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Li X, Lin Y, Huang L, Lin H, Cheng X, Li S, Hu R, Liao J. Effects of web neonatal intensive care unit diaries on the mental health, quality of life, sleep quality, care ability, and hormone levels of parents of preterm infants in the neonatal intensive care unit: A randomized controlled trial. Intensive Crit Care Nurs 2024; 83:103697. [PMID: 38583413 DOI: 10.1016/j.iccn.2024.103697] [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: 12/23/2023] [Revised: 03/20/2024] [Accepted: 03/28/2024] [Indexed: 04/09/2024]
Abstract
OBJECTIVE To examine the effects of web neonatal intensive care unit diaries on the mental health, quality of life, sleep quality, care ability, and hormone levels of parents of preterm infants in the neonatal intensive care unit. DESIGN Prospective randomized controlled parallel-group clinical trial. SETTING Maternal and Child Health Hospital, Fujian, China. METHODS The control group received routine neonatal intensive care unit care, while the intervention group received a web neonatal intensive care unit diary based on routine care. Outcomes, including anxiety, depression, and post-traumatic stress disorder symptoms, quality of life, sleep quality, care ability, and cortisol and melatonin levels, were evaluated at T1 (Time 1, before the intervention), T2 (Time 2, immediately after the intervention), and T3 (Time 3, 1 month after the intervention). RESULTS Seventy pairs of parents of preterm infants in the neonatal intensive care unit were randomly allocated to two groups: intervention (n = 35) and control (n = 35). The anxiety scores in the intervention group were significantly lower at T2 and T3 than those in the control group (P < 0.001). The care ability scores in the intervention group were significantly higher at T2 and T3 (P < 0.001). The prevalence of post-traumatic stress disorder at T3 was significantly different between the groups (P = 0.040). No significant differences were observed in the quality of life or sleep quality between the groups at T2 and T3 (P > 0.05). No significant differences were observed in cortisol and melatonin levels between the groups (P > 0.05). CONCLUSIONS Web neonatal intensive care unit diaries effectively relieved anxiety symptoms, reduced the prevalence of post-traumatic stress disorder, and enhanced the care abilities of parents of preterm infants in the neonatal intensive care unit. IMPLICATIONS FOR CLINICAL PRACTICE Web neonatal intensive care unit diary can be considered in clinical practice as a convenient psychological intervention method, especially among parents of preterm infants in the neonatal intensive care unit.
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Affiliation(s)
- Xiaoting Li
- The School of Nursing, Fujian Medical University, Fuzhou, China; Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| | - Ying Lin
- Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| | - Long Huang
- Zhuhai People's Hospital (Zhuhai Clinical Medical College of Jinan University), Zhuhai, China
| | - Huimin Lin
- Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| | - Xiao Cheng
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Sijia Li
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Rongfang Hu
- The School of Nursing, Fujian Medical University, Fuzhou, China.
| | - Jinhua Liao
- The School of Nursing, Fujian Medical University, Fuzhou, China; The Nursing National Experimental Learning Demonstration Center, Fujian Medical University, Fuzhou, China.
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Ahlqvist-Björkroth S, Axelin A, Lehtonen L. Close Collaboration with Parents-Implementation and effectiveness. Acta Paediatr 2024. [PMID: 38514910 DOI: 10.1111/apa.17210] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 02/23/2024] [Accepted: 03/08/2024] [Indexed: 03/23/2024]
Abstract
AIM There has been a need to develop programs to facilitate family-centered care. This paper describes the content of a program called Close Collaboration with Parents, its implementation, and research on its effectiveness. METHODS The program is a systematic training with a focus on staff communication and observation skills and skills to support parenting. The primary implementation strategy is mentoring. Staff engage in bedside practices and reflections with mentors covering all four phases of the program. The effects of this unit-wide program have been evaluated using a pre-post study design, a qualitative study design, and a register-based study design. RESULTS The program has been successfully implemented in 26 units so far. Our research has shown that the training benefits infants, parents, staff, and healthcare organisations. Specifically, family-centered care practices improved after the program, the parents' presence and parent-infant skin-to-skin contact increased, infant growth improved and the length of hospital stays shortened. The mothers' depressive symptoms decreased in the long term. CONCLUSION We have described an educational program for the multidisciplinary staff of a neonatal intensive care unit, Close Collaboration with Parents. The program has changed hospital care cultures for the benefit of infants, parents, staff, and even the healthcare organisation.
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Affiliation(s)
| | - Anna Axelin
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Liisa Lehtonen
- Department of Pediatrics and Adolescent Medicine, Turku University Hospital, Turku, Finland
- Department of Clinical Medicine, University of Turku, Turku, Finland
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Arwehed S, Axelin A, Björklund LJ, Thernström Blomqvist Y, Heiring C, Jonsson B, Klingenberg C, Metsäranta M, Ågren J, Lehtonen L. Nordic survey showed wide variation in discharge practices for very preterm infants. Acta Paediatr 2024; 113:48-55. [PMID: 37540833 DOI: 10.1111/apa.16934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 08/01/2023] [Accepted: 08/02/2023] [Indexed: 08/06/2023]
Abstract
AIM We aimed to describe clinical practices and criteria for discharge of very preterm infants in Nordic neonatal units. METHODS Medical directors of all 89 level-2 and level-3 units in Denmark, Finland, Iceland, Norway and Sweden were invited by e-mail to complete a web-based multiple-choice survey with the option to make additional free-text comments. RESULTS We received responses from 83/89 units (93%). In all responding units, discharge readiness was based mainly on clinical assessment with varying criteria. In addition, 36% used formal tests of cardiorespiratory stability and 59% used criteria related to infant weight or growth. For discharge with feeding tube, parental ability to speak the national language or English was mandatory in 45% of units, with large variation among countries. Post-discharge home visits and video-consultations were provided by 59% and 51%, respectively. In 54% of units, parental preparation for discharge were not initiated until the last two weeks of hospital stay. CONCLUSION Discharge readiness was based mainly on clinical assessment, with criteria varying among units despite similar population characteristics and care structures. This variation indicates a lack of evidence base and may unnecessarily delay discharge; further studies of this matter are needed. Earlier parental preparation and use of interpreters might facilitate earlier discharge.
