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Meiers S, de Goumoëns V, Thirsk L, Abbott-Anderson K, Brysiewicz P, Eggenberger S, Heitschmidt M, Kiszio B, Mcandrew NS, Morman A, Richardson S. Nursing strategies to mitigate separation between hospitalized acute and critical care patients and families: A scoping review. Intensive Crit Care Nurs 2024; 84:103773. [PMID: 39067380 DOI: 10.1016/j.iccn.2024.103773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Revised: 07/08/2024] [Accepted: 07/10/2024] [Indexed: 07/30/2024]
Abstract
OBJECTIVE To describe the nursing strategies used to mitigate the impact of forced separation between hospitalized acute and critical care patients and their families during the COVID-19 pandemic. RESEARCH METHODOLOGY/DESIGN A scoping review was performed in accordance with JBI methodology. SETTINGS Those acute and critical care areas in which sudden, often unexpected, emergent episodes of illness or injury were treated. MAIN OUTCOME MEASURES Articles written in English and French between March 2020 and September 2023 in Medline, CINAHL Complete, APA PsycInfo, Embase and the Cochrane COVID-19 study register databases that met our inclusion criteria were included. Gray literature included dissertations, theses and Base Bielefeld Academic Search Engines. RESULTS Among the 1,357 articles screened, 46 met the criteria for inclusion. Most of the articles were published in North America. Adult critical care units were the most frequently reported settings, followed by neonatal intensive care units. The most frequently reported strategies were virtual telephone or video communications. A majority of the innovative strategies involved interprofessional collaboration at the unit level. Core components included the provision of relational nursing practices, virtual visits, tailored information, fostering relationships between family members, palliative care support regarding end of life, and general information about hospitalization and COVID-19. Pediatric care settings were more likely than adult care settings to accommodate physical visitation. CONCLUSION Nurses used synchronous, episodic, and structured virtual interactions, either alone or as part of an interprofessional team, to mitigate separation between patients and families during the COVID-19 pandemic in acute and critical care settings. IMPLICATIONS FOR CLINICAL PRACTICE Permanent policy changes are needed across acute and critical care settings to provide support for nurses in mitigating patient and family separation. We recommend that family members be considered as caregivers and care receivers, not visitors in patient and family-centered care in acute and critical care settings.
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Affiliation(s)
- Sonja Meiers
- College of Nursing, University of Wisconsin-Eau Claire, 105 Garfield Ave, P.O. Box 4004, Eau Claire, WI 54702-4004, USA; Department of Graduate Nursing, Winona State University, 400 South Broadway, Suite 204, Rochester, MN 55904, USA.
| | - Véronique de Goumoëns
- La Source School of Nursing, HES-SO, University of Applied Sciences and Arts Western Switzerland, Av. Vinet 30, Lausanne, Switzerland; Bureau d'Echange des Savoirs pour des praTiques exemplaires de soins (BEST) a JBI Center of Excellence, Avenue Alexandra Vinet 30 - 1004, Lausanne, Switzerland.
| | - Lorraine Thirsk
- Faculty of Health Disciplines, Athabasca University, 1 University Drive, Athabasca, Alberta T9S 3A3, Canada.
| | - Kristen Abbott-Anderson
- College of Nursing, University of Wisconsin-Eau Claire, 105 Garfield Ave, P.O. Box 4004, Eau Claire, WI 54702-4004, USA.
| | - Petra Brysiewicz
- School of Nursing & Public Health, University of KwaZulu-Natal, Mazisi Kunene Road, Glenwood, Durban 4041, South Africa.
| | - Sandra Eggenberger
- Glen Taylor Nursing Institute for Family and Society, Minnesota State University, 360 Wissink Hall (WH 360), Mankato, Mankato, MN, USA.
| | - Mary Heitschmidt
- RUSH System for Health, Center for Clinical Research and Scholarship, 600 South Paulina, Suite 1080 AAC, Chicago, IL 60612, USA; Rush College of Nursing, 600 South Paulina, Suite 1080 AAC, Chicago, IL 60612, USA.
| | - Blanche Kiszio
- La Source School of Nursing, HES-SO, University of Applied Sciences and Arts Western Switzerland, Av. Vinet 30, Lausanne, Switzerland; Bureau d'Echange des Savoirs pour des praTiques exemplaires de soins (BEST) a JBI Center of Excellence, Avenue Alexandra Vinet 30 - 1004, Lausanne, Switzerland.
| | - Natalie S Mcandrew
- School of Nursing, College of Health Professions & Sciences, University of Wisconsin-Milwaukee, 1921 East Hartford Avenue, Milwaukee, WI 53211, USA; Department of Patient Care Research, Froedtert & the Medical College of Wisconsin, Froedtert Hospital, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, USA.
| | - Aspen Morman
- College of Nursing, University of Wisconsin-Eau Claire, 105 Garfield Ave, P.O. Box 4004, Eau Claire, WI 54702-4004, USA.
| | - Sandra Richardson
- Emergency Department, Christchurch Hospital, Canterbury - Te Waipounamu - Waitaha, Health New Zealand - Te Whatu Ora, New Zealand.
