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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.
Insights
A new framework offers structured neurodevelopmental care for preterm infants after neonatal intensive care unit (NICU) discharge. This culturally adapted approach supports infant development and parental well-being at home.
Area of Science:
- Neonatal care
- Developmental pediatrics
- Public health
Background:
- Preterm infants require specialized care post-neonatal intensive care unit (NICU) discharge.
- Existing post-discharge care lacks a structured, culturally responsive framework.
- Optimizing neurodevelopmental outcomes in preterm infants is crucial.
Purpose of the Study:
- To develop a structured, culturally responsive neurodevelopmental care framework for preterm infants.
- To base the framework on research evidence and multidisciplinary expert consensus.
- To guide care during the first three months after NICU discharge.
Main Methods:
- A two-phase study combining a scoping review and a Delphi survey.
- Scoping review identified key domains and items for post-discharge care (2000-2024).
- A 24-member multidisciplinary expert panel reached consensus using a two-round Delphi survey.
Main Results:
- A finalized framework with 57 items across eight domains was developed.
- Expert agreement on the framework items ranged from 87% to 95%.
- Key emphasized areas included positioning, continuity of care, and parent-mediated interventions.
Conclusions:
- The developed framework offers culturally adapted, family-centered neurodevelopmental care.
- It supports preterm infants' motor, sensory, cognitive, and emotional development.
- The framework aims to optimize neurodevelopmental outcomes and parental well-being in home settings.
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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