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Affiliation(s)
- Sofia Arwehed
- Department of Women's and Children's Health, Uppsala University and Uppsala University Hospital, Uppsala, Sweden
| | - Anna Axelin
- Department of Women's and Children's Health, Uppsala University and Uppsala University Hospital, Uppsala, Sweden
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Lars J Björklund
- Department of Clinical Sciences, Lund, Paediatrics, Lund University and Skåne University Hospital, Lund, Sweden
| | - Ylva Thernström Blomqvist
- Department of Women's and Children's Health, Uppsala University and Uppsala University Hospital, Uppsala, Sweden
| | - Christian Heiring
- Department of Neonatology, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Baldvin Jonsson
- Department of Women's and Children's Health, Karolinska Institute and Karolinska University Hospital, Stockholm, Sweden
| | - Claus Klingenberg
- Paediatric Research Group, Faculty of Health Sciences, UiT-The Arctic University of Norway, Tromsø, Norway
- Department of Pediatrics and Adolescence Medicine, University Hospital of North Norway, Tromsø, Norway
| | - Marjo Metsäranta
- Department of Pediatrics, University of Helsinki and Helsinki University Hospital (HUH), Helsinki, Finland
| | - Johan Ågren
- Department of Women's and Children's Health, Uppsala University and Uppsala University Hospital, Uppsala, Sweden
| | - Liisa Lehtonen
- Department of Paediatrics and Adolescent Medicine, Turku University, Hospital and University of Turku, Turku, Finland
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Zhang R, Wang D, Zhu L, He Y, Cheng L, Ma J, Zhang T, Zhang J, Li L. Research trends in readiness for hospital discharge between 2002 and 2021: A bibliometric analysis. Nurs Open 2023; 10:7676-7693. [PMID: 37775985 PMCID: PMC10643845 DOI: 10.1002/nop2.2009] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 06/16/2023] [Accepted: 09/17/2023] [Indexed: 10/01/2023] Open
Abstract
AIM This study aimed to undertake a bibliometric analysis to provide comprehensive information in demonstrating the current status and outline the overall trends in the area of readiness for hospital discharge (RHD). DESIGN A bibliometric and visual analysis of RHD literature was undertaken. METHODS Articles were retrieved from the Web of Science network from 2002 to 2021. VOSviewer was used to identify the co-authorship network of countries/institutions, co-authorship and co-citation analysis of authors, and co-citation analysis of references and citation analysis of documents. CiteSpace was used to identify the keyword co-occurrence network and perform cluster analysis, detecting the keywords with citation bursts and speculated frontiers in this research field. RESULTS A total of 512 articles were included in the final analysis. Key findings are: (1) There has been a continuous but somewhat fluctuating rise in the number of publications. (2) 56.05% of publications come from the USA with Marquette University making the highest contribution. (3) Most publications (17, 3.32%) in RHD research were from the Journal of Clinical Nursing, and Anaesthesia and Analgesia had the highest number of citations (584 citations). (4) Weiss ME (25, 4.88%) was the most productive author whose articles have been the most highly cited (646 citations). (5) Cited references from Weiss ME (2007) also made the largest contribution to co-citations, and the most cited reference was from Jack BW (2009) (1022 citations). (6) The 20 most frequent keywords and keywords with the strongest citation bursts were retrieved. There were seven research hotspots, and three emerging research frontiers were explored. CONCLUSIONS The bibliometric analysis of material published in the last 20 years indicates that there have been statistically significant gains in comprehensive information on RHD, including the knowledge mapping of the countries, institutions, authors, references and keywords. The hotspots and frontiers, which have been explored can give guidance to researchers as to new angles and directions to take. IMPLICATIONS FOR NURSING MANAGEMENT The effects of the implementation of ERAS on RHD-related risk for adverse post-discharge outcomes in surgical patients will be of increasing concern for healthcare professionals. It is important for patients and their relatives to be confident that on discharge they are sufficiently ready for hospital discharge to enable them to safely and smoothly make the transition to home. Improving the level of RHD in discharged patients can help nurse managers and researchers measure the effectiveness of discharge planning services.
