The experience of fathers whose infants were hospitalized in Neonatal Intensive Care Unit in South Korea: A scoping review

Fathers' Involvement in a Surgical Neonatal Intensive Care Unit: A Prospective Cohort Study

AIM

To date, studies exploring patterns of fathers' involvement in their neonate's care in the neonatal intensive care unit (NICU) and barriers to involvement have utilised qualitative approaches, which can be time- and resource-consuming. This study aimed to explore the fathers' involvement in a surgical NICU using a novel tool along with identifying potential facilitators and barriers to fathers' involvement in their neonate's care.

METHODS

This single-centre prospective cohort study was conducted at a surgical NICU (SNICU). A novel questionnaire, Fathers' Involvement Questionnaire: Neonatal Intensive Care Unit (FIQ:NICU) comprising four sections, was developed based on current evidence and expert consensus. Study data were collected and managed using REDCap electronic data capture tools. Involvement scores are reported for individual items, subscales (Physical contact, Verbal Interaction, During Procedures, Cares/Feeding, Participation in rounds), and total score (possible range 0-92). Associations between subscales and total FIQ scores and confidence levels were explored using bivariate correlation (Pearson's r).

RESULTS

Thirty-two fathers participated. Total FIQ:NICU scores ranged from 20 to 74, mean score 55.1 (95% confidence interval 49.9-60.2), SD 14.24. Fathers reported the highest level of involvement in 'During Procedures' subscale (M = 2.88, SD = 1.00) and the lowest involvement in 'Cares/Feeding' (M = 1.67, SD = 0.83). All fathers reported support from their partner (100%) as a facilitator, followed by support from nurses (71.9%). The most frequently reported barrier was lines and tubes on their neonate (46.9%), followed by work/job commitments (34.4%).

CONCLUSIONS

Support from healthcare professionals, psychologists and peers can increase father's involvement in their neonate's care in SNICU.

Parental stress and nurse-parent support in the neonatal intensive care unit: a cross-sectional study

BACKGROUND

Admission of a preterm infant to the Neonatal Intensive Care Unit (NICU) is highly stressful for parents. NICU nurses play a crucial role in providing support, positively impacting health and aiding effective stress management during this challenging period. This study assesses stress and nurse-parent support for parents with preterm infants in the NICU, exploring connections between stress, support, and various parental and infant variables.

METHODS

This descriptive cross-sectional study was conducted between January and July 2019 on a total of 150 parents (75 mothers and 75 fathers) with preterm infants in a private hospital's NICU in Ankara, Turkey. Data were collected using the Parent and Infant Information Form, Parental Stressor Scale: NICU (PSS: NICU), and Nurse-Parent Support Tool (NPST).

RESULTS

There was no significant correlation between PSS: NICU and NPST scores (p > 0.05). However, a significant difference was observed in the overall NPST score (p = 0.036) and its emotional support subscale (p = 0.013). Mothers' PSS: NICU was influenced by infant information (p = 0.027) and marital duration ((p = 0.002), while fathers' was influenced by number of children (p = 0.040) and infant care participation (p = 0.001). NPST was affected by number of children (p = 0.004) and infant respiratory status (p = 0.011) for mothers and number of children for fathers (p = 0.038). Since parents require informational, emotional, and care-related support, nurses should continuously enhance their professional and communication skills to establish effective communication with parents and provide targeted support.

CONCLUSION

This study found mothers received greater nurse support than fathers. Mothers with one child had higher nurse support, while mechanical ventilation for mothers and having more than one child for fathers were linked to reduced support. Lower stress levels were noted in mothers married for 6-10 years, those informed about the infant, and fathers actively participating in infant care with more than one child.

Psychological distress in the neonatal intensive care unit: a meta-review

INTRODUCTION

Parental psychological distress (PD) (anxiety, depression, stress and post-traumatic stress syndrome) can adversely affect parents' own physical and mental health as well as their children's long-term health and development. Numerous studies have addressed PD in mothers of infants admitted to NICU, with interventions proposed, but few have addressed the impact on fathers or other family members. The present review examined systematic reviews that addressed PD in NICU and potential interventions.

