Conditions for parents' participation in the care of their child in neonatal intensive care – a field study

<p>Abstract</p> <p>Background</p> <p>To promote participation by parents in the care of their child in neonatal intensive care units (NICU), health professionals need better understanding of what facilitates and what obstructs participation. The aim was to elucidate conditions for parents' participation in the care of their child in NICUs.</p> <p>Methods</p> <p>A field study with a hermeneutic lifeworld approach was used and data were collected at two NICUs through participative observations and interviews with representatives of management, staff and parents.</p> <p>Results</p> <p>The results point to a number of contradictions in the way parents were offered the opportunity to participate in neonatal intensive care. Management and staff both had good ambitions to develop ideal care that promoted parent participation. However, the care including the conditions for parental participation was driven by the terms of the staff, routines focusing on the medical-technical care and environment, and budgetary constraints.</p> <p>Conclusion</p> <p>The result shows that tangible strategies need to be developed in NICUs aimed at optimising conditions for parents to be present and involved in the care of their child.</p

Parents' views on care of their very premature babies in neonatal intensive care units: a qualitative study

Background The admission of a very premature infant to the neonatal intensive care unit (NICU) is often a difficult time for parents. This paper explores parents’ views and experiences of the care for their very premature baby on NICU. Methods Parents were eligible if they had a baby born before 32 weeks gestation and cared for in a NICU, and spoke English well. 32 mothers and 7 fathers were interviewed to explore their experiences of preterm birth. Although parents’ evaluation of care in the NICU was not the aim of these interviews, all parents spoke spontaneously and at length on this topic. Results were analysed using thematic analysis. Results Overall, parents were satisfied with the care on the neonatal unit. Three major themes determining satisfaction with neonatal care emerged: 1) parents’ involvement; including looking after their own baby, the challenges of expressing breast milk, and easy access to their baby; 2) staff competence and efficiency; including communication, experience and confidence, information and explanation; and 3) interpersonal relationships with staff; including sensitive and emotional support, reassurance and encouragement, feeling like an individual. Conclusions Determinants of positive experiences of care were generally consistent with previous research. Specifically, provision of information, support for parents and increasing their involvement in the care of their baby were highlighted by parents as important in their experience of care

The Hands-on Guide to Midwifery Placements

LOW-RISK. MIDWIFERY. The Hands-on Guide to Midwifery Placements, First Edition. Edited by Luisa Cescutti-Butler and ... As a qualified midwife, your role will be to view pregnancy and childbirth as normal events and to be expertin&nbsp;..

Föräldrars delaktighet i sitt barns vård vid neonatal intensivvård

When a newborn baby is in need of care in a neonatal intensive care unit (NICU), the care is assumed to be carried out not only by personnel but also by parents. To promote parental participation in this care, the parents are welcome to stay with their child whenever they wish. This thesis includes four papers and has the overall aim of contributing to the understanding of the significance of parental participation in the care of their child on the NICU, as well as the factors that influence, facilitate or obstruct that participation. The thesis is based on participative observations and interviews with parents and personnel at two NICUs. Paper I used a phenomenological hermeneutic lifeworld approach, while Papers II and III used a hermeneutic lifeworld approach, and Paper IV had a descriptive quantitative design. The results of this thesis show a general feeling of exclusion, with the mother experiencing a lack of interaction with the personnel and a sense of not belonging on the NICU. This has a negative impact on her maternal identity. However, when a continuous dialogue existed, and the mother was cared for as a unique person with unique needs, she experienced that she was participating, and this strengthened her maternal identity (I). The personnel on the NICU were ambivalent regarding the presence of parents, and set limits that included dictating conditions for parental participation. In the encounter with the parents they had difficulties in meeting worried parents and sometimes manifested an evasive attitude (II). Although the personnel had good ideals and intended to encourage parental participation, the care, including the terms of parental participation, was determined by the conditions set by the personnel, routines focusing on the care environment and medical technology, and budgetary constraints (III). The nature and extent of parental presence on the NICUs varied depending on the types of accommodations parents were offered. Those who stayed in parent rooms on the units showed more of presence with their children than did parents who stayed at a family hotel, at home or on the maternity ward. The main reason parents had for being with their child was a wish to take parental responsibility. Good treatment by the personnel was the primary factor facilitating parental presence, while parental ill health was the primary obstructing factor (IV). The results show a need to develop a family-friendly environment and tangible strategies to provide optimal conditions for enabling parents to be present and involved in the care of their child on a NICU. In addition, the personnel must be given the resources needed to make this possible