Fathers' needs in a surgical neonatal intensive care unit : assuring the other parent

Objectives: Fathers of infants admitted to Neonatal Intensive Care Unit (NICU) play an important role and have individual needs that are often not recognised. While there is considerable evidence regarding mothers’ needs in the NICU, information about fathers’ is particularly limited. This study identifies the needs of fathers of newborns admitted to NICU for general surgery of major congenital anomalies, and whether health-care professionals meet these needs. Methods: Forty-eight fathers of infants admitted for surgery between February 2014 and September 2015 were enrolled in a prospective cohort study. Fathers completed the Neonatal Family Needs Inventory comprising 56 items in 5 subscales (Support, Comfort, Information, Proximity, Assurance) at admission and discharge and whether these needs were met; as well as the Social Desirability Scale. Results: Responses showed Assurance was the most important subscale (M 3.8, SD .26). Having questions answered honestly (M 3.9, SD .20) and knowing staff provide comfort to their infant (M 3.94, SD .24) were fathers’ most important needs. By discharge, fathers expressed a greater importance on being recognised and more involved in their infant’s care. More than 91% indicated their ten most important needs were met by the NICU health-care professionals, with no significant changes at discharge. Clergical visits (M 2.08, SD 1.21) were least important. Conclusions: Reassurance is a priority for fathers of neonates in a surgical NICU, particularly regarding infant pain management and comfort. It is important that health-care professionals provide reliable, honest information and open-access visiting. Notably, fathers seek greater recognition of their role in the NICU—beyond being the ‘other’ parent

Needs and Stressors of Parents of Infants Undergoing General Surgery for Major Congenital Anomalies in a Surgical Neonatal Intensive Care Unit

BACKGROUND: As more babies survive major surgery in the newborn period, health- professionals are focusing on the quality of life for parents as well as babies. While much is known about the experiences of parents of preterm babies in Neonatal Intensive Care Units (NICUs), little is known about parents, particularly fathers, whose infants require general neonatal surgery for major congenital anomalies. AIMS: This study focusing on parents of infants undergoing general surgery for major congenital anomalies in the surgical NICU aimed to: - identify parents’ needs, the degree health- professionals meet these needs, changes in needs from admission to discharge, and identify fathers’ perspectives; - identify parents’ stressors, and compare mothers and fathers’ stressors; - evaluate health professionals’ perceptions of parents self-reported needs and stressors; - examine relationships between needs and stressors. METHODS: This descriptive, cross-sectional study prospectively enrolled a cohort of parents of infants admitted for general surgery for major congenital anomalies to a tertiary NICU, from January 2014 to September 2015. Parents completed three questionnaires; the Neonatal Family Needs Inventory, Parental Stressor Scale: Neonatal Intensive Care Unit, and Social Desirability Scale. Health- professionals provided matched data for agreement and comparison analysis with parents’ responses. RESULTS: 111 parents (57% mothers) were enrolled. Assurance was parents’ greatest need, especially for mothers. Honest accurate information and frequent visiting were most important. Fathers prioritised open visiting and infant comfort. Most important needs were well-met for 96% of parents. Parents reported moderate-high stress, with parental role alteration the greatest stressor and infant appearance more stressful for fathers. Seeing the baby in pain and feeling helpless to protect the baby were significant stressors. Health-professionals (89% nurses) identified parents greatest needs and stressors; underrating their impact led to fair agreement. Needs and stressors were independent constructs. CONCLUSION: Assuring parents, supporting their role, and managing infant pain are individualised family-centered care practices that promote parental well-being and infant outcomes in the surgical NICU

Maternal physical and psychological benefits of Kangaroo Mother Care in a Neonatal Intensive Care Unit: A scoping review protocol

Abstract Objective: This scoping review aims to map the available evidence of Kangaroo Mother Care (KMC) and the known physical and psychological benefits for the mother, giving insight into the available published and unpublished literature alongside any available grey literature. In addition, to provide ways to inform mothers in low-income countries (LIC) and culturally and linguistic diverse background (CALD) communities of these benefits. Introduction: The range of benefits KMC provides to the newborns participating are well known, with many extensive studies completed since the 1970s illustrating both short and long-term physical, psychological and social benefits. This review is to highlight and focus on the studies emphasising the evidence-based benefits of KMC for the newborn's biological mother. Inclusion criteria: When considering participants of these studies or other reviews, the mother of child-bearing age must be biologically related to the infant currently admitted to the Neonatal Intensive Care Unit (NICU). The concept of the review is to identify and document any physical and psychological benefits of KMC for the mother. For the context of this review, the newborns must be admitted in a NICU at the time of the study. Method: Five databases will be used for the search of this review, including CINAHL, EMBASE, Medline, MIDIRS and Scopus, where all papers will be accepted that are available with a translation in the English language and written after the 1970s. To further increase the result pool for the study, reference lists will be screened alongside search engines like Google and Google Scholar to find unpublished papers and grey literature

Needs and stressors of parents of term and near-term infants in the NICU : a systematic review with best practice guidelines

