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Feasibility of a guided participation discharge program for very preterm infants in a neonatal intensive care unit: a randomized controlled trial.
BMC Pediatr. 2019 11 04; 19(1):402.BPed

Abstract

BACKGROUND

Previous studies showed that parents of very preterm infants expressed feelings of incompetence and experienced high levels of stress upon the discharge of their infants. We conducted a systematic review of seven studies and observed potential benefits for parental outcomes when using discharge interventions that adopted guided participation (GP). More evidence is needed on the effective doses of discharge interventions underpinned by the principles of GP.

AIM

To investigate the feasibility and preliminarily estimate the effects on parental competence and stress outcomes of a newly developed, nurse-led, GP discharge program for mothers of very preterm infants.

METHODS

A two-arm randomized controlled trial was conducted in a neonatal intensive care unit (NICU). Mothers of infants with gestational ages of ≤32 weeks who had no congenital malformations and did not need to undergo major surgeries were recruited. All mothers were the primary caregivers to their infants. The intervention group received a nurse-led GP discharge intervention (three structured 30- to 60-min GP sessions and one follow-up phone call). The control group received usual care. The parental outcomes were measured using the Parenting Sense of Competence Scale (C-PSOC) and Perceived Stress Scale (C-PSS) at baseline (T0), on the day of discharge (T1), after the follow-up phone call (within 72 h after discharge) (T2), and 1 month after discharge (T3). The outcomes were analyzed using generalized estimating equations based on intention-to-treat principles.

RESULTS

Thirty infant-mother dyads were recruited. Greater improvements in the C-PSOC score were observed in the intervention group than in the control group at T1 and T2, although these differences were statistically insignificant. The intervention group exhibited greater improvements than the control group in the C-PSS scores at T1, T2, and T3, although these differences were also not statistically significant.

CONCLUSIONS

The findings suggest that a GP discharge intervention could improve parenting competence and stress among mothers with very preterm infants. The absence of adverse events suggests that the GP discharge intervention could be feasibly implemented in NICU settings. This feasibility study was not powered to determine the effectiveness of the intervention but is anticipated to lay the foundation for a future full-scale study.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT03668912. Date of registration: 13 September 2018 (retrospectively registered).

Authors+Show Affiliations

Department of Pediatrics, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, N.T., Hong Kong SAR.The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR. janitachau@cuhk.edu.hk.The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR.The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR.

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

31684903

Citation

Lee, S Y., et al. "Feasibility of a Guided Participation Discharge Program for Very Preterm Infants in a Neonatal Intensive Care Unit: a Randomized Controlled Trial." BMC Pediatrics, vol. 19, no. 1, 2019, p. 402.
Lee SY, Chau JPC, Choi KC, et al. Feasibility of a guided participation discharge program for very preterm infants in a neonatal intensive care unit: a randomized controlled trial. BMC Pediatr. 2019;19(1):402.
Lee, S. Y., Chau, J. P. C., Choi, K. C., & Lo, S. H. S. (2019). Feasibility of a guided participation discharge program for very preterm infants in a neonatal intensive care unit: a randomized controlled trial. BMC Pediatrics, 19(1), 402. https://doi.org/10.1186/s12887-019-1794-y
Lee SY, et al. Feasibility of a Guided Participation Discharge Program for Very Preterm Infants in a Neonatal Intensive Care Unit: a Randomized Controlled Trial. BMC Pediatr. 2019 11 4;19(1):402. PubMed PMID: 31684903.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Feasibility of a guided participation discharge program for very preterm infants in a neonatal intensive care unit: a randomized controlled trial. AU - Lee,S Y, AU - Chau,J P C, AU - Choi,K C, AU - Lo,S H S, Y1 - 2019/11/04/ PY - 2019/02/15/received PY - 2019/10/21/accepted PY - 2019/11/6/entrez PY - 2019/11/7/pubmed PY - 2020/8/5/medline KW - Discharge intervention KW - Guided participation KW - Mothers KW - Nurse-led KW - Very preterm infants SP - 402 EP - 402 JF - BMC pediatrics JO - BMC Pediatr VL - 19 IS - 1 N2 - BACKGROUND: Previous studies showed that parents of very preterm infants expressed feelings of incompetence and experienced high levels of stress upon the discharge of their infants. We conducted a systematic review of seven studies and observed potential benefits for parental outcomes when using discharge interventions that adopted guided participation (GP). More evidence is needed on the effective doses of discharge interventions underpinned by the principles of GP. AIM: To investigate the feasibility and preliminarily estimate the effects on parental competence and stress outcomes of a newly developed, nurse-led, GP discharge program for mothers of very preterm infants. METHODS: A two-arm randomized controlled trial was conducted in a neonatal intensive care unit (NICU). Mothers of infants with gestational ages of ≤32 weeks who had no congenital malformations and did not need to undergo major surgeries were recruited. All mothers were the primary caregivers to their infants. The intervention group received a nurse-led GP discharge intervention (three structured 30- to 60-min GP sessions and one follow-up phone call). The control group received usual care. The parental outcomes were measured using the Parenting Sense of Competence Scale (C-PSOC) and Perceived Stress Scale (C-PSS) at baseline (T0), on the day of discharge (T1), after the follow-up phone call (within 72 h after discharge) (T2), and 1 month after discharge (T3). The outcomes were analyzed using generalized estimating equations based on intention-to-treat principles. RESULTS: Thirty infant-mother dyads were recruited. Greater improvements in the C-PSOC score were observed in the intervention group than in the control group at T1 and T2, although these differences were statistically insignificant. The intervention group exhibited greater improvements than the control group in the C-PSS scores at T1, T2, and T3, although these differences were also not statistically significant. CONCLUSIONS: The findings suggest that a GP discharge intervention could improve parenting competence and stress among mothers with very preterm infants. The absence of adverse events suggests that the GP discharge intervention could be feasibly implemented in NICU settings. This feasibility study was not powered to determine the effectiveness of the intervention but is anticipated to lay the foundation for a future full-scale study. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03668912. Date of registration: 13 September 2018 (retrospectively registered). SN - 1471-2431 UR - https://www.unboundmedicine.com/medline/citation/31684903/Feasibility_of_a_guided_participation_discharge_program_for_very_preterm_infants_in_a_neonatal_intensive_care_unit:_a_randomized_controlled_trial_ L2 - https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-019-1794-y DB - PRIME DP - Unbound Medicine ER -