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van der Vaart M, Hauck AGV, Mansfield R, Adams E, Bhatt A, Cobo MM, Crankshaw D, Dhami A, Hartley C, Monk V, Evans Fry R, Moultrie F, Robinson S, Yong J, Poorun R, Baxter L, Slater R. Parental experience of neonatal pain research while participating in the Parental touch trial (Petal). Pain 2024:00006396-990000000-00510. [PMID: 38284396 DOI: 10.1097/j.pain.0000000000003177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 12/10/2023] [Indexed: 01/30/2024]
Abstract
ABSTRACT Parental involvement in neonatal comfort care is a core component of family-centred care. Yet, parents experience a range of positive and negative feelings when providing pain-relieving interventions for their infants. Parents of infants who participated in the Parental touch trial (Petal), a multicentre randomised controlled trial investigating the impact of gentle parental touch on neonatal pain, were asked to complete an anonymous survey. This survey aimed to (1) explore parent-reported motivations in deciding to participate in the Petal trial; (2) understand parent-reported experiences related to trial participation; (3) understand parents' willingness to participate in future studies; and (4) evaluate parent-reported feelings while they were delivering a gentle touch intervention either before or after a clinically necessary blood test. One hundred six parents (1 parent per infant) took part in the survey. Primary motivators for participation were altruistic. Parents most frequently reported that they wanted their child to take part in the research because it has a potential benefit to babies in the future and because they wanted to improve scientific understanding. Parents reported that providing gentle touch to their children during painful procedures was associated with positive emotions, such as feeling "useful" (64%) and "reassured" (53%). Furthermore, nearly all parents (98%) were pleased to have participated in the Petal trial and would consider, or maybe consider, participating in further research studies. These results underscore the importance of structuring trials around parental involvement and providing opportunities for parents to be involved in providing comfort to their infants during necessary painful clinical procedures.
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Affiliation(s)
| | | | - Roshni Mansfield
- Department of Paediatrics, University of Oxford, Oxford, United Kingdom
- Newborn Care Unit, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Eleri Adams
- Newborn Care Unit, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Aomesh Bhatt
- Department of Paediatrics, University of Oxford, Oxford, United Kingdom
| | - Maria M Cobo
- Department of Paediatrics, University of Oxford, Oxford, United Kingdom
- Colegio de Ciencias Biologicas y Ambientales, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - Daniel Crankshaw
- Department of Paediatrics, University of Oxford, Oxford, United Kingdom
| | - Amraj Dhami
- Department of Paediatrics, University of Oxford, Oxford, United Kingdom
| | - Caroline Hartley
- Department of Paediatrics, University of Oxford, Oxford, United Kingdom
| | - Vaneesha Monk
- Department of Paediatrics, University of Oxford, Oxford, United Kingdom
| | - Ria Evans Fry
- Department of Paediatrics, University of Oxford, Oxford, United Kingdom
| | - Fiona Moultrie
- Department of Paediatrics, University of Oxford, Oxford, United Kingdom
| | - Shellie Robinson
- Department of Paediatrics, University of Oxford, Oxford, United Kingdom
- Newborn Care Unit, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Jean Yong
- Newborn Care Unit, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Ravi Poorun
- University of Exeter Medical School, Exeter, United Kingdom
- Children's Services, Royal Devon University Healthcare NHS Foundation Trust, Exeter, United Kingdom
| | - Luke Baxter
- Department of Paediatrics, University of Oxford, Oxford, United Kingdom
| | - Rebeccah Slater
- Department of Paediatrics, University of Oxford, Oxford, United Kingdom
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Richter M, Angell A, Kellner P, Smith J, Pineda R. Infant and Parent Outcomes Related to NICU-Based Co-occupational Engagement. OTJR (Thorofare N J) 2024; 44:3-12. [PMID: 36945755 DOI: 10.1177/15394492231160690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
Neonatal intensive care unit (NICU) co-occupations may impact parent-infant outcomes. The main objective of this study was to explore relationships between parent and infant outcomes based on whether sensory-based interventions (co-occupations) occurred most often between parent-infant dyads or provider/volunteer-infant dyads. Thirty-five families received the Supporting and Enhancing NICU Sensory Experiences (SENSE) program, which includes education defining specific amounts of sensory exposures for infants to receive each day of NICU hospitalization (with a preference for parent delivery). Infant sensory experiences in the NICU were logged, and dyads were grouped based on who conducted most of the sensory interventions with the infant in the NICU into a Parent-Infant Co-occupation group or Other Administered group. The Parent-Infant Co-occupation group had infants with less lethargy on the NICU Network Neurobehavioral Scale (p = .04), and parents with lower scores on the Parental Stress Scale (p = .003) and State-Trait Anxiety Inventory-state (p = .047). Parent-infant engagement in co-occupations was related to parental mental health and infant neurobehavior.
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Affiliation(s)
- M Richter
- University of Southern California, Los Angeles, CA, USA
| | - A Angell
- University of Southern California, Los Angeles, CA, USA
| | - P Kellner
- University of Southern California, Los Angeles, CA, USA
| | - J Smith
- St. Louis Children's Hospital, St. Louis, MO, USA
| | - R Pineda
- University of Southern California, Los Angeles, CA, USA
- Washington University, St. Louis, MO, USA
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Oh WO, Lee A, Heo YJ. Transition in the Context of Parental Participation in Caring for Infants in Neonatal Intensive Care Units: An Evolutionary Concept Analysis. ANS Adv Nurs Sci 2024; 47:43-58. [PMID: 36656124 DOI: 10.1097/ans.0000000000000480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
While participating in the care for a baby in a neonatal intensive care unit, parents experience a transition in which they adapt to changes and reconstruct their roles and identities. However, there is no clear explanation for this concept of transition. The purpose of this study was to clarify this concept using Rodgers' evolutionary approach. The identified attributes of the concept were a process of learning, repeated undulating emotions, balancing a caring relationship with nurses, and embracing new roles and responsibilities. The findings can provide a knowledge base for future research aimed at enhancing nurses' understanding of transition and promoting parental participation.
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Affiliation(s)
- Won-Oak Oh
- College of Nursing, Korea University, Seoul, South Korea (Drs Oh and Heo); and College of Nursing, Yonsei University, Seoul, South Korea (Dr Lee)
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Hurt L, Odd D, Mann M, Beetham H, Dorgeat E, Isaac TC, Ashman A, Wood F. What matters to families about the healthcare of preterm or low birth weight infants: A qualitative evidence synthesis. Patient Educ Couns 2023; 115:107893. [PMID: 37473603 DOI: 10.1016/j.pec.2023.107893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 07/06/2023] [Accepted: 07/07/2023] [Indexed: 07/22/2023]
Abstract
OBJECTIVE We examined what matters to families about the healthcare provided to preterm or LBW infants in hospital and the community, to ensure that care meets the needs of infants and parents. METHODS We searched databases to identify eligible studies examining the views and expectations of families. Study quality was assessed using the CASP checklist for qualitative studies. The GRADE-CERQual approach was used to assess confidence in review findings. Studies were sampled and data analysed using thematic synthesis. RESULTS 222 studies (227 papers) were eligible for inclusion. 54 studies (57 papers) were sampled based on data richness, methodological quality, and representation across settings. Eight analytical themes were identified. Confidence in results was moderate to high. What mattered was a positive outcome for the child; active involvement in care; being supported to cope at home after discharge; emotional support; the healthcare environment; information needs met; logistical support available; and positive relationships with staff. CONCLUSION Although parents and family members reported a variety of experiences in the care of their infant, we found high consistency in what matters to families. PRACTICE IMPLICATIONS This review identifies approaches to improve experiences of parents which are consistent with the Family Centred Care model of healthcare.
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Affiliation(s)
- Lisa Hurt
- Division of Population Medicine, Cardiff University School of Medicine, Cardiff, UK.
| | - David Odd
- Division of Population Medicine, Cardiff University School of Medicine, Cardiff, UK
| | - Mala Mann
- Specialist Unit for Review Evidence, Cardiff University, Cardiff, UK
| | | | - Emma Dorgeat
- Cardiff University School of Medicine, Cardiff, UK
| | | | | | - Fiona Wood
- Division of Population Medicine, Cardiff University School of Medicine, Cardiff, UK
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Machry H, Joseph A, White R, Allison D. Designing for Family Engagement in Neonatal ICUs: How Is the Interior Design of Single-Family Rooms Supporting Family Behaviors, From Passive to Active? HERD 2023; 16:238-260. [PMID: 37157783 DOI: 10.1177/19375867231168651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
PURPOSE Understand how the interior design of single-family rooms (SFRs) in neonatal intensive care units (NICUs) can support family engagement behaviors. BACKGROUND Family members are integral contributors to infant care in NICUs, impacting infant development. While at the NICU, parents are encouraged to participate in a process called family engagement, where they are expected to move from passive to active caregivers, in preparation for their role after discharge. While family engagement is affected by the built environment, no studies have investigated this relationship in any depth. NICU settings morphed to involve families through the SFR design model, but the interior environment of SFRs have not been sufficiently explored as a resource to support specific family engagement behaviors. METHODS We interviewed family and staff and observed family engagement behaviors in SFRs at two NICUs. Behaviors were observed and described in terms of their location, number of people, and design elements involved. Built environment characteristics were collected through physical assessments, and interviews elicited participants' perceptions about design factors impacting family behaviors inside SFRs. Data analysis followed grounded theory segments and pattern matching. RESULTS Three behavioral patterns and five themes were identified showing how SFRs' private bathrooms, family storage, family zone partitions, positive distractions, and information boards can support families' home-like, educational, collaborative, and infant care behaviors. CONCLUSIONS The interior design of SFRs can be a resource to family engagement in the NICU. Future research should operationalize SFR features found in our study to measure and validate their impact on family engagement outcomes.
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Affiliation(s)
- Herminia Machry
- School of Architecture and Design, University of Kansas, Lawrence, KS, USA
| | - Anjali Joseph
- Center for Health Facilities Design and Testing, School of Architecture, Clemson University, SC, USA
| | - Robert White
- Regional Newborn Program, Beacon Children's Hospital, South Bend, IN, USA
| | - David Allison
- Graduate Program in Architecture and Health, School of Architecture, Clemson University, SC, USA
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Neshat H, Hassankhani H, Negarandeh R, Jabraeili M, Hosseini MB, Mahallei M. Care providers' experiences regarding barriers to maternal participation in neonatal pain management. Nurs Crit Care 2023; 28:245-252. [PMID: 35789147 DOI: 10.1111/nicc.12814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 05/03/2022] [Accepted: 06/08/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Mothers' involvement in the pain management of infants admitted to the intensive care unit can alleviate the infants' pain. Despite International guidelines, maternal involvement in neonatal pain management is low. Hence, investigating the perspectives of care providers (CPs) on barriers to maternal participation can be helpful in developing practice guidelines. AIMS The purpose of this study was to investigate the experiences of CPs on barriers to maternal involvement in neonatal pain management in the intensive care unit. DESIGN In this study, a qualitative design based on the content analysis approach was used. METHOD We included 24 nurses and physicians in the neonatal intensive care unit from February to September 2020. Data were collected through conducting 11 individual interviews and two focus group discussions with eight and five participants, respectively. RESULTS Three main categories and seven sub-categories were found, including maternal barriers (inadequate emotional readiness and unfamiliarity with role), CPs' barriers (time pressure, fear of family-care provider tension, and insufficient knowledge), and organizational barriers (neglected joint decision-making and restricted organizational participative policies). CONCLUSIONS The identified barriers could be classified into those related to mothers, care providers, and organizations. The lack of appropriate interaction and cooperation between parents and care-providers can affect the emergence of barriers related to the mothers and staff. RELEVANCE TO CLINICAL PRACTICE There is a lack of knowledge regarding neonatal pain management in the health care team and mothers. Educating mothers and CPs about the benefits and ways of mothers' participation can increase readiness and capabilities. Providing clear guidelines about family-centred care and promoting parent-CPs' interactions can increase the mothers' participation.