Having a sick infant in the NICU can be quite stressful and overwhelming to parents. They require support and may have varied needs. A systematic review of qualitative and quantitative studies from 5 electronic databases (Ovid Medline, EMBASE, PsycINFO, CINAHL and Sociological Abstracts), covering January 2001 – March 2016 identified the needs and stressors of parents of term or near-term Infants in the NICU. Six articles addressed the needs and 14 identified the stressors of parents. Parents' most important need was for accurate and honest information. Needs focused around sensitive infant care and involvement in decision-making. The greatest stressor for parents was alteration to the parental role, followed by infant appearance. Fathers and parents of infants undergoing surgery are an under-researched population. Based on the evidence, enhancing staff-parent communication would better meet parental needs and reduce stressors. Our key recommendations highlight the need for family-centred and individualised care practices in the NICU

Needs of parents in a surgical neonatal intensive care unit

Aim: While there is evidence of parental needs in the neonatal intensive care unit (NICU), parents of newborns admitted for general surgery are an under‐researched population. This study aimed to identify needs in parents of newborns admitted to the NICU for general surgery and whether health‐care professionals meet these needs. Methods: This was a prospective cohort study of 111 parents (57% mothers) of newborns admitted to a surgical NICU for general surgery in Australia from January 2014 to September 2015. Parents completed the Neonatal Family Needs Inventory (NFNI), comprising 56 items in five subscales (Support, Comfort, Information, Proximity, Assurance) at admission and discharge, as well as the Social Desirability Scale (SDS). Data were analysed using parametric and non‐parametric techniques. Results: At both admission and discharge, parents rated Assurance (M = 3.8, standard deviation (SD) = 0.24) needs as the most important, followed by Proximity (M = 3.6, SD = 0.32) and Information (M = 3.5, SD = 0.38). Mothers rated Assurance significantly more important than fathers (P < 0.02). Overall, parents' most important needs were having questions answered honestly (M = 3.96, SD = 0.19), seeing their infant frequently and knowing about the medical treatment (both M = 3.95, SD = 0.23). The 10 most important needs were met for more than 96% of parents, with no evidence of response bias. Conclusions: Reassurance is a priority need for parents in the surgical NICU. Mothers' and fathers' needs may be best met by practices based on family‐centred, individualised care principles

Needs of parents in a surgical neonatal intensive care unit

Aim: While there is evidence of parental needs in the neonatal intensive care unit (NICU), parents of newborns admitted for general surgery are an under‐researched population. This study aimed to identify needs in parents of newborns admitted to the NICU for general surgery and whether health‐care professionals meet these needs. Methods: This was a prospective cohort study of 111 parents (57% mothers) of newborns admitted to a surgical NICU for general surgery in Australia from January 2014 to September 2015. Parents completed the Neonatal Family Needs Inventory (NFNI), comprising 56 items in five subscales (Support, Comfort, Information, Proximity, Assurance) at admission and discharge, as well as the Social Desirability Scale (SDS). Data were analysed using parametric and non‐parametric techniques. Results: At both admission and discharge, parents rated Assurance (M = 3.8, standard deviation (SD) = 0.24) needs as the most important, followed by Proximity (M = 3.6, SD = 0.32) and Information (M = 3.5, SD = 0.38). Mothers rated Assurance significantly more important than fathers (P < 0.02). Overall, parents' most important needs were having questions answered honestly (M = 3.96, SD = 0.19), seeing their infant frequently and knowing about the medical treatment (both M = 3.95, SD = 0.23). The 10 most important needs were met for more than 96% of parents, with no evidence of response bias. Conclusions: Reassurance is a priority need for parents in the surgical NICU. Mothers' and fathers' needs may be best met by practices based on family‐centred, individualised care principles

Stressors of parents of infants undergoing neonatal surgery for major non-cardiac congenital anomalies in a surgical neonatal intensive care unit

Aim As more babies survive major neonatal surgery, the quality of life of the whole family is a major focus of health care. While there is evidence suggesting that parents of babies admitted to neonatal intensive care units (NICUs) experience high levels of stress, little is known about stressors in parents whose infants also require neonatal surgery. This study identified fathers' and mothers' stressors in a surgical NICU. Methods Parents of infants admitted for general surgery to the NICU at a tertiary children's hospital from February 2014 to September 2015 were eligible for enrolment. Parents completed the Parental Stressor Scale: NICU to measure levels of stress related to three subscales: sights and sounds, infant appearance and parental role alteration, using a 5-point Likert scale. Results Data for 111 parents (57% mothers) showed parental role alteration as the greatest stressor for parents (M = 2.98, standard deviation (SD) = 0.89), particularly for mothers, followed by infant appearance (M = 2.84, SD = 0.95). Both fathers and mothers rated feeling helpless (M = 4.1, SD = 1.0), unable to protect their baby (M = 4.1, SD = 0.9) and seeing their baby in pain (M = 3.9, SD = 1.2) the most common, most stressful experiences and highest contributors to overall stress in the surgical NICU environment. Conclusion Parental role alteration is the greatest stressor for parents in the surgical NICU. Reducing stress for parents of infants undergoing neonatal surgery requires management of the infant's pain and strategies to support parents in their role in the NICU