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Bansal S, Molloy EJ, Rogers E, Bidegain M, Pilon B, Hurley T, Lemmon ME. Families as partners in neonatal neuro-critical care programs. Pediatr Res 2024; 96:912-921. [PMID: 38886506 DOI: 10.1038/s41390-024-03257-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 04/07/2024] [Accepted: 04/15/2024] [Indexed: 06/20/2024]
Abstract
Parents of neonates with neurologic conditions face a specific breadth of emotional, logistical, and social challenges, including difficulties coping with prognostic uncertainty, the need to make complex medical decisions, and navigating new hopes and fears. These challenges place parents in a vulnerable position and at risk of developing mental health issues, which can interfere with bonding and caring for their neonate, as well as compromise their neonate's long-term neurodevelopment. To optimize neurologic and developmental outcomes, emerging neonatal neuro-critical care (NNCC) programs must concurrently attend to the unique needs of the developing newborn brain and of his/her parents. This can only be accomplished by embracing a family-centered care environment-one which prioritizes effective parent-clinician communication, longitudinal parent support, and parents as equitable partners in clinical care. NNCC programs offer a multifaceted approach to critical care for neonates at-risk for neurodevelopmental impairments, integrating expertise in neonatology and neurology. This review highlights evidence-based strategies to guide NNCC programs in developing a family-partnered approach to care, including primary staffing models; staff communication, implicit bias, and cultural competency trainings; comprehensive and tailored caregiver training; single-family rooms; flexible visitation policies; colocalized neonatal and maternal care; uniform mental health screenings; follow-up care referrals; and connections to peer support. IMPACT: Parents of neonates with neurologic conditions are at high-risk for experiencing mental health issues, which can adversely impact the parent-neonate relationship and long-term neurodevelopmental outcomes of their neonates. While guidelines to promote families as partners in the neonatal intensive care unit (NICU) have been developed, no protocols integrate the unique needs of parents in neonatal neurologic populations. A holistic approach that makes families true partners in the care of their neonate with a neurologic condition in the NICU has the potential to improve mental and physical well-being for both parents and neonates.
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Affiliation(s)
- Simran Bansal
- Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA
| | - Eleanor J Molloy
- Paediatric Research Laboratory, Trinity Translational Medicine Institute (TTMI), St. James' Hospital, Dublin, Ireland
- Discipline of Paediatrics, Dublin Trinity College, The University of Dublin, Dublin, Ireland
- Trinity Research in Childhood Centre (TriCC), Children's Health Ireland & Coombe Hospital, Dublin, Ireland
| | - Elizabeth Rogers
- Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA
| | - Margarita Bidegain
- Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA
| | | | - Tim Hurley
- Paediatric Research Laboratory, Trinity Translational Medicine Institute (TTMI), St. James' Hospital, Dublin, Ireland
- Discipline of Paediatrics, Dublin Trinity College, The University of Dublin, Dublin, Ireland
| | - Monica E Lemmon
- Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA.
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA.
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Edwards G, O'Shea JE. Is telemedicine suitable for remotely supporting non-tertiary units in providing emergency care to unwell newborns? Arch Dis Child 2023; 109:5-10. [PMID: 37438088 DOI: 10.1136/archdischild-2022-325057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 05/08/2023] [Indexed: 07/14/2023]
Abstract
Although the majority of term infants will breathe spontaneously at birth, the requirement for advanced resuscitation can be unpredictable, as can the precipitous delivery of an extremely preterm infant in a non-tertiary neonatal unit. Infants born in hospitals without a tertiary neonatal intensive care unit have a higher mortality which is a disparity that has been difficult to resolve.Telemedicine, the use of videoconferencing software to connect those at the scene of a resuscitation to a remote clinician, can allow for real-time two-way communication between a local unit and a tertiary neonatal specialist. It has been present for some time in neonatology to provide secure video messaging with families and its use in neonatal acute care and resuscitation has been growing in recent years.We sought to perform a review of the current evidence available on the use of telemedicine in neonatal resuscitation. Studies demonstrate improved quality of resuscitation, improved adherence to resuscitation guidelines and positive experiences reported by local and tertiary teams. Suitable technology needs to be available to establish a rapid and secure video connection, as does adequate availability of experienced neonatologists to provide remote guidance. Telemedicine is an exciting and emerging tool which is being developed as a standard of care in units which have piloted it.