METHODS

A meta-review was performed by searching various databases between 2000 and May 2024.

RESULTS

Fifty-four studies were included. The incidence of maternal PD varied depending on the screening tool used (13-93%), as did paternal PD (0.08-46%). The incidence of PD in sexual, racial and gender minorities, siblings, grandparents and those in lower-middle income countries is not known. Numerous screening tools were used with a wide variety of cut-off values. Various intervention programmes were evaluated and showed contradictory evidence regarding their effect on PD.

DISCUSSION

Routine screening should be implemented together with a combination of interventional programmes, specifically family-centred interventions. More research is required for PD in siblings, sexual and gender minority parents as well as parents living in low middle income countries.

IMPACT STATEMENT

Psychological distress is high in NICU, affecting parents and siblings. Maternal psychological distress may have long lasting effects on infant health and differs from that of fathers, who require as much attention as mothers Little is known about emotional stress in siblings and sex and gender minority group peoples Few interventions showed conclusive effectiveness in reducing psychological distress with combination interventions showing more effectiveness than single interventions.

Barriers and opportunities for health service access among fathers: A review of empirical evidence

ISSUE ADDRESSED

Engagement with health supports benefits the whole family, yet few health services report successful engagement of fathers. Our aim was to describe available evidence on barriers and opportunities relevant to health system access for fathers.

METHODS

Scoping reviews were conducted seeking empirical evidence from (1) Australian studies and (2) international literature reviews.

RESULTS

A total of 52 Australian studies and 44 international reviews were included. The most commonly reported barriers were at the health service level, related to an exclusionary health service focus on mothers. These included both 'surface' factors (e.g., appointment times limited to traditional employment hours) and 'deep' factors, in which health service policies perpetuate traditional gender norms of mothers as 'caregivers' and fathers as 'supporters' or 'providers'. Such barriers were reported consistently, including but not limited to fathers from First Nations or culturally diverse backgrounds, those at risk of poor mental health, experiencing perinatal loss or other adverse pregnancy and birth events, and caring for children with illness, neurodevelopmental or behavioural problems. Opportunities for father engagement include offering father-specific resources and support, facilitating health professionals' confidence and training in working with fathers, and 'gateway consultations', including engaging fathers via appointments for mothers or infants. Ideally, top-down policies should support fathers as infant caregivers in a family-based approach.

CONCLUSIONS

Although barriers and opportunities exist at individual and cultural levels, health services hold the key to improved engagement of fathers. SO WHAT?: Evidence-based, innovative strategies, informed by fathers' needs and healthy masculinities, are needed to engage fathers in health services.

Development and Psychometric Testing of the Fathers' Self-Efficacy Scale for Newborn Care

PURPOSE

Fathers' involvement in newborn care positively affects both work sharing between parents, newborn quality of life, and the relationship between father and newborn. However, there is no valid and reliable measurement tool to evaluate fathers' self-efficacy levels for newborn care. This study aimed to develop the fathers' self-efficacy scale for newborn care (FSSNC) and to examine its psychometric properties.

METHODS

This study is an instrument development and validation study. After a comprehensive literature review, expert opinion, and pilot application stages, an item pool was developed. For validity and reliability analyses, data were collected between March and December 2022 from 442 individuals, including fathers with newborn babies and expectant fathers whose partners are pregnant. Validity assessments included content, exploratory and confirmatory factor analyses, and convergent validity. The scale was also evaluated for its internal consistency, and two-half-test reliability. In this study, the STROBE checklist was used as a guideline.

RESULTS

The final version of the scale consisted of three subdimensions (hygiene, safety, and nutrition). The total number of items is 17. Confirmatory factor analysis results confirm the results of exploratory factor analysis. There was a strong correlation between the scale score and the participants' self-assessment score.

CONCLUSIONS

The study demonstrates that the FSSNC was a valid, reliable, and user-friendly measurement tool used to evaluate fathers' self-efficacy regarding hygiene, safety, and nutrition in newborn care.