospitals, Berlin, Germany
| | - Jana Herzberg
- Clinical Nursing Science Unit, Charité Center 1 for Health and Human Sciences, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Adama EA, Adua E, Bayes S, Mörelius E. Support needs of parents in neonatal intensive care unit: An integrative review. J Clin Nurs 2021; 31:532-547. [PMID: 34312923 DOI: 10.1111/jocn.15972] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 06/09/2021] [Accepted: 06/22/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Having an infant in the neonatal intensive care unit (NICU) is associated with intense emotional stress for both mothers and fathers. However, with the right support from staff, this stress can be reduced significantly. Although evidence on needs of parents in the neonatal unit exists, there is lack of a systematic integrative review on the support needs of parents in the neonatal unit. Current review evidence is needed to support busy neonatal unit clinicians in their practice. AIM AND OBJECTIVES The purpose of this integrative review is to explore the current available evidence to describe and understand the support needs of parents of infants in the NICU. METHODS The integrative review process of Whittemore and Knafl (2005) was used to guide this study. Six databases-MEDLINE, CINHAL, PubMed, Scopus, Google Scholar and PsycINFO-were searched for eligible studies using relevant keywords. Primary studies published in English language from 2010 to 2021 were reviewed following a pre-determined inclusion criteria. Studies that met the inclusion criteria were critically appraised using the Mixed Methods Appraisal Tool (MMAT). The review report is guided by the PRISMA 2020 checklist for systematic reviews. RESULTS Overall, 24 primary qualitative, quantitative and mixed methods studies were included in the review. Analysis of included studies resulted in six themes that demonstrate the support needs of parents in the NICU; 1. Information needs; 2. Emotionally intelligent staff; 3. Hands-on support; 4. Targeted support; 5. Emotional needs; and 6. Practical needs. CONCLUSION This review has presented the current evidence on the needs of parents from their own perspective. Healthcare workers' understanding and supporting these needs in the NICU is likely to increase parental satisfaction and improve health outcomes for parents, infants and their family. RELEVANCE TO CLINICAL PRACTICE Parents of infants in the NICU require staff support to enhance their experiences, well-being, caring and parenting confidence during admission and post-discharge. As parents are in constant need for informational, emotional and practical support, continuing professional development for NICU staff should place emphasis on effective communication strategies, enhancing emotional intelligence and empathy among staff. NICU staff should build positive ongoing relationships with parents and provide targetted support for mothers and fathers.
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Affiliation(s)
- Esther Abena Adama
- School of Nursing and Midwifery, Edith Cowan University, Perth, Western Australia, Australia
| | - Eric Adua
- School of Nursing and Midwifery, Edith Cowan University, Perth, Western Australia, Australia.,Department of Biochemistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Sara Bayes
- School of Nursing and Midwifery, Edith Cowan University, Perth, Western Australia, Australia.,Faculty of Health Sciences, School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, Victoria, Australia
| | - Evalotte Mörelius
- School of Nursing and Midwifery, Edith Cowan University, Perth, Western Australia, Australia.,Perth Children's Hospital, Perth, Western Australia, Australia
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Sánchez-Rubio L, Cleveland LM, Durán de Villalobos MM, McGrath JM. Parental Decision-Making in Pediatric Intensive Care: A Concept Analysis. J Pediatr Nurs 2021; 59:115-124. [PMID: 33848782 DOI: 10.1016/j.pedn.2021.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 02/23/2021] [Accepted: 03/18/2021] [Indexed: 11/15/2022]
Abstract
The development of nursing knowledge requires a close relationship between theory, research, and practice. The purpose of the analysis of the concept of "parental decision-making in pediatric critical care" is to facilitate nurses' therapeutic care of critically ill children and their families. To construct, structure, and give meaning to the concept, we use our experience in the field, critical reading of the literature, and careful analysis of data that have emerged about parental decision-making in pediatric intensive care. Several factors affect parent's ability to act as decision-makers: the psychosocial and physical disorders they develop, the subordination of their parental roles by the health care team, and the child's critical state of health. While different disciplines, including nursing, have well described the decision-making concept, parental decision-making in the context of pediatric intensive care has not been as well delineated. Nursing science recognizes the importance of decision-making and has incorporated the concept as an essential domain of its philosophical and disciplinary interests. Following the method proposed by Walker and Avant, the concept was analyzed, attributes, background, and consequences described. A model case was presented and discussed. An operational definition emerges, providing knowledge for professional nursing practice and will be the basis for an essential theoretical development around this phenomenon. Parents' recognition, the promotion of family-centered care, and shared decisions are ideal for encouraging parental participation.
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Affiliation(s)
- Lorena Sánchez-Rubio
- Programa de Enfermería, Facultad de Ciencias de la Salud, Universidad del Tolima, Ibagué, Colombia.
| | - Lisa M Cleveland
- School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX.
| | | | - Jacqueline M McGrath
- School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX.
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12
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Needs of Socioeconomically Diverse Fathers of Premature Hospitalized Infants: A Multicenter Study. Adv Neonatal Care 2021; 21:E11-E22. [PMID: 32769372 DOI: 10.1097/anc.0000000000000767] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND To effectively practice true family-centered care (FCC) in the neonatal intensive care unit (NICU) setting, a nurse needs to understand the perceptions and concerns of all fathers. Although research is emerging on fathers' perceptions and experiences, the samples of fathers represented are not from diverse socioeconomic, racial, and ethnic populations, which limit the findings' generalizability. PURPOSE The purpose of this study was to determine the needs of NICU fathers and whether these needs differed based on sociodemographic factors. METHODS A quantitative, comparative, descriptive design was used to determine the needs of NICU fathers. Additional analysis was conducted to determine whether the needs differed based on education, income, and gestational age, whether the father preferred speaking English or Spanish, and whether these sociodemographic factors could predict needs. To determine sociodemographic factors and needs, a demographic questionnaire and the NICU Family Needs Inventory were administered to 99 fathers in 6 level III NICUs. RESULTS Data were analyzed using independent sample t test, 1-way analysis of variance, and multiple linear regression. The results showed that fathers reported a broad span of needs and fathers from disadvantaged populations may have greater needs in certain areas. IMPLICATIONS FOR PRACTICE These results emphasize the importance of the nurses' role in assessing the needs of NICU fathers. By understanding fathers' needs, nurses can provide individualized FCC to fathers to help them be more involved in the care and support of their infant. IMPLICATIONS FOR RESEARCH Further research is needed to support these findings and test interventions that promote communication between providers and fathers.
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13
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Abstract
Having a child admitted to the neonatal intensive care unit (NICU) is traumatic for both parents, but mothers and fathers may have different experiences, and thus, different needs. The purpose of this integrative review was to identify the needs of fathers of premature infants. A systematic review of 7 databases was conducted, and studies were evaluated by the Critical Appraisal Programme checklist. To provide structure for searching and reporting findings, the Whittemore and Knafle interpretive methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis methodology were used. A total of 19 articles were identified. The resulting themes included: need to be close to infant and involved in infant's care; need for information; need for a better NICU environment; need for emotional support; and need for a relationship with the NICU staff.
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Affiliation(s)
- Linda Merritt
- College of Nursing, Texas Woman's University, Dallas
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14
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Comparative Evaluation of Parental Stress Experiences Up to 2 to 3 Years After Preterm and Term Birth. Adv Neonatal Care 2020; 20:301-313. [PMID: 32108660 PMCID: PMC7379044 DOI: 10.1097/anc.0000000000000714] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Parenting stress after preterm birth (PTB) has negative long-term effects on parenting. Research about parental experiences after PTB and on parenting stress in early childhood has focused on mothers.