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Affiliation(s)
- Gemma Edwards
- Neonatal Unit, Princess Royal Maternity Hospital, Glasgow, UK
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Bourque SL, Williams VN, Scott J, Hwang SS. The Role of Distance from Home to Hospital on Parental Experience in the NICU: A Qualitative Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1576. [PMID: 37761537 PMCID: PMC10529472 DOI: 10.3390/children10091576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 09/03/2023] [Accepted: 09/19/2023] [Indexed: 09/29/2023]
Abstract
Prolonged admission to the neonatal intensive care unit presents challenges for families, especially those displaced far from home. Understanding specific barriers to parental engagement in the NICU is key to addressing these challenges with hospital-based interventions. The objective of this qualitative study was to explore the impact of distance from home to hospital on the engagement of parents of very preterm infants (VPT) in the neonatal intensive care unit (NICU). We used a grounded theory approach and conducted 13 qualitative interviews with parents of VPT who were admitted ≥14 days and resided ≥50 miles away using a semi-structured interview guide informed by the socio-ecological framework. We used constant comparative method with double coders for theme emergence. Our results highlight a multitude of facilitators and barriers to engagement. Facilitators included: (1) individual-delivery preparedness and social support; (2) environmental-medical team relationships; and (3) societal-access to perinatal care. Barriers included: (1) individual-transfer stressors, medical needs, mental health, and dependents; (2) environmental-NICU space, communication, and lack of technology; and (3) societal-lack of paid leave. NICU parents with geographic separation from home experienced a multitude of barriers to engagement, many of which could be addressed by hospital-based interventions.
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Affiliation(s)
- Stephanie L. Bourque
- Department of Pediatrics, Section of Neonatology, University of Colorado School of Medicine, Aurora, CO 80045, USA; (J.S.); (S.S.H.)
| | - Venice N. Williams
- Department of Pediatrics, Prevention Research Center for Family & Child Health, University of Colorado School of Medicine, Aurora, CO 80045, USA;
| | - Jessica Scott
- Department of Pediatrics, Section of Neonatology, University of Colorado School of Medicine, Aurora, CO 80045, USA; (J.S.); (S.S.H.)
| | - Sunah S. Hwang
- Department of Pediatrics, Section of Neonatology, University of Colorado School of Medicine, Aurora, CO 80045, USA; (J.S.); (S.S.H.)
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Bott S, Dantas Fernandez N, Narciso J, MacAlpine J, Quain N, Rettie J, Sharpe L, Diambomba Y, Al Bizri A, O’Brien K, Shah V. Building Connections with Families: Implementation of a Video-Messaging Service in the Neonatal Intensive Care Unit. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1338. [PMID: 37628337 PMCID: PMC10453278 DOI: 10.3390/children10081338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/14/2023] [Accepted: 07/27/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Family involvement is vital to optimize the care of infants in the neonatal intensive care unit (NICU). Various technologies have been used to support communication with parents in the NICU. The purpose of this study was to evaluate the parent and staff experience and perception of the use of a cloud-based video-messaging service in our NICU. METHODS This study was a single center observational study conducted at Mount Sinai Hospital, Toronto, Canada. Following the implementation of a video-messaging service, parent and staff surveys were distributed to evaluate their experience and perception. RESULTS Parent responses were positive with respect to how the service helped them feel: closer to their infant (100%) and reassured about their infant's care (100%). Nursing staff responses indicated that they perceived a benefit to parents (100%) and to their building a relationship with families (79%). However, they also identified time constraints (85%) and the use of the technology hardware (24%) as challenges. CONCLUSIONS The use of an asynchronous video-messaging service was perceived as beneficial to both parents and staff in the NICU. Complaints pertained to the impact of the technology on nursing workflow and the difficulty using the hardware provided for use of the service.