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Affiliation(s)
- Rong Zhang
- Department of Neuro‐Oncology Center, Taihe HospitalHubei University of MedicineShiyanChina
| | - Dongmei Wang
- Department of Neuro‐Oncology Center, Taihe HospitalHubei University of MedicineShiyanChina
| | - Ling Zhu
- Department of Neuro‐Oncology Center, Taihe HospitalHubei University of MedicineShiyanChina
| | - Yongdong He
- Department of Neuro‐Oncology Center, Taihe HospitalHubei University of MedicineShiyanChina
| | - Ling Cheng
- Department of Neuro‐Oncology Center, Taihe HospitalHubei University of MedicineShiyanChina
| | - Jifen Ma
- Department of Neuro‐Oncology Center, Taihe HospitalHubei University of MedicineShiyanChina
| | - Ting Zhang
- Department of Thoracic, Cardiac, and Great Vascular Surgery, Taihe HospitalHubei University of MedicineShiyanChina
| | - Jun Zhang
- School of NursingWuhan UniversityWuhanChina
| | - Longti Li
- Nursing Department, Taihe HospitalHubei University of MedicineShiyanChina
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Lasby K, Sherrow T, Fenton T, Jackson J, Kelly EN, Stagg V, McNeil DA. Very-low-birth-weight infant short-term post-discharge outcomes: A retrospective study of specialized compared to standard care. Matern Child Health J 2023; 27:487-96. [PMID: 36588143 DOI: 10.1007/s10995-022-03517-z] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2022] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Ongoing health care challenges, low breast milk intake, and the need for rehospitalization are common during the first year of life after hospital discharge for very low birth weight (VLBW) infants. This retrospective cohort study examined breast milk intake, growth, emergency department (ED) visits, and non-surgical rehospitalizations for VLBW infants who received specialized post-discharge follow-up in western Canada, compared to VLBW infants who received standard follow-up in central Canada. DESIGN Data were collected from two neonatal follow-up programs for VLBW babies (n = 150 specialized-care; n = 205 standard-care). Logistic regression was used to examine odds of breast milk intake and generalized estimating equations were used for odds of growth, ED visits and non-surgical rehospitalization by site. RESULTS Specialized-care was associated with enhanced breast milk intake duration; the odds of receiving breastmilk at 4 months in the specialized-care cohort was 6 times that in the standard-care cohort. The specialized-care cohort had significantly more ED visits and rehospitalizations. However, for infants with oxygen use beyond 36 weeks compared to those with no oxygen use, the standard-care cohort had over 7 times the odds of rehospitalization where as the specialized-care cohort with no increased odds of rehospitalization. CONCLUSION Specialized neonatal nursing follow-up was associated with continued breastmilk intake beyond discharge. Infants in the specialized-care cohort used the ED and were hospitalized more often than the standard-care cohort with the exception of infants with long term oxygen needs.
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Lebel V, Argiropoulos N, Robins S, Charbonneau L, Feeley N. Family-centred care and breastfeeding self-efficacy determined how ready mothers were for their infants to be discharged from a neonatal intensive care unit. Acta Paediatr 2022; 111:2299-2306. [PMID: 36057447 DOI: 10.1111/apa.16538] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 05/03/2022] [Revised: 08/16/2022] [Accepted: 09/02/2022] [Indexed: 11/28/2022]
Abstract
AIM We examined if a range of factors were associated with how ready mothers were for their infants to be discharged from a neonatal intensive care unit (NICU). METHODS This was a secondary analysis of a study on the well-being of mothers whose infants were hospitalised in the level 3 NICU at the Jewish General Hospital in Canada. We studied 132 mother-infant dyads: 70 from an open ward NICU and 62 from the purpose-built NICU with pods or single family rooms that replaced it in 2016. The mothers completed a questionnaire on NICU stress and their perceptions of family-centred care on enrolment and another on breastfeeding self-efficacy and readiness to go home a week before discharge. The infants' characteristics were retrieved from the medical files. RESULTS The infants were born at a mean age of 29.8 ±3.1 weeks. Greater family-centred care during early hospitalisation (p=0.01) and greater breastfeeding self-efficacy in the period before discharge (p=0.04) were significantly associated with higher readiness for discharge. The unit design was not a significantly associated with readiness for discharge. CONCLUSION The quality of early family-centred care and breastfeeding self-efficacy were significantly associated with how ready mothers were for their preterm infant to be discharged from the NICU.
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Affiliation(s)
- Valérie Lebel
- Nursing Department, Université du Québec en Outaouais, Saint-Jérôme, Québec, Canada
| | - Nikolas Argiropoulos
- Centre for Nursing Research & Lady Davis Institute, Jewish General Hospital, Montreal, Québec, Canada
| | - Stephanie Robins
- Nursing Department, Université du Québec en Outaouais, Saint-Jérôme, Québec, Canada
| | - Lyne Charbonneau
- Department of Nursing, Jewish General Hospital, Montreal, Québec, Canada
| | - Nancy Feeley
- Centre for Nursing Research & Lady Davis Institute, Jewish General Hospital, Montreal, Québec, Canada.,Ingram School of Nursing, McGill University, Montreal, Québec, Canada
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Meng L, Lingling Z, Haihong Z, Xiaobai Z, Dandan H, Shaoyan W. Readiness for Hospital Discharge and Its Correlation with the Quality of Discharge Teaching among the Parents of Premature Infants in NICU. Appl Bionics Biomech 2022; 2022:4924021. [PMID: 35874642 PMCID: PMC9300354 DOI: 10.1155/2022/4924021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 06/29/2022] [Indexed: 11/29/2022] Open
Abstract
Objectives To assess the extent of the readiness for hospital discharge and the correlation with discharge teaching quality among parents of premature infants' in the NICU. Background Low readiness for discharge from the hospital can lead to negative outcomes in healthcare for infants born prematurely and their parents. Discharge guidelines are a basic approach to ensure the readiness of the parents for discharge from the hospital. No investigation has ever been conducted into the sufficiency of hospital discharge guidelines for premature infants and their impact on parental readiness for hospital discharge. Design Data was collected from four hospitals in China using a correlational descriptive study. Methods Two hundred and eight parents of premature NICU-hospitalized infants of four tertiary hospitals in Henan Province from May to October 2020 were enrolled. The general information questionnaire, the readiness for hospital discharge scale- (RHDS-) parent form, and the quality of discharge teaching scale- (QDTS-) parent form were used for data collection. Spearman correlation analysis and descriptive statistics were used to analyze the data. Results The total score for hospital discharge readiness was high (8.05 ± 1.11). The total score of the quality of discharge guidelines was moderate (7.44 ± 1.44). Moreover, the discharge teaching quality was positively correlated with the parents' readiness. Positive correlations were found between PRHDS and QDTS subscales, including content received and delivery, physical-emotional status, knowledge, and expected support. Conclusion The quality of the discharge guidelines perceived by parents of premature infants was moderate, which may have reduced their readiness for hospital discharge. Relevance to Clinical Practice. This study furnishes basic information on the importance of readiness of discharge for the parents of premature infants. The teaching guides nurses to enhance the quality of discharge teaching and the readiness of parents for discharge from the hospital.
