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Akerman, S., Axelin, A., Traube, C., Frithiof, R. & Thernström Blomqvist, Y. (2024). Adapting the Cornell assessment of pediatric delirium for Swedish context: translation, cultural validation and inter-rater reliability. BMC Pediatrics, 24(1), Article ID 413.
Open this publication in new window or tab >>Adapting the Cornell assessment of pediatric delirium for Swedish context: translation, cultural validation and inter-rater reliability
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2024 (English)In: BMC Pediatrics, E-ISSN 1471-2431, Vol. 24, no 1, article id 413Article in journal (Refereed) Published
Abstract [en]

Background: Pediatric delirium causes prolonged hospital stays, increased costs, and distress for children and caregivers. Currently, there is no delirium screening tool available in Sweden that has been translated, culturally validated, and tested for reliability. This study aimed to translate, culturally adapt, and assess the suitability of the Cornell Assessment of Pediatric Delirium (CAPD) for implementation in Swedish healthcare settings.

Methods: The CAPD was translated and culturally adapted to Swedish context following the ten-step process recommended by the International Society for Pharmacoeconomics and Outcomes Task Force for Translation and Cultural Adaptation. The Swedish CAPD was tested in the pediatric intensive care unit of Uppsala University Hospital, a tertiary hospital in Sweden. Inter-rater reliability was tested using intraclass correlation coefficient (ICC), with both Registered Nurses (RNs) and Assistant Nurses (ANs) conducting parallel measurements using the Swedish CAPD. A reliability score of ICC > 0.75 was considered indicative of good reliability.

Results: After translation of the CAPD into Swedish, 10 RNs participated in the cultural adaptation process. Issues related to word choice, education, and instructions were addressed. Wording improvements were made to ensure accurate interpretation. Supplementary training sessions were organized to strengthen users' proficiency with the Swedish CAPD. Additional instructions were provided to enhance clarity and usability. Inter-rater reliability testing resulted in an ICC of 0.857 (95% CI: 0.708-0.930), indicating good reliability.

Conclusion: This study successfully translated and culturally adapted the CAPD to align with Swedish contextual parameters. The resulting Swedish CAPD demonstrated good inter-rater reliability, establishing its viability as a tool for measuring delirium among pediatric patients in Swedish pediatric intensive care units. Trail registration Not applicable.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2024
Keywords
Pediatric, Delirium, Pediatric intensive care (PICU), Critical care, Sweden, Reliability, CAPD
National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-534766 (URN)10.1186/s12887-024-04886-w (DOI)001255413200001 ()38926708 (PubMedID)
Funder
Swedish Research Council, 2014-02569Swedish Research Council, 2014-07606
Available from: 2024-07-09 Created: 2024-07-09 Last updated: 2024-07-09Bibliographically approved
KC, A., Rönnbäck, M., Humgain, U., Basnet, O., Bhattarai, P. & Axelin, A. (2024). Implementation barriers and facilitators of Moyo foetal heart rate monitor during labour in public hospitals in Nepal. Global Health Action, 17(1), Article ID 2328894.
Open this publication in new window or tab >>Implementation barriers and facilitators of Moyo foetal heart rate monitor during labour in public hospitals in Nepal
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2024 (English)In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 17, no 1, article id 2328894Article in journal (Refereed) Published
Abstract [en]

Background: Globally, every year, approximately 1 million foetal deaths take place during the intrapartum period, fetal heart monitoring (FHRM) and timely intervention can reduce these deaths.

Objective: This study evaluates the implementation barriers and facilitators of a device, Moyo for FHRM.

Methods: The study adopted a qualitative study design in four hospitals in Nepal where Moyo was implemented for HRM. The study participants were labour room nurses and convenience sampling was used to select them. A total of 20 interviews were done to reach the data saturation. The interview transcripts were translated to English, and qualitative content analysis using deductive approach was applied.