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Affiliation(s)
- Stephanie Bott
- Department of Nursing, Mount Sinai Hospital, 600 University Avenue, Toronto, ON M5G 1X5, Canada; (S.B.); (N.D.F.); (J.N.); (J.M.)
| | - Nicole Dantas Fernandez
- Department of Nursing, Mount Sinai Hospital, 600 University Avenue, Toronto, ON M5G 1X5, Canada; (S.B.); (N.D.F.); (J.N.); (J.M.)
| | - Janet Narciso
- Department of Nursing, Mount Sinai Hospital, 600 University Avenue, Toronto, ON M5G 1X5, Canada; (S.B.); (N.D.F.); (J.N.); (J.M.)
| | - Janet MacAlpine
- Department of Nursing, Mount Sinai Hospital, 600 University Avenue, Toronto, ON M5G 1X5, Canada; (S.B.); (N.D.F.); (J.N.); (J.M.)
| | - Nicole Quain
- Department of Paediatrics, Mount Sinai Hospital, 600 University Avenue, Toronto, ON M5G 1X5, Canada; (N.Q.); (J.R.); (L.S.); (Y.D.); (A.A.B.); (V.S.)
| | - Julia Rettie
- Department of Paediatrics, Mount Sinai Hospital, 600 University Avenue, Toronto, ON M5G 1X5, Canada; (N.Q.); (J.R.); (L.S.); (Y.D.); (A.A.B.); (V.S.)
| | - Lia Sharpe
- Department of Paediatrics, Mount Sinai Hospital, 600 University Avenue, Toronto, ON M5G 1X5, Canada; (N.Q.); (J.R.); (L.S.); (Y.D.); (A.A.B.); (V.S.)
| | - Yenge Diambomba
- Department of Paediatrics, Mount Sinai Hospital, 600 University Avenue, Toronto, ON M5G 1X5, Canada; (N.Q.); (J.R.); (L.S.); (Y.D.); (A.A.B.); (V.S.)
| | - Ayah Al Bizri
- Department of Paediatrics, Mount Sinai Hospital, 600 University Avenue, Toronto, ON M5G 1X5, Canada; (N.Q.); (J.R.); (L.S.); (Y.D.); (A.A.B.); (V.S.)
| | - Karel O’Brien
- Department of Paediatrics, Mount Sinai Hospital, 600 University Avenue, Toronto, ON M5G 1X5, Canada; (N.Q.); (J.R.); (L.S.); (Y.D.); (A.A.B.); (V.S.)
| | - Vibhuti Shah
- Department of Paediatrics, Mount Sinai Hospital, 600 University Avenue, Toronto, ON M5G 1X5, Canada; (N.Q.); (J.R.); (L.S.); (Y.D.); (A.A.B.); (V.S.)
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Monti L, Marconi E, Bocci MG, Kotzalidis GD, Mazza M, Galliani C, Tranquilli S, Vento G, Conti G, Sani G, Antonelli M, Chieffo DPR. COVID-19 pandemic in the intensive care unit: Psychological implications and interventions, a systematic review. World J Psychiatry 2023; 13:191-217. [PMID: 37123099 PMCID: PMC10130962 DOI: 10.5498/wjp.v13.i4.191] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 02/06/2023] [Accepted: 03/27/2023] [Indexed: 04/18/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic produced changes in intensive care units (ICUs) in patient care and health organizations. The pandemic event increased patients’ risk of developing psychological symptoms during and after hospitalisation. These consequences also affected those family members who could not access the hospital. In addition, the initial lack of knowledge about the virus and its management, the climate of fear and uncertainty, the increased workload and the risk of becoming infected and being contagious, had a strong impact on healthcare staff and organizations. This highlighted the importance of interventions aimed at providing psychological support to ICUs, involving patients, their relatives, and the staff; this might involve the reorganisation of the daily routine and rearrangement of ICU staff duties.
AIM To conduct a systematic review of psychological issues in ICUs during the COVID-19 pandemic involving patients, their relatives, and ICU staff.
METHODS We investigated the PubMed and the ClinicalTrials.gov databases and found 65 eligible articles, upon which we commented.
RESULTS Our results point to increased perceived stress and psychological distress in staff, patients and their relatives and increased worry for being infected with severe acute respiratory syndrome coronavirus-2 in patients and relatives. Furthermore, promising results were obtained for some psychological programmes aiming at improving psychological measures in all ICU categories.
CONCLUSION As the pandemic limited direct inter-individual interactions, the role of interventions using digital tools and virtual reality is becoming increasingly important. All considered, our results indicate an essential role for psychologists in ICUs.