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Affiliation(s)
- Li Meng
- Health Management Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Zhang Lingling
- The First Affiliated Hospital and Clinical Medicine College, Henan University of Science and Technology, Luoyang, 471003, China
| | - Zhang Haihong
- The First Affiliated Hospital and Clinical Medicine College, Henan University of Science and Technology, Luoyang, 471003, China
| | - Zhang Xiaobai
- The First Affiliated Hospital and Clinical Medicine College, Henan University of Science and Technology, Luoyang, 471003, China
| | - Huang Dandan
- The First Affiliated Hospital and Clinical Medicine College, Henan University of Science and Technology, Luoyang, 471003, China
| | - Wu Shaoyan
- Health Management Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
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Vasli P, Valipour S, Estebsari F, Nasiri M. Predictors of readiness for discharge in mothers of preterm infants: The role of stress, self-efficacy and perceived social support. Asian Pac J Reprod 2022. [DOI: 10.4103/2305-0500.356845] [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: 11/24/2022] Open
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Yang F, Li L, Mi Y, Zou L, Chu X, Sun A, Sun H, Liu X, Xu X. Effectiveness of the Tailored, Early Comprehensive Rehabilitation Program (t-ECRP) based on ERAS in improving the physical function recovery for patients following minimally invasive esophagectomy: a prospective randomized controlled trial. Support Care Cancer 2022; 30:5027-5036. [PMID: 35190895 PMCID: PMC9046291 DOI: 10.1007/s00520-022-06924-8] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 02/16/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Perioperative rehabilitation management is essential to enhanced recovery after surgery (ERAS). Limited reports, however, have focused on quantitative, detailed early activity plans for patients receiving minimally invasive esophagectomy (MIE). The purpose of this research was to estimate the effectiveness of the Tailored, Early Comprehensive Rehabilitation Program (t-ECRP) based on ERAS in the recovery of bowel and physical functions for patients undergoing MIE. METHODS In this single-blind, 2-arm, parallel-group, randomized pilot clinical trial, patients admitted to the Affiliated Cancer Hospital of Zhengzhou University from June 2019 to February 2020 were selected and randomly assigned to an intervention group (IG) or a control group (CG). The participants in the IG received medical care based on the t-ECRP strategy during perioperative period, and participants in the CG received routine care. The recovery of bowel and physical functions, readiness for hospital discharge (RHD), and postoperative hospital stay were evaluated on the day of discharge. RESULTS Two hundred and fifteen cases with esophageal cancer (EC) were enrolled and randomized to the IG (n = 107) or CG (n = 108). The mean age was 62.58 years (SD 9.07) and 71.16% were male. For EC, 53.49% were mid-location cancers and 79.07% were classified as pathological stage II and III cancers. There were no significant differences between the two groups in terms of demographic and clinical characteristics and baseline physical functions. Participants in the IG group presented significantly shorter lengths of time to first flatus (P < 0.001), first postoperative bowel movement (P = 0.024), and for up and go test (P < 0.001), and lower scores of frailty (P < 0.001). The analysis also showed that participants in the IG had higher scores of RHD and shorter lengths of postoperative stay than in the CG (P < 0.05). CONCLUSIONS The t-ECRP appears to improve bowel and physical function recovery, ameliorate RHD, and shorten postoperative hospital stay for patients undergoing MIE. Clinicians should consider prescribing quantitative, detailed, and individualized early activity plans for these patients. TRIAL REGISTRATION ClinicalTrials.gov (Identifier: NCT01998230).
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Affiliation(s)
- Funa Yang
- Nursing Department, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, 450008 China
| | - Lijuan Li
- Department of Thoracic Surgery, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, 450000 China
| | - Yanzhi Mi
- Department of Thoracic Surgery, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, 450000 China
| | - Limin Zou
- Department of Thoracic Surgery, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, 450000 China
| | - Xiaofei Chu
- Department of Thoracic Surgery, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, 450000 China
| | - Aiying Sun
- Department of Thoracic Surgery, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, 450000 China
| | - Haibo Sun
- Department of Thoracic Surgery, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, 450000 China
| | - Xianben Liu
- Department of Thoracic Surgery, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, 450000 China
| | - Xiaoxia Xu
- Nursing Department, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, 450008 China
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Abstract
BACKGROUND A successful transition from the neonatal intensive care unit to home is fundamental for the long-term health and well-being of preterm infants; however, the process parents' experience during their transition home is poorly understood. An improved understanding of this concept will allow nurses to offer families comprehensive and collaborative discharge preparation. PURPOSE To describe the defining attributes, antecedents, and consequences for the concept of transition in the context of the neonatal intensive care unit to home. METHODS Databases, MEDLINE, CINAHL, PsycINFO, and EMBASE were searched for articles containing "transition" in combination with "neonatal intensive care unit" or variants of these terms. The Walker and Avant method was used for this concept analysis. RESULTS The defining attributes of transition in the context of the neonatal intensive care unit to home are "mix of emotions," "uncertainty," and "coming into parenthood." The principal antecedent is "hospital discharge preparation" and consequences include "feeding and medical needs," "family life changes," and "parental confidence." IMPLICATIONS FOR PRACTICE Gradually increasing parents' participation in their infant's care and forming a partnership and collaborative plan with families will help ease the uncertainty parents experience during their transition home. IMPLICATIONS FOR RESEARCH Further investigation is needed to determine how best to provide emotional support for parents during their transition home and to explore a feasible option for neonatal nurses to follow up with parents after hospital discharge.
