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Published on: November 7, 2020
Family-centred care change during COVID-19
Siriporn Vetcho1,2,3, Marie Cooke1, Helen Petsky1,2
1School of Nursing and Midwifery, Griffith University, Brisbane.
Insights
Family-centred care (FCC) innovations improved parental perceptions of respect, collaboration, and support in a Thai neonatal intensive care unit (NICU), even during COVID-19 restrictions. This study highlights successful FCC adaptations in resource-limited settings.
Area of Science:
- Neonatal Intensive Care Unit (NICU) care
- Healthcare delivery in resource-limited settings
- Family-centered care (FCC) principles
Background:
- Family-centred care (FCC) is crucial for partnership between families and healthcare providers in neonatal intensive care units (NICUs).
- Implementing FCC in low-resource settings like Thailand presents unique challenges, exacerbated by the COVID-19 pandemic.
- Previous FCC initiatives in Thai NICUs faced significant hurdles.
Purpose of the Study:
- To evaluate innovations designed to enhance respect, collaboration, and support within the FCC framework in a Thai NICU.
- To adapt FCC practices to meet the constraints imposed by the COVID-19 pandemic.
- To assess the impact of these innovations on parental and healthcare professional perceptions of FCC.
Main Methods:
- A quasi-experimental study was conducted in a southern Thailand NICU, comparing pre- and post-implementation perceptions of FCC.
- Innovations were developed collaboratively, considering COVID-19 restrictions, pre-survey data, and stakeholder interviews.
- Parental and staff perceptions were measured using the Perceptions of Family Centred Care-Parent (PFCC-P) and -Staff (PFCC-S) surveys, analyzed with Mann-Whitney U and Wilcoxon's Rank Sum tests.
Main Results:
- Parental perceptions significantly improved across respect (median 2.50-3.50), collaboration (2.33-3.33), and support (2.60-3.60) domains (p < .001).
- Overall parental perception of FCC increased from 2.50 to 3.43.
- Healthcare professionals' perceptions of FCC showed no significant changes, with overall scores remaining stable (3.15-3.20).
Conclusions:
- Despite COVID-19 challenges limiting NICU access, FCC provision was successfully maintained and enhanced for parents.
- Innovations like structured telephone updates and revised information booklets proved effective in adapting FCC.
- Further research is needed to develop communication-focused FCC innovations applicable across diverse healthcare systems and resource levels.
Background:
Family-centred care (FCC) is an approach to promote family and health care provider partnership. This has been incorporated into neonatal intensive care units (NICUs) worldwide. However, FCC in low resource health settings, such as Thailand, is challenging and further impacted by coronavirus disease 2019 (COVID-19).
Aims:
To evaluate FCC innovations to improve respect, collaboration and support in a Thai NICU.
Study Design:
A quasi-experimental study was conducted in an NICU in southern Thailand. Pre-implementation was prior to COVID-19, and parental and staff perceptions of FCC were measured via Perceptions of Family Centred Care-Parent (PFCC-P) and -Staff (PFCC-S) survey. The FCC innovations were developed by stakeholders based on the COVID-19 restrictions, pre-survey results, parents' and clinicians' interviews and integrative review, then implemented via a flowchart. Post-implementation evaluation was via repeated surveys. Comparisons were made pre-and post-implementation, with Mann-Whitney U-test statistics for parents and Wilcoxon's Rank Sum for staff.
Results:
A total of 185 (85 pre; 100 post) parents and 20 (pre and post; paired group) health care professionals participated. Because of COVID-19, many planned interventions were unfeasible, however, other innovations achieved (e.g., structured telephone updates, information booklet revision). There was an increase in parents' perception of respect ([median] 2.50-3.50), collaboration (2.33-3.33) and support (2.60-3.60) domains and overall (2.50-3.43; p < .001; 95% CI: 2.93-3.11). Interdisciplinary professionals' perception of FCC did not significantly change pre-and post-implementation/COVID-19 pandemic for respect (3.00-2.92), collaboration (3.22-3.33), support (3.20-3.20) and overall (3.15-3.20; 95% CI: 3.10-3.25).
Conclusion:
Despite the challenges of COVID-19 restricting NICU access, the provision of FCC was maintained and even improved.
Relevance To Clinical Practice:
Further research is necessary to develop FCC practice innovations associated with communication, across diverse health care systems and resources.
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