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Affiliation(s)
- Laura Monti
- UOS Psicologia Clinica, Governo Clinico, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
| | - Elisa Marconi
- UOS Psicologia Clinica, Governo Clinico, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
| | - Maria Grazia Bocci
- UOC Anestesia, Rianimazione, Terapia Intensiva e Tossicologia Clinica, Dipartimento di Scienze Dell’Emergenza, Anestesiologiche e Della Rianimazione, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
| | - Georgios Demetrios Kotzalidis
- UOC Psichiatria Clinica e d’Urgenza, Dipartimento di Scienze Dell’Invecchiamento, Neurologiche, Ortopediche e Della Testa-collo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
- NESMOS Department, Facoltà di Medicina e Psicologia, Sant’Andrea University Hospital, Rome 00189, Italy
| | - Marianna Mazza
- UOC Psichiatria Clinica e d’Urgenza, Dipartimento di Scienze Dell’Invecchiamento, Neurologiche, Ortopediche e Della Testa-collo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
- Department of Psychiatry, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Carolina Galliani
- Department of Psychology, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Sara Tranquilli
- Department of Psychology, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Giovanni Vento
- UOC Neonatologia, Dipartimento di Scienze Della Salute Della Donna, Del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
- UOC Neonatologia, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Giorgio Conti
- UOC Terapia Intensiva Pediatrica e Trauma Center Pediatrico, Dipartimento di Scienze Dell’Emergenza, Anestesiologiche e Della Rianimazione, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
- UOC Terapia Intensiva Pediatrica e Trauma Center Pediatrico, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Gabriele Sani
- UOC Psichiatria Clinica e d’Urgenza, Dipartimento di Scienze Dell’Invecchiamento, Neurologiche, Ortopediche e Della Testa-collo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
- Department of Psychiatry, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Massimo Antonelli
- UOC Anestesia, Rianimazione, Terapia Intensiva e Tossicologia Clinica, Dipartimento di Scienze Dell’Emergenza, Anestesiologiche e Della Rianimazione, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
- Department of Anesthesiology and Intensive Care Medicine, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Daniela Pia Rosaria Chieffo
- UOS Psicologia Clinica, Governo Clinico, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Rome 00168, Italy
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Engel FD, da Fonseca GGP, Cechinel-Peiter C, Backman C, da Costa DG, de Mello ALSF. Impact of the COVID-19 Pandemic on the Experiences of Hospitalized Patients: A Scoping Review. J Patient Saf 2023; 19:e46-e52. [PMID: 36459699 PMCID: PMC9940789 DOI: 10.1097/pts.0000000000001084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
OBJECTIVE This study aimed to identify the factors that exerted an impact on the experiences of hospitalized patients during the COVID-19 pandemic from the quality and safety perspectives. METHOD A scoping review that followed the 5 stages described by Arksey and O'Malley was used. A systematized search of original studies was conducted in 9 databases: PubMed/MEDLINE, BDENF, CINAHL, LILACS, SciELO, Embase, Scopus, Web of Science, and Google Scholar. The factors that exerted an impact on patients' experiences were summarized, considering the perspective of quality and patient safety in health institutions. The factors were categorized using the Content Analysis technique. RESULTS A total of 6950 studies were screened, and 32 met the eligibility criteria. The main factors that exerted an impact on the patients' experience were as follows: caregiver/family concern with the patients' well-being during hospitalization, search for alternative communication and interaction means between the patients and their family, and changes in health care organization. The restrictions inherent to the policy regarding visits and companions exerted a negative impact on the experiences, increasing the patients' feelings of loneliness and isolation. Negative impacts were also evidenced in the hospital admission and discharge process and in the limitation of treatment possibilities offered to the patients, because of contact restrictions. CONCLUSIONS The factors that exerted an impact on the patients' experiences permeate communication between professionals, patients, and family members, with implications for health care quality.
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Affiliation(s)
- Franciely Daiana Engel
- From the Graduate Program in Nursing, Health Sciences Center, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | | | - Caroline Cechinel-Peiter
- From the Graduate Program in Nursing, Health Sciences Center, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Chantal Backman
- School of Nursing, Faculty of Health Sciences, University of Ottawa
- Ottawa Hospital Research Institute
- Bruyère Research Institute, Ottawa, Ontario, Canada
| | - Diovane Ghignatti da Costa
- From the Graduate Program in Nursing, Health Sciences Center, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
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Campbell-Yeo M, McCulloch H, Hughes B, Hundert A, Dol J, Smit M, Afifi J, Bacchini F, Bishop T, Dorling J, Earle R, Elliott Rose A, Inglis D, Leighton C, MacRae G, Melanson A, Simpson DC, Whitehead L. Parental perspectives on technology use to enhance communication and closeness during the COVID-19 parental presence restrictions. JOURNAL OF NEONATAL NURSING : JNN 2023; 29:169-173. [PMID: 35578634 PMCID: PMC9095434 DOI: 10.1016/j.jnn.2022.05.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 04/22/2022] [Accepted: 05/03/2022] [Indexed: 01/07/2023]
Abstract
Objective To explore parental perspectives on the use of technology in neonatal intensive care units (NICU), and its impact during COVID-19 parental presence restrictions. Methods Co-designed online survey targeting parents of infants admitted to a Canadian NICU from March 1st, 2020 until March 5th, 2021. Results Parents (n = 117) completed the survey from 38 NICUs. Large variation in policies regarding parental permission to use technology across sites was reported. Restrictive use of technology was reported as a source of parental stress. While families felt that technology helped them feel close to their infant when they could not be in the NICU, it did not replace being in-person. Conclusion Large variation in policies were reported. Despite concerns about devices in NICUs, evidence on how to mitigate these concerns exists. Benefits of using technology to enhance parental experiences appear substantial. Future study is needed to inform recommendations on technology use in the NICU.