Results: Using the deductive approach, the data were organised into three categories i) changes in practice of FHRM, ii) barriers to implementing Moyo and iii) facilitators of implementing Moyo. Moyo improved adherence to intermittent FHRM as the device could handle higher caseloads compared to the previous devices. The implementation of Moyo was hindered by difficulty to organise training ondevice during non-working hours, technical issue of the device, nurse mistrust towards the device and previous experience of poor implementation to similar innovations. Facilitators for implementation included effective training on how to use Moyo, improvement in intrapartum foetal monitoring and improvement in staff morale, ease of using the device, Plan Do Study Act (PDSA) meetings to improve use of Moyo and supportive leadership.

Conclusion: The change in FHRM practice suggests that the implementation of innovative solution such as Moyo was successful with adequate facilitation, supportive staff attitude and leadership.

Place, publisher, year, edition, pages
Taylor & Francis, 2024
Keywords
Moyo, fetal heart rate monitoring practice change, barriers for implementation, facilitators for implementation, Nepal
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:uu:diva-527000 (URN)10.1080/16549716.2024.2328894 (DOI)001197371300001 ()38577869 (PubMedID)
Funder
Uppsala University
Available from: 2024-04-22 Created: 2024-04-22 Last updated: 2024-04-22Bibliographically approved
Kukka, A. J., Bhattarai, P., Sundelin, H. E. K., Gurung, R., Brown, N. J. W., Litorp, H., . . . KC, A. (2024). 'We did everything by phone': a qualitative study of mothers' experience of smartphone-aided screening of cerebral palsy in Kathmandu, Nepal. BMC Pediatrics, 24, Article ID 357.
Open this publication in new window or tab >>'We did everything by phone': a qualitative study of mothers' experience of smartphone-aided screening of cerebral palsy in Kathmandu, Nepal
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2024 (English)In: BMC Pediatrics, E-ISSN 1471-2431, Vol. 24, article id 357Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: International guidelines recommend early intervention to all children at risk of cerebral palsy, but targeted screening programs are often lacking in low- and middle-income settings with the highest burden of disease. Smartphone applications have the potential to improve access to early diagnostics by empowering parents to film their children at home followed by centralized evaluation of videos with General Movements Assessment. We explored mothers’ perceptions about participating in a smartphone aided cerebral palsy screening program in Kathmandu, Nepal.

METHODS: This is an explorative qualitative study that used focus group discussions (n=2) and individual interviews (n=4) with mothers of term-born infants surviving birth asphyxia or neonatal seizures. Parents used the NeuroMotion™ smartphone app to film their children at home and the videos were analysed using General Movements Assessment. Sekhon et al.’s framework on the acceptability of health care interventions guided the design of the interviews and the deductive qualitative content analysis.

RESULTS: Mothers were interested in engaging with the programme and expressed hope it would benefit their children. Most felt use of the app was intuitive. They were, however, unclear about the way the analysis was performed. Support from the research team was often needed to overcome an initial lack of self-confidence in using the technology and to reduce anxiety related to the follow-up. The intervention was overall perceived as recommendable but should be supplemented by a face-to-face consultation.

CONCLUSION: Smartphone aided remote screening of cerebral palsy is acceptable in a lower middle-income population but requires additional technical support.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2024
Keywords
cerebral palsy, qualitative research, general movements assessment, neonatal follow-up, low- and middle-income countries, telemedicine
National Category
Pediatrics
Research subject
Pediatrics
Identifiers
urn:nbn:se:uu:diva-523708 (URN)10.1186/s12887-024-04829-5 (DOI)
Available from: 2024-02-22 Created: 2024-02-22 Last updated: 2024-07-04Bibliographically approved
Ekström, N., Gurung, R., Humagain, U., Basnet, O., Bhattarai, P., Thakur, N., . . . Axelin, A. (2023). Facilitators and barriers for implementation of a novel resuscitation quality improvement package in public referral hospitals of Nepal. BMC Pregnancy and Childbirth, 23, Article ID 662.
Open this publication in new window or tab >>Facilitators and barriers for implementation of a novel resuscitation quality improvement package in public referral hospitals of Nepal
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2023 (English)In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 23, article id 662Article in journal (Refereed) Published
Abstract [en]

Background: Improving the healthcare providers (HCP) basic resuscitation skills can reduce intrapartum related mortality in low- and middle-income countries. However, the resuscitation intervention's successful implementation is largely dependent on proper facilitation and context. This study aims to identify the facilitators and barriers for the implementation of a novel resuscitation package as part of the quality improvement project in Nepal.