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Affiliation(s)
- Hanieh Neshat
- School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hadi Hassankhani
- Emergency & Trauma Care Research Center, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Negarandeh
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahnaz Jabraeili
- Department of Pediatrics, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Majid Mahallei
- Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Hirani SAA, Ratushniak A. Analgesic Role of Breastfeeding: Analysis of Effectiveness, Implementation Barriers, and Strategies to Promote Evidence-Based Practice. Clin Lactation 2023. [DOI: 10.1891/cl.2022-0020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Objective:Exposure to painful stimuli serves as toxic stress for infants, increasing their subsequent pain sensitivity and resulting in neurodevelopmental impairments. Besides offering nutritional, psychological, immunological, and economic benefits, breastfeeding is reported as the most effective analgesia for the management of minor procedural pain in infants. Although breastfeeding holds several advantages, implementation of this nonpharmacological intervention is still uncommon in many clinical settings.Methods:This scoping review presents an analysis of 29 clinical trials that compare the effectiveness of breastfeeding with other nonpharmacological methods.Findings:Breastfeeding is an efficacious analgesia compared with sucrose, sweet solutions, and other nonpharmacological methods. When used alone or in combination with other nonpharmacological interventions, breastfeeding reduces infants’ biobehavioral responses to pain and promotes faster physiologic recovery after painful procedures. Breastfeeding is recommended as the first choice whenever feasible. Barriers to the uptake of this effective pain management method in clinical practice include misinformation/inconsistent use of evidence, an infant’s impaired sucking reflex, maternal–child separation, the workload of healthcare professionals, a lack of parental involvement, assumptions of healthcare providers, and a lack of adequate information/guidance for parents. Strategies to promote the uptake of breastfeeding for the management of procedural pain in infants include an effective partnership between healthcare providers and breastfeeding mothers, knowledge mobilization resources in multiple languages, informational support and media campaigns, and experiential learning opportunities for breastfeeding mothers.Conclusions:Successful implementation of baby-friendly hospital initiatives, a patient-centered approach, family-centered care, and the collaborative efforts of healthcare providers in all healthcare settings is recommended to promote the uptake of breastfeeding as analgesia.
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Koukou Z, Theodoridou A, Taousani E, Antonakou A, Panteris E, Papadopoulou SS, Skordou A, Sifakis S. Effectiveness of Non-Pharmacological Methods, Such as Breastfeeding, to Mitigate Pain in NICU Infants. Children (Basel) 2022; 9:1568. [PMID: 36291504 DOI: 10.3390/children9101568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 10/09/2022] [Accepted: 10/13/2022] [Indexed: 11/05/2022]
Abstract
Neonates do experience pain and its management is necessary in order to prevent long-term, as well as, short-term effects. The most common source of pain in the neonatal intensive care unit (NICU) is caused by medically invasive procedures. NICU patients have to endure trauma, medical adhesive related skin injuries, heel lance, venipuncture and intramuscular injection as well as nasogastric catheterization besides surgery. A cornerstone in pain assessment is the use of scales such as COMFORT, PIPP-R, NIPS and N-PASS. This narrative review provides an up to date account of neonate pain management used in NICUs worldwide focusing on non-pharmacological methods. Non-steroidal anti-inflammatory drugs have well established adverse side effects and opioids are addictive thus pharmacological methods should be avoided if possible at least for mild pain management. Non-pharmacological interventions, particularly breastfeeding and non-nutritive sucking as primary strategies for pain management in neonates are useful strategies to consider. The best non-pharmacological methods are breastfeeding followed by non-nutritive sucking coupled with sucrose sucking. Regrettably most parents used only physical methods and should be trained and involved for best results. Further research in NICU is essential as the developmental knowledge changes and neonate physiology is further uncovered together with its connection to pain.
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Abstract
BACKGROUND Parent-infant interaction is poorly understood among high-risk dyads in NICU settings. No parent-infant interaction measures are specifically designed for preterm infants within the NICU nor account for the education NICU parents receive to tailor their interactions based on the infant's cues. AIM To improve our understanding of a measure of parent-infant interaction in the NICU, we investigated relationships between parent-infant interaction scores on the Nursing Child Assessment Feeding Scale (NCAFS) and 1) socio-demographic and medical factors, 2) parent mental health and confidence, and 3) enhanced parental education (delivered as part of the Supporting and Enhancing NICU Sensory Experiences program) on tailoring interactions based on the infant's cues. METHOD Twenty-six preterm infants (born ≤32 weeks) had a video recorded oral feeding conducted by a parent in the NICU when the infant was 34-48 weeks postmenstrual age. A certified evaluator scored parent-infant interaction from the videos using the NCAFS. RESULTS Seventeen (65 %) parent-infant dyads scored below the 10th percentile on the total NCAFS score. Despite it being well-understood that parent-infant interaction is related to sociodemographic factors and parental mental health, there were no relationships between these factors and NCAFS scores in this study. Dyads who received enhanced parent education (n = 15) had lower NCAFS scores than dyads receiving usual care (n = 11) (p = 0.01). CONCLUSION It remains unclear if the standard measure of parent-infant interaction, NCAFS, captured positive and negative interactions in context of assessment of a high-risk dyad within the NICU setting. The utility of the NCAFS with preterm infants in the NICU was not supported by this study.
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Affiliation(s)
- M Richter
- University of Southern California, Chan Division of Occupational Science and Occupational Therapy, 1540 Alcazar St, Los Angeles, CA 90089, United States of America
| | - K Fehringer
- Self-employed, Ridgeway, CO 81432, United States of America
| | - J Smith
- Department of Quality, Safety, and Practice Excellence, St. Louis Children's Hospital, St Louis, MO, United States of America
| | - R Pineda
- University of Southern California, Chan Division of Occupational Science and Occupational Therapy, 1540 Alcazar St, Los Angeles, CA 90089, United States of America; Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, United States of America; Gehr Family Center for Health Systems Science and Innovation, University of Southern California, Los Angeles, CA, United States of America; Center for the Changing Family, University of Southern California, Los Angeles, CA, United States of America.
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Tajalli S, Ebadi A, Parvizy S, Kenner C. Maternal caring ability with the preterm infant: A Rogerian concept analysis. Nurs Forum 2022; 57:920-931. [PMID: 35716151 DOI: 10.1111/nuf.12756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 04/23/2022] [Accepted: 05/10/2022] [Indexed: 11/29/2022]
Abstract
AIM To analyze the concept of maternal caring ability for a preterm infant to develop an operational definition. BACKGROUND Each year, many newborns are born preterm and admitted to the neonatal intensive care unit (NICU). Although their mothers are prepared for discharge home by the staff, it is difficult to identify an operational definition of their maternal caring ability for the preterm infant. DESIGN Concept analysis. DATA SOURCES Searches used PubMed, as the primary health-related literature, ProQuest, Science Direct, CINHAL, web of science, Scopus, and Google Scholar. Keywords caring ability, mother, and preterm infant were used to analyze the development of the concept from 1965 to 2020. METHODS Rogers' and Knafl's evolutionary approach has been used to explain the concept of maternal caring ability for the preterm infant. RESULTS The combined searches yielded 23,291 documents published in English. After the screening process, 43 documents were selected. The Graneheim and Lundman analysis method was used to identify the themes related to the attributes of maternal caring ability. Findings showed the caring ability to have four antecedents (maternal characteristics, support systems, infant characteristics, and the illness severity), four attributes (knowledge and skill in neonatal care, self-efficacy, sensitivity, responsibility, and problem-solving), and three consequences (parental adjustment, improving infant growth and development, and improving parent-infant relationships). CONCLUSION The caring ability of the mother of a preterm infant is grounded in an adequate knowledge of caregiving needs of a preterm infant, high caregiving skills, a sense of self-efficacy, problem-solving, sensitivity, and responsibility.
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Affiliation(s)
- Saleheh Tajalli
- School of Nursing and Midwifery, Nursing Care Research Center (NCRC), Iran University of Medical Sciences, Tehran, Iran
| | - Abbas Ebadi
- Behavioral Sciences Research Center, Life Style Institute, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Soroor Parvizy
- Department of Medical Education, Center for Educational Research in Medical Sciences (CERMS), School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Carole Kenner
- School of Nursing, Health, and Exercise Science, The College of New Jersey, Ewing, New Jersey, USA
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Dodge A, Gibson C, Williams M, Ross K. Exploring the needs and coping strategies of New Zealand parents in the neonatal environment. J Paediatr Child Health 2022; 58:1060-1065. [PMID: 35178796 PMCID: PMC9307014 DOI: 10.1111/jpc.15908] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 01/18/2022] [Accepted: 01/24/2022] [Indexed: 12/16/2022]
Abstract
AIM Having an infant admitted to a neonatal care facility can be highly distressing for parents given the fragile state of their child and the often-unfamiliar environment. This study aimed to explore the needs and coping strategies of parents in this setting. METHODS An online qualitative survey was used to explore the needs of parents who had a child discharged from a New Zealand neonatal unit in the past 12 months. A total of 394 parents participated in the study (387 mothers, 5 fathers), providing 970 responses across three open-ended questions examining their needs, unmet needs and coping strategies. The study included participants across both neonatal intensive care units and special care baby units, with prematurity (47%) the most common reason for admission. An inductive form of thematic analysis was used to analyse the data. RESULTS Four themes were developed that capture the needs and coping strategies expressed by parents in this study: communication and information; physical contact and access to the baby; emotional and non-medical support; and involvement, autonomy and respect. CONCLUSIONS The themes developed largely centre around the struggle parents face when confronting the uncertainty of the neonatal environment and the difficulty in establishing their parental role. Parental distress may be reduced through communicating accurate information regularly and providing empathetic understanding, while opportunities for physical contact and involvement may assist in raising parental confidence and scaffolding the journey to independent care of their infant.
