Journal of Qualitative Research in Health Sciences
Journal of Qualitative Research in Health Sciences

Investigating the Strategic Elements of Family-Centered Care in the Neonatal Intensive Care Unit: A Qualitative Study

Document Type : Original Article

Authors

niloofar hajiaraghi 1
narges sadeghi 2
minoo motaghi 2
mahsasadat mousavi 2

1 M.Sc. in Pediatric Nursing, Community Health Research Center, Islamic Azad University, Isfahan Branch (Khorasgan), Isfahan, Iran

2 Assistant Professor, Community Health Research Center, Islamic Azad University, Isfahan Branch (Khorasgan), Isfahan, Iran

https://doi.org/10.22062/jqr.2021.193611.0
Abstract
Introduction: The family is an integral part of the health care team. Focusing on family-centered care in neonatal intensive care units (NICUs) involves using strategies to support families by supporting parental involvement in NICUs. Accordingly, the present study aimed to examine the strategic elements of family-centered care in NICUs.
Methods: The present study was conducted using conventional qualitative content analysis based on Graneheim and Lundman’s approach and purposive sampling. This study was conducted in NICUs of Isfahan hospitals in 2018. The data were collected through unstructured face-to-face interviews with 15 participants including parents and NICU staff.  The collected data were encoded and analyzed through Microsoft Word Office and OneNote 2010.
Results: The analysis of the data revealed 3 main themes and 7 subthemes related to the strategic elements of family-centered care. The extracted themes (and subthemes) were: (1) Family and care (family involvement in the care process, the interaction between the medical staff and the family), (2) Parental characteristics in care (the mother as the core element of care, the father’s role in care), (3) Family needs (the need of the family for information, the importance of family preparation, the family’s need for spiritual support).
Conclusion: The present study revealed the key elements of the structure of family-centered care from the perspective of families and medical staff. The findings of this study also highlighted the role of the family in caring for patients and meeting their needs. Accordingly, measures should be taken to improve the quality of family-centered care by taking into account the strengths of this strategy.