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15
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Gonçalves JL, Fuertes M, Alves MJ, Antunes S, Almeida AR, Casimiro R, Santos M. Maternal pre and perinatal experiences with their full-term, preterm and very preterm newborns. BMC Pregnancy Childbirth 2020; 20:276. [PMID: 32375667 PMCID: PMC7204281 DOI: 10.1186/s12884-020-02934-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 04/13/2020] [Indexed: 01/07/2023] Open
Abstract
Background Mothers’ reports about pregnancy, maternity and their experiences during the perinatal period have been associated with infants’ later quality of attachment and development. Yet, there has been little research with mothers of very preterm newborns. This study aimed to explore mothers’ experiences related to pregnancy, premature birth, relationship with the newborn, and future perspectives, and to compare them in the context of distinct infants’ at-birth-risk conditions. Methods A semi-structured interview was conducted with women after birth, within the first 72 h of the newborn’s life. A total of 150 women participated and were divided in three groups: (1) 50 mothers of full-term newborns (Gestational Age (GA) ≥ 37 weeks; FT), (2) 50 mothers of preterm newborns (GA 32–36 weeks; PT) and (3) 50 mothers of very preterm newborns (GA < 32 weeks; VPT). Results Mothers of full-term infants responded more often that their children were calm and that they did not expect difficulties in taking care of and providing for the baby. Mothers of preterm newborns although having planned and accepted well the pregnancy (with no mixed or ambivalent feelings about it) and while being optimistic about their competence to take care of the baby, mentioned feeling frightened because of the unexpected occurrence of a premature birth and its associated risks. Mothers of very preterm newborns reported more negative and distressful feelings while showing more difficulties in anticipating the experience of caring for their babies. Conclusion The results indicate that Health Care Systems and Neonatal Care Policy should provide differentiated psychological support and responses to mothers, babies and families, taking into account the newborns’ GA and neonatal risk factors.
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Affiliation(s)
- Joana L Gonçalves
- Center for Psychology at University of Porto (CPUP), Rua Alfredo Allen, 4200-135, Porto, Portugal.
| | - Marina Fuertes
- Center for Psychology at University of Porto (CPUP), Rua Alfredo Allen, 4200-135, Porto, Portugal
| | - Maria João Alves
- Center for Psychology at University of Porto (CPUP), Rua Alfredo Allen, 4200-135, Porto, Portugal
| | - Sandra Antunes
- School of Health Technology, Polytechnic Institute of Lisbon, Lisbon, Portugal
| | - Ana Rita Almeida
- Lisbon School of Education/CIED, Polytechnic Institute of Lisbon, Lisbon, Portugal
| | - Rute Casimiro
- Lisbon School of Education/CIED, Polytechnic Institute of Lisbon, Lisbon, Portugal
| | - Margarida Santos
- School of Health Technology, Polytechnic Institute of Lisbon, Lisbon, Portugal.,Faculty of Psychology and Education Sciences, University of Lisbon, Lisbon, Portugal
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16
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Govindaswamy P, Laing SM, Waters D, Walker K, Spence K, Badawi N. Fathers' needs in a surgical neonatal intensive care unit: Assuring the other parent. PLoS One 2020; 15:e0232190. [PMID: 32374739 PMCID: PMC7202595 DOI: 10.1371/journal.pone.0232190] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 04/08/2020] [Indexed: 11/19/2022] Open
Abstract
Objectives Fathers of infants admitted to Neonatal Intensive Care Unit (NICU) play an important role and have individual needs that are often not recognised. While there is considerable evidence regarding mothers’ needs in the NICU, information about fathers’ is particularly limited. This study identifies the needs of fathers of newborns admitted to NICU for general surgery of major congenital anomalies, and whether health-care professionals meet these needs. Methods Forty-eight fathers of infants admitted for surgery between February 2014 and September 2015 were enrolled in a prospective cohort study. Fathers completed the Neonatal Family Needs Inventory comprising 56 items in 5 subscales (Support, Comfort, Information, Proximity, Assurance) at admission and discharge and whether these needs were met; as well as the Social Desirability Scale. Results Responses showed Assurance was the most important subscale (M 3.8, SD .26). Having questions answered honestly (M 3.9, SD .20) and knowing staff provide comfort to their infant (M 3.94, SD .24) were fathers’ most important needs. By discharge, fathers expressed a greater importance on being recognised and more involved in their infant’s care. More than 91% indicated their ten most important needs were met by the NICU health-care professionals, with no significant changes at discharge. Clergical visits (M 2.08, SD 1.21) were least important. Conclusions Reassurance is a priority for fathers of neonates in a surgical NICU, particularly regarding infant pain management and comfort. It is important that health-care professionals provide reliable, honest information and open-access visiting. Notably, fathers seek greater recognition of their role in the NICU—beyond being the ‘other’ parent.
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Affiliation(s)
- Priya Govindaswamy
- Grace Centre for Newborn Care, Children’s Hospital at Westmead, Westmead, Australia
- Sydney Medical School, University of Sydney, Sydney, Australia
- * E-mail:
| | | | - Donna Waters
- Sydney Medical School, University of Sydney, Sydney, Australia
- Sydney Nursing School, University of Sydney, Sydney, Australia
| | - Karen Walker
- Sydney Medical School, University of Sydney, Sydney, Australia
- Sydney Nursing School, University of Sydney, Sydney, Australia
| | - Kaye Spence
- Grace Centre for Newborn Care, Children’s Hospital at Westmead, Westmead, Australia
| | - Nadia Badawi
- Grace Centre for Newborn Care, Children’s Hospital at Westmead, Westmead, Australia
- Sydney Medical School, University of Sydney, Sydney, Australia
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Aurich B, Vermeulen E, Elie V, Driessens MHE, Kubiak C, Bonifazi D, Jacqz-Aigrain E. Informed consent for neonatal trials: practical points to consider and a check list. BMJ Paediatr Open 2020; 4:e000847. [PMID: 33437878 PMCID: PMC7778778 DOI: 10.1136/bmjpo-2020-000847] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 11/23/2020] [Accepted: 11/29/2020] [Indexed: 12/04/2022] Open
Abstract
Obtaining informed consent from parents of critically ill neonates can be challenging. The parental decision-making process is influenced by the severity of the child's condition, the benefit-risk balance, their emotional state and the quality of the relationship with the clinical team. Independent of local legislation, parents may prefer that consent is sought from both. Misconceptions about the absence of risks or unrealistic expectations about benefits should be openly addressed to avoid misunderstandings which may harm the relationship with the clinical team. Continuous consent can be sought where it is unclear whether the free choice of parental consent has been compromised. Obtaining informed consent is a dynamic process building on trusting relationships. It should include open and honest discussions about benefits and risks. Investigators may benefit from training in effective communication. Finally, involving parents in neonatal research including the development of the informed consent form and the process of obtaining consent should be considered standard practice.
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Affiliation(s)
- Beate Aurich
- Department of Paediatric Clinical Pharmacology and Pharmacogenetics, Robert Debré Hospital, 48 Boulevard Sérurier, Institut National de la Santé et de la Recherche Médicale (INSERM), Paris, France
| | - Eric Vermeulen
- Dutch patient association for rare and genetic diseases (VSOP), Soest, The Netherlands
| | - Valéry Elie
- Department of Paediatric Clinical Pharmacology and Pharmacogenetics, Robert Debré Hospital, 48 Boulevard Sérurier, Institut National de la Santé et de la Recherche Médicale (INSERM), Paris, France
| | | | - Christine Kubiak
- The European Clinical Research Infrastructure Network (ECRIN), 5-7 Rue Watt, Paris, France
| | - Donato Bonifazi
- Consorzio per le Valutazioni Biologiche e Farmacologiche, Via Nicolo Putignani, Bari, Italy.,TEDDY European Network of Excellence for Paediatric Research, Via Luigi Porta 14, Pavia, Italy
| | - Evelyne Jacqz-Aigrain
- Department of Paediatric Clinical Phramcology and Pharmacogenetics, Robert Debré Hospital, APHP, 48 Boulevard Sérurier, Paris, France.,Paris University, Paris, France
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18
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Needs and stressors of parents of term and near-term infants in the NICU: A systematic review with best practice guidelines. Early Hum Dev 2019; 139:104839. [PMID: 31439386 DOI: 10.1016/j.earlhumdev.2019.104839] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Having a sick infant in the NICU can be quite stressful and overwhelming to parents. They require support and may have varied needs. A systematic review of qualitative and quantitative studies from 5 electronic databases (Ovid Medline, EMBASE, PsycINFO, CINAHL and Sociological Abstracts), covering January 2001 - March 2016 identified the needs and stressors of parents of term or near-term Infants in the NICU. Six articles addressed the needs and 14 identified the stressors of parents. Parents' most important need was for accurate and honest information. Needs focused around sensitive infant care and involvement in decision-making. The greatest stressor for parents was alteration to the parental role, followed by infant appearance. Fathers and parents of infants undergoing surgery are an under-researched population. Based on the evidence, enhancing staff-parent communication would better meet parental needs and reduce stressors. Our key recommendations highlight the need for family-centred and individualised care practices in the NICU.
