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Investigating Father or Partner Involvement in Family Integrated Care in Neonatal Units: Protocol for a Prospective,
Rupa Rubinstein1,2, Katie Gallagher3, John Ho4
1Neonatal Unit, Homerton Healthcare NHS Foundation Trust, London, United Kingdom.
Insights
This study explores enhanced family-integrated care (FICare) for fathers of premature infants, aiming to improve parental mental health (MH). Findings may inform inclusive care guidelines for nonbirthing parents and their hospitalized newborns.
Area of Science:
- Neonatal care
- Parental mental health
- Family-integrated care
Background:
- Neonatal unit (NU) admissions for premature infants can negatively impact parental mental health (MH), causing depression, stress, and anxiety.
- Fathers experience similar MH symptoms to mothers, yet research on their well-being in neonatal care is limited.
- Family-integrated care (FICare) involves parents as partners in their newborn's care, improving infant outcomes and maternal MH.
Purpose of the Study:
- To investigate the impact of enhanced father or partner engagement in FICare on their mental health up to 6 weeks postdischarge.
- To assess the effect of FICare on maternal mental health.
Main Methods:
- A 2-phase study in 2 neonatal units (NUs) assessing enhanced FICare (information booklet, workbook, classes, peer support) alongside standard practices.
- Father/partner MH assessed via qualitative interviews and validated questionnaires (GAD-7, PHQ-9, PSS:NICU) from NU admission to 6 weeks postdischarge.
- Maternal MH assessed via focus groups and the same questionnaires; data analyzed using descriptive statistics, comparative tests, and thematic analysis.
Main Results:
- The study is ongoing, with data collection projected to end in July 2024.
- Systematic reviews on fathers' FICare experiences and MH outcomes are being conducted concurrently.
- A maximum of 20 parents per phase will be studied, with infants born before 33 weeks' gestation.
Conclusions:
- The study aims to demonstrate the feasibility of a father/partner-sensitive FICare model and its positive impact on parental mental health.
- It will assess the feasibility of providing FICare for extremely premature infants requiring intensive care.
- Findings may support the development of inclusive FICare guidelines for nonbirthing parents and their extremely premature infants.
Background:
Neonatal unit (NU) admissions for premature babies can last for months, which can significantly impact parental mental health (MH) with symptoms of depression, stress, and anxiety. Literature suggests fathers experience comparable MH symptoms to mothers. Family integrated care (FICare) is a culture where parents are collaborators and partners in caring for their hospitalized newborns. FICare improves infant outcomes and maternal MH. Similar reports on fathers are limited.
Objective:
The primary aim of this study is to investigate the impact of supporting father or partner engagement in FICare of preterm infants on their MH up to 6 weeks postdischarge. The secondary aim is to investigate the impact on maternal MH.
Methods:
This is a 2-phase study: phase 1 to gather baseline information and phase 2 to assess the impact of enhanced father or partner engagement in FICare on their MH, involving 2 NUs (tertiary and level 2). Enhanced FICare will be developed and introduced (eg, information booklet, workbook, classes, and a father peer-support group) alongside standard FICare practices. Father or partner MH will be assessed with semistructured qualitative interviews and validated questionnaires: Generalized Anxiety Disorder Assessment, Patient Health Questionnaire, and Parental Stressor Scale: Neonatal Intensive Care Unit from NU admission to 6 weeks postdischarge. Mothers will be assessed by focus groups and the same questionnaires. Descriptive statistics and appropriate comparative tests, such as the 2-tailed t test, will be used to analyze and compare phase 1 and 2 data. Qualitative data will be coded line by line with the use of NVivo (Lumivero) and thematically analyzed. Simultaneously, systematic reviews (SRs) of fathers' experiences of FICare and their MH outcomes will be conducted. The study was approved by the National Research Ethics Committee (22/EM/0140) in August 2022. A parent advisory group was formed to advise on the study methodology, materials, involvement of participant parents, and dissemination of study findings.
Results:
A recent SR demonstrated that data saturation is likely to be achieved by interviewing 9 to 17 participants. We will study a maximum of 20 parents of infants born at less than 33 weeks' gestation in each phase. As of October 2023, the study was ongoing. The SR studies are registered with the PROSPERO database (324275 and 306760). The projected end date for data collection is July 2024; data analysis will be conducted in November 2024 and publication will occur in 2025.
Conclusions:
The study aims to demonstrate the feasibility of using a father or partner-sensitive FICare model for parents of premature babies with a positive impact on their MH. It will demonstrate the feasibility of providing FICare to extremely premature babies receiving intensive care. This study may support the development of inclusive FICare guidelines for nonbirthing parents and their extremely premature infants.
Trial Registration:
ClinicalTrials.gov: NCT06022991; https://classic.clinicaltrials.gov/ct2/show/NCT06022991.
International Registered Report Identifier (Irrid):
DERR1-10.2196/53160.
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