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A Pilot Study of Family-Integrated Care (FICare) in Critically Ill Preterm and Term Infants in the NICU: FICare Plus
Najmus Sehr Ansari1,2, Linda S Franck3, Christopher Tomlinson1,2
1Department of Pediatrics, University of Toronto, Toronto, ON M5S 1A1, Canada.
Insights
Family-integrated care (FICare) Plus is safe and feasible for critically ill infants, improving parental confidence and reducing anxiety. This approach enhances early parental engagement without adverse events.
Area of Science:
- Neonatal Intensive Care Unit (NICU) care
- Pediatric critical care
- Family-centered medicine
Background:
- Family-integrated care (FICare) improves outcomes in stable preterm infants.
- Limited data exists on FICare for critically ill infants.
- Critically ill infants face higher risks for adverse outcomes.
Purpose of the Study:
- To assess the safety and feasibility of an augmented FICare program (FICare Plus) for critically ill infants.
- To evaluate parental engagement and mental health outcomes.
- To determine infant health outcomes in the FICare Plus model.
Main Methods:
- Prospective cohort study involving 41 critically ill infants.
- Comparison between standard care (SC) and FICare Plus groups.
- Utilized questionnaires for parental stress, anxiety, and self-efficacy.
Main Results:
- FICare Plus facilitated greater parental engagement without increasing adverse events or stress.
- Parents in the FICare Plus group reported increased confidence in infant care.
- Anxiety scores decreased significantly by discharge in the FICare Plus group.
Conclusions:
- Family-integrated care Plus is a safe and feasible model for critically ill infants.
- The program supports parental confidence and reduces anxiety.
- Further research is warranted to explore long-term impacts.
Abstract:
Family-integrated care (FICare) is associated with improved developmental outcomes and decreased parental mental health risks in stable preterm infants. However, less is known about its application in critically ill infants who are at greater risk for adverse outcomes. The objective of this study was to assess the safety and feasibility of implementation of an augmented FICare program, FICare Plus, in critically ill infants in the first few weeks of life. Resources were specifically developed for staff and parents to support earlier parental engagement in infant care. Infant health outcomes and standardized measures of parental stress, anxiety and parenting self-efficacy were also collected using standardized questionnaires: State -Trait Anxiety Inventory (STAI), Parental Stressor Scale: NICU (PSS: NICU), Perceived Parenting Self-Efficacy Tool and Family Centered Care Survey. The t-test or Wilcoxon rank-sum test were used to compare continuous variables, while the Chi-square or Fisher exact test were used for categorical variables, respectively. In this prospective cohort study, 41 critically ill infants were enrolled: 17 in standard care (SC) and 24 in the FICare Plus group. The tools and procedures developed for FICare Plus successfully supported greater engagement in the care of their infants with no increase in adverse events and no increase in parental stress. Parents in the FICare Plus cohort felt confident to participate in their infant's care. The staff also found this model of care acceptable and well adopted. Preliminary measures of infant efficacy were similar in both groups. Total anxiety scores were high among all parents at enrollment (87 (67-94) vs. 70.5 (66-86); p-value 0.22). However, the scores prior to discharge were lower in FICare Plus group (78 (71-90) vs. 63 (52-74.5); p-value 0.02). This pilot study showed that it is feasible and safe to implement family-integrated care in critically ill infants.
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