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Affiliation(s)
- Andrew Dodge
- School of PsychologyMassey University – Albany CampusAucklandNew Zealand
| | - Charlotte Gibson
- School of PsychologyMassey University – Albany CampusAucklandNew Zealand
| | - Matt Williams
- School of PsychologyMassey University – Albany CampusAucklandNew Zealand
| | - Kirsty Ross
- School of PsychologyMassey University – Palmerston North CampusPalmerston NorthNew Zealand
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Soltani N, Seyedrasooli A, Jabraeili M, Mousavi S. The effect of maternal multisensory stimulations on bath stress in premature infants: A randomized controlled clinical trial. Infant Behav Dev 2022; 67:101720. [PMID: 35561627 DOI: 10.1016/j.infbeh.2022.101720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 04/17/2022] [Accepted: 04/23/2022] [Indexed: 11/28/2022]
Abstract
Bathing in Neonatal Intensive Care Unit (NICU) is a stressful experience to preterm infants. Reducing this stress is an important challenge in bathing preterm infants. The aim of present study was to evaluate the effects of maternal supportive interventions on the stress caused by swaddled bathing in preterm infants. In this randomized clinical trial, 48 preterm infants randomly allocated into control and intervention groups. In intervention group the mothers were asked to initiate multisensory supportive interventions 5 min before and through swaddled bathing. In controls the mothers were only present during bathing. To determine the level of stress, infant responses were recorded by camera 5 min before bathing and 5 min after bathing. Then infants' stress measured by using Newborn Stress Scale (NSS). Finding was shown that the level of stress in control group was especially increased after bathing that was statistically significant (p < 0.001). Although there was an increase in stress among interventions but it was not statistically significant (p > 0.05). Considering the positive effects of multisensory interventions in decreasing the stress of preterm infants, it can be recommended as cost-free and non-pharmacological care during infants bathing.
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Affiliation(s)
- Nasim Soltani
- Master of Science Neonatal Intensive Care Nursing, Student Research Center of Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Alehe Seyedrasooli
- Department of Medical surgical, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Mahnaz Jabraeili
- Department of Pediatrics, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Saeed Mousavi
- Department of Statistics and Epidemiology, Tabriz University of Medical Sciences, Faculty of Health Sciences, Tabriz, Iran.
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Fernández X. Revisión sistemática de intervenciones tempranas en bebés prematuros para fomentar las interacciones sensibles padres-bebé y el vínculo de apego. Clínica Contemporánea 2022. [DOI: 10.5093/cc2022a3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Campbell-Yeo M, Eriksson M, Benoit B. Assessment and Management of Pain in Preterm Infants: A Practice Update. Children (Basel) 2022; 9:244. [PMID: 35204964 PMCID: PMC8869922 DOI: 10.3390/children9020244] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/20/2022] [Accepted: 02/02/2022] [Indexed: 12/11/2022]
Abstract
Infants born preterm are at a high risk for repeated pain exposure in early life. Despite valid tools to assess pain in non-verbal infants and effective interventions to reduce pain associated with medical procedures required as part of their care, many infants receive little to no pain-relieving interventions. Moreover, parents remain significantly underutilized in provision of pain-relieving interventions, despite the known benefit of their involvement. This narrative review provides an overview of the consequences of early exposure to untreated pain in preterm infants, recommendations for a standardized approach to pain assessment in preterm infants, effectiveness of non-pharmacologic and pharmacologic pain-relieving interventions, and suggestions for greater active engagement of parents in the pain care for their preterm infant.
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Affiliation(s)
- Marsha Campbell-Yeo
- School of Nursing, Faculty of Health, Dalhousie University, Halifax, NS B3H 4R2, Canada
- Department of Pediatrics, Psychology and Neuroscience, Dalhousie University, Halifax, NS B3H 4R2, Canada
- IWK Health, Halifax, NS B3K 6R8, Canada
| | - Mats Eriksson
- School of Health Sciences, Faculty of Medicine and Health, Örebro University, SE-701 82 Örebro, Sweden;
| | - Britney Benoit
- Rankin School of Nursing, St. Francis Xavier University, Antigonish, NS B2G 2N5, Canada;
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15
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Lisle J, Buma K, Smith J, Richter M, Satpute P, Pineda R. Maternal Perceptions About Sensory Interventions in the Neonatal Intensive Care Unit: An Exploratory Qualitative Study. Front Pediatr 2022; 10:884329. [PMID: 35783324 PMCID: PMC9240393 DOI: 10.3389/fped.2022.884329] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 05/10/2022] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Mothers play an important role in providing positive sensory experiences to their infants during NICU hospitalization. However, little is known regarding maternal perceptions about sensory-based interventions in the NICU. Further, understanding maternal perceptions was an important part of the process during development of the Supporting and Enhancing NICU Sensory Experiences (SENSE) program. METHODS Twenty mothers of very preterm infants were interviewed after NICU discharge and asked open-ended questions about sensory-based interventions they performed in the NICU and probed about their perceptions related to the development of a sensory-based guideline and the use of volunteers to provide sensory-based interventions when unable to be present in the NICU. Interviews were transcribed and uploaded into NVivoV.12 for content analysis. RESULTS Mothers reported that kangaroo care was a common sensory intervention they performed in the NICU. Of the 18 mothers who commented on the development of a sensory-based guideline, 17 (94%) said they would be accepting of one. Among 19 mothers, 18 (95%) supported volunteers conducting sensory-based interventions in their absence. Identified themes included: 1) Perceptions about development of a sensory-based guideline, 2) Perceptions of interactions with healthcare providers, 3) Maternal participation in sensory interventions, 4) Maternal experience, and 5) Emotions from mothers. CONCLUSION Maternal perceptions regarding the development of a sensory-based guideline were favorable, and the SENSE program has since been finalized after incorporating important insights learned from stakeholders in this study. Mothers' perceptions were tied to their NICU experiences, which elicited strong emotions. These findings highlight important considerations when developing family-centered interventions.
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Affiliation(s)
- Julia Lisle
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, United States
| | - Kylie Buma
- Program in Occupational Therapy, Washington University School of Medicine in St. Louis, St. Louis, MO, United States
| | - Joan Smith
- Department of Quality, Safety and Practice Excellence St. Louis Children's Hospital, St. Louis, MO, United States
| | - Marinthea Richter
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, United States
| | - Prutha Satpute
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, United States
| | - Roberta Pineda
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, United States.,Program in Occupational Therapy, Washington University School of Medicine in St. Louis, St. Louis, MO, United States.,Department of Pediatrics, Keck School of Medicine, Los Angeles, CA, United States.,Gehr Family Center for Health Systems Science and Innovation, University of Southern California, Los Angeles, CA, United States
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Lilliesköld S, Zwedberg S, Linnér A, Jonas W. Parents' Experiences of Immediate Skin-to-Skin Contact After the Birth of Their Very Preterm Neonates. J Obstet Gynecol Neonatal Nurs 2021; 51:53-64. [PMID: 34767779 DOI: 10.1016/j.jogn.2021.10.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2021] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To explore parents' experiences of immediate skin-to-skin contact after the birth of their very preterm neonates and their perceptions regarding care and support from staff. DESIGN A descriptive qualitative study. SETTING Birth and neonatal units within a university hospital in Sweden. PARTICIPANTS Six parent couples who co-cared for their very preterm neonates with skin-to-skin contact throughout the first 6 hours after birth. METHODS We analyzed individual interviews using reflexive thematic analysis as described by Braun and Clarke. RESULTS The parents' experiences of immediate skin-to-skin contact with their very preterm neonates were represented by the following three themes: A Pathway to Connectedness, Just Being in a Vulnerable State, and Creating a Safe Haven in an Unknown Terrain. Skin-to-skin contact helped the parents attain their roles as essential caregivers and provided a calming physical sensation that promoted parents' feelings of connectedness with their newborns. When parents provide skin-to-skin contact at birth, staff members need to recognize and address their vulnerability. A good relationship with nursing staff, which was mediated through staff behaviors and availability, facilitated skin-to-skin contact. CONCLUSION Skin-to-skin contact initiated at birth with very preterm neonates was a valuable and empowering experience for parents and enhanced early bonding between parents and their newborns. Staff members should recognize that skin-to-skin contact between parents and neonates is an interactive process that has challenges. Future research is warranted to understand the needs of nursing staff who provide initial care in the postpartum period. Furthermore, we recommend the implementation of maternal-neonatal couplet care.
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17
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Pineda R, Smith J, Roussin J, Wallendorf M, Kellner P, Colditz G. Randomized clinical trial investigating the effect of consistent, developmentally-appropriate, and evidence-based multisensory exposures in the NICU. J Perinatol 2021; 41:2449-2462. [PMID: 34012055 PMCID: PMC8516670 DOI: 10.1038/s41372-021-01078-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/25/2021] [Accepted: 04/27/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Evaluate the effect of a manualized multisensory program, applied across NICU hospitalization, on infant and parent outcomes. STUDY DESIGN Seventy parent-infant dyads (born ≤32 weeks gestation) in a Level IV NICU were randomized at birth to the multisensory program or standard-of-care. Parents in the multisensory group administered prespecified amounts of age-appropriate, evidence-based sensory interventions to their infants each day during NICU hospitalization according to the Supporting and Enhancing NICU Sensory Experiences (SENSE) program. RESULTS Infants who received the SENSE program had more lethargy on the NICU Network Neurobehavioral Scale (NNNS) (p = 0.05), even after controlling for medical and social risk (p = 0.043), and had higher Communication scores on the Ages and Stages Questionnaire (p = 0.04) at 1-year corrected age, but this relationship failed to reach significance after controlling for medical and social risk (p = 0.12). CONCLUSION The SENSE program shows promise for improving outcomes, but more research with larger sample sizes is needed.
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Affiliation(s)
- Roberta Pineda
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA.
- Department of Pediatrics, Keck School of Medicine, Los Angeles, CA, USA.
- Gehr Family Center for Health Systems Science and Innovation, University of Southern California, Los Angeles, CA, USA.
- Program in Occupational Therapy, Washington University, St. Louis, MO, USA.
| | - Joan Smith
- Department of Quality, Safety, and Practice Excellence, St. Louis Children's Hospital, St. Louis, MO, USA
| | - Jessica Roussin
- Department of Radiation Oncology, Washington University, St. Louis, MO, USA
| | | | - Polly Kellner
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
| | - Graham Colditz
- Department of Surgery, Washington University, St. Louis, MO, USA
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18
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Negarandeh R, Hassankhani H, Jabraeili M, Abbaszadeh M, Best A. Health care staff support for mothers in NICU: a focused ethnography study. BMC Pregnancy Childbirth 2021; 21:520. [PMID: 34289802 PMCID: PMC8296702 DOI: 10.1186/s12884-021-03991-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 07/08/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Mothers of premature newborns in the neonatal intensive care unit (NICU) have complex needs and require a significant amount of support during the NICU admission. However, little is known about mothers' support needs in the NICU. This study aimed to explore health care staff and mothers' experiences of meeting the mothers support needs in the NICU. This study aimed to explore health care staff and mothers' experiences of meeting the mothers' support needs in the NICU. METHODS A focused ethnographic approach was adopted. Observations and interviews with 21 mothers, 18 nurses, and five physicians were undertaken over a seven months period. Qualitative data analysis was conducted using the Roper and Shapira (2000) five-step framework. RESULT Two main themes of "insufficient provision of the mothers' support needs" (subthemes: inadequate accompany of the mothers in care, assigning monitoring and care to the mothers, inadequate sharing of medical the information) and "supporting the mothers in certain circumstances" (subthemes: reassuring the mothers, supporting the mothers with reduced functional capacity, providing information) were obtained. CONCLUSION The mothers experienced a gap between expected and actual support provided by health care staff. Although, the health care staff believed that mothers' support was a necessity, it was not their main concerns, and they considered workload as a barrier for the mothers support in the NICU.
