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Parent Readiness for Their Preterm Infant's Neonatal Intensive Care Unit Discharge
Linda S Franck1, Rebecca M Kriz, Robin Bisgaard
1Department of Family Health Care Nursing and the California Preterm Birth Initiative, University of California, San Francisco, San Francisco (Drs Franck and Gay and Ms Kriz); Intensive Care Nursery (Mss Bisgaard and S. Sossaman and Mr J. Sossaman) and Division of Neonatology (Dr Sun), UCSF Benioff Children's Hospital, San Francisco, California; Neonatal and Pediatrics, Community Regional Medical Center, Fresno, California (Dr Cormier); Division of Neonatology, UCSF Benioff Children's Hospital, Oakland, California (Dr Joe); Intensive Care Nursery, Santa Monica Medical Center, UCLA Health, Santa Monica, California (Ms Sasinski); Division of Neonatology, Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio (Dr Kim); and Division of Neonatology, Kaiser Permanente, Santa Clara, California (Dr Lin).
Abstract:
This study aims to examine the influence of hospital experience factors on parental discharge readiness, accounting for key background characteristics. Parents/guardians of infants 33 weeks of gestation or less at birth receiving neonatal intensive care at 6 sites were enrolled from April 2017 to August 2018. Participants completed surveys at enrollment, 3 weeks later, and at discharge. Multiple regression analysis assessed relationships between parental experience, well-being, and perceived readiness for infant discharge, adjusting for socioenvironmental, infant clinical, and parent demographic characteristics. Most (77%) of the 139 parents reported high levels of readiness for their infant's discharge and 92% reported high self-efficacy at discharge. The multiple regression model accounted for 40% of the variance in discharge readiness. Perceptions of family-centered care accounted for 12% of the variance; measures of parent well-being, anxiety, and parenting self-efficacy accounted for an additional 16% of the variance; parent characteristics accounted for an additional 9%; and infant characteristics accounted for less than 3% of the variance. Parental perceptions of the family-centeredness of the hospital experience, anxiety, and parenting self-efficacy accounted for a substantial proportion of the variance in readiness for discharge scores among parents of preterm infant. These influential perceptions are potentially modifiable by nursing-led interventions.
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