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'Not a goal, but a given': Neonatal care participation through parents' perspective, a cross-sectional study
Hannah Hoeben1,2, Sylvia A Obermann-Borst3, Mireille A Stelwagen1
1Department of Pediatrics/Neonatology, OLVG, Amsterdam, The Netherlands.
Insights
Parents are satisfied with neonatal care participation but desire more involvement. The family integrated care (FICare) model shows potential, yet its structural implementation needs improvement for enhanced parent-infant closeness.
Area of Science:
- Neonatal care
- Parental involvement
- Family Integrated Care (FICare) model
Background:
- Parental presence and involvement in neonatal intensive care units (NICUs) are crucial for parent-infant bonding.
- The Family Integrated Care (FICare) model aims to enhance parent-infant closeness and participation in care.
- Architectural settings may influence parents' experiences in neonatal wards.
Purpose of the Study:
- To explore parents' perspectives on participating in neonatal care.
- To evaluate the implementation of the FICare model in Dutch neonatal wards.
- To understand the impact of architectural settings on parental experiences.
Main Methods:
- An online survey was distributed to parents of hospitalized newborns in Dutch NICUs (2015-2020).
- The survey data was categorized by the four FICare pillars.
- Quantitative data were analyzed using descriptive statistics, and qualitative data underwent thematic analysis.
Main Results:
- Most parents (98% mothers) felt involved but also separated from their infants (79%).
- Implementation of FICare pillars was incomplete: parent education (14%), staff education (51%), psychosocial support (21%), and environment (22%).
- While 65% attended clinical rounds, only 32% actively participated in decision-making.
Conclusions:
- Parents reported satisfaction with their participation in neonatal care.
- There is a significant gap in the structural implementation of the FICare model.
- Enhancing parental participation beyond mere presence is essential, irrespective of the ward's architecture.
Aim:
To explore parents' perspectives regarding participation in neonatal care, with focus on the family integrated care (FICare) model utilised as a tool to enhance parent-infant closeness. Additionally, we describe experiences in different architectural settings.
Methods:
An online survey, categorised by four FICare pillars, was distributed through social media to parents of newborns hospitalised to Dutch neonatal wards between 2015 and 2020. Quantitative findings were summarised using descriptive statistics, while open-ended responses were thematically analysed.
Results:
Among the 344 respondents (98% mothers), most reported feeling involved in care (315/340). However, 79% also felt separated from their infant (265/337). Irrespective of architectural settings, parents reported incomplete implementation of FICare pillars: 14% was invited to educational sessions (parent education), 51% discussed family-specific care plans (staff education), 21% was facilitated in connecting with veteran parents (psychosocial support) and 22% received couplet-care (environment). Although 65% of parents were invited to attend clinical rounds, 32% actively participated in decision making. Thematic analysis revealed fundamentals for feeling welcome on the ward, peer-to-peer support, psychosocial support and participation in clinical rounds.
Conclusion:
Overall, parents expressed satisfaction with participation in neonatal care. However, structural implementation of FICare lacks. Regardless of architecture, expanding parent participation beyond presence requires attention.
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