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Affiliation(s)
- Reza Negarandeh
- Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hadi Hassankhani
- Center of Qualitative Studies, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahnaz Jabraeili
- School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Amy Best
- Campus Teacher, School of Nursing, Massey University Wellington, Wellington, Australia
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Ullsten A, Andreasson M, Eriksson M. State of the Art in Parent-Delivered Pain-Relieving Interventions in Neonatal Care: A Scoping Review. Front Pediatr 2021; 9:651846. [PMID: 33987153 PMCID: PMC8112545 DOI: 10.3389/fped.2021.651846] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 02/17/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction: Parents' active involvement during painful procedures is considered a critical first step in improving neonatal pain practices. Of the non-pharmacological approaches in use, the biopsychosocial perspective supports parent-delivered interventions, in which parents themselves mediate pain relief, consistent with modern family-integrated care. This scoping review synthesizes the available research to provide an overview of the state of the art in parent-delivered pain-relieving interventions. Methods: A scoping review was performed to achieve a broad understanding of the current level of evidence and uptake of parent-driven pain- and stress-relieving interventions in neonatal care. Results: There is a strong evidence for the efficacy of skin-to-skin contact and breastfeeding, preferably in combination. These parent-delivered interventions are safe, valid, and ready for prompt introduction in infants' pain care globally. Research into parents' motivations for, and experiences of, alleviating infant pain is scarce. More research on combined parent-delivered pain alleviation, including relationship-based interventions such as the parent's musical presence, is needed to advance infant pain care. Guidelines need to be updated to include infant pain management, parent-delivered interventions, and the synergistic effects of combining these interventions and to address parent involvement in low-income and low-tech settings. Conclusions: A knowledge-to-practice gap currently remains in parent-delivered pain management for infants' procedure-related pain. This scoping review highlights the many advantages of involving parents in pain management for the benefit not only of the infant and parent but also of health care.
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Affiliation(s)
- Alexandra Ullsten
- Center for Clinical Research, Region Värmland, Karlstad, Sweden
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
| | - Matilda Andreasson
- Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Mats Eriksson
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
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20
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Olsson E, Carlsen Misic M, Dovland Andersen R, Ericson J, Eriksson M, Thernström Blomqvist Y, Ullsten A. Study protocol: parents as pain management in Swedish neonatal care - SWEpap, a multi-center randomized controlled trial. BMC Pediatr 2020; 20:474. [PMID: 33046026 PMCID: PMC7549219 DOI: 10.1186/s12887-020-02356-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 09/20/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND During the first period of life, critically ill as well as healthy newborn infants experience recurrent painful procedures. Parents are a valuable but often overlooked resource in procedural pain management in newborns. Interventions to improve parents' knowledge and involvement in infants' pain management are essential to implement in the care of the newborn infant. Neonatal pain research has studied a range of non-pharmacological pain alleviating strategies during painful procedures, yet, regarding combined multisensorial parent-driven non-pharmacological pain management, research is still lacking. METHODS/DESIGN A multi-center randomized controlled trial (RCT) with three parallel groups with the allocation ratio 1:1:1 is planned. The RCT "Parents as pain management in Swedish neonatal care - SWEpap", will investigate the efficacy of combined pain management with skin-to-skin contact, breastfeeding and live parental lullaby singing compared with standard pain care initiated by health care professionals, during routine metabolic screening of newborn infants (PKU-test). DISCUSSION Parental involvement in neonatal pain management enables a range of comforting parental interventions such as skin-to-skin contact, breastfeeding, rocking and soothing vocalizations. To date, few studies have been published examining the efficacy of combined multisensorial parent-driven interventions. So far, research shows that the use of combined parent-driven pain management such as skin-to-skin contact and breastfeeding, is more effective in reducing behavioral responses to pain in infants, than using the pain-relieving interventions alone. Combined parental soothing behaviors that provide rhythmic (holding/rocking/vocalizing) or orogustatory/orotactile (feeding/pacifying) stimulation that keep the parent close to the infant, are more effective in a painful context. In the SWEpap study we also include parental live lullaby singing, which is an unexplored but promising biopsychosocial, multimodal and multisensory pain alleviating adjuvant, especially in combination with skin-to-skin contact and breastfeeding. TRIAL REGISTRATION ClinicalTrials.gov ( NCT04341194 ) 10 April 2020.
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Affiliation(s)
- Emma Olsson
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, S-701 82, Örebro, Sweden.
- Department of Pediatrics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
| | - Martina Carlsen Misic
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, S-701 82, Örebro, Sweden
- Department of Pediatrics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Randi Dovland Andersen
- Department of Research, Telemark Hospital Trust, Skien, Norway
- Research Center for Habilitation and Rehabilitation Services and Models (CHARM), Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Jenny Ericson
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
- Center for Clinical Research Dalarna, Uppsala University, Falun, Sweden
- Department of Pediatrics, Falun Hospital, Falun, Sweden
| | - Mats Eriksson
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, S-701 82, Örebro, Sweden
| | - Ylva Thernström Blomqvist
- Neonatal Intensive Care Unit, University Hospital, Uppsala, Sweden
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Alexandra Ullsten
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, S-701 82, Örebro, Sweden
- Centre for Clinical Research, Region Värmland, Karlstad, Sweden
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Pellikka HK, Pölkki T, Sankilampi U, Kangasniemi M. Finnish Parents' Responsibilities for Their Infant's Care When They Stayed in a Single Family Room in a Neonatal Intensive Care Unit. J Pediatr Nurs 2020; 53:e28-e34. [PMID: 32081527 DOI: 10.1016/j.pedn.2020.01.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 01/30/2020] [Accepted: 01/31/2020] [Indexed: 11/17/2022]
Abstract
PURPOSE To describe parents' perceptions of their responsibilities for their infant's care during admission to a single family room in a neonatal intensive care unit (NICU). DESIGN AND METHODS A qualitative study with semi-structured individual interviews conducted at a family-centered level III Finnish NICU in late 2016 and early 2017. The participants were 10 mothers and nine fathers of infants aged from six days to eight months. The data were analyzed with inductive content analysis. RESULTS The parents wanted to take responsibility for their infant's care during their stay in a single family room in the NICU, because it prepared them for their infant's discharge. The mothers and fathers reported that their responsibilities supported them as they grew into parenthood and enabled their infants' rights. On the other hand, the parents needed nurses to empower them to commit to, and take, responsibility for their infant's care and share decision making. The nurses also taught the parents caring skills. CONCLUSIONS Empowering parents to take responsibility enabled their infant's rights during their stay in a single family room in the NICU. More research is needed about how nurses transfer these responsibilities to parents and how those are connected to the infant's rights and well-being. PRACTICE IMPLICATIONS Organizations who provide single family rooms in NICUs need to develop guidelines that facilitate the responsibilities that parents and nurses have to care for the infants. Although parents are the infant's primary caregivers, they depend on nurses to ensure their infant is safely cared for.
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Affiliation(s)
| | - Tarja Pölkki
- Department of Children and Women, Oulu University Hospital, Oulu, Finland.
| | - Ulla Sankilampi
- Kuopio University Hospital, Department of Paediatrics, KYS, Finland
| | - Mari Kangasniemi
- Department of Nursing Science, Faculty of Medicine, University of Turku, Finland
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Pladys P, Zaoui C, Girard L, Mons F, Reynaud A, Casper C, Kuhn P, Souet G, Fichtner C, Laprugne‐garcia E, Legouais S, Zores C, Thiriez G, Duboz MA, Knezovic‐Daniel N, Renesme L, Brandicourt A, Gonnaud F, Picaud JC, Julie‐Fische C, Tourneux P, Truffert P, Berne Audeoud F, Pierrat V, Caeymaex L, Granier M, Bouvard C, Evrard A, Saliba E, Allen A, Sizun J, Zana‐Taieb E, Huppi P. French neonatal society position paper stresses the importance of an early family-centred approach to discharging preterm infants from hospital. Acta Paediatr 2020; 109:1302-1309. [PMID: 31774567 DOI: 10.1111/apa.15110] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 11/23/2019] [Accepted: 11/25/2019] [Indexed: 12/01/2022]
Abstract
AIM The families of hospitalised preterm infants risk depression and post-traumatic stress and the preterm infants risk re-hospitalisation. The French neonatal society's aim was to review the literature on how the transition from hospital to home could limit these risks and to produce a position paper. METHODS A systematic literature review was performed covering 1 January 2000 to 1 January 2018, and multidisciplinary experts examined the scientific evidence. RESULTS We identified 939 English and French papers and 169 are quoted in the position paper. Most studies stressed the importance of early, personalised and progressive involvement of the family. Healthcare staff and families should assess discharge preparations jointly. This evaluation should assess the capacities of the newborn infant, with regard to its physiological maturity. It should also assess the family's ability to supply the medical, psychological and social assistance required before and after discharge. There should be a structured follow-up process that includes effective communication, various tools, interventions, networks, health and social professionals. CONCLUSION Discharge preparations may improve the transition from hospital to home and the outcomes for the parents and newborn preterm infant. This early family-centred approach should be structured, coordinated and based on individual needs and circumstances.
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Affiliation(s)
- Patrick Pladys
- CHU Rennes Inserm LTSI ‐ UMR 1099 Univ Rennes Rennes France
| | | | | | | | - Audrey Reynaud
- SOS‐Prema family association Boulogne‐Billancourt France
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McNair C, Chinian N, Shah V, McAllister M, Franck LS, Stevens B, Burry L, Taddio A. Metasynthesis of Factors That Influence Parents' Participation in Pain Management for Their Infants in the NICU. J Obstet Gynecol Neonatal Nurs 2020; 49:263-271. [PMID: 32277879 DOI: 10.1016/j.jogn.2020.02.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2020] [Indexed: 10/24/2022] Open
Abstract
OBJECTIVE To metasynthesize the results of qualitative studies on the factors that affect parents' participation in pain management for their infants during procedures in the NICU. DATA SOURCES We conducted a literature search for articles published from 1976 through November 2019 using MeSH terminology in the following databases: MEDLINE, CINAHL Plus, EMBASE, PubMed, PsycINFO, Cochrane, Scopus, and Web of Science. All qualitative studies in which researchers explored parental participation and education in the NICU were included. STUDY SELECTION A total of 29,937 articles were returned. Once we removed duplicates and limited results to qualitative studies, 48 articles remained. We excluded 41 articles because the studies reported were not conducted in NICUs, involved neonatal palliative care, or were review or opinion articles. We included seven articles for review. DATA EXTRACTION Two authors reviewed all articles using the Critical Appraisal Skills Programme tool to assess study quality and independently scored each study. We reviewed and extracted authors, publication date, type of study, sample size, results, themes, and quotes and included these data elements in the analysis. DATA SYNTHESIS We used a thematic synthesis technique to review the qualitative data, entered codes into NVivo software, and compared codes to create descriptive themes. From these descriptive themes, we generated four analytic themes: Learning to Parent a Hospitalized Infant, Stress and Anxiety, Health Care Providers as Gatekeepers, and NICU Environment. CONCLUSION The four themes identified in this qualitative metasynthesis represent the factors that affect parents' abilities to participate in their infants' pain management. Further research is recommended to develop interventions that address these factors to optimize parents' participation in pain management for their infants during procedures in the NICU.
