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Psychosocial support for parents of extremely preterm infants in neonatal intensive care: a qualitative interview
Anna Bry1, Helena Wigert2,3
1Division of Neonatology, Sahlgrenska University Hospital, Gothenburg, Sweden. annakrisbry@gmail.com.
Insights
Parents of extremely premature infants need better psychosocial support in the NICU. Key needs include emotional support, trust in healthcare providers, help balancing responsibilities, and privacy. Improving staff training and communication is crucial.
Area of Science:
- Neonatal Intensive Care Unit (NICU) Care
- Parental Psychosocial Support
- Perinatology
Background:
- Extremely premature infants (born before 28 weeks' gestational age) require prolonged NICU stays.
- Parental stress and psychological disruption are common due to infant's critical condition and hospitalization duration.
- Understanding parental psychosocial needs in the NICU is essential for supportive care.
Purpose of the Study:
- To explore the psychosocial support needs of parents with extremely premature infants.
- To assess how the NICU environment and staff meet or fail to meet these parental needs.
Main Methods:
- Conducted 16 open-ended interviews with 27 parents post-NICU discharge.
- Utilized inductive content analysis to identify key themes.
Main Results:
- Identified four key themes: emotional support (from staff, other parents), trust in healthcare providers, balancing responsibilities, and privacy.
- Parents expressed varied needs for emotional support and clear communication regarding staff roles.
- Challenges included maintaining trust due to communication issues and staff discontinuity, perceived pressure to be present, and limited privacy.
Conclusions:
- NICU psychosocial support for parents of extremely preterm infants is complex and individualized.
- Recommendations include increasing staffing, enhancing nurses' psychosocial competence, clarifying interprofessional roles, and improving communication.
- Proactive communication about available support is vital for parental coping during NICU hospitalization.
Background:
Extremely premature infants (those born before 28 weeks' gestational age) are highly immature, requiring months of care at a neonatal intensive care unit (NICU). For parents, their child's grave medical condition and prolonged hospitalization are stressful and psychologically disruptive. This study aimed at exploring the needs of psychosocial support of parents of extremely premature infants, and how the NICU as an organization and its staff meets or fails to meet these needs.
Method:
Sixteen open-ended interviews were conducted with 27 parents after their infant's discharge from the NICU. Inductive content analysis was performed.
Results:
Four themes were identified: Emotional support (with subthemes Empathic treatment by staff, Other parents as a unique source of support, Unclear roles of the various professions); Feeling able to trust the health care provider; Support in balancing time spent with the infant and other responsibilities; Privacy. Parents of extremely premature infants needed various forms of emotional support at the NICU, including support from staff, professional psychological help and/or companionship with other patients' parents. Parents were highly variable in their desire to discuss their emotional state with staff. The respective roles of nursing staff, social workers and psychologists in supporting parents emotionally and identifying particularly vulnerable parents appeared unclear. Parents also needed to be able to maintain a solid sense of trust in the NICU and its staff. Poor communication with and among staff, partly due to staff discontinuity, damaged trust. Parents struggled with perceived pressure from staff to be at the hospital more than they could manage and with the limited privacy of the NICU.
Conclusions:
The complex and individual psychosocial needs of parents of extremely preterm infants present many challenges for the NICU and its staff. Increasing staffing and improving nurses' competence in addressing psychosocial aspects of neonatal care would help both nurses and families. Clarifying the roles of different professions in supporting parents and developing their teamwork would lessen the burden on nurses. Communicating with parents about their needs and informing them early in their NICU stay about available support would be essential in helping them cope with their infant's hospitalization.
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