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Affiliation(s)
- Marsha Campbell-Yeo
- School of Nursing, Dalhousie University, Halifax, NS, Canada
- Departments of Pediatrics, Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
- IWK Health, Halifax, NS, Canada
| | | | - Brianna Hughes
- School of Nursing, Dalhousie University, Halifax, NS, Canada
| | | | | | - Michael Smit
- School of Information Management, Dalhousie University, Halifax, NS, Canada
| | - Jehier Afifi
- Departments of Pediatrics, Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
- IWK Health, Halifax, NS, Canada
| | | | | | - Jon Dorling
- Department of Neonatal Medicine, Princess Anne Hospital, University Hospital Southampton NHS Foundation Trust, Southampton, England, United Kingdom
| | | | | | | | | | | | | | - David C Simpson
- Departments of Pediatrics, Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
- IWK Health, Halifax, NS, Canada
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Psychosocial Difficulties Experienced By Parents Of Babies Treated In A Neonatal Intensive Care Unit During The Coronavirus Pandemic. Arch Psychiatr Nurs 2022; 41:295-299. [PMID: 36428063 PMCID: PMC9444850 DOI: 10.1016/j.apnu.2022.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 08/04/2022] [Accepted: 08/22/2022] [Indexed: 12/14/2022]
Abstract
AIM This study had two objectives: (1) to investigate the psychosocial difficulties experienced by parents of babies treated in a neonatal intensive care unit during the coronavirus pandemic and (2) to determine parent-infant attachment. MATERIALS AND METHODS This study adopted phenomenology, a qualitative research design in order to answer the research questions design. The sample consisted of 20 parents of babies treated in the neonatal intensive care unit (NICU) of a City Hospital in Turkey between July and August 2021. Participation was voluntary. Data were collected using a sociodemographic characteristics questionnaire and a semi-structured qualitative interview form. Each participant was interviewed face to face. Each interview was recorded and transcribed. The data were analyzed using content analysis. RESULTS Participants had a mean age of 32.2 ± 3.61 years and at least secondary school degrees. Babies were admitted to the NICU for congenital anomalies (n = 3) or preterm birth (n = 7). Participants experienced anxiety, worry, and loneliness and produced less milk because they could not see and touch their babies. Their greatest source of support was their spouses. CONCLUSION Parents of babies treated in the NICU during the COVID-19 pandemic experience anxiety, sadness, unhappiness, and loneliness. The preventive measures against the pandemic affect parents psychosocially. Healthcare professionals should plan and implement care practices and establish effective communication with parents to identify their physiological, psychological, and social needs and help them produce breastmilk and bond with their babies.
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Zorro C, MacRae E, Teresa-Palacio M, Williams EE, Aldecoa-Bilbao V, Bhat R, Hickey A, Dassios T, Greenough A. Assessing the impact of the COVID-19 pandemic on parental satisfaction in two European neonatal intensive care units. BMJ Paediatr Open 2022; 6:10.1136/bmjpo-2021-001396. [PMID: 36645774 PMCID: PMC9490299 DOI: 10.1136/bmjpo-2021-001396] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 05/12/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Neonatal units across the world have altered their policies to prevent the spread of infection during the COVID-19 pandemic. Our aim was to report parental experience in two European neonatal units during the pandemic. METHODS Parents of infants admitted to each neonatal unit were asked to complete a questionnaire regarding their experience during the COVID-19 pandemic. At King's College Hospital, UK (KCH), data were collected prospectively between June 2020 and August 2020 (first wave). At the Hospital Clínic Barcelona (HCM), data were collected retrospectively from parents whose infants were admitted between September 2020 and February 2021 (second and third wave). RESULTS A total of 74 questionnaires were completed (38 from KCH and 36 from HCM). The parents reported that they were fully involved or involved in the care of their infants in 34 (89.4%) responses in KCH and 33 (91.6%) responses in HCM. Quality time spent with infants during the pandemic was more negatively affected at KCH compared with HCM (n=24 (63.2%) vs n=12 (33.3%)). Parents felt either satisfied or very satisfied with the updates from the clinical care team in 30 (79.0%) responses at KCH and 30 (83.4%) responses in HCM. The parents felt that the restrictions negatively affected breast feeding in six (15.8%) responses at KCH and two (5.6%) responses in HCM. Travelling to the hospital was reported overall to be sometimes difficult (39.2%); this did not differ between the two units (14 (36.8%) respondents at KCH and 15 (41.6%) from HCM). Furthermore, the self-reported amount of time spent giving kangaroo care also did not differ between the two countries. CONCLUSION Restrictive policies implemented due to the COVID-19 pandemic had a negative impact on the perception of quality of time spent by parents with their newborns admitted to neonatal units.