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Mazur KM, Desmadryl M, VanAntwerp K, Ziegman C, Nemshak M, Shuman CJ. Implementing Evidence-Informed Discharge Preparedness Tools in the NICU: Parents' Perceptions. Adv Neonatal Care 2021; 21:E111-E119. [PMID: 33538497 DOI: 10.1097/anc.0000000000000836] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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 Few studies address preparing parents of neonatal intensive care unit (NICU) infants for infant discharge. Inadequate or ineffective parental preparedness for discharge can result in preventable emergency department and primary care visits. Parents' perceptions are needed to inform development and implementation of effective educational tools to improve parent discharge preparedness in the NICU. PURPOSE To describe the perceptions of parents of recently discharged NICU infants regarding discharge preparedness and implementation of the My Flight Plan for Home parent discharge preparedness tool. METHODS We used a qualitative descriptive design to collect individual interview data from 15 parents with infants discharged from a level 4 NICU in the Midwest. Individual interviews were conducted using a semistructured guide and were audio-recorded, transcribed verbatim, and thematically analyzed using the constant comparative method. RESULTS We identified 5 major themes: (1) family dynamics; (2) parenting in the NICU; (3) discharge preparedness; (4) engaging parents in infant care; and (5) implementation recommendations for the My Flight Plan for Home tool. Minor themes supported each of the major themes. IMPLICATIONS FOR PRACTICE To improve parents' confidence in caring for their infant after discharge, parents suggest nurses must engage parents in discharge education and infant care shortly following NICU admission and use parent-centered discharge preparedness tools. IMPLICATIONS FOR RESEARCH Future studies are needed to develop and test parent-tailored strategies for implementing parent discharge preparedness tools in the NICU.
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Koçak V, Persson EK, Svalenius EC, Altuntuğ K, Ege E. What are the factors affecting parents' postnatal sense of security? Eur J Midwifery 2021; 5:38. [PMID: 34568779 PMCID: PMC8424696 DOI: 10.18332/ejm/140139] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 05/30/2021] [Accepted: 07/11/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION The postpartum period is part of an important process for mothers and fathers. A sense of security is central as it might influence a parent's journey towards becoming a successful parent. The aim was to determine factors affecting parents' postnatal sense of security (PPSS) before postpartum discharge from a hospital in Konya, Turkey. METHODS A descriptive study was conducted. From January 2019 to March 2019, a questionnaire was given to a convenience sample of 188 couples discharged from a regional hospital in Turkey. The sense of security was assessed using the PPSS instrument, with low scores defined as those less than the mean. RESULTS Low and high sense of security was based on the mean in the population, for mothers 49.36 and for fathers 34.90. It was found that 43.6% of mothers and 69.7 % of fathers had a low score, which was linked to some specific factors in the postpartum period. These were the type of birth, being ready to take responsibility for baby care, being ready to be discharged, being healthy, having any concern about the baby's health, social support presence, having professional support, and presence of a sense of security. CONCLUSIONS Many parents, particularly fathers, have a low postnatal sense of security. In the postpartum period, it is very important for midwives, who are always with the family, to identify the risks for a low sense of security during this period and provide effective care. More studies in different settings with larger samples are recommended.
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Affiliation(s)
- Vesile Koçak
- Department of Obstetric and Gynecology Nursing, Faculty of Nursing, Necmettin Erbakan University, Konya, Turkey
| | - Eva-Kristina Persson
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | | | - Kamile Altuntuğ
- Department of Obstetric and Gynecology Nursing, Faculty of Nursing, Necmettin Erbakan University, Konya, Turkey
| | - Emel Ege
- Department of Obstetric and Gynecology Nursing, Faculty of Nursing, Necmettin Erbakan University, Konya, Turkey
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Abstract
Neonatal intensive care unit (NICU) discharge readiness is the primary caregivers' masterful attainment of technical care skills and knowledge, emotional comfort and confidence with infant care by the time of discharge. NICU discharge preparation is the process of facilitating discharge readiness. Discharge preparation is the process with discharge readiness as the goal. Our previous work described the importance of NICU discharge readiness and strategies for discharge preparation from an American medical system perspective. NICU discharge planning is, however, of international relevance as challenges in relation to hospital discharge are a recurring global theme. In this manuscript, we conceptualise NICU discharge preparation with international perspective.