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19
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Bry A, Wigert H. Psychosocial support for parents of extremely preterm infants in neonatal intensive care: a qualitative interview study. BMC Psychol 2019; 7:76. [PMID: 31783784 PMCID: PMC6883543 DOI: 10.1186/s40359-019-0354-4] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 11/15/2019] [Indexed: 01/25/2023] Open
Abstract
Background Extremely premature infants (those born before 28 weeks’ gestational age) are highly immature, requiring months of care at a neonatal intensive care unit (NICU). For parents, their child’s grave medical condition and prolonged hospitalization are stressful and psychologically disruptive. This study aimed at exploring the needs of psychosocial support of parents of extremely premature infants, and how the NICU as an organization and its staff meets or fails to meet these needs. Method Sixteen open-ended interviews were conducted with 27 parents after their infant’s discharge from the NICU. Inductive content analysis was performed. Results Four themes were identified: Emotional support (with subthemes Empathic treatment by staff, Other parents as a unique source of support, Unclear roles of the various professions); Feeling able to trust the health care provider; Support in balancing time spent with the infant and other responsibilities; Privacy. Parents of extremely premature infants needed various forms of emotional support at the NICU, including support from staff, professional psychological help and/or companionship with other patients’ parents. Parents were highly variable in their desire to discuss their emotional state with staff. The respective roles of nursing staff, social workers and psychologists in supporting parents emotionally and identifying particularly vulnerable parents appeared unclear. Parents also needed to be able to maintain a solid sense of trust in the NICU and its staff. Poor communication with and among staff, partly due to staff discontinuity, damaged trust. Parents struggled with perceived pressure from staff to be at the hospital more than they could manage and with the limited privacy of the NICU. Conclusions The complex and individual psychosocial needs of parents of extremely preterm infants present many challenges for the NICU and its staff. Increasing staffing and improving nurses’ competence in addressing psychosocial aspects of neonatal care would help both nurses and families. Clarifying the roles of different professions in supporting parents and developing their teamwork would lessen the burden on nurses. Communicating with parents about their needs and informing them early in their NICU stay about available support would be essential in helping them cope with their infant’s hospitalization.
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Affiliation(s)
- Anna Bry
- Division of Neonatology, Sahlgrenska University Hospital, Gothenburg, Sweden.
| | - Helena Wigert
- Division of Neonatology, Sahlgrenska University Hospital, Gothenburg, Sweden.,Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
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20
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Amorim M, Alves E, Kelly-Irving M, Silva S. Needs of parents of very preterm infants in Neonatal Intensive Care Units: A mixed methods study. Intensive Crit Care Nurs 2019; 54:88-95. [DOI: 10.1016/j.iccn.2019.05.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 03/29/2019] [Accepted: 05/31/2019] [Indexed: 11/16/2022]
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21
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Govindaswamy P, Laing S, Waters D, Walker K, Spence K, Badawi N. Needs of parents in a surgical neonatal intensive care unit. J Paediatr Child Health 2019; 55:567-573. [PMID: 30288834 DOI: 10.1111/jpc.14249] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 09/05/2018] [Accepted: 09/07/2018] [Indexed: 11/28/2022]
Abstract
AIM While there is evidence of parental needs in the neonatal intensive care unit (NICU), parents of newborns admitted for general surgery are an under-researched population. This study aimed to identify needs in parents of newborns admitted to the NICU for general surgery and whether health-care professionals meet these needs. METHODS This was a prospective cohort study of 111 parents (57% mothers) of newborns admitted to a surgical NICU for general surgery in Australia from January 2014 to September 2015. Parents completed the Neonatal Family Needs Inventory (NFNI), comprising 56 items in five subscales (Support, Comfort, Information, Proximity, Assurance) at admission and discharge, as well as the Social Desirability Scale (SDS). Data were analysed using parametric and non-parametric techniques. RESULTS At both admission and discharge, parents rated Assurance (M = 3.8, standard deviation (SD) = 0.24) needs as the most important, followed by Proximity (M = 3.6, SD = 0.32) and Information (M = 3.5, SD = 0.38). Mothers rated Assurance significantly more important than fathers (P < 0.02). Overall, parents' most important needs were having questions answered honestly (M = 3.96, SD = 0.19), seeing their infant frequently and knowing about the medical treatment (both M = 3.95, SD = 0.23). The 10 most important needs were met for more than 96% of parents, with no evidence of response bias. CONCLUSIONS Reassurance is a priority need for parents in the surgical NICU. Mothers' and fathers' needs may be best met by practices based on family-centred, individualised care principles.
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Affiliation(s)
- Priya Govindaswamy
- Grace Centre for Newborn Care, Children's Hospital at Westmead, Sydney, New South Wales, Australia.,Children's Hospital Westmead Clinical School, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Sharon Laing
- School of Social Sciences and Psychology, Western Sydney University, Sydney, New South Wales, Australia
| | - Donna Waters
- Children's Hospital Westmead Clinical School, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.,Sydney Nursing School, University of Sydney, Sydney, New South Wales, Australia
| | - Karen Walker
- Grace Centre for Newborn Care, Children's Hospital at Westmead, Sydney, New South Wales, Australia.,Children's Hospital Westmead Clinical School, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.,Sydney Nursing School, University of Sydney, Sydney, New South Wales, Australia
| | - Kaye Spence
- Grace Centre for Newborn Care, Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Nadia Badawi
- Grace Centre for Newborn Care, Children's Hospital at Westmead, Sydney, New South Wales, Australia.,Children's Hospital Westmead Clinical School, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
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22
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Alsaiari EM, Magarey J, Rasmussen P. An Investigation of the Needs of Saudi Parents of Preterm Infants in the Neonatal Intensive Care Unit. Cureus 2019; 11:e3887. [PMID: 30911444 PMCID: PMC6424543 DOI: 10.7759/cureus.3887] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objective This study aimed to identify the needs of Saudi parents who had an infant in a neonatal intensive care unit (NICU) in one of five hospitals in Riyadh City, Saudi Arabia. Materials and methods Data were collected using a questionnaire that comprised questions about demographic characteristics and a modified version of the NICU Family Needs Inventory. A convenience sample of 36 Muslim Saudi mothers and fathers completed a self-reported questionnaire. Parents were asked to rate 52 statements in the NICU Family Needs Inventory as not important, somewhat important, important or very important. Results Saudi parents ranked the needs for assurance, proximity, and information as the most important needs. The comfort and support needs were ranked as the least important. Moreover, the highest top-ranked items were related to assurance of pain infant being treated for (86%), infant expected outcome (83%), and infant being handled gently (83%). Conclusion Nurses should create a relationship with parents and provide them with comprehensible and honest assurance and information. Likewise, it is imperative to provide a high-quality holistic care for parents that relies on their needs assessment.