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Affiliation(s)
- Carolina Zorro
- Neonatal Intensive Care Unit, King's College Hospital NHS Foundation Trust, London, UK
| | - Eva MacRae
- Neonatal Intensive Care Unit, King's College Hospital NHS Foundation Trust, London, UK
| | - Marta Teresa-Palacio
- Neonatology Department, Barcelona Clinic University Hospital Biomedical Diagnosis Center, Barcelona, Spain
| | - Emma E Williams
- Department of Women and Children's Health, King's College London, London, UK
| | - Victoria Aldecoa-Bilbao
- Neonatology Department, Barcelona Clinic University Hospital Biomedical Diagnosis Center, Barcelona, Spain
| | - Ravindra Bhat
- Neonatal Intensive Care Unit, King's College Hospital NHS Foundation Trust, London, UK
| | - Ann Hickey
- Neonatal Intensive Care Unit, King's College Hospital NHS Foundation Trust, London, UK
| | - Theodore Dassios
- Neonatal Intensive Care Unit, King's College Hospital NHS Foundation Trust, London, UK.,Department of Women and Children's Health, King's College London, London, UK
| | - Anne Greenough
- Department of Women and Children's Health, King's College London, London, UK
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Webcam use in German neonatological intensive care units: an interview study on parental expectations and experiences. BMC Health Serv Res 2021; 21:970. [PMID: 34521406 PMCID: PMC8440115 DOI: 10.1186/s12913-021-06901-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 08/16/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To bridge the physical distance between parents and children during a neonatal intensive care unit (NICU) stay, webcams are used in few German NICUs. They allow parents to view their infant even when they cannot be present on the ward. The aim of the study was to explore the factors for and against webcam use that parents with or without webcam use encountered. METHODS Guideline-based, semi-structured qualitative interviews were conducted in the period from September 2019 to August 2020. Interview transcripts were analysed using a category-based content analysis. The categories were generated in a combined deductive-inductive procedure. RESULTS We interviewed 33 mothers and seven fathers. Parents with webcam experience emphasised positive aspects concerning their webcam use. Factors that increased webcam acceptance included feeling certain about the child's well-being and an increased sense of proximity. Only a few critical voices emerged from parents who had webcam experience, e.g. regarding privacy concerns. Parents who had no experience with webcam use showed ambivalence. On the one hand, they expressed a positive attitude towards the webcam system and acknowledged that webcam use could result in feelings of control. On the other hand, reservations emerged concerning an increase of mental stress or a negative influence on parental visitation behaviour. CONCLUSION In addition to the parents' positive experiences with webcam use, results show a need within parents who lacked webcam experience. Despite some criticism, it was evident that webcam use was primarily seen as an opportunity to counteract the negative consequences of separation in the postnatal phase. TRIAL REGISTRATION The Neo-CamCare study is registered at the German Clinical Trials Register. DRKS-ID DRKS00017755 . Date of Registration in DRKS: 25-09-2019.
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Psychological Wellbeing of Parents with Infants Admitted to the Neonatal Intensive Care Unit during SARS-CoV-2 Pandemic. CHILDREN-BASEL 2021; 8:children8090755. [PMID: 34572187 PMCID: PMC8471119 DOI: 10.3390/children8090755] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 08/25/2021] [Accepted: 08/26/2021] [Indexed: 01/25/2023]
Abstract
The current SARS-CoV-2 disease (COVID-19) pandemic is a sudden major stressor superimposed on pre-existing high distress in parents of infants admitted to the neonatal intensive care unit (NICU). This study aimed to investigate the psychological wellbeing of NICU parents during the COVID-19 pandemic. Forty-four parents of 25 inpatients of the Padua University Hospital NICU were included from June 2020 to February 2021. At 7–14 days postpartum parents completed the Edinburgh Postnatal Depression Scale (EPDS), State-Trait Anxiety Inventory (STAI), Parental Stressor Scale: NICU (PSS:NICU) and an ad-hoc questionnaire measuring parental COVID-19 related stress. About one third of parents reported extreme/high stress and a relevant negative impact on parenthood experience. Less time (82%) and less physical contact (73%) with infants due to COVID-19 preventive measures were the most frequent negative factors. Higher COVID-19 related parental stress was positively associated with anxiety, depression, NICU parental stress, stress related to NICU environment, and parental role alterations. Depression symptoms, stress related to infant condition and parental role alterations were higher in mothers. The pandemic affected parental emotional and relational wellbeing directly through additional stress due to COVID-19 concerns and indirectly through the impact of restrictions on the experience of becoming parents.
