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Psychosocial support for parents of extremely preterm infants in neonatal intensive care: a qualitative interview study.
BMC Psychol. 2019 Nov 29; 7(1):76.BP

Abstract

BACKGROUND

Extremely premature infants (those born before 28 weeks' gestational age) are highly immature, requiring months of care at a neonatal intensive care unit (NICU). For parents, their child's grave medical condition and prolonged hospitalization are stressful and psychologically disruptive. This study aimed at exploring the needs of psychosocial support of parents of extremely premature infants, and how the NICU as an organization and its staff meets or fails to meet these needs.

METHOD

Sixteen open-ended interviews were conducted with 27 parents after their infant's discharge from the NICU. Inductive content analysis was performed.

RESULTS

Four themes were identified: Emotional support (with subthemes Empathic treatment by staff, Other parents as a unique source of support, Unclear roles of the various professions); Feeling able to trust the health care provider; Support in balancing time spent with the infant and other responsibilities; Privacy. Parents of extremely premature infants needed various forms of emotional support at the NICU, including support from staff, professional psychological help and/or companionship with other patients' parents. Parents were highly variable in their desire to discuss their emotional state with staff. The respective roles of nursing staff, social workers and psychologists in supporting parents emotionally and identifying particularly vulnerable parents appeared unclear. Parents also needed to be able to maintain a solid sense of trust in the NICU and its staff. Poor communication with and among staff, partly due to staff discontinuity, damaged trust. Parents struggled with perceived pressure from staff to be at the hospital more than they could manage and with the limited privacy of the NICU.

CONCLUSIONS

The complex and individual psychosocial needs of parents of extremely preterm infants present many challenges for the NICU and its staff. Increasing staffing and improving nurses' competence in addressing psychosocial aspects of neonatal care would help both nurses and families. Clarifying the roles of different professions in supporting parents and developing their teamwork would lessen the burden on nurses. Communicating with parents about their needs and informing them early in their NICU stay about available support would be essential in helping them cope with their infant's hospitalization.

Authors+Show Affiliations

Division of Neonatology, Sahlgrenska University Hospital, Gothenburg, Sweden. annakrisbry@gmail.com.Division of Neonatology, Sahlgrenska University Hospital, Gothenburg, Sweden. Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31783784

Citation

Bry, Anna, and Helena Wigert. "Psychosocial Support for Parents of Extremely Preterm Infants in Neonatal Intensive Care: a Qualitative Interview Study." BMC Psychology, vol. 7, no. 1, 2019, p. 76.
Bry A, Wigert H. Psychosocial support for parents of extremely preterm infants in neonatal intensive care: a qualitative interview study. BMC Psychol. 2019;7(1):76.
Bry, A., & Wigert, H. (2019). Psychosocial support for parents of extremely preterm infants in neonatal intensive care: a qualitative interview study. BMC Psychology, 7(1), 76. https://doi.org/10.1186/s40359-019-0354-4
Bry A, Wigert H. Psychosocial Support for Parents of Extremely Preterm Infants in Neonatal Intensive Care: a Qualitative Interview Study. BMC Psychol. 2019 Nov 29;7(1):76. PubMed PMID: 31783784.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Psychosocial support for parents of extremely preterm infants in neonatal intensive care: a qualitative interview study. AU - Bry,Anna, AU - Wigert,Helena, Y1 - 2019/11/29/ PY - 2019/02/18/received PY - 2019/11/15/accepted PY - 2019/12/1/entrez PY - 2019/12/1/pubmed PY - 2020/2/25/medline KW - Emotional support KW - Extreme prematurity KW - Neonatal intensive care KW - Nursing KW - Parental stress KW - Psychosocial needs SP - 76 EP - 76 JF - BMC psychology JO - BMC Psychol VL - 7 IS - 1 N2 - BACKGROUND: Extremely premature infants (those born before 28 weeks' gestational age) are highly immature, requiring months of care at a neonatal intensive care unit (NICU). For parents, their child's grave medical condition and prolonged hospitalization are stressful and psychologically disruptive. This study aimed at exploring the needs of psychosocial support of parents of extremely premature infants, and how the NICU as an organization and its staff meets or fails to meet these needs. METHOD: Sixteen open-ended interviews were conducted with 27 parents after their infant's discharge from the NICU. Inductive content analysis was performed. RESULTS: Four themes were identified: Emotional support (with subthemes Empathic treatment by staff, Other parents as a unique source of support, Unclear roles of the various professions); Feeling able to trust the health care provider; Support in balancing time spent with the infant and other responsibilities; Privacy. Parents of extremely premature infants needed various forms of emotional support at the NICU, including support from staff, professional psychological help and/or companionship with other patients' parents. Parents were highly variable in their desire to discuss their emotional state with staff. The respective roles of nursing staff, social workers and psychologists in supporting parents emotionally and identifying particularly vulnerable parents appeared unclear. Parents also needed to be able to maintain a solid sense of trust in the NICU and its staff. Poor communication with and among staff, partly due to staff discontinuity, damaged trust. Parents struggled with perceived pressure from staff to be at the hospital more than they could manage and with the limited privacy of the NICU. CONCLUSIONS: The complex and individual psychosocial needs of parents of extremely preterm infants present many challenges for the NICU and its staff. Increasing staffing and improving nurses' competence in addressing psychosocial aspects of neonatal care would help both nurses and families. Clarifying the roles of different professions in supporting parents and developing their teamwork would lessen the burden on nurses. Communicating with parents about their needs and informing them early in their NICU stay about available support would be essential in helping them cope with their infant's hospitalization. SN - 2050-7283 UR - https://www.unboundmedicine.com/medline/citation/31783784/Psychosocial_support_for_parents_of_extremely_preterm_infants_in_neonatal_intensive_care:_a_qualitative_interview_study_ L2 - https://bmcpsychology.biomedcentral.com/articles/10.1186/s40359-019-0354-4 DB - PRIME DP - Unbound Medicine ER -