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Affiliation(s)
- Eman M Alsaiari
- Pediatrics, Prince Sattam Bin Abdulaziz University, Riyadh, SAU
| | - Judy Magarey
- Pediatrics, The University of Adelaide, Adelaide, AUS
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Choi E, Lee Y. A Mother’s Experience of Hospitalization of Her Newborn in the Neonatal Intensive Care Unit. CHILD HEALTH NURSING RESEARCH 2018. [DOI: 10.4094/chnr.2018.24.4.407] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Noergaard B, Ammentorp J, Garne E, Fenger-Gron J, Kofoed PE. Fathers' Stress in a Neonatal Intensive Care Unit. Adv Neonatal Care 2018; 18:413-422. [PMID: 29746269 PMCID: PMC6155352 DOI: 10.1097/anc.0000000000000503] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Healthcare professionals in neonatal intensive care units (NICUs) tend to focus attention on the mothers and the newborn infants. Thus, fathers may find it difficult to establish an optimal father-child relationship and their stress may increase and persist during hospitalization. PURPOSE To investigate the impact of a more father-friendly NICU on paternal stress and their participation in childcare. METHODS A quasiexperimental design was conducted on Danish-speaking fathers of newborn infants 28 or more weeks' gestational age. The Parental Stressor Scale: Neonatal Intensive Care Unit (PSS:NICU) was used to measure paternal perceptions of stressors. Paternal participation in childcare was measured using 7 additional items. The questionnaires were distributed on admission to the NICU, at the 14th day of hospitalization, and at the time of discharge. The primary outcome was the difference in the PSS:NICU overall stress score on admission to the NICU and at the time of discharge in the control group compared with the intervention group. RESULTS A total of 109 fathers were included. The overall PSS:NICU stress score increased after the intervention. Paternal involvement, staff expectations, and the social expectation to fulfill the traditional role of a breadwinner and additionally of a caregiver may have caused increased stress. IMPLICATIONS FOR PRACTICE Healthcare professionals must be aware of the father's need to be an equal coparent. Nurses, as key persons, should motivate and expect fathers to be involved, and support them to establish a father-child relationship, although they might become more stressed. IMPLICATIONS FOR RESEARCH More adequate outcome measures are needed to determine the effect of interventions on paternal stress.
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Hagen IH, Svindseth MF, Nesset E, Orner R, Iversen VC. Validation of the Neonatal Satisfaction Survey (NSS-8) in six Norwegian neonatal intensive care units: a quantitative cross-sectional study. BMC Health Serv Res 2018; 18:222. [PMID: 29587812 PMCID: PMC5872573 DOI: 10.1186/s12913-018-3031-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 03/16/2018] [Indexed: 11/18/2022] Open
Abstract
Background The experience of having their new-borns admitted to an intensive care unit (NICU) can be extremely distressing. Subsequent risk of post-incident-adjustment difficulties are increased for parents, siblings, and affected families. Patient and next of kin satisfaction surveys provide key indicators of quality in health care. Methodically constructed and validated survey tools are in short supply and parents’ experiences of care in Neonatal Intensive Care Units is under-researched. This paper reports a validation of the Neonatal Satisfaction Survey (NSS-8) in six Norwegian NICUs. Methods Parents’ survey returns were collected using the Neonatal Satisfaction Survey (NSS-13). Data quality and psychometric properties were systematically assessed using exploratory factor analysis, tests of internal consistency, reliability, construct, convergent and discriminant validity. Each set of hospital returns were subjected to an apostasy analysis before an overall satisfaction rate was calculated. Results The survey sample of 568 parents represents 45% of total eligible population for the period of the study. Missing data accounted for 1,1% of all returns. Attrition analysis shows congruence between sample and total population. Exploratory factor analysis identified eight factors of concern to parents,“Care and Treatment”, “Doctors”, “Visits”, “Information”, “Facilities”, “Parents’ Anxiety”, “Discharge” and “Sibling Visits”. All factors showed satisfactory internal consistency, good reliability (Cronbach’s alpha ranged from 0.70–0.94). For the whole scale of 51 items α 0.95. Convergent validity using Spearman’s rank between the eight factors and question measuring overall satisfaction was significant on all factors. Discriminant validity was established for all factors. Overall satisfaction rates ranged from 86 to 90% while for each of the eight factors measures of satisfaction varied between 64 and 86%. Conclusion The NSS-8 questionnaire is a valid and reliable scale for measuring parents’ assessment of quality of care in NICU. Statistical analysis confirms the instrument’s capacity to gauge parents’ experiences of NICU. Further research is indicated to validate the survey questionnaire in other Nordic countries and beyond.
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Affiliation(s)
- Inger Hilde Hagen
- NTNU Norwegian University of Science and Technology, Aalesund, Postbox 1517, 6025, Aalesund, Norway.
| | - Marit Følsvik Svindseth
- NTNU Norwegian University of Science and Technology, Aalesund, Postbox 1517, 6025, Aalesund, Norway
| | - Erik Nesset
- NTNU Norwegian University of Science and Technology, Aalesund, Postbox 1517, 6025, Aalesund, Norway
| | - Roderick Orner
- College of Social Science, University of Lincoln, Brayford Pool, Lincoln, Lincolnshire, LN6 7TS, UK
| | - Valentina Cabral Iversen
- St Olav's University Hospital HF, Tiller District Psychiatric Center, Trondheim, Norway.,NTNU Norwegian University of Science and Technology, Faculty of Medicine and Health Science, 7491, Trondheim, Norway
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Amorim M, Alves E, Barros H, Silva S. [Parental roles and needs in neonatal intensive care: a review of Portuguese guidelines]. CIENCIA & SAUDE COLETIVA 2018; 21:2583-94. [PMID: 27557031 DOI: 10.1590/1413-81232015218.07292015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2014] [Accepted: 07/04/2015] [Indexed: 11/21/2022] Open
Abstract
The scope of this article is to analyze the parental roles and needs included in Neonatal Intensive Care Unit guidelines. Thematic content analysis was conducted of 33 guidelines (28 consensuses and 5 documents directed to parents) freely available on the Portuguese Pediatrics Society website in August 2014. These documents deal mainly with information needs, child care activities performed by the parents and the respective responsibilities in decision making with respect to the health of children. Furthermore, parental and family characteristics were mentioned as risk factors for prematurity and perinatal diseases. The psychosocial consequences of parenthood experienced in Neonatal Intensive Care Units, as well as the adequacy of their environmental characteristics to parental needs, were less frequently touched upon. Issues related to the safety and comfort, confidence of parents in healthcare and social support were rarely touched upon. The results reflect sociocultural norms associated with intensive parenting, which is exclusively child centered, highly emotional and performed under the guidance of health professionals. The important aspect is to issue and disseminate guidelines that foster the integration of family-centered care in the dynamics of Neonatal Intensive Care Units.
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Affiliation(s)
- Mariana Amorim
- ISPUP-EPIUnit,, Universidade do Porto. R. das Taipas 135. 4050-600 Porto Portugal.
| | - Elisabete Alves
- ISPUP-EPIUnit,, Universidade do Porto. R. das Taipas 135. 4050-600 Porto Portugal.
| | - Henrique Barros
- ISPUP-EPIUnit,, Universidade do Porto. R. das Taipas 135. 4050-600 Porto Portugal.
| | - Susana Silva
- ISPUP-EPIUnit,, Universidade do Porto. R. das Taipas 135. 4050-600 Porto Portugal.
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Thomson-Salo F, Kuschel CA, Kamlin OF, Cuzzilla R. A fathers' group in NICU: Recognising and responding to paternal stress, utilising peer support. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.jnn.2017.04.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Ladani MT, Abdeyazdan Z, Sadeghnia A, Hajiheidari M, Hasanzadeh A. Comparison of Nurses and Parents' Viewpoints Regarding the Needs of Parents of Premature Infants in Neonatal Intensive Care Units. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2017; 22:367-371. [PMID: 29033991 PMCID: PMC5637145 DOI: 10.4103/1735-9066.215672] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND The birth of a premature infant and her/his hospitalization can cause the parents to experience a variety of needs. Understanding the needs of parents by nurses can lead to provision of high quality care to premature infants. This study aimed to compare the parents' and nurses' viewpoints regarding parents' needs in the neonatal intensive care units (NICU). MATERIALS AND METHODS In this descriptive cross-sectional study, 63 nurses, 120 mothers, and 120 fathers, who met the inclusion criteria, participated. Nurses were selected through a census method and parents through a simple convenience sampling method. Data were gathered using a researcher-made questionnaire and were analyzed using descriptive-analytic statistical methods in the Statistical Package for the Social Sciences software version 16. RESULTS From the viewpoint of mothers, the need for assurance with a mean score of 87.4 was the most important and the need for support with a mean score of 71.37 was the least important need. From the perspective of fathers, the need for assurance with a mean score of 78.5 was the most important and the need for support with a mean score of 51.20 was the least important need. From the viewpoint of the nurses, the need for assurance with a mean score of 77.6 was the most important and the need for support with a mean score of 59.77 was the least important need. The mean scores of the needs of mothers in all subscales were higher than that of the fathers' and nurses' (P < 0.001). CONCLUSIONS From the viewpoint of nurses, the scores of parents' needs were significantly less than that of the parents' for all subscales. It is suggested that appropriate education programs be provided for nurses regarding how they can understand parents' needs to provide high quality care.