Methods: The study used a qualitative descriptive design. The study sites included four purposively chosen public hospitals in Nepal, where the resuscitation package (Helping Babies Breathe [HBB] training, resuscitation equipment and NeoBeat) had been implemented as part of the quality improvement project. Twenty members of the HCP, who were trained and exposed to the package, were selected through convenience sampling to participate in the study interviews. Data were collected through semi-structured interviews conducted via telephone and video calls. Twenty interview data were analyzed with a deductive qualitative content analysis based on the core components of the i-PARiHS framework.

Results: The findings suggest that there was a move to more systematic resuscitation practices among the staff after the quality improvement project's implementation. This positive change was supported by a neonatal heart rate monitor (NeoBeat), which guided resuscitation and made it easier. In addition, seeing the positive outcomes of successful resuscitation motivated the HCPs to keep practicing and developing their resuscitation skills. Facilitation by the project staff enabled the change. At the same time, facilitators provided extra support to maintain the equipment, which can be a challenge in terms of sustainability, after the project. Furthermore, a lack of additional resources, an unclear leadership role, and a lack of coordination between nurses and medical doctors were barriers to the implementation of the resuscitation package.

Conclusion: The introduction of the resuscitation package, as well as the continuous capacity building of local multidisciplinary healthcare staff, is important to continue the accelerated efforts of improving newborn care. To secure sustainable change, facilitation during implementation should focus on exploring local resources to implement the resuscitation package sustainably.Trial RegistrationNot applicable. Factors such as the context, facilitation, and site of implementation influence the successful implementation of the resuscitation bundle.The introduction of innovation for quality healthcare requires adequate facilitation and continuous capacity-building efforts.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2023
Keywords
Neonatal resuscitation, Facilitation, Implementation, Plan-Do-Study-Act cycle, Nepal
National Category
Public Health, Global Health, Social Medicine and Epidemiology Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:uu:diva-516643 (URN)10.1186/s12884-023-05989-5 (DOI)001094596800003 ()37704967 (PubMedID)
Available from: 2023-11-29 Created: 2023-11-29 Last updated: 2023-11-29Bibliographically approved
Ahlqvist-Bjorkroth, S., Thernström Blomqvist, Y., Nyberg, J., Normann, E. & Axelin, A. (2023). Improving NICU staff decision-making with parents in medical rounds: a pilot study of reflective group dialogue intervention. Frontiers in Pediatrics , 11, Article ID 1249345.
Open this publication in new window or tab >>Improving NICU staff decision-making with parents in medical rounds: a pilot study of reflective group dialogue intervention
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2023 (English)In: Frontiers in Pediatrics , E-ISSN 2296-2360, Vol. 11, article id 1249345Article in journal (Refereed) Published
Abstract [en]

Introduction: The communication skills of healthcare professionals play a crucial role in successful shared decision-making with parents in neonatal intensive care. Improving communication skills can be achieved through practice and reflection on personal experiences after authentic interaction events with parents. The process of reflection typically involves three phases: description, reflection, and critical reflection. In this study, our aim was to explore the acceptability of the Reflective Group Dialogue intervention and its effectiveness in supporting the reflective process.

Methods: This qualitative pilot study was conducted in the neonatal intensive care unit at Uppsala University Children's Hospital, Sweden. The sample consisted of nine medical rounds with seven families, five neonatologists, seven registered nurses, and five assistant nurses. Purposive sampling was used to collect the data. The intervention comprised four elements: (1) before the intervention, a recorded presentation on shared decision-making was given to the entire unit staff, (2) an observation of a normal medical round discussion with parents, (3) an interview with parents about their experience after the same round, and (4) a reflective discussion with the participating health care professionals after the round. The parent interviews and reflective discussions were audio-recorded and transcribed verbatim. They were analyzed using thematic analysis as a theoretical strategy.

