[The Need for Psychosocial Support of Parents of Children in Neonatal Care]
Nicole Schäfer1, Harald Karutz1, Olaf Schenk1
1Department Pädagogik, Pflege und Gesundheit, MSH Medical School Hamburg.
Insights
Psychosocial support is crucial for parents of infants in neonatal care, yet practice often lags behind theory. Evidence-based, individualized support is needed, considering the parent-child relationship and healthcare economics.
Area of Science:
- Neonatal Care
- Parental Psychology
- Health Services Research
Background:
- Neonatal care advances reduce infant mortality but increase morbidity, creating parental stress.
- Psychosocial support for parents in neonatal intensive care units (NICUs) is vital.
- Existing literature highlights the importance of addressing parental psychosocial needs.
Purpose of the Study:
- To systematically review the literature on psychosocial support for parents of children in neonatal care.
- To identify the gap between theoretical models and practical implementation of family-centered care in NICUs.
- To explore factors influencing the need for and delivery of parental psychosocial support.
Main Methods:
- Systematic literature search across multiple databases (PubMed, PsycINFO, CINAHL, Medpilot).
- Inclusion of reference lists and free-text searches for relevant publications.
- Review of 78 publications from 1975-2015.
Main Results:
- Neonatal care has shifted towards family-centered approaches, but a gap persists in practice.
- While the need for psychosocial support is recognized, clinical focus remains on medical interventions.
- Validated screening tools for assessing parental needs are underutilized, and support needs extend beyond medical risk.
Conclusions:
- Delivering individualized psychosocial support in resource-limited healthcare systems presents challenges.
- Practitioners must balance the developing parent-child relationship with health economic considerations.
- Future psychosocial support should be evidence-based, integrating insights from attachment theory and health psychology.
Abstract:
Background Advances in neonatal care have reduced mortality but increased morbidity in babies born pre-maturely or after high-risk pregnancies. However, this often increases the burden on the family and the parents in particular. A systematic review of the literature was conducted that demonstrated the importance of psychosocial support for parents of children in neonatal care. Methods A systematic search of Pubmed, Psyndex, CINAHI and medpilot was conducted. Reference lists of the included articles were also searched for relevant publications. A free-text search found further publications. Together, 78 publications (from 1975-2015) were included in our review. Results A shift from a biomedical model and child-centred treatment to family-centred care has already taken place in neonatal care. However, there is still a considerable gap between theory and practice. Although there is awareness of the need for psychosocial support of parents, the focus of day-to-day care is still on medical interventions and life-supporting treatment for the child. In particular, while the importance of an assessment of needs as a basis for family-centred psychosocial support appears to be well-known, validated screening instruments are rarely used. In addition, the demand for psychosocial support of parents is not just solely determined by the child's medical risk. Conclusions The results highlight the challenges of delivering individualised psychosocial support to families within a healthcare system of limited resources, with practitioners having to take into account the developing parent-child relationship as well as health economics. In future, psychosocial support should be based on evidence rather than intuition. Attachment theory and research, and health psychology can contribute to this development.
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