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Affiliation(s)
- Marziyeh Tork Ladani
- Student Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Abdeyazdan
- Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Sadeghnia
- Student Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahnoosh Hajiheidari
- Student Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Akbar Hasanzadeh
- Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
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Aftyka A, Rozalska-Walaszek I, Wróbel A, Bednarek A, Dąbek K, Zarzycka D. Support provided by nurses to parents of hospitalized children - cultural adaptation and validation of Nurse Parent Support Tool and initial research results. Scand J Caring Sci 2017; 31:1012-1021. [DOI: 10.1111/scs.12426] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Accepted: 12/09/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Anna Aftyka
- Department of Anaesthesiological and Intensive Care Nursing; Faculty of Health Sciences; Medical University of Lublin; Lublin Poland
| | - Ilona Rozalska-Walaszek
- Department of Anaesthesiological and Intensive Care Nursing; Faculty of Health Sciences; Medical University of Lublin; Lublin Poland
| | - Aleksandra Wróbel
- Department of Anaesthesiological and Intensive Care Nursing; Faculty of Health Sciences; Medical University of Lublin; Lublin Poland
| | - Anna Bednarek
- Chair and Department of Paediatric Nursing; Faculty of Health Sciences; Medical University of Lublin; Lublin Poland
| | - Katarzyna Dąbek
- Chair and Clinic of Obstetrics and Gynaecology; Medical University of Lublin; Lublin Poland
- Neonatal Department with Neonatal Intensive Care Unit; Friderick Chopin Clinical Provincial Hospital No 1 in Rzeszów
| | - Danuta Zarzycka
- Chair and Department of Paediatric Nursing; Faculty of Health Sciences; Medical University of Lublin; Lublin Poland
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Fotiou C, Vlastarakos PV, Bakoula C, Papagaroufalis K, Bakoyannis G, Darviri C, Chrousos G. Parental stress management using relaxation techniques in a neonatal intensive care unit: A randomised controlled trial. Intensive Crit Care Nurs 2017; 32:20-8. [PMID: 26520208 DOI: 10.1016/j.iccn.2015.08.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 08/19/2015] [Accepted: 08/22/2015] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The objective of this study was to investigate the effect of relaxation techniques on the stress/anxiety of parents with hospitalised premature infants, three months following discharge from the neonatal intensive care unit. STUDY DESIGN A randomised controlled trial was conducted in the neonatal intensive care unit of a tertiary maternity hospital including 59 parents, who were randomised into two groups: 31 in the intervention group and 28 in the control group. Parents in the intervention group practiced three different relaxation techniques, in addition to undergoing the same information-based training courses as did the parents of the control group. DATA COLLECTION Data were collected 10-15 days post delivery and three months post discharge. The assessment measures included the Perceived Stress Scale, the State and Trait Anxiety Inventory 1 and 2 and salivary cortisol levels. RESULTS The psychometric assessment at baseline was comparable between the two groups. The intervention group showed a significant reduction in trait anxiety (p=0.02) compared with the control group three months post discharge. The perceived stress decreased in both groups (p=0.699). No difference in salivary cortisol levels was detected. The multivariate analysis revealed that higher initial stress levels (p<0.001) and university/college education (p=0.003) were associated with higher parental stress, whereas moderate-to-high income satisfaction was associated with lower parental stress (p=0.003). CONCLUSION Further long-term follow-up of families with a neonatal intensive care unit experience could assess more delayed effects of stress management by relaxation techniques.
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Affiliation(s)
- Catherine Fotiou
- Postgraduate Program in Stress Management and Health Promotion, University of Athens, Athens, Greece
| | | | - Chrysa Bakoula
- Second Department of Pediatrics, University of Athens, "P. & A. Kyriakou" Children's Hospital, Athens, Greece
| | | | - George Bakoyannis
- Department of Biostatistics, "Richard M. Fairbanks" School of Public Health, University of Indiana, Indianapolis, IN, USA
| | - Christine Darviri
- Postgraduate Program in Stress Management and Health Promotion, University of Athens, Athens, Greece
| | - George Chrousos
- First Department of Pediatrics, University of Athens, "Aghia Sophia" Children's Hospital, Athens, Greece
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Abstract
To investigate the needs of parents of premature infants hospitalized in a neonatal intensive care unit (NICU) and explore associated factors. This study includes a convenience sample of 198 parents of premature infants hospitalized in a NICU in Chenzhou, Hunan province, China. Parents completed a study-specific questionnaire and the Chinese version of Critical Care Family Need Inventory (CCFNI). Analysis was conducted by multiple linear regression. Parents rated 30 of 45 items on the Chinese version of the CCFNI as important or very important. Items on the assurance, information, and proximity subscales were perceived as the most important, while items on the comfort subscale were the least important. Gender of parents and experience of visiting a NICU were significantly associated with the total needs of the parents. These insights should be used to inform clinical practice in the NICU.
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Affiliation(s)
- Li Wang
- 1 The First People's Hospital of Chenzhou, P. R. China
| | - Jun Li He
- 1 The First People's Hospital of Chenzhou, P. R. China
| | - Shu Lan Fei
- 1 The First People's Hospital of Chenzhou, P. R. China
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Noergaard B, Johannessen H, Fenger-Gron J, Kofoed PE, Ammentorp J. Participatory Action Research in the Field of Neonatal Intensive Care: Developing an Intervention to Meet the Fathers' Needs. A Case Study. J Public Health Res 2016; 5:744. [PMID: 28083521 PMCID: PMC5206773 DOI: 10.4081/jphr.2016.744] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 12/11/2016] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND In neonatal intensive care units (NICUs) health care professionals typically give most of their attention to the infants and the mothers while many fathers feel uncertain and have an unmet need for support and guidance. This paper describes and discusses participatory action research (PAR) as a method to improve NICUs' service for fathers. Our goal is to develop a father-friendly NICU where both the needs of fathers and mothers are met using an approach based on PAR that involves fathers, mothers, interdisciplinary healthcare professionals, and managers. DESIGN AND METHODS This PAR process was carried out from August 2011 to July 2013 and included participant observations, semi-structured interviews, multi sequential interviews, workshops, focus groups, group discussion, and a seminar. The theoretical framework of validity described by Herr and Anderson's three criteria; process-, democratic-, and catalytic validity were used to discuss this PAR. RESULTS Twelve fathers, 11 mothers, 48 health professionals and managers participated in the PAR process. The collaboration ensured the engagement for viable and constructive local changes to be used in designing the concept of the father friendly NICU. CONCLUSIONS This paper contributed new knowledge of how PAR can be used to ensure that participants engaged in the field are involved in the entire process; consequently, this will ensure that the changes are feasible and sustainable.
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Affiliation(s)
- Betty Noergaard
- Department of Paediatrics, Lillebaelt Hospital
- Institute of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark
| | - Helle Johannessen
- Research Unit of User Perspectives, Department of Public Health, University of Southern Denmark
| | | | - Poul-Erik Kofoed
- Department of Paediatrics, Lillebaelt Hospital
- Institute of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark
| | - Jette Ammentorp
- Institute of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark
- Health Services Research Unit, Lillebaelt Hospital, Denmark
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Martin AE, D’Agostino JA, Passarella M, Lorch SA. Racial differences in parental satisfaction with neonatal intensive care unit nursing care. J Perinatol 2016; 36:1001-1007. [PMID: 27583386 PMCID: PMC5079824 DOI: 10.1038/jp.2016.142] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 07/25/2016] [Indexed: 12/03/2022]
Abstract
OBJECTIVE Nurses provide parental support and education in the neonatal intensive care unit (NICU), but it is unknown if satisfaction and expectations about nursing care differ between racial groups. STUDY DESIGN A prospective cohort was constructed of families with a premature infant presenting to primary care between 1 January 2010 and 1 January 2013 (N=249, 52% white, 42% black). Responses to questions about satisfaction with the NICU were analyzed in ATLAS.ti using the standard qualitative methodology. RESULTS One hundred and twenty (48%) parents commented on nursing. Fifty-seven percent of the comments were positive, with black parents more negative (58%) compared with white parents (33%). Black parents were most dissatisfied with how nurses supported them, wanting compassionate and respectful communication. White parents were most dissatisfied with inconsistent nursing care and lack of education about their child. CONCLUSIONS Racial differences were found in satisfaction and expectations with neonatal nursing care. Accounting for these differences will improve parental engagement during the NICU stay.
