Evaluating the effect of Family Integrated Care on maternal stress and anxiety in neonatal intensive care units

Background: Family Integrated Care (FICare) integrates parents in the direct care of their child while the healthcare personnel act as teachers and guides. To this date, most reports on the feasibility of this model refer to stable preterm infants admitted to Neonatal Intensive Care Units (NICUs).Objectives: To scale up and adapt FICare to make it suitable in level IIIC NICUs, which care for extreme prematurity and other complex medical or surgical neonatal conditions.Materials and Methods: Step 1 was the creation of the FICare implementation team (FICare-IT) and baseline analysis of current procedures for critical care to identify needs, wishes, and requirements; we aimed for protocol elaboration tailored to our cultural, architectural, and clinical context (March 2017 to April 2018). Step 2 as a dissemination strategy by FICare-IT acting as primary trainers and mentors to ensure the education of 90% of nursing staff (May 2018 to July 2018). Step 3 involved piloting and evaluation with the aim to refine the procedure (July 2018 to December 2020).Results: A rigorous but flexible protocol was edited. The FICare educational manual included two curricula: for healthcare professionals/staff (Training the trainers) and for families (Education of caregivers), the latter being categorized in two intervention levels (basic and advanced), depending on the infant care needs and parent's decision. In total, 76 families and 91 infants (74.7% preterm; 18.7% complex surgery; 6.6% others) were enrolled in the pilot. No differences in acceptance rate (overall 86.4%) or in the number of infant-family dyads in the program per month were observed when considering the pre- and post-Covid-19 pandemic periods. All families, except for one who dropped out of the program, completed the agreed individualized training. Mothers spent more time in NICU than fathers (p < 0.05); uninterrupted time spent by mothers in NICU was longer during the pre-pandemic period (p < 0.01). Observed time to reach proficiency by task was within the expected time in 70% of the program contents. The parents revealed educational manuals, workshops, and cot-side teaching sessions as essential for their training, and 100% said they would accept entry into the FICare program again.Conclusions: The principles of the FICare model are suitable for all levels of care in NICUs. Leadership and continuous evaluation/refinement of implementation procedures are essential components to achieve the objectives.

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The Perceptions and Experiences of Parents and Families of Preterm Infants Who Participate in Family Integrated Care Programs in Neonatal Intensive Care Units: A Qualitative Systematic Review Protocol

10.21203/rs.3.rs-509989/v1 ◽

2021 ◽

Author(s):

Rebecca Anne Carman ◽

Claire Adams ◽

Mary Sharp ◽

Daniel McAullay ◽

Rhonda Marriott ◽

...

Keyword(s):

Systematic Review ◽

Intensive Care ◽

Integrated Care ◽

Preterm Infants ◽

Neonatal Intensive Care ◽

Care Program ◽

The Family ◽

Full Text Review ◽

Family Integrated Care ◽

Family Integrated

Abstract BackgroundThe premature birth of an infant coupled with admission to a Neonatal Intensive Care Unit (NICU) can pose complex psychosocial challenges to parents and the family unit. Measures designed to counteract the effects of restricted visitation and prolonged separation from the infant within the NICU setting have led to the development of the Family Integrated Care model; emphasis in this program is placed on the active participation of the parent alongside the healthcare team in providing direct care to the preterm infant. The aim of this systematic review is to explore the perceptions and experiences of parents and families of preterm infants who have used a Family Integrated Care program during hospitalisation in a NICU. MethodsA systematic literature search will be performed on six electronic databases (Medline, CINAHL, Embase, PsycINFO, Web of Science, and Scopus) to identify relevant articles which meet the a priori inclusion criteria. A hand-search of the reference lists of all articles taken to full text review will supplement the search. The search will be limited to peer-reviewed, primary research articles written in English only; nil publication date restrictions will be applied. Two independent reviewers will screen all retrieved articles, perform the full-text review, critically appraise the included articles, and extract the data. Where consensus cannot be reached, a third reviewer will be consulted. To assess the quality of included studies and the risk of bias, the Critical Appraisal Skills Programme checklist will be used. Data will be extracted using a data extraction tool developed by the review team and piloted for use by two independent reviewers. A thematic analysis and narrative synthesis of the review findings will follow. DiscussionThis review will importantly describe the experiences of parents and families of preterm infants using a Family Integrated Care program delivered within a NICU; review findings will be used to inform the associated program protocols in a Perth (Western Australia) based NICU and be disseminated via a peer-reviewed publication. Systematic review registration: PROSPERO, Submission ID: 243818.

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