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Telemedicine in Neonatal Home Care: Identifying Parental Needs Through Participatory Design
Kristina Garne1, Anne Brødsgaard, Gitte Zachariassen
1Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark. kristina.holm@rsyd.dk.
Insights
Parents of preterm infants need telemedicine for neonatal home care (NH). This technology can provide 24-hour nurse access, video-conferencing, and an online knowledge base, enhancing parental self-efficacy and security.
Area of Science:
- Neonatal care
- Pediatric nursing
- Telemedicine applications
Background:
- Neonatal home care (NH) supports tube feeding and breastfeeding for preterm infants.
- Traditional home visits present logistical challenges for regional hospitals.
- Alternative NH models are needed to improve accessibility and efficiency.
Purpose of the Study:
- To identify parental needs for neonatal home care (NH) supported by telemedicine.
- To explore how technology can facilitate remote infant care and parental support.
Main Methods:
- Qualitative study using participatory design.
- Data collected via observational studies, individual, and focus group interviews.
- Involved parents of preterm infants from units with and without established NH programs.
Main Results:
- Parents desire a telemedicine device for 24-hour nurse access ('bell cord').
- Video-conferencing and timely email communication are crucial for security.
- An online knowledge base for infant care, breastfeeding, and nutrition is needed.
Conclusions:
- Neonatal home care (NH) enhances parental feelings of family connection, self-efficacy, and security.
- Telemedicine can effectively meet parental needs for communication and guidance in NH.
- Parents prioritize remote support over hands-on assistance for infant care.
Background:
For the majority of preterm infants, the last weeks of hospital admission mainly concerns tube feeding and establishment of breastfeeding. Neonatal home care (NH) was developed to allow infants to remain at home for tube feeding and establishment of breastfeeding with regular home visits from neonatal nurses. For hospitals covering large regions, home visits may be challenging, time consuming, and expensive and alternative approaches must be explored.
Objective:
To identify parental needs when wanting to provide neonatal home care supported by telemedicine.
Methods:
The study used participatory design and qualitative methods. Data were collected from observational studies, individual interviews, and focus group interviews. Two neonatal units participated. One unit was experienced in providing neonatal home care with home visits, and the other planned to offer neonatal home care with telemedicine support. A total of 9 parents with preterm infants assigned to a neonatal home care program and 10 parents with preterm infants admitted to a neonatal unit participated in individual interviews and focus group interviews, respectively.
Results:
Three overall themes were identified: being a family, parent self-efficacy, and nurse-provided security. Parents expressed desire for the following: (1) a telemedicine device to serve as a "bell cord" to the neonatal unit, giving 24-hour access to nurses, (2) video-conferencing to provide security at home, (3) timely written email communication with the neonatal unit, and (4) an online knowledge base on preterm infant care, breastfeeding, and nutrition.
Conclusions:
Our findings highlight the importance of neonatal home care. NH provides parents with a feeling of being a family, supports their self-efficacy, and gives them a feeling of security when combined with nursing guidance. Parents did not request hands-on support for infant care, but instead expressed a need for communication and guidance, which could be met using telemedicine.
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