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Richardson B, Falconer A, Shrestha J, Cassidy C, Campbell-Yeo M, Curran JA. Parent-Targeted Education Regarding Infant Pain Management Delivered During the Perinatal Period: A Scoping Review. J Perinat Neonatal Nurs 2020; 34:56-65. [PMID: 31996645 DOI: 10.1097/JPN.0000000000000439] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
All infants experience pain in early life from procedures. Parents recognize pain as a prevalent issue, reporting a strong desire for more information on infant pain. The aim of this study was to explore and map the current evidence of parent-targeted educational interventions about infant pain, delivered throughout the perinatal period. Records were identified in PubMed, CINAHL, EMBASE, and ERIC databases and hand searching recent publications in 3 relevant journals. Records in English that described or evaluated educational interventions on infant pain management aimed at parents during the perinatal period were eligible for review and those not related to pain or aimed at healthcare providers were excluded. Evaluation was completed following the Methodology for JBI Scoping Reviews and standardized critical appraisal instruments from the Joanna Briggs Institute. Initial search yielded 6946 records, with 9 included in analysis. Six studies were quantitative, 2 qualitative, and 1 mixed methods. Included interventions contained information about parent-led pain management strategies for infants in the neonatal intensive care unit (n = 4), full term (n = 4), or both (n = 1). Despite being an area of high concern for parents of newborns, few studies addressed parent-targeted education regarding infant pain. Future research examining the impact and efficacy of these interventions addressing parental and neonatal outcomes is warranted.
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Pierrat V, Marchand-Martin L, Durrmeyer X, Vasante L, Burguet A, Cambonie G, Kuhn P, Datin-Dorrière V, Durox M, Kaminski M, Carbajal R, Ancel PY; Neurodevelopmental Care Study Group of EPIPAGE -2. Perceived maternal information on premature infant's pain during hospitalization: the French EPIPAGE-2 national cohort study. Pediatr Res 2020; 87:153-62. [PMID: 31086294 DOI: 10.1038/s41390-019-0422-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 03/26/2019] [Accepted: 03/26/2019] [Indexed: 11/08/2022]
Abstract
BACKGROUND Parents of preterm neonates wish greater involvement in pain management; little is known about factors associated with this involvement. We aim to describe perceived maternal information on infants' pain during hospitalization (PMIP), to study associations between PMIP and mothers' attitudes during painful procedures, and to identify individual and contextual factors associated with PMIP. METHODS Analyses of questionnaires from the French national cohort study of preterm neonates, EPIPAGE-2. PMIP was derived from mothers' answers to questions about information perceived on both pain assessment and management. RESULTS Among 3056 eligible neonates born before 32 weeks, 1974, with available maternal reports, were included in the study. PMIP was classified as "sufficient," "little, not sufficient," or "insufficient, or none" for 22.7, 45.9, and 31.3% of neonates, respectively. Mothers reporting PMIP as "sufficient" were more frequently present and more likely comforting their child during painful procedures. Factors independently associated with "sufficient" PMIP were high maternal education, gestational age <29 weeks, daily maternal visits, perception of high team support, and implementation of the neonatal and individualized developmental care and assessment program. CONCLUSION Perceived maternal information on premature infants' pain reported as sufficient increased maternal involvement during painful procedures and was associated with some units' policies.
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Abstract
Preterm and term neonate pain assessment in neonatal intensive care units is vitally important because of the prevalence of procedural and postoperative pain. Of the 40 plus tools available, a few should be chosen for different populations and contexts (2 have been validated in premature infants). Preterm neonates do not display pain behaviors and physiologic indicators as reliably and specifically as full-term infants, and are vulnerable to long-term sequelae of painful experiences. Brain-oriented approaches may become available in the future; meanwhile, neonatal pain assessment tools must be taught, implemented, and their use optimized for consistent, reproducible, safe, and effective treatment.
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Affiliation(s)
- Lynne G Maxwell
- Anesthesiology and Critical Care, Perelman School of Medicine at the University of Pennsylvania, The Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Wood 6021, Philadelphia, PA 19104, USA.
| | - María V Fraga
- Perelman School of Medicine, University of Pennsylvania, The Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA
| | - Carrie P Malavolta
- The Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA
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Hassankhani H, Negarandeh R, Abbaszadeh M, Craig JW, Jabraeili M. Mutual trust in infant care: the nurses and mothers experiences. Scand J Caring Sci 2019; 34:604-612. [PMID: 31657062 DOI: 10.1111/scs.12758] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Accepted: 08/26/2019] [Indexed: 11/29/2022]
Abstract
The relationship between healthcare providers and parents of infants in neonatal intensive care unit is based on trust and constitutes a core measure of family-centred care and health. The aim of the present qualitative study was to explore mothers and nurses experiences of trust in one another around the caregiving of the hospitalised infant in intensive neonatal care unit. Focused ethnographic research study conducted through observations and in-depth interviews with 20 mothers and 16 nurses in NICU of Tabriz (Iran) in 2017. Two main themes of 'gradual and fragile trust of mother-to-nurse' (subthemes: Primary trust-mistrust, mother's trust to responsible nurse, mother trust Increase with skilful nurse performance, and vulnerability to trust) and 'gradual and fragile trust of nurse-to-mother' (subthemes: Nurse's initial assessment of trust to mother's readiness to participate, Development of trust to mother, and vulnerability of nurse's trust to mother) were obtained. The present study revealed that mutual trust between the nurse and the mother in the care of the infant was a gradual and progressive process that was achieved over time. Complexities around the care of a hospitalised infant influenced how fragile or vulnerable the trust became between nurse and mother. Findings from this research can be used in supporting increased maternal participation in infant care and improvement of family-centred care in the neonatal intensive care unit.
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Affiliation(s)
- Hadi Hassankhani
- Center of Qualitative Studies, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Negarandeh
- Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Jenene W Craig
- Brenau University, Norcross, GA, USA.,National Association of Neonatal Therapists, Cincinnati, OH, USA.,National Perinatal Association, Lonedell, MO, USA
| | - Mahnaz Jabraeili
- Pediatric Department, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
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Mitha A, Piedvache A, Khoshnood B, Fresson J, Glorieux I, Roué JM, Blondel B, Durox M, Burguet A, Ancel PY, Kaminski M, Pierrat V. The impact of neonatal unit policies on breast milk feeding at discharge of moderate preterm infants: The EPIPAGE-2 cohort study. Matern Child Nutr 2019; 15:e12875. [PMID: 31310706 DOI: 10.1111/mcn.12875] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 06/26/2019] [Accepted: 07/09/2019] [Indexed: 01/30/2023]
Abstract
Facilitating factors and barriers to breast milk feeding (BMF) for preterm infants have been mainly studied in very preterm populations, but little is known about moderate preterm infants. We aimed to analyze hospital unit characteristics and BMF policies associated with BMF at discharge for infants born at 32 to 34 weeks' gestation. EPIPAGE-2, a French national cohort of preterm births, included 883 infants born at 32 to 34 weeks' gestation. We investigated kangaroo care in the first 24 hr, early involvement of parents in feeding support, volume of the unit, BMF information given to mothers hospitalized for threatened preterm delivery, protocols for BMF, presence of a professional trained in human lactation, unit training in neurodevelopmental care, and regional BMF initiation rates in the general population. Multilevel logistic regression analysis was used to investigate associations between unit policies and BMF at discharge, adjusted for individual characteristics and estimating odds ratios (ORs) and 95% confidence intervals (CIs). Overall, 59% (490/828) of infants received BMF at discharge (27% to 87% between units). Rates of BMF at discharge were higher with kangaroo care (adjusted OR 2.03 [95% CI 1.01, 4.10]), early involvement of parents in feeding support (1.94 [1.23, 3.04]), unit training in a neurodevelopmental care programme (2.57 [1.18, 5.60]), and in regions with a high level of BMF initiation in the general population (1.85 [1.05, 3.28]). Creating synergies by interventions at the unit and population level may reduce the variability in BMF rates at discharge for moderate preterm infants.
