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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Optimising parental self-efficacy in the neonatal intensive care unit (NICU) and its implications on child care and
Tina C Montreuil1,2,3,4,5, Chloé Gratton6, Kimia Mir-Shokraei7
1Department of Educational and Counselling Psychology, McGill University Faculty of Education, Montreal, Quebec, Canada tina.montreuil@mcgill.ca.
Insights
Enhancing parental self-efficacy in the neonatal intensive care unit (NICU) is key for parent engagement and improved infant outcomes. Higher self-efficacy is linked to better parental well-being and collaboration with healthcare providers.
Area of Science:
- Neonatal intensive care unit (NICU) care
- Parental mental health and well-being
- Family-centered care models
Background:
- Parenting in the NICU is stressful, impacting parental confidence and infant care involvement.
- Enhancing parental self-efficacy is crucial for active engagement and positive child outcomes.
- Identifying psychosocial needs of NICU parents is vital for effective support.
Purpose of the Study:
- To identify psychosocial needs (emotion regulation, stress management) of NICU parents.
- To examine factors influencing parental engagement in infant care.
- To determine if higher parental self-efficacy correlates with greater engagement, collaboration with healthcare providers (HCPs), and shorter NICU stays.
Main Methods:
- Mixed-methods study at a Level III NICU in Quebec, Canada.
- Parents completed questionnaires on engagement, self-efficacy, attachment, mental health, stress, and social support.
- Qualitative interviews with parents and HCPs analyzed thematically; statistical analyses performed using RStudio.
Main Results:
- Higher parental self-efficacy is anticipated to correlate with parental well-being and increased caregiving engagement.
- Anticipated findings include improved communication with NICU staff and enhanced parent-infant bonding.
- Study aims to identify factors strongly associated with parental engagement and interactions with the clinical team.
Conclusions:
- Findings will inform clinical strategies to enhance parental engagement and self-efficacy in the NICU.
- Potential to improve neonatal outcomes, parental mental health, and advance family-centered care policies.
- Insights can guide interventions to empower parents, optimize discharge, and reduce provider burden.
Introduction:
Parenting an infant in the neonatal intensive care unit (NICU) can be highly stressful, undermine parental confidence and minimise involvement in infant care. Enhancing parental self-efficacy is therefore crucial to promoting active engagement and supporting positive child outcomes. This study aims to identify the psychosocial needs (emotion regulation and stress management) of NICU parents and examine the factors that influence their engagement in infant care. It also seeks to determine whether higher levels of parental self-efficacy are associated with greater engagement and collaboration with healthcare providers (HCPs) and a shorter NICU stay.
Methods And Analysis:
A mixed-methods study will be conducted at the Montreal Children's Hospital's Level III NICU located in Quebec, Canada. Parents (ie, mothers and, when available, their partners) will be recruited during their infant's hospitalisation. Participants will complete a set of self-report questionnaires measuring parental engagement, self-efficacy, parent-infant attachment, mental health, perceived stress and social support. Additionally, one parent per family will be invited to participate in a qualitative interview to discuss their experience in the NICU. Qualitative data will be analysed thematically using NVivo 12 to identify key themes, and statistical analyses will be conducted using RStudio to determine which factors are most strongly associated with parental engagement and their interactions with the clinical team. Finally, HCPs will be invited to assist and participate in a qualitative interview regarding their perspectives on the NICU environment and the study's impact on the unit (ie, reduction in HCP burden due to increased parental engagement). Findings from this study will offer valuable insights to inform future clinical strategies aimed at enhancing parental engagement and self-efficacy in the NICU. These outcomes may contribute to improved neonatal outcomes, parental mental health and the advancement of evidence-based, family-centred care policies.
Ethics And Dissemination:
The protocol was approved by the Montreal University Health Centre's (MUHC) Research Ethics Board (2025-9392). Findings derived from this study have the potential to optimise parental engagement in the NICU to promote family resilience and child well-being.
Implications Of Findings:
Our study protocol aims to underscore the critical role of self-efficacy and other key psychosocial factors, such as lower parental stress and higher emotion regulation, in promoting parental engagement and collaboration within the NICU. We anticipate that higher levels of self-efficacy will correlate with parental well-being, increased caregiving engagement (ie, basic baby care, improved communication with NICU staff) and enhanced parent-infant bonding. These findings may support the development of structured interventions that empower parents and streamline provider-parent collaboration. In clinical practice, these insights can guide the integration of tailored parental support programmes to optimise discharge preparation and reduce provider burden by promoting shared caregiving responsibilities. Future initiatives could build further on this model to guide institutional policies that aim to prioritise parental empowerment (ie, greater self-efficacy and engagement) as a fundamental pillar of neonatal care.
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