Keywords

Family-centered care
Neonatal intensive care unit
Parents
Qualitative study
  1. Kenner C, Press J, Ryan D. Recommendations for palliative and bereavement care in the NICU: a family-centered integrative approach. J Perinatol 2015; 35(S1):S19-23. doi: 10.1038/jp.2015.145.
  2. Nouhi E, Karbalaizadeh M, Abazari F. The effect of mothers' participation and the family-centered care on mother's anxiety with children suffering from gastrointestinal infections: a randomized clinical trial. Journal of Clinical Nursing and Midwifery 2015; 3(4):47-55. [In Persian].
  3. Brelsford GM, Ramirez J, Veneman K, Doheny KK. Religious and secular coping and family relationships in the neonatal intensive care unit. Adv Neonatal Care 2016; 16(4):315-22. doi: 10.1097/ANC.0000000000000263.
  4. Craig JW, Glick C, Phillips R, Hall SL, Smith J, Browne J. Recommendations for involving the family in developmental care of the NICU baby. J Perinatol 2015; 35(S1): S5-8. doi: 10.1038/jp.2015.142.
  5. Hendson L, Reis MD, Nicholas DB. Health care providers’ perspectives of providing culturally competent care in the NICU. J Obstet Gynecol Neonatal Nurs 2015; 44(1):17-27. doi: 10.1111/1552-6909.12524.
  6. Roque AT, Lasiuk GC, Radünz V, Hegadoren K. Scoping review of the mental health of parents of infants in the NICU. J Obstet Gynecol Neonatal Nurs 2017; 46(4):576-87. doi: 10.1016/j. jogn.2017.02.005.
  7. Hall SL, Ryan DJ, Beatty J, Grubbs L. Recommendations for peer-to-peer support for NICU parents. J Perinatol 2015; 35(S1):S9-13. doi: 10.1038/jp.2015.143.
  8. Verklan MT, Walden M. Core Curriculum for Neonatal Intensive Care Nursing. 6th ed. USA: Elsevier; 2020.
  9. Aran A, Abazari F, Farokhzadian J, Azizzadeh Forouzi M. Comparing the perception of family-centered care from the perspectives of nursing staff and mothers of hospitalized children in children’s wards. Hayat 2018; 24(1):48-58. [In Persian].
  10. Mirlashari J, Sadeghi T, Sagheb S, Khanmohammad zadeh T. Nurses' and physicians' perspectives about barriers to implement family centered care in Neonatal Intensive Care Units. Iran Journal of Nursing 2015; 28(93):140-50. doi: 10.29252/ijn.
    28.93.94.140. [In Persian].
  11. Abedi H, Abbaszadeh A, Motaghi M. Factors influencing school health in elementary schools in Isfahan, Iran: a qualitative study. Int J Community Based Nurs Midwifery 2016; 4(4):352-62.
  12. Ghaljaei F, Goli H, Rezaee N, Sadeghi N. Spiritual challenges experienced by nurses in neonatal end of life: a qualitative study. International Journal of Pediatrics 2018; 6(9):8161-75. doi: 10.22038/ijp.2018.28630.2511.
  13. Coats H, Bourget E, Starks H, Lindhorst T, Saiki-Craighill S, Curtis JR, et al. Nurses’ reflections on benefits and challenges of implementing family-centered care in pediatric intensive care units. Am J Crit Care 2018; 27(1):52-8. doi: 10.4037/ajcc2018353.
  14. Aloysius A, Kharusi M, Winter R, Platonos K, Banerjee J, Deierl A. Support for families beyond discharge from the NICU. Journal of Neonatal Nursing 2018; 24(1):55-60. doi: 10.1016/j. jnn.2017.11.013.
  15. Purdy IB, Craig JW, Zeanah P. NICU discharge planning and beyond: recommendations for parent psychosocial support. J Perinatol 2015; 35(S1):S24-8. doi: 10.1038/jp.2015.146.
  16. Li XY, Lee S, Yu HF, Ye XY, Warre R, Liu XH, et al. Breaking down barriers: enabling care-by-parent in neonatal intensive care units in China. World J Pediatr 2017; 13(2):144-51. doi: 10.1007/s12519-016-0072-4.
  17. Aliabadi F, Kamali M, Borimnejad L, Rassafiani M, Rasti M, Shafaroodi N, et al. Supporting-emotional needs of Iranian parents with premature infants admitted to Neonatal Intensive Care Units. Med J Islam Repub Iran 2014; 28:53.
  18. Fleury C, Parpinelli MA, Makuch MY. Perceptions and actions of healthcare professionals regarding the mother-child relationship with premature babies in an intermediate neonatal intensive care unit: a qualitative study. BMC Pregnancy Childbirth 2014; 14:313. doi: 10.1186/1471-2393-14-313.
  19. Wigert H, Blom MD, Bry K. Parents’ experiences of communication with neonatal intensive-care unit staff: an interview study. BMC Pediatr 2014; 14:304. doi: 10.1186/s12887-014-0304-5.
  20. Macdonell K, Omrin D, Pytlik K, Pezzullo S, Bracht M, Diambomba Y. An effective communication initiative: using parents' experiences to improve the delivery of difficult news in the NICU. Journal of Neonatal Nursing 2015; 21(4):142-9. doi: 10.1016/j.jnn.2015. 01.002.
  21. Kalhor M, Samiee Rad F, Garshasbi M, Mohit Abadi Z, Sefollah S. Evaluating the effect of mother-baby skin-to-skin care on neonatal outcomes in preterm infants. Journal of Shahid Sadoughi University of Medical sciences 2016; 24(5):375-86. [In Persian].
  22. Arzani A, Valizadeh L, Zamanzadeh V, Mohammadi E. Mothers' experiences of caring for prematurely born infants: growth sparks in the face of caregiver burden. Journal of Qualitative Research in Health Sciences 2014; 3(3):217-29. [In Persian].
  23. Warre R, O’Brien K, Lee SK. Parents as the primary caregivers for their infant in the NICU: benefits and challenges. NeoReviews 2014; 15(11):e472-7. doi: 10.1542/neo.15-11-e472.
  24. McGowan EC, Du N, Hawes K, Tucker R, O'Donnell M, Vohr B. Maternal mental health and neonatal intensive care unit discharge readiness in mothers of preterm infants. J Pediatr 2017; 184:68-74. doi: 10.1016/j.jpeds.2017.01.052.
  25. Prouhet PM, Gregory MR, Russell CL, Yaeger LH. Fathers' stress in the neonatal intensive care unit: A systematic review. Adv Neonatal Care 2018; 18(2):105-20. doi: 10.1097/ANC. 0000000000000472.
  26. Ionio C, Colombo C, Brazzoduro V, Mascheroni E, Confalonieri E, Castoldi F, et al. Mothers and fathers in NICU: the impact of preterm birth on parental distress. Eur J Psychol 2016; 12(4):604-21. doi: 10.5964/ejop.v12i4.1093.
  27. Kim MA, Kim SJ, Cho H. Effects of tactile stimulation by fathers on physiological responses and paternal attachment in infants in the NICU: a pilot study. J Child Health Care 2017; 21(1):36-45. doi: 10.1177/1367493516666729.
  28. Sadeghi N, Hasanpour M, Heidarzadeh M. Information and communication needs of parents in infant end-of-life: a qualitative study. Iran Red Crescent Med J 2016; 18(6) e25665. doi: 10.5812/ircmj.25665.
  29. Wang L, He JL, Fei SL. Perceived needs of parents of premature infants in NICU. Western Journal of Nursing Research 2018; 40(5):688-700. doi: 10.1177/0193945916683679.
  30. Modé RI, Mard E, Nyqvist KH, Blomqvist YT. Fathers’ perception of information received during their infants’ stay at a neonatal intensive care unit. Sex Reprod Healthc 2014; 5(3):131-6. doi: 10.1016/j.srhc. 2014.05.001.
  31. Lake ET, Hallowell SG, Kutney-Lee A, Hatfield LA, Del Guidice M, Boxer B, et al. Higher quality of care and patient safety associated with better NICU work environments. J Nurs Care Qual 2016; 31(1):24-32. doi: 10.1097/NCQ.0000000000000146.
  32. Larsson C, Wågström U, Normann E, Thernström Blomqvist Y. Parents experiences of discharge readiness from a Swedish neonatal intensive care unit. Nurs Open 2017; 4(2):90-5. doi: 10.1002/nop2.71.
  33. Abdeyazdan Z, Shahkolahi Z, Mehrabi T, Hajiheidari M. A family support intervention to reduce stress among parents of preterm infants in the neonatal intensive care unit. Iran J Nurs Midwifery Res 2014; 19(4):349-53.
  34. Milford CA. Care of the family of an infant with a congenital heart defect during the NICU hospitalization. J Perinat Neonatal Nurs 2016; 30(1):64-7. doi: 10.1097/JPN.0000000000000155.
  35. Penny KA, Friedman SH, Halstead GM. Psychiatric support for mothers in the neonatal intensive care unit. J Perinatol 2015; 35(6):451-7. doi: 10.1038/jp.2014.221.

 

 

Journal of Qualitative Research in Health Sciences
Volume 10, Issue 2
Spring 2021
Pages 65-74

  • Receive Date 21 April 2019
  • Accept Date 19 November 2019

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