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Affiliation(s)
- Ashley E. Martin
- Center for Perinatal and Pediatric Health Disparities Research, The Children’s Hospital of Philadelphia, Philadelphia, PA
- Center for Outcomes Research, The Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Jo Ann D’Agostino
- Center for Perinatal and Pediatric Health Disparities Research, The Children’s Hospital of Philadelphia, Philadelphia, PA
- Center for Outcomes Research, The Children’s Hospital of Philadelphia, Philadelphia, PA
- Department of Pediatrics, The Children’s Hospital of Philadelphia
| | - Molly Passarella
- Center for Perinatal and Pediatric Health Disparities Research, The Children’s Hospital of Philadelphia, Philadelphia, PA
- Center for Outcomes Research, The Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Scott A. Lorch
- Center for Perinatal and Pediatric Health Disparities Research, The Children’s Hospital of Philadelphia, Philadelphia, PA
- Center for Outcomes Research, The Children’s Hospital of Philadelphia, Philadelphia, PA
- Department of Pediatrics, The Children’s Hospital of Philadelphia
- The University of Pennsylvania School of Medicine, Philadelphia, PA
- Senior Scholar, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
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Ireland J, Minesh Khashu, Cescutti-Butler L, van Teijlingen E, Hewitt-Taylor J. Experiences of fathers with babies admitted to neonatal care units: A review of the literature. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.jnn.2016.01.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Han SY, Chae SM. Perceived Parental Stress and Nursing Support for Fathers of High Risk Infants. CHILD HEALTH NURSING RESEARCH 2016. [DOI: 10.4094/chnr.2016.22.3.190] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Ettenberger M, Rojas Cárdenas C, Parker M, Odell-Miller H. Family-centred music therapy with preterm infants and their parents in the Neonatal Intensive Care Unit (NICU) in Colombia – A mixed-methods study. NORDIC JOURNAL OF MUSIC THERAPY 2016. [DOI: 10.1080/08098131.2016.1205650] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Hagen IH, Iversen VC, Svindseth MF. Differences and similarities between mothers and fathers of premature children: a qualitative study of parents' coping experiences in a neonatal intensive care unit. BMC Pediatr 2016; 16:92. [PMID: 27422718 PMCID: PMC4946152 DOI: 10.1186/s12887-016-0631-9] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2016] [Accepted: 07/08/2016] [Indexed: 11/10/2022] Open
Abstract
Background The aim of this study was to explore and describe the coping experiences of parents to children admitted to a neonatal unit. Methods A qualitative research approach was chosen, using in-depth interviews with eight fathers and eight mothers. Results The main findings were that parents with previous complicated births had more difficulties in coping compared to those parents with no experience with complications. Coping seemed easier where parents’ opinions were heard regarding their baby’s care and when both parents were present in the neonatal intensive care unit (NICU). The main similarities between mothers and fathers were the reluctance to speak their opinions on childcare, and both experienced a sense of alienation and problems in bonding with the baby. They also needed a limitation on the number of visitors in the NICU. Differences between mothers and fathers were that fathers tried hard to be the strong partner in the relationship, and were more concerned with the mother if she was seriously ill postpartum, while mothers were more concerned for their baby. Mothers’ postpartum period was felt as more stressful if the father was not present, but mothers were also better at welcoming support from the health personnel. Conclusion This study highlights the parent’s coping experiences in NICUs. Coping seemed easier where parents’ opinions were heard. Nurses in the NICU should take the former experiences of the parents into consideration when nursing in the NICU and planning for discharge.
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Affiliation(s)
- I H Hagen
- NTNU, Norwegian University of Science and Technology in Aalesund, Postbox 1517, 6025, Aalesund, Norway.
| | - V C Iversen
- NTNU, Norwegian University of Science and Technology in Trondheim Institute of neuroscience, Postbox 8905, Medisinsk teknisk forskningssenter, 7491, Trondheim, Norway
| | - M F Svindseth
- NTNU, Norwegian University of Science and Technology in Aalesund, Postbox 1517, 6025, Aalesund, Norway
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Mousavi SS, Chaman R, Khosravi A, Mohagheghi P, Mousavi SA, Keramat A. The Needs of Parents of Preterm Infants in Iran and a Comparison With Those in Other Countries: A Systematic Review and Meta-Analysis. IRANIAN JOURNAL OF PEDIATRICS 2016; 26:e4396. [PMID: 28203326 PMCID: PMC5294933 DOI: 10.5812/ijp.4396] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Revised: 03/06/2016] [Accepted: 03/27/2016] [Indexed: 11/24/2022]
Abstract
Context Proper accountability to needs of preterm infants’ parents requires recognition of these needs and how they change in different conditions. The aim of this study was to assess the needs of parents of preterm infants in Iran, as compared to those in other regions in the world. Evidence Acquisition A search of Iranian databases (Iran Medex, Magiran, and SID) and international resources (PubMed, Scopus, and Google Scholar) was conducted, with no time limitations, to 5 October 2014. Using standard tools, all quantitative studies that considering the parental needs of preterm infants and parental support were extracted. The STROBE checklist was used for the evaluation of the studies. Thirty-one studies were extracted in the qualitative evaluation, of which 17 were included in the meta-analysis. The variance between the studies was analyzed using tau-squared (Tau2) and review manager 5 software. Results The results obtained using the nurse-parent support tool (NPST) showed that mothers considered that all the fields of support were of great importance. The parental needs in Iran were similar to those of parents in other regions worldwide. However, the mean score for Iranian parents’ assessment of the support they received was 2.20 ± 0.06, whereas it was 3.84 ± 0.72 for other countries. The mean scores for parents’ assessment of the provision of emotional, informational appraisal, and instrumental support in Iran were 1.73 ± 0.06, 2.1 ± 0.06, 1.54 ± 0.6, and 3.44 ± 0.04, respectively, compared to 3.18 ± 1.34, 4.11 ± 0.5, 4.26 ± 0.18, and 4.51 ± 0.14, respectively, in other countries. Conclusions Parents always prefer the priorities of their babies to their individual needs. Given the lower scores for the parental assessment of received support in Iran, it is important to focus on these specific items in providing interventions to meet the needs of Iranian parents.
