scholarly journals A comparative study of mothers of infants hospitalized in an open ward neonatal intensive care unit and a combined pod and single-family room design

2019 ◽  
Author(s):  
Nancy Feeley ◽  
Stephanie Robins ◽  
Christine Genest ◽  
Robyn Stremler ◽  
Phyllis Zelkowitz ◽  
...  

Abstract Background: The well-being of mothers of infants requiring Neonatal Intensive Care Unit (NICU) hospitalization may be affected by the architectural design of the unit. A few recent studies suggest there may be some drawbacks of single-family rooms (SFRs) for infants and their mothers, such as isolation of mothers and reduced exposure to auditory stimulation for infants. Purpose: To compare NICU-stress, symptoms of depression, perceptions of nurse-parent support and family-centered care, sleep disturbances, breastfeeding self-efficacy and readiness for discharge in mothers of infants cared for in an open ward (OW) to those cared for in a unit that includes both pods and SFRs. Methods: A pre-post quasi-experimental study was conducted in a Canadian level 3 unit before and after transitioning to a new unit of 6-bed pods and SFRs. OW data were collected in 2014 and pod/SFR data one year after the transition in 2017 to 2018. Mothers of infants hospitalized for at least 2 weeks completed questionnaires about stress, depressive symptoms, support, family-centered care, and sleep disturbances. In the week prior to discharge, they responded to breastfeeding self-efficacy and readiness for discharge questionnaires. They described their presence in the NICU at enrollment and again prior to discharge. Results: Pod/SFR mothers reported significantly less NICU-stress compared to OW mothers. OW mothers had greater sights and sounds stress and felt more restricted in their parental role. Pod/SFR mothers reported greater respect from staff. Controlling for maternal education, pod/SFR mothers perceived their infant’s readiness for discharge to be greater than OW mothers. There were no significant differences between groups in depressive symptoms, nurse-parent support, sleep disturbances, and breastfeeding self-efficacy. At enrollment and again in the weeks preceding discharge, pod/SFR mothers were present significantly more hours per week than OW mothers, controlling for maternal education. Conclusions: Further study of small pods is indicated as these units may be less stressful for parents, and enhance family-centered care, as well as maternal presence, compared to OWs.

2019 ◽  
Author(s):  
Nancy Feeley ◽  
Stephanie Robins ◽  
Christine Genest ◽  
Robyn Stremler ◽  
Phyllis Zelkowitz ◽  
...  

Abstract Background: The well-being of mothers of infants requiring Neonatal Intensive Care Unit (NICU) hospitalization may be affected by the architectural design of the unit. A few recent studies suggest there may be some drawbacks of single-family rooms (SFRs) for infants and their mothers, such as isolation of mothers and reduced exposure to auditory stimulation for infants. Purpose: To compare NICU-stress, symptoms of depression, perceptions of nurse-parent support and family-centered care, sleep disturbances, breastfeeding self-efficacy and readiness for discharge in mothers of infants cared for in an open ward (OW) to those cared for in a unit that includes both pods and SFRs. Methods: A pre-post quasi-experimental study was conducted in a Canadian level 3 unit before and after transitioning to a new unit of 6-bed pods and SFRs. OW data were collected in 2014 and pod/SFR data one year after the transition in 2017 to 2018. Mothers of infants hospitalized for at least 2 weeks completed questionnaires about stress, depressive symptoms, support, family-centered care, and sleep disturbances. In the week prior to discharge, they responded to breastfeeding self-efficacy and readiness for discharge questionnaires. They described their presence in the NICU at enrolment and again prior to discharge. Results: Pod/SFR mothers reported significantly less NICU-stress compared to OW mothers. OW mothers had greater sights and sounds stress and felt more restricted in their parental role. Pod/SFR mothers reported greater respect from staff. Controlling for maternal education, pod/SFR mothers perceived their infant’s readiness for discharge to be greater than OW mothers. There were no significant differences between groups in depressive symptoms, nurse-parent support, sleep disturbances, and breastfeeding self-efficacy. At enrolment and again in the weeks preceding discharge, pod/SFR mothers were present significantly more hours per week than OW mothers, controlling for maternal education. Conclusions: Further study of small pods is indicated as these units may be less stressful for parents, and enhance family-centered care, as well as maternal presence, compared to OWs.