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Veenendaal NR, Deierl A, Bacchini F, O’Brien K, Franck LS. Supporting parents as essential care partners in neonatal units during the SARS-CoV-2 pandemic. Acta Paediatr 2021; 110:2008-2022. [PMID: 33772861 PMCID: PMC8250667 DOI: 10.1111/apa.15857] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 03/23/2021] [Indexed: 12/18/2022]
Abstract
AIM To review the evidence on safety of maintaining family integrated care practices and the effects of restricting parental participation in neonatal care during the SARS-CoV-2 pandemic. METHODS MEDLINE, EMBASE, PsycINFO and CINAHL databases were searched from inception to the 14th of October 2020. Records were included if they reported scientific, empirical research (qualitative, quantitative or mixed methods) on the effects of restricting or promoting family integrated care practices for parents of hospitalised neonates during the SARS-CoV-2 pandemic. Two authors independently screened abstracts, appraised study quality and extracted study and outcome data. RESULTS We retrieved 803 publications and assessed 75 full-text articles. Seven studies were included, reporting data on 854 healthcare professionals, 442 parents, 364 neonates and 26 other family members, within 286 neonatal units globally. The pandemic response resulted in significant changes in neonatal unit policies and restricting parents' access and participation in neonatal care. Breastfeeding, parental bonding, participation in caregiving, parental mental health and staff stress were negatively impacted. CONCLUSION This review highlights that SARS-CoV-2 pandemic-related hospital restrictions had adverse effects on care delivery and outcomes for neonates, families and staff. Recommendations for restoring essential family integrated care practices are discussed.
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Affiliation(s)
- Nicole R. Veenendaal
- Department of Pediatrics/Neonatology OLVG Amsterdam The Netherlands
- Department of Pediatrics, Emma Children's Hospital Amsterdam UMC, Vrije Universiteit, University of Amsterdam Amsterdam The Netherlands
| | - Aniko Deierl
- Department of Neonatology Imperial College Healthcare NHS Trust London UK
| | | | - Karel O’Brien
- Department of Pediatrics Mount Sinai Hospital Toronto Ontario Canada
| | - Linda S. Franck
- School of Nursing University of California San Francisco San Francisco CA USA
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Waddington C, van Veenendaal NR, O’Brien K, Patel N. Family integrated care: Supporting parents as primary caregivers in the neonatal intensive care unit. Pediatr Investig 2021; 5:148-154. [PMID: 34179713 PMCID: PMC8212757 DOI: 10.1002/ped4.12277] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 05/21/2021] [Indexed: 01/19/2023] Open
Abstract
Family integrated care (FICare) is a collaborative model of neonatal care which aims to address the negative impacts of the neonatal intensive care unit (NICU) environment by involving parents as equal partners, minimizing separation, and supporting parent-infant closeness. FICare incorporates psychological, educational, communication, and environmental strategies to support parents to cope with the NICU environment and to prepare them to be able to emotionally, cognitively, and physically care for their infant. FICare has been associated with improved infant feeding, growth, and parent wellbeing and self-efficacy; important mediators for long-term improved infant neurodevelopmental and behavioural outcomes. FICare implementation requires multi-disciplinary commitment, staff motivation, and sufficient time for preparation and readiness for change as professionals relinquish power and control to instead develop collaborative partnerships with parents. Successful FICare implementation and culture change have been applied by neonatal teams internationally, using practical approaches suited to their local environments. Strategies such as parent and staff meetings and relational communication help to break down barriers to change by providing space for the co-creation of knowledge, the negotiation of caregiving roles and the development of trusting relationships. The COVID-19 pandemic highlighted the vulnerability within programs supporting parental presence in neonatal units and the profound impacts of parent-infant separation. New technologies and digital innovations can help to mitigate these challenges, and support renewed efforts to embed FICare philosophy and practice in neonatal care during the COVID-19 recovery and beyond.
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Affiliation(s)
| | - Nicole R. van Veenendaal
- OLVGAmsterdamthe Netherlands
- Emma Children’s HospitalAmsterdam UMCUniversity of AmsterdamVrije UniversiteitAmsterdamthe Netherlands
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