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A Family-Centered Neurodevelopmental Care Framework for Post-neonatal Intensive Care Unit of Preterm Infants: Delphi
Hajar Sabour Eghbali Mostafa Khan1, Farin Soleimani2, Nazila Akbar Fahimi2
1Pediatric Neurorehabilitation Research Center, Occupational therapy department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
Objectives:
This study aimed to develop a structured, culturally responsive neurodevelopmental care framework for preterm infants during the first three months following the neonatal intensive care unit (NICU) discharge, based on research evidence and multidisciplinary expert consensus in Iran.
Materials & Methods:
A two-phase study was conducted. First, a scoping review (2000-2024) identified key domains and items for post-discharge care. Second, a panel of 24 multidisciplinary experts completed a two-round Delphi survey. Consensus was defined as 75% agreement or higher and a mean Likert score of 3.75 or above on a five-point scale. Quantitative and qualitative analyses were performed in accordance with Delphi study guidelines.
Results:
The finalized framework comprises 57 items categorized across eight primary domains. Expert agreement ranged from 87% to 95%, with mean Likert scores ranging from 4.42 to 4.65. Positioning and postural care showed the highest agreement (95% t, mean = 4.57). Experts emphasized continuity of care, parent-mediated interventions, and integration of developmental, emotional, and environmental components.
Conclusion:
This culturally adapted, family-centered framework provides structured post-discharge neurodevelopmental care for preterm infants. It promotes infants' motor, sensory, cognitive, and emotional development while supporting parental empowerment and psychological well-being, potentially optimizing early neurodevelopmental outcomes in home-based care settings.
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