2019 ◽  
Author(s):  
Nancy Feeley ◽  
Stephanie Robins ◽  
Christine Genest ◽  
Robyn Stremler ◽  
Phyllis Zelkowitz ◽  
...  

Abstract Background: The well-being of mothers of infants requiring Neonatal Intensive Care Unit (NICU) hospitalization may be affected by the architectural design of the unit. A few recent studies suggest there may be some drawbacks of single-family rooms (SFRs) for infants and their mothers, such as isolation of mothers and reduced exposure to auditory stimulation for infants. Purpose: To compare NICU-stress, symptoms of depression, perceptions of nurse-parent support and family-centered care, sleep disturbances, breastfeeding self-efficacy and readiness for discharge in mothers of infants cared for in an open ward (OW) to those cared for in a unit that includes both pods and SFRs. Methods: A pre-post quasi-experimental study was conducted in a Canadian level 3 unit before and after transitioning to a new unit of 6-bed pods and SFRs. OW data were collected in 2014 and pod/SFR data one year after the transition in 2017 to 2018. Mothers of infants hospitalized for at least 2 weeks completed questionnaires about stress, depressive symptoms, support, family-centered care, and sleep disturbances. In the week prior to discharge, they responded to breastfeeding self-efficacy and readiness for discharge questionnaires. They described their presence in the NICU at enrolment and again prior to discharge. Results: Pod/SFR mothers reported significantly less overall NICU-stress compared to OW mothers. OW mothers had greater sights and sounds stress and felt more restricted in their parental role. Pod/SFR mothers reported greater respect from staff. Controlling for maternal education, pod/SFR mothers perceived their infant’s readiness for discharge to be greater than OW mothers. There were no significant differences between groups in depressive symptoms, nurse-parent support, sleep disturbances, and breastfeeding self-efficacy. At enrolment and again in the weeks preceding discharge, pod/SFR mothers were present significantly more hours per week than OW mothers, controlling for maternal education. Conclusions: Further study of small pods is indicated as these units may be less stressful for parents, and enhance family-centered care, as well as maternal presence, compared to OWs.


Author(s):  
Emma Kainiemi ◽  
Pilvi Hongisto ◽  
Liisa Lehtonen ◽  
Bernd Pape ◽  
Anna Axelin

Abstract Objective The aim of this study was to evaluate the effects of a single family room architecture in a neonatal intensive care unit (SFR-NICU) on parents’ presence, parent–infant skin-to-skin contact (SSC) and the quality of family centered care. Study design Two cohorts of parents of preterm infants were compared: those in the unit before and after the move to SFR-NICU. The parents used daily diaries to report their presence and SSC, and they responded to daily text message questions about the quality of family centered care. Results Parents spent more time in the SFR-NICU, but no significant change was found in SSC. Parents rated the quality of family centered care highly in both unit architectures, without a change in rating after the move. Conclusion The SFR-NICU increased parents’ presence but not SSC. The change in architecture did not affect parents’ evaluations of the quality of family centered care, which was already highly rated before the move.


2019 ◽  
Vol 09 (01) ◽  
pp. 016-020
Author(s):  
Haydeh Heidari ◽  
Marjan Mardani-Hamooleh

AbstractFamily-centered care (FCC) is one of the important elements of care in neonatal intensive care units (NICUs). The aim of this study was to understand the nurses' perception of FCC in NICUs. This qualitative study was performed using conventional content analysis. Participants in this study included 18 nurses who were selected by a purposeful method. Semistructured, in-depth and face-to-face interviews were conducted with the participants. All interviews were written down, reviewed, and analyzed. Two categories were identified after the data analysis: (1) prerequisite for providing FCC and (2) parents' participation. Prerequisite for providing FCC consisted of two subcategories namely suitable facilities and adequate personnel. Parents' participation included subcategories of parents: neonate's attachment and parents' training. Nurses' perception of FCC in NICUs can facilitate an appropriate condition for the participation of family members in the care of neonates.