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Affiliation(s)
- Ayoub Mitha
- French National Institute of Health and Medical Research Unit 1153, Obstetrical, Perinatal, and Pediatric Epidemiology Team, Centre of Research in Epidemiology and Statistics Sorbonne Paris Cité, Paris Descartes University, Paris, France.,Department of Neonatal Medicine, CHU Lille, Jeanne de Flandre Hospital, Lille, France
| | - Aurélie Piedvache
- French National Institute of Health and Medical Research Unit 1153, Obstetrical, Perinatal, and Pediatric Epidemiology Team, Centre of Research in Epidemiology and Statistics Sorbonne Paris Cité, Paris Descartes University, Paris, France
| | - Babak Khoshnood
- French National Institute of Health and Medical Research Unit 1153, Obstetrical, Perinatal, and Pediatric Epidemiology Team, Centre of Research in Epidemiology and Statistics Sorbonne Paris Cité, Paris Descartes University, Paris, France
| | - Jeanne Fresson
- French National Institute of Health and Medical Research Unit 1153, Obstetrical, Perinatal, and Pediatric Epidemiology Team, Centre of Research in Epidemiology and Statistics Sorbonne Paris Cité, Paris Descartes University, Paris, France.,Department of Clinical Epidemiology and Biostatistics, CHRU Nancy, Nancy, France
| | - Isabelle Glorieux
- Department of Neonatology, Toulouse University Hospital, Toulouse, France
| | - Jean-Michel Roué
- Department of Neonatal Pediatrics and Intensive Care, Brest University Hospital, Brest, France
| | - Béatrice Blondel
- French National Institute of Health and Medical Research Unit 1153, Obstetrical, Perinatal, and Pediatric Epidemiology Team, Centre of Research in Epidemiology and Statistics Sorbonne Paris Cité, Paris Descartes University, Paris, France
| | - Mélanie Durox
- French National Institute of Health and Medical Research Unit 1153, Obstetrical, Perinatal, and Pediatric Epidemiology Team, Centre of Research in Epidemiology and Statistics Sorbonne Paris Cité, Paris Descartes University, Paris, France
| | - Antoine Burguet
- Department of Neonatal Pediatrics, Dijon University Hospital, Dijon, France
| | - Pierre-Yves Ancel
- French National Institute of Health and Medical Research Unit 1153, Obstetrical, Perinatal, and Pediatric Epidemiology Team, Centre of Research in Epidemiology and Statistics Sorbonne Paris Cité, Paris Descartes University, Paris, France.,Clinical Research Unit, Center for Clinical Investigation P1419, Cochin Broca Hôtel-Dieu Hospital, Paris, France
| | - Monique Kaminski
- French National Institute of Health and Medical Research Unit 1153, Obstetrical, Perinatal, and Pediatric Epidemiology Team, Centre of Research in Epidemiology and Statistics Sorbonne Paris Cité, Paris Descartes University, Paris, France
| | - Véronique Pierrat
- French National Institute of Health and Medical Research Unit 1153, Obstetrical, Perinatal, and Pediatric Epidemiology Team, Centre of Research in Epidemiology and Statistics Sorbonne Paris Cité, Paris Descartes University, Paris, France.,Department of Neonatal Medicine, CHU Lille, Jeanne de Flandre Hospital, Lille, France
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Clubbs BH, Barnette AR, Gray N, Weiner L, Bond A, Harden J, Pineda R. A Community Hospital NICU Developmental Care Partner Program: Feasibility and Association With Decreased Nurse Burnout Without Increased Infant Infection Rates. Adv Neonatal Care 2019; 19:311-20. [PMID: 30893098 DOI: 10.1097/ANC.0000000000000600] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Volunteers can provide staff-directed sensory inputs to infants hospitalized in the NICU, but research on volunteer programs is limited. PURPOSE To evaluate the feasibility of a developmental care partner (DCP) program in a level III NICU and determine its relationship with provider burnout and infant infection rates. METHODS DCPs were trained to provide sensory input to infants, based on the behavioral cues observed by the occupational therapists and nursing staff, in medically stable infants. Feasibility was assessed by documenting the process of training and utilizing volunteers, as well as tracking duration and frequency of DCP visits. Staff burnout measures were assessed using the Maslach Burnout Inventory Human Services Survey (MBI-HSS) before and after implementation. Infant infection rates before and after the introduction of volunteers were compared. RESULTS Seventy-two volunteers were interested, and 25 (35%) completed the DCP competencies and provided sensory exposures to 54 neonates, who were visited an average of 8 times (range 1-15). Twelve (48%) DCPs did once-per-week visits, and 9 (36%) did at least 50 contact hours. MBI-HSS scores for staff emotional exhaustion (P < .001) and depersonalization (P < .006) were lower after DCP implementation. There were no differences in infant infection rates before and after DCP implementation (Fisher exact P = 1.000). IMPLICATIONS FOR PRACTICE Volunteer-based DCP programs may be feasible to implement in community hospitals and could help reduce staff emotional exhaustion and depersonalization without increasing the incidence of infant infections. IMPLICATIONS FOR RESEARCH Future research on NICU volunteer programs with larger sample sizes and different infant populations is warranted.
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Uhm JY, Choi MY. Mothers' needs regarding partnerships with nurses during care of infants with congenital heart defects in a paediatric cardiac intensive care unit. Intensive Crit Care Nurs 2019; 54:79-87. [PMID: 31353190 DOI: 10.1016/j.iccn.2019.07.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Revised: 06/28/2019] [Accepted: 07/04/2019] [Indexed: 11/20/2022]
Abstract
OBJECTIVES We investigated mothers' needs in forming partnerships with nurses based on children's postoperative recovery in a paediatric cardiac intensive care unit. DESIGN This was a descriptive study using prospective data. SETTING Data were collected from 36 mothers enrolled in a mother-nurse partnership program. MAIN OUTCOME MEASURES We investigated mothers' need for information and participation activities using a self-made survey tool, as well as the duration of mothers' care participation and physical engagement and psychological connectedness. RESULTS The mothers desired information on their infants' postoperative stability in the early recovery phases and information on infants' transfer and care in the later phases. Mothers' mean duration of care participation increased as infants' recovery progressed (15.82 ± 8.76 minutes in the second phase of recovery to 29.46 ± 4.53 minutes in the fifth phase; F = 19.54, p < .001). Mothers' physical engagement and psychological connectedness also increased with infants' recovery (F = 200.95, p < .001; F = 93.27, p < .001, respectively). Mothers generally passively participated at first and gradually developed more positive and enthusiastic participation as infants recovered. CONCLUSION Infants' condition heavily influenced mothers' needs regarding partnerships. Thus, nurses must individually provide mothers with information and encourage them to participate in care.
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Affiliation(s)
- Ju-Yeon Uhm
- Department of Nursing, Daegu Haany University, 1 Haanydaero, Gyeongsan-si, Gyeongsangbuk-Do 712-715, Republic of Korea.
| | - Mi-Young Choi
- Department of Nursing Science, Chungbuk National University, Chungdae-ro 1, Seowon-Gu, Cheongju, Chungbuk 28644, Republic of Korea.
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Reid S, Bredemeyer S, Chiarella M. Integrative Review of Parents' Perspectives of the Nursing Role in Neonatal Family-Centered Care. J Obstet Gynecol Neonatal Nurs 2019; 48:408-417. [PMID: 31150595 DOI: 10.1016/j.jogn.2019.05.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2019] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES To identify the perceptions of mothers and fathers of newborns admitted to NICUs regarding the role of neonatal nurses in the provision of family-centered care and how neonatal nurses were able to interpret and meet parents' needs. DATA SOURCES We conducted literature searches in the CINAHL, MEDLINE, Embase, PsycINFO, Dissertations and Theses Global, and Maternity and Infant Care databases. STUDY SELECTION Articles on qualitative and quantitative studies were selected if they were published in English from 2009 to 2018; they were set in countries with similar health care resources in Australasia, Canada, Europe, Scandinavia, the United Kingdom, and the United States; and the data were collected from parents. We identified 31 studies for analysis. DATA EXTRACTION We used the thematic analysis method of Braun and Clarke to extract data elements that were grouped and coded into themes and subthemes. DATA SYNTHESIS Through ongoing iterative analysis, we generated six themes from the 18 subthemes that in combination presented the experiences of parents in the context of family-centered care provided by neonatal nurses: Process of Becoming a Parent, Neonatal NursesSupportingParents, Infant Safety, Communication, Barriers to Parenting, and Parenting Inhibited by Neonatal Nurses. CONCLUSION The six themes reflected the contribution made by neonatal nurses to family-centered care in the NICU. The parents' perspectives of nurses were mostly positive, but some negative aspects attributed to nurses identified in earlier studies persisted.
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Abstract
Infant medical trauma in the NICU is associated with serious and lasting consequences. Skin-to-skin contact (SSC) of infants with their parents is a nursing intervention that provides significant benefits and can mitigate the negative consequences of the infant's traumatic experiences in the NICU. The purpose of this article is to explain how SSC aligns with the concept of trauma-informed age-appropriate care (TIAAC) in the NICU. The evidence supporting SSC will be reviewed and discussed using TIAAC as a framework. SSC is an effective and evidence-based care strategy that reduces the infant's traumatic NICU experiences by improving parental proximity, attachment, and lactation; decreasing stress and pain; improving physiologic stability; supporting sleep; and enhancing neurologic outcomes.
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Abstract
Qualitative research in the health system has made tremendous developments in the last decade to better understand patient experiences. What is often overlooked, are the influences that the internal structures, policies and people have on the individuals that use health services. Institutional ethnography is a qualitative approach that aims to capture the social organization of "everyday life" at various system levels. An institutional ethnographic framework was applied to two research studies exploring how families experience care in neonatal intensive care units. Data were collected to develop a deep understanding of the social contexts that exist within institutional boundaries. This paper provides evidence that how care is organized and delivered can significantly influence patient experiences, perceptions and ultimately health outcomes. Adopting institutional ethnographic techniques as a common research method is a valuable tool for health leaders seeking to understand and develop recommendations for health system reform.
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Affiliation(s)
- Emily Rowland
- 1 Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Myuri Manogaran
- 2 Royal College of Physicians and Surgeons of Canada, Ottawa, Ontario, Canada.,3 Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.,4 University of Ontario Institute of Technology, Oshawa, Ontario, Canada
| | - Ivy Lynn Bourgeault
- 3 Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.,4 University of Ontario Institute of Technology, Oshawa, Ontario, Canada.,5 Gender, Work and Health Human Resources, Canadian Health Human Resources Network, Telfer School of Management, University of Ottawa, Ottawa, Ontario, Canada
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Sarin E, Maria A. Acceptability of a family-centered newborn care model among providers and receivers of care in a Public Health Setting: a qualitative study from India. BMC Health Serv Res 2019; 19:184. [PMID: 30898170 PMCID: PMC6427855 DOI: 10.1186/s12913-019-4017-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 03/15/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Family-centered care (FCC), based on collaborative participation of the family along with a team of health care providers, is found to increase the well-being of sick infants in neonatal critical care units. Over the last 4 years, the neonatal unit of Dr. Ram Manohar Lohia Hospital in Delhi has innovated and developed an implementation framework for FCC. This qualitative study assessed the acceptability of family-centered care among providers and family members of neonates to identify gaps and challenges in implementation. METHODS In-depth interviews were conducted among a purposive sample of twelve family members of admitted neonates and six providers to examine their perceptions and experiences regarding FCC. RESULTS Family members and providers expressed a positive perception and acceptance of FCC based on the competencies and knowledge acquired by parents and other caregivers of essential newborn care. Family members reported being satisfied with the overall health care experience due to the transparency of care and allowing them to be by their baby's bedside. Limitations in the infrastructure or lack of facilities at the public hospital did not seem to dilute these positive perceptions. Providers also perceived FCC as a good practice to be continued in spite of concerns around sharing of nursery space with parents, the need for constant vigilance of parents' practices in handling of their newborns, and the need for separate, designated nursing staff for FCC. CONCLUSION Both providers and receivers of neonatal care found FCC to be an acceptable form of care. Providers identified challenges and suggested possible solutions, such as need of periodic provider sensitization on FCC, improved staff organization, and provision of mother-friendly facilities to enable her to provide around-the-clock care by her baby's bedside. Overcoming these challenges would allow for better integration of FCC within general clinical care in neonatal care units.