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Affiliation(s)
- Vincent C Smith
- Pediatrics Division of Newborn Medicine, Boston Medical Center, Boston, Massachusetts, USA
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14
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Hua W, Wang L, Li C, Simoni JM, Yuwen W, Jiang L. Understanding preparation for preterm infant discharge from parents' and healthcare providers' perspectives: Challenges and opportunities. J Adv Nurs 2020; 77:1379-1390. [PMID: 33249653 DOI: 10.1111/jan.14676] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 05/18/2020] [Revised: 10/03/2020] [Accepted: 10/30/2020] [Indexed: 11/29/2022]
Abstract
AIM To describe the facilitating/inhibiting factors of preparation for preterm infant discharge and recommendations for increasing discharge readiness from parents' and healthcare providers' perspectives based on Meleis's Transitions Theory. DESIGN A qualitative cross-sectional descriptive design. METHODS We selected a purposive sample of 17 parents (9 fathers and 8 mothers) and 13 healthcare providers (10 nurses and 3 clinicians) from the neonatal intensive care unit of a tertiary hospital in Eastern China. Data were collected between May -July 2018. Data from audio-recorded semi-structured individual interviews were coded with content analysis both inductively and deductively. RESULTS The analyses yielded four themes: personal conditions, community conditions, nursing therapeutics, and patterns of response. Parents and healthcare providers had unique opinions about the themes. CONCLUSION Meleis's Transitions Theory seems to be an applicable and practicable framework for understanding the discharge preparation of parents with preterm infants and may be used to help healthcare providers to develop appropriate interventions on discharge preparation practice. IMPACT To address the lack of discharge readiness of preterm infants in China and countries with a similar clinical context, healthcare providers should help parents play a more active role to promote their engagement in discharge preparation. In a wider global community, healthcare providers should consider parents' personal conditions and their practical needs in performing discharge preparation.
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Affiliation(s)
- Wenzhe Hua
- Shanghai Jiao Tong University School of Nursing, Shanghai, PR China
| | - Liying Wang
- Department of Psychology, University of Washington, Seattle, WA, USA
| | | | - Jane M Simoni
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - Weichao Yuwen
- School of Nursing and Healthcare Leadership, University of Washington, Tacoma, WA, USA
| | - Liping Jiang
- Department of Nursing, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
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15
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Grundvig Nylund A, Gonzalez Lindh M, Ahlsson F, Thernström Blomqvist Y. Parents experiences of feeding their extremely preterm children during the first 2-3 years - A qualitative study. Acta Paediatr 2020; 109:976-981. [PMID: 31621108 DOI: 10.1111/apa.15060] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 06/13/2019] [Revised: 08/28/2019] [Accepted: 10/15/2019] [Indexed: 11/28/2022]
Abstract
AIM To describe parents of extremely preterm children experiences regarding feeding of their children during the first 3 years of the child's life. METHODS This is a qualitative study involving interviews conducted with 12 parents of nine children who had been cared for at one neonatal intensive care unit in Sweden. The interviews were conducted between May and September 2018; the data were analysed using qualitative content analysis. RESULTS All parents experienced some difficulties with their child's eating development and described feeding their child as sometimes both difficult and frustrating. Variation in when these difficulties arose made it hard for the parents to obtain the individual support they wanted and needed. Parents experienced a need for more support - from both staff members and parents with similar experiences - during and after their child's stay at the NICU. CONCLUSION All parents participating in the study experienced difficulties during some phase of their child's feeding development. They expressed the need for more specialised support both during and after their child's time at the hospital.
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Affiliation(s)
- Anna Grundvig Nylund
- Department of Neuroscience, Speech and Language Pathology Uppsala University Uppsala Sweden
- KOM‐X County Council of Gävleborg Region Hospital Gävle Sweden
| | - Margareta Gonzalez Lindh
- Department of Neuroscience, Speech and Language Pathology Uppsala University Uppsala Sweden
- Centre for Research and Development (CFUG) County Council of Gävleborg Uppsala University Gävle Sweden
- Speech Pathology Department Gävle Hospital Gävle Sweden
| | - Fredrik Ahlsson
- Neonatal Intensive Care Unit University Hospital Uppsala Sweden
- Department of Women's and Children's Health Uppsala University Uppsala Sweden
| | - Ylva Thernström Blomqvist
- Neonatal Intensive Care Unit University Hospital Uppsala Sweden
- Department of Women's and Children's Health Uppsala University Uppsala Sweden
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16
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Heidari H, Mardani-Hamooleh M. Nurses' Perception of Family-Centered Care in Neonatal Intensive Care Units. J Pediatr Intensive Care 2020; 9:16-20. [PMID: 31984152 PMCID: PMC6978175 DOI: 10.1055/s-0039-1695060] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 05/15/2019] [Accepted: 07/13/2019] [Indexed: 01/17/2023] Open
Abstract
Family-centered care (FCC) is one of the important elements of care in neonatal intensive care units (NICUs). The aim of this study was to understand the nurses' perception of FCC in NICUs. This qualitative study was performed using conventional content analysis. Participants in this study included 18 nurses who were selected by a purposeful method. Semistructured, in-depth and face-to-face interviews were conducted with the participants. All interviews were written down, reviewed, and analyzed. Two categories were identified after the data analysis: (1) prerequisite for providing FCC and (2) parents' participation. Prerequisite for providing FCC consisted of two subcategories namely suitable facilities and adequate personnel. Parents' participation included subcategories of parents: neonate's attachment and parents' training. Nurses' perception of FCC in NICUs can facilitate an appropriate condition for the participation of family members in the care of neonates.
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Affiliation(s)
- Haydeh Heidari
- Faculty of Nursing and Midwifery, Modeling in Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Marjan Mardani-Hamooleh
- Nursing Care Research Center, Nursing Midwifery Department, Iran University of Medical Sciences, Tehran, Iran,Address for correspondence Marjan Mardani-Hamooleh, PhD Nursing Care Research Center, Nursing Midwifery Department, Iran University of Medical SciencesZafar Str, Vanak Sq, PO Box1419733171, TehranIran
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17
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Mendes CQDS, Mandetta MA, Tsunemi MH, Balieiro MMFG. Cross-cultural adaptation of the Preterm Parenting & Self-efficacy Checklist. Rev Bras Enferm 2019; 72:274-281. [DOI: 10.1590/0034-7167-2018-0658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 11/06/2018] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objective: To conduct a cross-cultural adaptation of the Preterm Parenting & Self-Efficacy Checklist to the Brazilian Portuguese. Method: A methodological study was carried out with 51 parents of premature infants. Data analysis was based on psychometric and inferential statistical analyses. Results: The instrument content validation by experts obtained excellent agreement (97%) and the semantic analysis by the target population showed good understanding of the terms and ease of use. In test-retest, most participants were female (64.7%); and parents with higher education (47.1%). The instrument showed stability over time, with good internal consistency (α = 0.84). Four factors were generated in the subscales parenting self-efficacy, importance of tasks and self-perceived parental competence (67.0% to 74.2% of the variance). Conclusion: The properties of the Preterm Parenting & Self-Efficacy Checklist – Brazilian Version were maintained, which is a reliable indicator to evaluate the hospital discharge of premature infants.