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Affiliation(s)
| | - Reza Chaman
- Associate Professor, Epidemiology, Department of Community Medicine, Yasuj University Of Medical Sciences, Yasuj, IR Iran
| | - Ahmad Khosravi
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, IR Iran
| | - Parisa Mohagheghi
- Associate Professor, Iran University of Medical Sciences, Tehran, IR Iran
| | - Seyed Abbas Mousavi
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, IR Iran
| | - Afsaneh Keramat
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, IR Iran
- Corresponding author: Afsaneh Keramat, Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, IR Iran. Tel: +98-2332395054, Fax: +98-2332394800, E-mail:
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Determining the Psychometric Properties of the Turkish Version of the Nurse-Parent Support Tool and the Stress Levels of Parents of Premature Infants Hospitalized in the Neonatal Intensive Care Unit. CLIN NURSE SPEC 2016; 30:E1-10. [DOI: 10.1097/nur.0000000000000204] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Hajj M, Gulgulian T, Haydar L, Saab A, Dirany F, Badr LK. The satisfaction of families in the care of their loved ones in CCUs in Lebanon. Nurs Crit Care 2015; 22:203-211. [PMID: 26256561 DOI: 10.1111/nicc.12195] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Revised: 05/07/2015] [Accepted: 05/28/2015] [Indexed: 12/21/2022]
Abstract
BACKGROUND The needs of family members vary among cultures and hospitals. Often, these needs remain unmet increasing their stress and anxiety and decreasing their satisfaction with care, which may negatively impact the quality of patient care. AIMS To assess the satisfaction of families with the care of their loved ones in critical care units (CCUs) in a large university medical centre in Lebanon and to assess the predictors of satisfaction. METHODS A cross-sectional descriptive design was conducted using the Critical Care Family Satisfaction Survey (CCFSS). The participants were 123 adult relatives or significant others of patients cared for in both adult and paediatric intensive care units for at least 3 days. RESULTS The CCFSS showed acceptable internal reliability and construct validity in a Lebanese population. In general, families were satisfied with the care their loved ones received in the CCUs, and the least satisfaction was in the area of 'comfort' and the highest was in 'assurance'. Younger family members with more education were less satisfied with care and Christian families expressed less satisfaction with informational needs compared with Muslim families. Families of children in the paediatric CCU expressed least satisfaction with care. Gender, residency, relationship to patient, unit, prior experience in a CCU and diagnosis had no effect on satisfaction scores. CONCLUSIONS Assessment of family satisfaction in different cultures is important as each culture has specific needs that are essential to decipher. IMPLICATIONS FOR PRACTICE Patient satisfaction leads to improved quality of care; thus, it behoves nurses to meet the needs of families from different cultures to help them cope and increase their satisfaction, which leads to improve patient outcomes.
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Affiliation(s)
- Madeleine Hajj
- Department of Nursing, Keserwan Medical Center, Jounieh, Lebanon
| | - Taline Gulgulian
- School of Nursing, American University of Beirut, Beirut, Lebanon
| | - Lili Haydar
- PICU, American University of Beirut Medical Center, Beirut, Lebanon
| | - Amali Saab
- American University of Beirut Medical Center, Beirut, Lebanon
| | - Fatima Dirany
- American University of Beirut Medical Center, Beirut, Lebanon
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Rosenstock A, van Manen M. Adolescent parenting in the neonatal intensive care unit. J Adolesc Health 2014; 55:723-9. [PMID: 25287982 DOI: 10.1016/j.jadohealth.2014.08.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Revised: 07/16/2014] [Accepted: 08/01/2014] [Indexed: 11/26/2022]
Abstract
This review presents data from studies that report on adolescent parents as part of larger neonatal intensive care unit (NICU) parent populations, as well as studies where adolescent parents are given central consideration. A systematic search for English publications from 1990 onward relevant to adolescent parenting in the NICU was conducted. Most studies reporting on adolescent parents focus on parental stress or parenting practices in the NICU. A few studies examine parent-staff communication, parental needs, and parent intervention programs. One study presents a qualitative examination of teenage mothers' experiences in the NICU. Areas for further research include experiences of younger adolescent parents, adolescent fathers, and same-sex partners; issues unique to adolescent parents; and support programs for adolescent parents in the NICU.
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Affiliation(s)
- Amanda Rosenstock
- John Dossetor Health Ethics Centre, University of Alberta, Edmonton, Alberta, Canada
| | - Michael van Manen
- John Dossetor Health Ethics Centre, University of Alberta, Edmonton, Alberta, Canada; Neonatal-Perinatal Medicine, Department of Paediatrics, University of Alberta, Edmonton, Alberta, Canada.
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Ignell Modé R, Mard E, Nyqvist K, Blomqvist Y. Fathers’ perception of information received during their infants’ stay at a neonatal intensive care unit. SEXUAL & REPRODUCTIVE HEALTHCARE 2014; 5:131-6. [DOI: 10.1016/j.srhc.2014.05.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Revised: 04/08/2014] [Accepted: 05/04/2014] [Indexed: 12/26/2022]
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Russell G, Sawyer A, Rabe H, Abbott J, Gyte G, Duley L, Ayers S. Parents' views on care of their very premature babies in neonatal intensive care units: a qualitative study. BMC Pediatr 2014; 14:230. [PMID: 25216714 PMCID: PMC4190336 DOI: 10.1186/1471-2431-14-230] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Accepted: 09/10/2014] [Indexed: 11/10/2022] Open
Abstract
Background The admission of a very premature infant to the neonatal intensive care unit (NICU) is often a difficult time for parents. This paper explores parents’ views and experiences of the care for their very premature baby on NICU. Methods Parents were eligible if they had a baby born before 32 weeks gestation and cared for in a NICU, and spoke English well. 32 mothers and 7 fathers were interviewed to explore their experiences of preterm birth. Although parents’ evaluation of care in the NICU was not the aim of these interviews, all parents spoke spontaneously and at length on this topic. Results were analysed using thematic analysis. Results Overall, parents were satisfied with the care on the neonatal unit. Three major themes determining satisfaction with neonatal care emerged: 1) parents’ involvement; including looking after their own baby, the challenges of expressing breast milk, and easy access to their baby; 2) staff competence and efficiency; including communication, experience and confidence, information and explanation; and 3) interpersonal relationships with staff; including sensitive and emotional support, reassurance and encouragement, feeling like an individual. Conclusions Determinants of positive experiences of care were generally consistent with previous research. Specifically, provision of information, support for parents and increasing their involvement in the care of their baby were highlighted by parents as important in their experience of care.
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Affiliation(s)
| | | | | | | | | | | | - Susan Ayers
- Centre for Maternal and Child Health Research, School of Health Sciences, City University London, London EC1R 1UW, UK.
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Tooten A, Hoffenkamp HN, Hall RAS, Braeken J, Vingerhoets AJJM, van Bakel HJA. Parental perceptions and experiences after childbirth: a comparison between mothers and fathers of term and preterm infants. Birth 2013; 40:164-71. [PMID: 24635501 DOI: 10.1111/birt.12052] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/08/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Parents experience a lot of positive and negative feelings and emotions after birth. The main purpose of this study was to compare perceptions and experiences of mothers and fathers with term, moderately and very preterm infants. METHODS We included 202 infants with both parents, divided into three groups: 1) term infants (≥ 37 weeks' gestation), 2) moderately preterm infants (≥32-<37 weeks' gestation) and 3) very preterm infants (< 32 weeks' gestation). The Clinical Interview for Parents of High-risk Infants (CLIP) was used to examine parental perceptions and experiences in eight areas: 1) Infant's current condition, 2) Course of the pregnancy, 3) Labor and delivery, 4) Relationship with infant and feelings as a parent, 5) Reactions to hospital and staff, 6) Support system, 7) Discharge and beyond, and 8) Quality of narratives during the interview. RESULTS The lower the gestational age of the infant, the more negative parental experiences and perceptions were on the following five areas: infant's current condition, pregnancy course, labor and delivery, relationship with the infant, and discharge and beyond. No differences were found between maternal and paternal perceptions on any of the eight CLIP areas. CONCLUSIONS Negative parental perceptions and experiences were mainly associated with the gestational age of the infant and not at all with the gender of the parent. These findings resulted in several recommendations to optimize care for parents after preterm birth.
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Affiliation(s)
- Anneke Tooten
- International Victimology Institute Tilburg, Tilburg University, The Netherlands
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Rahiminia E. Nursing Behaviors which Facilitate the Grief Work of Parents with Premature Infants in Neonatal Intensive Care Unit: A Comparison of Mothers and Fathers. Nurs Midwifery Stud 2013; 2:206-9. [PMID: 25414860 PMCID: PMC4228555 DOI: 10.5812/nms.10369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2013] [Revised: 02/24/2013] [Accepted: 04/11/2013] [Indexed: 11/22/2022] Open
Abstract
Background: The birth of a child is an event to be remembered. However, a premature birth may shock the parents and cause their grief. Understanding differences between mothers and fathers can help nurses in providing nursing supports. Objectives: This study was performed with the aim of comparing nursing behaviors which facilitate grief work for parents of premature infants hospitalized in the NICU from perspectives of mothers and fathers. Patients and Methods: This comparative descriptive design was conducted among 40 pairs of mothers and fathers selected by convenience sampling method. The study was performed in 2011 using the Fordham Scale (1989). Data were analyzed with "wilcoxon ranks test" by using SPSS software version 13. Results: The mean scores of nursing behaviors which facilitate grief work were 2.81 ± 0.16 and 2.82 ± 0.29 in the perspectives of mothers and fathers, respectively. The Wilcoxon test did not show any statistically significant difference between mothers and fathers (P = 0.55). Conclusions: Despite expectations, provided nursing behaviors in mothers and fathers showed no difference in this study. Therefore, nursing policymakers and directors should take measures in order to provide appropriate services to the parents.