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Affiliation(s)
| | - Arti Maria
- Department of Neonatology, PGIMER & assoc. Dr. RML Hospital, New Delhi, India
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Skene C, Gerrish K, Price F, Pilling E, Bayliss P, Gillespie S. Developing family-centred care in a neonatal intensive care unit: An action research study. Intensive Crit Care Nurs 2019; 50:54-62. [DOI: 10.1016/j.iccn.2018.05.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 05/11/2018] [Accepted: 05/12/2018] [Indexed: 11/19/2022]
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John HB, Padankatti SM, Kuruvilla KA, Rebekah G, Rajapandian E. Effectiveness of oral motor stimulation administered by mothers of preterm infants- A pilot study. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.jnn.2018.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Affiliation(s)
| | - Elisabeth Podsiadly
- Senior Lecturer, School of Nursing, Kingston University and St George's University of London
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Pineda R, Bender J, Hall B, Shabosky L, Annecca A, Smith J. Parent participation in the neonatal intensive care unit: Predictors and relationships to neurobehavior and developmental outcomes. Early Hum Dev 2018; 117:32-38. [PMID: 29275070 PMCID: PMC5856604 DOI: 10.1016/j.earlhumdev.2017.12.008] [Citation(s) in RCA: 134] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 12/08/2017] [Accepted: 12/10/2017] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To 1) define predictors of parent presence, any holding, holding in arms, and skin-to-skin care in the NICU and 2) investigate the relationships between parent participation and a) early neurobehavior and b) developmental outcomes at age 4 to 5years among preterm infants. METHODS Eighty-one preterm infants born ≤32weeks estimated gestational age were prospectively enrolled within one week of life in a level III-IV NICU. Parent (maternal and paternal) presence and holding (including holding in arms and skin-to-skin care) were tracked throughout NICU hospitalization. Neurobehavior at term equivalent age and development at 4 to 5years were determined using standardized assessments. RESULTS The median number of days per week parents were documented to be present over NICU hospitalization was 4.0 (IQR=2.4-5.8) days; days held per week 2.8 (IQR=1.4-4.3) days [holding in arms days per week was 2.2 (IQR=1.2-3.2) days and parent skin-to-skin care days per week was 0.2 (IQR=0.0-0.7) days]. More parent presence was observed among mothers who were Caucasian, married, older, or employed and among those who had fewer children, familial support and provided breast milk (p<0.05). More holding was observed in infants with fewer medical interventions (p<0.05) and among those who were Caucasian, had a father who was employed, had fewer children and family support (p<0.05). More parent holding in the NICU was related to better reflex development at term age (p=0.02). More parent skin-to-skin care was related to better infant reflexes (p=0.03) and less asymmetry (p=0.04) at term and better gross motor development (p=0.02) at 4-5years. DISCUSSION Social and medical factors appear to impact parent presence, holding, and skin-to-skin care in the NICU. Parent holding is related to better developmental outcomes, which highlights the importance of engaging families in the NICU.
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Affiliation(s)
- Roberta Pineda
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA; Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA.
| | | | - Bailey Hall
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO
| | - Lisa Shabosky
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO
| | - Anna Annecca
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO
| | - Joan Smith
- St. Louis Children’s Hospital, St. Louis, MO
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Shimizu A, Mori A. Maternal perceptions of family-centred support and their associations with the mother-nurse relationship in the neonatal intensive care unit. J Clin Nurs 2018; 27:e1589-e1599. [PMID: 29266474 DOI: 10.1111/jocn.14243] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2017] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To evaluate maternal perceptions of family-centred support with hospitalised preterm infants and their relationship between mothers and nurses in the neonatal intensive care unit (NICU). BACKGROUND Mothers who gave birth to preterm infants tend to suffer more stress and need individual support based on family-centred care. However, there may be a shortage of support for mothers to obtain parent-crafting skills before bringing their infants home. DESIGN This cross-sectional study used path analysis and multiple group analysis to evaluate a structural equation model of the relationship between maternal perception based on family-centred support in parent-crafting training and the mothers-nurses collaboration. METHODS We analysed data from 98 mothers (valid response proportion, 41.0%) whose infants were hospitalised in the NICU of two types of perinatal centres in Japan. We used three revised standardised questionnaires in Japanese: Measure of Process of Care in the NICU (Neo-MPOC 20), Enabling Practice Scale in the NICU (Neo-EPS) and the author-developed Mother and Infant Questionnaire. RESULTS Path analysis revealed that the relationship between mothers and nurses was linked to three factors related to the perinatal centres' support: consideration of parents' feelings, ability to deal with specific needs and coordination in dealing with situations that interact with provision of parent-friendly visual information. Separate path analyses for each perinatal centre showed the same pattern, although the standard coefficients were different. CONCLUSIONS Maternal perceptions of family-centred support with hospitalised preterm infants promoted better collaboration between mothers and nurses to obtain parent-crafting skills at two types of perinatal units in Japan. RELEVANCE TO CLINICAL PRACTICE Clear visual information materials might promote better maternal understanding of their infants, help in acquisition of parent-crafting skills and improve mother-nurse collaboration, with the result that mothers are better able to care for their infants autonomously at home.
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Affiliation(s)
- Aya Shimizu
- Department of Nursing, Graduate School of Health Sciences, Kobe University, Hyogo, Japan
| | - Akiko Mori
- Department of Women's Health and Midwifery, Graduate School of Nursing Science, St. Luke's International University, Tokyo, Japan
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Pölkki T, Korhonen A, Laukkala H. Parents' Use of Nonpharmacologic Methods to Manage Procedural Pain in Infants. J Obstet Gynecol Neonatal Nurs 2017; 47:43-51. [PMID: 29156211 DOI: 10.1016/j.jogn.2017.10.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2017] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE To describe parents' use of nonpharmacologic methods to manage infant procedural pain in the NICU and determine the demographic factors related to such use. DESIGN A cross-sectional and descriptive study design. SETTING Level III and Level II NICUs (seven units) of four University Hospitals in Finland. PARTICIPANTS Parents (N = 178) whose infants were treated in Finnish NICUs. METHODS Parents were asked to respond to a structured questionnaire during their infants' hospitalizations. We analyzed the data using the nonparametric Kruskal-Wallis one-way analysis of variance and Mann-Whitney U test. RESULTS Most parents reported that they used physical methods, such as touching, holding, and positioning, nearly always/always (86%, 76%, and 55%, respectively). However, less commonly used strategies included recorded music (2%), breastfeeding (2%), and non-nutritive sucking with oral sucrose (6%). Many characteristics of the infants, such as their gestational ages and their conditions, were significantly related to the implementation of nonpharmacologic methods. CONCLUSION There is a clear need to extend parents' use of nonpharmacologic methods to manage their infants' procedural pain in the NICU. Because many methods were not considered as pain-relieving strategies, it is important to increase knowledge about the effectiveness of these interventions among parents and nurses.
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Aydon L, Hauck Y, Murdoch J, Siu D, Sharp M. Transition from hospital to home: Parents' perception of their preparation and readiness for discharge with their preterm infant. J Clin Nurs 2017; 27:269-277. [PMID: 28514524 DOI: 10.1111/jocn.13883] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2017] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To explore the experiences of parents with babies born between 28-32 weeks' gestation during transition through the neonatal intensive care unit and discharge to home. BACKGROUND Following birth of a preterm baby, parents undergo a momentous journey through the neonatal intensive care unit prior to their arrival home. The complexity of the journey varies on the degree of prematurity and problems faced by each baby. The neonatal intensive care unit environment has many stressors and facilitating education to assist parents to feel ready for discharge can be challenging for all health professionals. DESIGN Qualitative descriptive design. METHODS The project included two phases, pre- and postdischarge, to capture the experiences of 20 couples (40 parents), whilst their baby was a neonatal intensive care unit inpatient and then after discharge. Face-to-face interviews, an online survey and telephone interviews were employed to gather parent's experiences. Constant comparative analysis was used to identify commonalities between experiences. Recruitment and data collection occurred from October 2014-February 2015. RESULTS/FINDINGS Overlapping themes from both phases revealed three overarching concepts: effective parent staff communication; feeling informed and involved; and being prepared to go home. CONCLUSION Our findings can be used to develop strategies to improve the neonatal intensive care unit stay and discharge experience for parents. Proposed strategies would be to improve information transfer, promote parental contact with the multidisciplinary team, encourage input from fathers to identify their needs and facilitate parental involvement according to individual needs within families. RELEVANCE TO CLINICAL PRACTICE Providing information to parents during their time in hospital, in a consistent and timely manner is an essential component of their preparation when transitioning to home.
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Affiliation(s)
- Laurene Aydon
- Neonatal Clinical Care Unit, King Edward Memorial Hospital and Princess Margaret Hospital, Women and Newborn Health Service, Subiaco, WA, Australia.,Department Nursing and Midwifery Education and Research, Women and Newborn Health Service, Subiaco, WA, Australia.,Centre for Research and Neonatal Education, School of Child and Paediatric Health, University of Western Australia, Perth, WA, Australia
| | - Yvonne Hauck
- Department Nursing and Midwifery Education and Research, Women and Newborn Health Service, Subiaco, WA, Australia.,School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, WA, Australia
| | - Jamee Murdoch
- Neonatal Clinical Care Unit, King Edward Memorial Hospital and Princess Margaret Hospital, Women and Newborn Health Service, Subiaco, WA, Australia.,Department Nursing and Midwifery Education and Research, Women and Newborn Health Service, Subiaco, WA, Australia
| | - Daphne Siu
- Neonatal Clinical Care Unit, King Edward Memorial Hospital and Princess Margaret Hospital, Women and Newborn Health Service, Subiaco, WA, Australia
| | - Mary Sharp
- Neonatal Clinical Care Unit, King Edward Memorial Hospital and Princess Margaret Hospital, Women and Newborn Health Service, Subiaco, WA, Australia.,Centre for Research and Neonatal Education, School of Child and Paediatric Health, University of Western Australia, Perth, WA, Australia
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Treherne SC, Feeley N, Charbonneau L, Axelin A. Parents' Perspectives of Closeness and Separation With Their Preterm Infants in the NICU. J Obstet Gynecol Neonatal Nurs 2017; 46:737-747. [PMID: 28802557 DOI: 10.1016/j.jogn.2017.07.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2017] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE To discover parents' perceptions of closeness to and separation from their preterm infants in the NICU. DESIGN Qualitative descriptive. SETTING Urban Level III NICU. PARTICIPANTS Twenty parents of preterm infants in the NICU. METHODS After ethics approval, data were collected with a smartphone application created for this study. Parents recorded their descriptions of moments of closeness and separation over a 24-hour period in the NICU. Data were transcribed verbatim and content was analyzed. RESULTS Five themes related to parents' perceptions of closeness and separation were identified: Having a role as a parent: Feeling autonomous and making decisions; Providing for and getting to know the infant: Feeding, holding, and interacting; Support from staff; Reluctantly leaving the infant's bedside; and NICU environment. CONCLUSION Autonomy is a key element of a parent's perception of closeness. Staff in the NICU can facilitate autonomy by involving parents in the care of their preterm infants as much as possible to reinforce the parental role. Parents described leaving their infants' bedsides as very difficult.
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Liput SA, Kane-Gill SL, Seybert AL, Smithburger PL. A Review of the Perceptions of Healthcare Providers and Family Members Toward Family Involvement in Active Adult Patient Care in the ICU. Crit Care Med 2016; 44:1191-7. [PMID: 26958747 DOI: 10.1097/CCM.0000000000001641] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The objective of this article is to provide a summary of the perceptions of healthcare providers and family members toward their role in active patient care in the ICU and compare the views of healthcare providers with those of relatives of critically ill patients. DATA SOURCES The search was conducted using PubMed as the primary search engine and EMBASE as a secondary search engine. STUDY SELECTION Studies were included if they were conducted in the ICU, had an adult patient population, and contained a discussion of active patient care, including perspective or actions of family members or healthcare providers about the active participation. DATA EXTRACTION Titles and abstracts of articles identified through PubMed and EMBASE were assessed for relevancy of family involvement. The full article was reviewed of titles and abstracts involving family involvement of care in the ICU to assess if the topic was active care and if the article involved perceptions of healthcare providers or family members. The references of all selected articles were then evaluated for the inclusion of additional studies. DATA SYNTHESIS Articles including perceptions of healthcare providers were grouped separately from articles including attitudes of family members. Articles that contained the perceptions of both healthcare providers and family members were considered in both groups but were evaluated with each perspective separately. Examples of specific patient care tasks that were mentioned in each article were identified. CONCLUSIONS A positive attitude exists among both family members and providers toward the involvement of family members in active care tasks. Providers and family members share the attitude that a partnership is necessary and that encouragement for family members to participate is essential. The findings in this review support the need for more objective research regarding how families are caring for their loved ones and how family involvement in care is affecting patient and family outcomes.