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18
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Ericson J, Palmér L. Mothers of preterm infants' experiences of breastfeeding support in the first 12 months after birth: A qualitative study. Birth 2019; 46:129-136. [PMID: 30053350 PMCID: PMC6585803 DOI: 10.1111/birt.12383] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 03/29/2018] [Revised: 06/25/2018] [Accepted: 06/27/2018] [Indexed: 02/03/2023]
Abstract
BACKGROUND Breastfeeding support is important for breastfeeding mothers; however, it is less clear how mothers of preterm infants (< 37 gestational weeks) experience breastfeeding support during the first year. Thus, the aim of this study was to describe how mothers of preterm infants in Sweden experience breastfeeding support during the first 12 months after birth. METHODS This qualitative study used data from 151 mothers from questionnaires with open-ended questions and telephone interviews. The data were analyzed using an inductive thematic network analysis with a hermeneutical approach. RESULTS The results exposed two organizing themes and one global theme. In the organizing theme "genuine support strengthens," the mothers described how they were strengthened by being listened to and met with respect, understanding, and knowledge. The support was individually adapted and included both practical and emotional support. In the organizing theme "inadequate support diminishes," the mothers described how health professionals who were controlling and intrusive diminished them and how the support they needed was not provided or was inappropriate. Thus, the global theme "being thrown into a lottery-dependent on the health professional who provided breastfeeding support" emerged, meaning that the support received was random in terms of knowledge and support style, depending on the individual health professionals who were available. CONCLUSION Breastfeeding support to mothers of preterm infants was highly variable, either constructive or destructive depending on who provided support. This finding clearly shows major challenges for health care, which should make breastfeeding support more person-centered, equal, and supportive in accordance with individual needs.
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Affiliation(s)
- Jenny Ericson
- Center for Clinical Research DalarnaUppsala UniversityFalunSweden,Department of PediatricsFalu HospitalFalunSweden,School of Education, Health and Social StudiesDalarna UniversityFalunSweden
| | - Lina Palmér
- Faculty of Caring Science, Work Life and Social WelfareUniversity of BoråsBoråsSweden
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19
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Granero-Molina J, Fernández Medina IM, Fernández-Sola C, Hernández-Padilla JM, Jiménez Lasserrotte MDM, López Rodríguez MDM. Experiences of Mothers of Extremely Preterm Infants after Hospital Discharge. J Pediatr Nurs 2019; 45:e2-8. [PMID: 30581066 DOI: 10.1016/j.pedn.2018.12.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [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: 06/14/2018] [Revised: 12/07/2018] [Accepted: 12/07/2018] [Indexed: 11/21/2022]
Abstract
PURPOSE The purpose of this study was to describe and understand the experiences of mothers of extremely preterm infants during the first twelve months at home following discharge from a neonatal intensive care unit. DESIGN AND METHODS A qualitative, interpretative approach using Gadamer's philosophical hermeneutics was carried out. One focus group and fifteen in-depth, semi-structured interviews were conducted twelve months after hospital discharge. Responses were recorded, transcribed and analyzed using computer-assisted qualitative data analysis. RESULTS The study´s participants were twenty women. The following themes emerged from the data analysis: 1) 'The journey home: the discharge process', which included the sub-themes 'escaping the hospital environment: between desire and fear' and 'preparing parents for hospital discharge: practice and formal support'; and 2) 'The difficulty of living with an extremely preterm infant', including the sub-themes 'the challenge of an unexpected form of childcare', 'overprotection of and bond with a child with special needs' and 'disturbance in the social/familiar setting: when a mother becomes a nurse'. CONCLUSIONS The process of hospital discharge and the first months at home are difficult. The birth and care of an extremely preterm infant affect the mothers' quality of life as well as their family and social life. Practice and early discharge programmes can make the discharge process easier. PRACTICE IMPLICATIONS The knowledge and understanding of the experience of mothers of extremely preterm infants in the first months at home after hospital discharge could help healthcare professionals to develop educational strategies and counselling interventions in accordance with the mothers' needs.