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Affiliation(s)
- Elaheh Rahiminia
- School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IR Iran
- Corresponding author: Elaheh Rahiminia, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IR Iran. Tel.:+98-9122503699, Fax: +98-2166048003, E-mail:
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Thomson G, Moran VH, Axelin A, Dykes F, Flacking R. Integrating a sense of coherence into the neonatal environment. BMC Pediatr 2013; 13:84. [PMID: 23697687 PMCID: PMC3663664 DOI: 10.1186/1471-2431-13-84] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Accepted: 05/15/2013] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Family centred care (FCC) is currently a valued philosophy within neonatal care; an approach that places the parents at the heart of all decision-making and engagement in the care of their infant. However, to date, there is a lack of clarity regarding the definition of FCC and limited evidence of FCCs effectiveness in relation to parental, infant or staff outcomes. DISCUSSION In this paper we present a new perspective to neonatal care based on Aaron Antonovksy's Sense of Coherence (SOC) theory of well-being and positive health. Whilst the SOC was originally conceptualised as a psychological-based construct, the SOCs three underpinning concepts of comprehensibility, manageability and meaningfulness provide a theoretical lens through which to consider and reflect upon meaningful care provision in this particular care environment. By drawing on available FCC research, we consider how the SOC concepts considered from both a parental and professional perspective need to be addressed. The debate offered in this paper is not presented to reduce the importance or significance of FCC within neonatal care, but, rather, how consideration of the SOC offers the basis through which meaningful and effective FCC may be delivered. Practice based implications contextualised within the SOC constructs are also detailed. SUMMARY Consideration of the SOC constructs from both a parental and professional perspective need to be addressed in FCC provision. Service delivery and care practices need to be comprehensible, meaningful and manageable in order to achieve and promote positive well-being and health for all concerned.
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Affiliation(s)
- Gill Thomson
- Maternal and Infant Nutrition and Nurture (MAINN), University of Central Lancashire, Preston PR1 2HE, UK.
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Wigert H, Dellenmark MB, Bry K. Strengths and weaknesses of parent-staff communication in the NICU: a survey assessment. BMC Pediatr 2013; 13:71. [PMID: 23651578 PMCID: PMC3651269 DOI: 10.1186/1471-2431-13-71] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Accepted: 05/02/2013] [Indexed: 01/01/2023] Open
Abstract
Background Parents of infants hospitalized in the neonatal intensive care unit (NICU) find themselves in a situation of emotional strain. Communication in the NICU presents special challenges due to parental stress and the complexity of the highly technologized environment. Parents’ need for communication may not always be met by the NICU staff. This study aimed to describe strengths and weaknesses of parent–nurse and parent–doctor communication in a large level III NICU in Sweden in order to improve our understanding of parents’ communication needs. Methods Parents were asked to complete a survey consisting of sixteen questions about their experiences of communication with nurses and doctors in the NICU. In each question the parents evaluated some aspect of communication on a five- or six-point Likert scale. They also had the opportunity on each question to comment on their experiences in their own words. Data were analyzed using IBM SPSS Statistics 20.0 and qualitative manifest content analysis. Results 270 parents (71.4%) completed the survey. Parents generally rated communication with the staff in the NICU positively and appreciated having received emotional support and regular information about their child´s care. Although a large majority of the parents were satisfied with their communication with doctors and nurses, only about half of the parents felt the nurses and doctors understood their emotional situation very well. Some parents would have desired easier access to conversations with doctors and wanted medical information to be given directly by doctors rather than by nurses. Parents’ communication with the staff was hampered when many different nurses were involved in caring for the infant or when the transfer of information in connection with shift changes or between the maternity ward and NICU was poor. Parents also desired to be present during doctors’ rounds on their infant. Conclusions Training both doctors and nurses in communication skills, especially in how to meet parents’ emotional needs better, could make communication at the NICU more effective and improve parental well-being. Creating a framework for the parents of what to expect from NICU communication might also be helpful. In addition, our results support the use of primary nurse teams to improve continuity of care and thereby promote successful communication.
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Affiliation(s)
- Helena Wigert
- Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Box 457, Gothenburg, SE 405 30, Sweden.
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Mbwele B, Ide NL, Reddy E, Ward SAP, Melnick JA, Masokoto FA, Manongi R. Quality of neonatal healthcare in Kilimanjaro region, northeast Tanzania: learning from mothers' experiences. BMC Pediatr 2013; 13:68. [PMID: 23642257 PMCID: PMC3660191 DOI: 10.1186/1471-2431-13-68] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2012] [Accepted: 04/22/2013] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND With a decline of infant mortality rates, neonatal mortality rates are striking high in development countries particularly sub Saharan Africa. The toolkit for high quality neonatal services describes the principle of patient satisfaction, which we translate as mother's involvement in neonatal care and so better outcomes. The aim of the study was to assess mothers' experiences, perception and satisfaction of neonatal care in the hospitals of Kilimanjaro region of Tanzania. METHODS A cross sectional study using qualitative and quantitative approaches in 112 semi structured interviews from 14 health facilities. Open ended questions for detection of illness, care given to the baby and time spent by the health worker for care and treatment were studied. Probing of the responses was used to extract and describe findings by a mix of in-depth interview skills. Closed ended questions for the quantitative variables were used to quantify findings for statistical use. Narratives from open ended questions were coded by colours in excel sheet and themes were manually counted. RESULTS 80 mothers were interviewed from 13 peripheral facilities and 32 mothers were interviewed at a zonal referral hospital of Kilimanjaro region. 59 mothers (73.8%) in the peripheral hospitals of the region noted neonatal problems and they assisted for attaining diagnosis after a showing a concern for a request for further investigations. 11 mothers (13.8%) were able to identify the baby's diagnosis directly without any assistance, followed by 7 mothers (8.7%) who were told by a relative, and 3 mothers (3.7%) who were told of the problem by the doctor that their babies needed medical attention. 24 times mothers in the peripheral hospitals reported bad language like "I don't have time to listen to you every day and every time." 77 mothers in the periphery (90.6%) were not satisfied with the amount of time spent by the doctors in seeing their babies. CONCLUSION Mothers of the neonates play great roles in identifying the illness of the newborn. Mother's awareness of what might be needed during neonatal support strategies to improve neonatal care in both health facilities and the communities.
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Affiliation(s)
- Bernard Mbwele
- Kilimanjaro Clinical Research Institute, Kilimanjaro Christian Medical Center, P,O Box 2236, KCMC, Moshi, Tanzania.
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Implementing family-integrated care in the NICU: a parent education and support program. Adv Neonatal Care 2013; 13:115-26. [PMID: 23532031 DOI: 10.1097/anc.0b013e318285fb5b] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to develop, implement, and evaluate a parent education and support program that enhances family-integrated care in a Canadian neonatal intensive care unit (NICU). A total of 39 mothers of infants born at 35 or fewer weeks' gestation were enrolled in the pilot program. We examined the development, implementation, and qualitative assessment of the education component of a family-integrated care program. We enrolled in groups of 4 or 5, the study mothers agreed to attend daily educational sessions, provide care for their infants for at least 8 hours daily, and participate in medical rounds. The educational sessions were provided by staff and veteran parents to assist parents' development of confidence in providing caregiving skills and assuming the role of a primary caregiver for their infants as they moved closer to discharge. Effectiveness of the program was evaluated through anecdotal feedback and a formal evaluation process at discharge. The results indicated that the mothers were provided with the tools to parent their infants in the NICU, recognize their own strengths, increase their problem-solving strategies, and emotionally prepare them to take their infant home. Feedback from the participants provided direction to adapt the program to provide optimal parent support and education. Parental education is a valued and vital component of family-integrated care in the NICU.
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