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Orr T, Campbell-Yeo M, Benoit B, Hewitt B, Stinson J, McGrath P. Smartphone and Internet Preferences of Parents: Information Needs and Desired Involvement in Infant Care and Pain Management in the NICU. Adv Neonatal Care 2017; 17:131-8. [PMID: 27759567 DOI: 10.1097/ANC.0000000000000349] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Despite an abundance of research that identifies the benefits for both parent and child when parents are actively involved in their infant's care, challenges related to the best methods to engage families persist. PURPOSE To conduct a feasibility study that aims to understand the preferences of smartphone and Internet use by parents of infants admitted to the neonatal intensive care unit (NICU) related to information seeking and active participation in infant care, with a focus on pain management interventions. METHODS A paper-based survey was distributed to 90 parents in a tertiary-level NICU from September to November 2013. RESULTS Response rate was 80% (72 of the 90). Ninety-seven percent accessed the Internet daily, 87% using their smartphone, and ranked it as an important source of NICU information (81%), more than books (56%) and brochures (33%). Participants reported a desire to have more information on how they could provide general comfort (96%), as well as greater participation in comforting their baby during painful procedures (94%). IMPLICATIONS FOR PRACTICE Parents in the NICU want more information and greater involvement in their infant's care and pain management and place a higher value on the Internet compared with traditional resources. IMPLICATIONS FOR RESEARCH Researchers and clinicians should work together to determine the quality of online resources to better support and evaluate parent use of the Internet as a health information resource. Future studies should examine parental preference regarding the optimal balance between online sources and face-to-face interactions.
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Abstract
PURPOSE To investigate parents' knowledge, self-efficacy, and satisfaction about infant pain in the NICU. DESIGN AND SAMPLE A survey was conducted, and 80 parents (57 mothers and 23 fathers) participated in the study. MAIN OUTCOME VARIABLE A researcher-developed questionnaire composed of 3 dimensions: parents' knowledge about infant pain, perception of self-efficacy regarding infant pain, and satisfaction with infant pain management. RESULTS Most parents had adequate knowledge and moderate to high self-efficacy and were satisfied with infant pain management in the NICU. Mothers and fathers responded differently regarding self-efficacy and satisfaction, and parents' perceptions were correlated with infants' correct age and parents' own age. Most important, most parents wanted to be present and to be given the opportunity to comfort their infant during and after a painful procedure. Parents also preferred to receive formal/written information on infant pain.
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Abstract
Objective of this study was to conduct a systematic review of YouTube videos showing neonatal blood sampling, and to evaluate pain management and comforting interventions used. Selected videos were consumer- or professional-produced videos showing human newborns undergoing heel lancing or venipuncture for blood sampling, videos showing the entire blood sampling procedure (from the first attempt or puncture to the time of application of a cotton ball or bandage), publication date prior to October 2014, Portuguese titles, available audio. Search terms included "neonate," "newborn," "neonatal screening," and "blood collection." Two reviewers independently screened the videos and extracted the following data. A total of 13 140 videos were retrieved, of which 1354 were further evaluated, and 68 were included. Videos were mostly consumer produced (97%). Heel lancing was performed in 62 (91%). Forty-nine infants (72%) were held by an adult during the procedure. Median pain score immediately after puncture was 4 (interquartile range [IQR] = 0-5), and median length of cry throughout the procedure was 61 seconds (IQR = 88). Breastfeeding (3%) and swaddling (1.5%) were rarely implemented. Posted YouTube videos in Portuguese of newborns undergoing blood collection demonstrate minimal use of pain treatment, and maximal distress during procedures. Knowledge translation strategies are needed to implement effective measures for neonatal pain relief and comfort.
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Campbell-Yeo M, Dol J, Disher T, Benoit B, Chambers CT, Sheffield K, Boates T, Harrison D, Hewitt B, Jangaard K, Stinson J, Taddio A, Parker JA, Caddell K. The Power of a Parent's Touch: Evaluation of Reach and Impact of a Targeted Evidence-Based YouTube Video. J Perinat Neonatal Nurs 2017; 31:341-9. [PMID: 28520656 DOI: 10.1097/JPN.0000000000000263] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Despite strong evidence that skin-to-skin contact and breast-feeding are effective pain-relieving interventions for infants undergoing painful procedures, they remain underutilized in clinical practice. Given the important contribution of parents, there is a need to find innovative ways to assist parents to become actively involved in their infant's care. We developed a YouTube video to disseminate evidence-based information on the effectiveness of skin-to-skin contact and breast-feeding for infant pain management. The 2-minute 39-second video launched on December 2, 2014, and was promoted through Web-based and in-person communication and YouTube advertisements. Data were collected using YouTube analytics and an online survey. Post-18 months from its launch, the video had a reach of 157 938 views from 154 countries, with most viewers watching an average of 73% of the video (1 minute 56 seconds). Parents (n = 32) and healthcare providers (n = 170) completed the survey. Overall, both reported that they liked the video, found it helpful, felt more confident, and were more likely to use skin-to-skin contact (16% and 12%) and breast-feeding (3% and 11%), respectively, during future painful procedures. Despite the high-viewing patterns, alternative methods should be considered to better evaluate the impact on practice change.
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Martel MJ, Milette I, Bell L, Tribble DS, Payot A. Establishment of the Relationship Between Fathers and Premature Infants in Neonatal Units. Adv Neonatal Care 2016; 16:390-8. [PMID: 27501070 DOI: 10.1097/ANC.0000000000000292] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Parents and their preterm infants (born between 32-37 weeks of gestation) are often overlooked by the healthcare system. And very little attention is given to the relationship parents develop with their infants in the neonatal unit (NNU). Specifically, very few studies focused on fathers and how they establish a relationship with their infants. However, we know that the father-infant relationship is extremely important for their future social development and more. PURPOSE This article presents the results of a qualitative study of the establishment of the father-premature infant relationship in an NNU. METHODS/SEARCH STRATEGY The study's theoretical framework was Bell's model of the parent-infant relationship, which encompasses discovery, physical proximity, communication, involvement, and emotional attachment. Ten fathers of premature infants (gestational age: 32-37 weeks) participated in 2 semistructured interviews (1 individual and 1 "in situ," ie, at the infant's bedside) during the first week following the premature birth. FINDINGS/RESULTS The results confirm the emergence of different components of the relationship between fathers and their children from the first days of hospitalization in the NNU. The commitment component is the basis for the development of other components in the relationship with their children. Furthermore, involvement influences the deployment of emotional attachment, discovery, physical proximity, and communication toward premature infants. Similarly, the 5 themes of the model can be seen as forming a dynamic nexus in which each theme influences the others. IMPLICATIONS FOR PRACTICE For neonatal nurses, this model of the early father-child relationship helps the understanding of the deployment of that relationship according to 5 components. Similarly, it provides awareness of the experiences of fathers so that nurses can be better equipped to support and individualize interventions tailored to their specific needs, thus helping them develop and sustain the relationship with their children. IMPLICATIONS FOR RESEARCH This study allows us to better understand fathers' experience regarding the establishment of the relationship to their premature infants born between 32 and 37 weeks of gestation. However, there is little understanding about the early paternal experience and more research on this dyad is necessary in neonatology.
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Palomaa AK, Korhonen A, Pölkki T. Factors Influencing Parental Participation in Neonatal Pain Alleviation. J Pediatr Nurs 2016; 31:519-27. [PMID: 27339733 DOI: 10.1016/j.pedn.2016.05.004] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2015] [Revised: 05/15/2016] [Accepted: 05/26/2016] [Indexed: 11/21/2022]
Abstract
PURPOSE Neonates are likely to experience numerous painful procedures in neonatal intensive care units (NICUs). Parents have expressed a wish to be more involved in their infants' pain alleviation. The purpose of this study was to describe parents' perceptions concerning the factors that influence parental participation in pain alleviation in an NICU. DESIGN AND METHODS The qualitative study was conducted in level II and III NICUs (7 units) of Finland's four university hospitals. Data were collected through open-ended questionnaires and analyzed using inductive content analysis. RESULTS Factors that promoted parental participation consisted of five main categories: parental counseling by staff, parents' awareness of their own role, parents' motivation to participate in pain relief, family-friendly facilities and good communication. Factors hindering parental participation consisted of eight categories, including restrictive environment, lack of knowledge, everyday life requirements, underestimation of parents, the nature of the medical procedures, procedure- and pain-related emotions, deteriorated health status of the child and mother and (8) uncertainty of parenting. CONCLUSIONS This study revealed a number of factors that are important to take into account when improving parental involvement in neonatal pain alleviation. Especially, parental participation can be promoted by providing sufficient counseling based on the parents' needs and creating facilities that support parents' participation. PRACTICE IMPLICATION Parents should be engaged as partners in caregiving and decision making, and they should be given space to assume the role of parents during their child's hospitalization.
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Reichert APDS, Rodrigues PF, Albuquerque TM, Collet N, Minayo MCDS. Vínculo entre enfermeiros e mães de crianças menores de dois anos: percepção de enfermeiros. Ciênc saúde coletiva 2016; 21:2375-82. [DOI: 10.1590/1413-81232015218.07662016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 03/23/2016] [Indexed: 11/22/2022] Open
Abstract
Resumo Na promoção da saúde infantil, durante a consulta de enfermagem, é fundamental que o enfermeiro estabeleça vínculo com as mães para orientá-las em relação aos cuidados com o filho. Objetivou-se identificar se existe vínculo entre enfermeiras e mães de crianças menores de dois anos na consulta de enfermagem, na percepção de enfermeiras que atuam na Estratégia Saúde da Família. Pesquisa qualitativa, realizada em sete Unidades de Saúde da Família da cidade de João Pessoa-PB no período de maio a novembro de 2013, por meio de entrevista semiestruturada com enfermeiras. A partir da análise temática identificaram-se como núcleos relevantes: (1) elementos formadores do vínculo e (2) dificuldades para a construção do vínculo. As enfermeiras percebem que na atenção básica já existe uma relação pautada na intersubjetividade e elas atuam na perspectiva de atenção singular, com abordagem individualizada e humanizada, concebendo o vínculo como um processo fundamental para o cuidado integral. Todavia, enfrentam dificuldades para estabelecê-lo e as justificam pela grande demanda por atendimento e pela dificuldade de dar continuidade às presenças das mães na unidade.
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