Obstacles to Parents’ Interaction with Neonates in Neonatal Intensive Care Units from Parents’ and Nurses’ Points of View

Background: This study aimed to identify the most important obstacles to proper interaction of parents with their neonates who were hospitalized in neonatal intensive care units (NICUs). Methods: This descriptive cross-sectional study was conducted on 90 NICU nurses and 400 female and male parents using census and convenience sampling methods. To collect data, in a period of three months, a researcher-made questionnaire was prepared, including the factors threatening the parents' interaction with their neonates in NICUs. Data analysis was performed using the descriptive statistics including the number, percentage and mean scores of responses in SPSS software (version 16). Results: By calculating the mean scores of responses, from the nurses' points of view, "feeling of emotional discomfort due to being away from the neonate" (3.63) and "nurses’ not understanding parents since they have no children" (1.42) were the most and the least important factors, respectively. From the mothers' points of view, "parental stress due to the neonate’s hospitalization" (3.47), and "the maternity wards being away from NICUs" (1.37) were the most and the least important factors, respectively. Also, the most and the least important obstacles in the perspectives of the fathers were "parental stress due to the neonate’s hospitalization" (3.09) and "the unwanted neonate", respectively. Conclusion: The results showed that the stress and tension of parents were the most influencing factor on the interaction of neonate-parent in NICUs. Some neonatal and organizational factors were considered less important as the barriers to neonate-parent interactions in these wards

Hospital-based prospective study of pertussis in infants and close contacts in Tehran, Iran

International audienceBackground : Pertussis remain a global health concern, especially in infants too young to initiate their vaccination. Effective vaccination and high coverage limit the circulation of the pathogen, yet duration of protection is limited and boosters are recommended during a lifetime. In Iran, boosters are given at 18 months and 6 years old using whole pertussis vaccines for which efficacy is not known, and pertussis surveillance is scant with only sporadic biological diagnosis. Burden of pertussis is not well understood and local data are needed. Methods : Hospital-based prospective study implementing molecular laboratory testing in infants aged ≤6 months and presenting ≥5 days of cough associated to one pertussis-like symptom in Tehran. Household and non-household contact cases of positive infants were evaluated by comprehensive pertussis diagnosis (molecular testing and serology) regardless of clinical signs. Clinical evaluation and source of infection were described. Results : A total of 247 infants and 130 contact cases were enrolled. Pertussis diagnosis result was obtained for 199 infants and 104 contact cases. Infant population was mostly < 3 months old (79.9%; 157/199) and unvaccinated (62.3%; 124/199), 20.1% (40/199) of them were confirmed having B. pertussis infection. Greater cough duration and lymphocyte counts were the only symptoms associated to positivity. Half of the contact cases (51.0%; 53/104) had a B. pertussis infection, median age was 31 years old. A proportion of 28.3% (15/53) positive contacts did not report any symptom. However, 67.9% (36/53) and 3.8% (2/53) of them reported cough at inclusion or during the study, including 20.8% (11/53) who started coughing ≥7 days before infant cough onset. Overall, only five samples were successfully cultured. Conclusion : These data evidenced the significant prevalence of pertussis infection among paucy or poorly symptomatic contacts of infants with pertussis infection. Widespread usage of molecular testing should be implemented to identify B. pertussis infections