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20
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Petty J, Jarvis J, Thomas R. Understanding parents' emotional experiences for neonatal education: A narrative, interpretive approach. J Clin Nurs 2019; 28:1911-1924. [PMID: 30698304 DOI: 10.1111/jocn.14807] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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: 09/09/2018] [Revised: 12/17/2018] [Accepted: 01/20/2019] [Indexed: 10/27/2022]
Abstract
AIMS AND OBJECTIVES To explore the emotional experiences of parents who have had premature babies to inform and educate neonatal nurses and health professionals in this field. BACKGROUND Parents find the neonatal unit a daunting and unfamiliar place leading to anxiety, uncertainty and fear about the future of their baby. Parents have significant emotional needs in relation to assisting them to cope with their neonatal experience. In line with a family-centred approach to neonatal education, it is essential to teach health professionals about the emotional impact of neonatal care based on an appreciation of the parent experience. DESIGN A narrative-based, interpretive approach was undertaken in line with constructivist learning theory. METHODS Twenty narrative interviews took place, with a total of 23 parents of premature babies. Following core story creation to create coherent stories from the raw transcripts, thematic analysis of the narrative constructs using the principles of Braun and Clarke's, International Journal of Qualitative Studies on Health and Well-Being, 2014, 9, 1, framework was undertaken. The study methods were compliant with the consolidated criteria for reporting qualitative research (COREQ). FINDINGS Thematic analysis revealed key themes relating to the following: parents' emotions through the whole neonatal experience, feelings towards the baby, the environment, the staff and the transitions through the different phases of neonatal care. Both negative and positive experiences were reported. CONCLUSION Understanding the emotional experience from the parent's perspective, following birth of their premature baby, informs empathic, family-centred teaching and learning within the neonatal education arena. RELEVANCE TO CLINICAL PRACTICE Students and health professionals alike can learn what is important in the delivery of care that addresses the emotional needs of parents and families. Educators can use narratives and key messages from parents, both negative and positive, to teach family-centred principles to nurses and health professionals as a core component of a narrative curricula and potentially to enhance empathy.
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Affiliation(s)
| | - Joy Jarvis
- University of Hertfordshire, Hatfield, UK
| | - Rebecca Thomas
- Centre for Staff and Educational Development, University of East Anglia, Norwich, UK
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21
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Norén J, Nyqvist KH, Rubertsson C, Blomqvist YT. Becoming a mother - Mothers' experience of Kangaroo Mother Care. Sex Reprod Healthc 2018; 16:181-185. [PMID: 29804764 DOI: 10.1016/j.srhc.2018.04.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 04/06/2018] [Accepted: 04/08/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To describe mothers' experiences of providing their preterm infants with Kangaroo Mother Care (KMC). STUDY DESIGN A qualitative descriptive design. SETTING Two level III neonatal intensive care units (NICUs) in Sweden. PARTICIPANTS Thirteen mothers of preterm infants. METHODS The mothers were interviewed when their infant had reached a corrected age of 4 months ± 2 weeks. The interviews were recorded and transcribed and data were analyzed using qualitative content analysis. RESULTS The mothers described the skin-to-skin contact with, and closeness to, the preterm infant as something they valued, and involuntary physical separation as something they had to accept and adapt to. Providing the infant with breast milk by expressing and tube feeding was experienced as time-consuming and as impinging on the skin-to-skin contact. CONCLUSION Mothers want to stay close to their preterm infant. The NICU environment and staff can facilitate KMC by providing a private space for parents and infants, and enable mothers to breastfeed and express breast milk by giving them support based on science and proven experience.
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Affiliation(s)
- Josefine Norén
- University Hospital, Neonatal Intensive Care Unit, Uppsala, Sweden
| | | | - Christine Rubertsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; University of Lund, Department of Health Science, Lund, Sweden
| | - Ylva Thernström Blomqvist
- University Hospital, Neonatal Intensive Care Unit, Uppsala, Sweden; Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
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22
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Ericson J, Flacking R, Udo C. Mothers' experiences of a telephone based breastfeeding support intervention after discharge from neonatal intensive care units: a mixed-method study. Int Breastfeed J 2017; 12:50. [PMID: 29270208 PMCID: PMC5735875 DOI: 10.1186/s13006-017-0142-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [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: 09/12/2017] [Accepted: 12/11/2017] [Indexed: 02/06/2023] Open
Abstract
Background After discharge from a neonatal intensive care unit (NICU), many mothers of preterm infants (gestational age < 37 weeks) experience a lack of support for breastfeeding. An intervention study was designed to evaluate the effects of proactive (a daily telephone call initiated by a member of a breastfeeding support team) and/or reactive (mothers could call the breastfeeding support team) telephone based breastfeeding support for mothers after discharge from the NICU. The mothers in the intervention group had access to both proactive and reactive support; the mothers in the control group only had access to reactive support. The aim of this study was to explore the mothers’ experiences of the proactive and reactive telephone support. Methods This study was a qualitatively driven, mixed-method evaluation using three data sources: questionnaires with qualitative open-ended questions, visual analogue scales and telephone interviews. In total, 365 mothers contributed data for this study. The qualitative data were analysed with an inductive thematic network analysis, while the quantitative data were analysed with Student’s t-test and the chi-square test. Results Proactive support contributed to greater satisfaction and involvement in breastfeeding support. The mothers who received proactive support reported that they felt strengthened, supported and secure, as a result of the continuous care provided by staff who were knowledgeable and experienced (i.e., in breastfeeding and preterm infants), which resulted in the global theme ‘Empowered by proactive support’. The mothers who received reactive support experienced contradictory feelings; some felt secure because they had the opportunity to call for support, whereas others found it difficult to decide when and if they should use the service, which resulted in the global theme; ‘Duality of reactive support’. Conclusion There were positive aspects of both proactive (i.e., greater satisfaction and feelings of empowerment) and reactive support (i.e., the opportunity to call for support); however, the provision of reactive support alone may be inadequate for those with the greatest need for support as they are the least likely to access it. Trial registration NCT01806480 on 5 March 2013.
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Affiliation(s)
- Jenny Ericson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Centre for Clinical Research Dalarna, Nissersväg 3, S-79182 Falun, Sweden.,Department of Paediatrics, Falu Hospital, Falun, Sweden
| | - Renée Flacking
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
| | - Camilla Udo
- Centre for Clinical Research Dalarna, Nissersväg 3, S-79182 Falun, Sweden.,School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
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