PEDIATRICS ◽  
2003 ◽  
Vol 111 (Supplement_E1) ◽  
pp. e450-e460
Author(s):  
Kimberly A. Cisneros Moore ◽  
Kara Coker ◽  
Allison B. DuBuisson ◽  
Betsy Swett ◽  
William H. Edwards

Objective. Multidisciplinary teams from 11 medical center neonatal intensive care units collaborated in a quality improvement project with a focus on family-centered care. Methods. Through a process of self-analysis, literature review, benchmarking site visits, and expert consultation, 10 potentially better practice (PBP) areas were defined. Improvement activities in 4 of the 10 areas are given as examples of successes and challenges that individual centers encountered. The 4 areas are vision and philosophy, unit culture, family participation in care, and families as advisors. Results. Centers were at different places for all of the PBPs at the beginning and throughout the collaboration. Seven centers developed or revised their vision or philosophy of care statements about family-centered care. Incorporating the vision and philosophy of care into performance appraisals, hiring of new personnel, and changing unit culture to a more family-centered practice were more challenging than developing the statements. Full parent participation in care requires unrestricted access to the neonatal intensive care unit. The shift from considering parents to be “visitors” to being partners in caring for their child was more difficult for centers with restricted visitation policies. All centers developed, expanded, or started plans for establishing family advisory councils. The experience of 2 centers is described. Conclusions. Family-centered care is more of a journey than a destination. Collaborating centers in this project found themselves at different places in that journey. Through perseverance in implementing the PBPs, all have moved further along the path.


Author(s):  
Flávia Simphronio Balbino ◽  
Maria Magda Ferreira Gomes Balieiro ◽  
Myriam Aparecida Mandetta

ABSTRACT Objective: to evaluate the effects of the implementation of the Patient and Family-Centered Care Model on parents and healthcare perceptions and parental stress. Method: a quasi-experimental study developed in a neonatal unit of a university hospital in the municipality of São Paulo, Brazil, with the implementation of this model of care. Data collection were performed by two sample groups, one using non-equivalent groups of parents, and another using equivalent groups of healthcare professionals. The instruments Perceptions of Family-Centered Care-Parent Brazilian Version, Perceptions of Family-Centered Care-Staff Brazilian Version and Parental Stress Scale: Neonatal Intensive Care Unit, were applied to 132 parents of newborns hospitalized and to 57 professionals. Results: there was a statistically significant improvement in the perceptions of the parents in most items assessed (p ≤0,05) and for the staff in relation to the family welcome in the neonatal unit (p = 0.041) and to the comprehension of the family's experience with the infant´s hospitalization (p = 0,050). There was a reduction in the average scores of parental stress, with a greater decrease in the Alteration in Parental Role from 4,2 to 3,8 (p = 0,048). Conclusion: the interventions improved the perceptions of parents and healthcare team related to patient and family-centered care and contributed to reducing parental stress.


Rev Rene ◽  
2019 ◽  
Vol 20 ◽  
pp. e39767 ◽  
Author(s):  
Bruna Caroline Rodrigues ◽  
Roberta Tognollo Borotta Uema ◽  
Gabrieli Patrício Rissi ◽  
Larissa Carolina Segantini Felipin ◽  
Ieda Harumi Higarashi

PEDIATRICS ◽  
2003 ◽  
Vol 111 (Supplement_E1) ◽  
pp. e437-e449
Author(s):  
Roger P. Saunders ◽  
Marie R. Abraham ◽  
Mary Jo Crosby ◽  
Karen Thomas ◽  
William H. Edwards

Objective. Technological and scientific advances have progressively decreased neonatal morbidity and mortality. Less attention has been given to meeting the psychosocial needs of the infant and family than on meeting the infant’s physical needs. Parents’ participation in making decisions and caring for their child has often been limited. Environments designed for efficient technological care may not be optimal for nurturing the growth and development of sick neonates or their families. Eleven centers collaborating on quality improvement tried to make the care of families better by focusing on understanding and improving family-centered care. Methods. Through internal process analysis, review of the evidence, collaborative learning, and benchmarking site visits to centers of excellence in family-centered care, a list of potentially better practices was developed. Choice of which practices to implement and methods of implementation were center specific. Improvement goals were in 3 areas: parent-reported outcomes, staff beliefs and practices, and clinical outcomes in length of stay and feeding practices. Measurement tools for the first 2 areas were developed and pilots were conducted. Results. Length of stay and feeding outcomes were not different before the collaboration (1998) and at the formal end of the collaboration (2000). Conclusions. Prospective parent-reported outcomes are being collected, and the staff beliefs and practices questionnaire will be repeated in all centers to determine the impact of the project in those areas.


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