Results: Both parents and staff widely accepted the intervention and found it beneficial. We identified four discussions that remained in the descriptive phase of the reflection process, four that reached the reflective phase, and one that reached the critical reflection phase. The descriptive discussions were characterized by using a single perspective to reflect, often based on personal opinions. The reflective discussions included analyzing interaction sequences from both staff and parent perspectives and were primarily based on actual observations of communication during medical rounds. The critical discussion led to a new awareness of current practices concerning parental involvement in decision-making. These discussions also utilized "what-if" thinking to evaluate potential new practices and their pros and cons.

Conclusions: The intervention seems promising as it was perceived as beneficial by the recipients and facilitated reflection in most cases. However, to enhance the feasibility of the intervention, some improvements are discussed.

Place, publisher, year, edition, pages
Frontiers Media S.A., 2023
Keywords
family-centered care, parental involvement, communication, reflective practice, medical round
National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-514364 (URN)10.3389/fped.2023.1249345 (DOI)001072845300001 ()37772036 (PubMedID)
Available from: 2023-10-24 Created: 2023-10-24 Last updated: 2023-10-24Bibliographically approved
Arwehed, S., Axelin, A., Björklund, L. J., Thernström Blomqvist, Y., Heiring, C., Jonsson, B., . . . Lehtonen, L. (2023). Nordic survey showed wide variation in discharge practices for very preterm infants. Acta Paediatrica
Open this publication in new window or tab >>Nordic survey showed wide variation in discharge practices for very preterm infants
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2023 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227Article in journal (Refereed) Epub ahead of print
Abstract [en]

Aim

We aimed to describe clinical practices and criteria for discharge of very preterm infants in Nordic neonatal units.

Methods

Medical directors of all 89 level-2 and level-3 units in Denmark, Finland, Iceland, Norway and Sweden were invited by e-mail to complete a web-based multiple-choice survey with the option to make additional free-text comments.

Results

We received responses from 83/89 units (93%). In all responding units, discharge readiness was based mainly on clinical assessment with varying criteria. In addition, 36% used formal tests of cardiorespiratory stability and 59% used criteria related to infant weight or growth. For discharge with feeding tube, parental ability to speak the national language or English was mandatory in 45% of units, with large variation among countries. Post-discharge home visits and video-consultations were provided by 59% and 51%, respectively. In 54% of units, parental preparation for discharge were not initiated until the last two weeks of hospital stay.

Conclusion

Discharge readiness was based mainly on clinical assessment, with criteria varying among units despite similar population characteristics and care structures. This variation indicates a lack of evidence base and may unnecessarily delay discharge; further studies of this matter are needed. Earlier parental preparation and use of interpreters might facilitate earlier discharge.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023
Keywords
early discharge, length of stay, neonatal home care, preterm infant, telemedicine
National Category
Pediatrics
Identifiers
urn:nbn:se:uu:diva-512706 (URN)10.1111/apa.16934 (DOI)001047084900001 ()37540833 (PubMedID)
Available from: 2023-09-28 Created: 2023-09-28 Last updated: 2023-09-28Bibliographically approved
Gurung, R., Moinuddin, M., Sunny, A. K., Bhandari, A., Axelin, A. & KC, A. (2022). Mistreatment during childbirth and postnatal period reported by women in Nepal -a multicentric prevalence study. BMC Pregnancy and Childbirth, 22(1), Article ID 319.
Open this publication in new window or tab >>Mistreatment during childbirth and postnatal period reported by women in Nepal -a multicentric prevalence study
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2022 (English)In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 22, no 1, article id 319Article in journal (Refereed) Published
Abstract [en]

Introduction Trust of women and families toward health institutions has led to increased use of their services for childbirth. Whilst unpleasant experience of care during childbirth will halt this achievement and have adverse consequences. We examined the experience of women regarding the care received during childbirth in health institutions in Nepal. Method A prospective cohort study conducted in 11 hospitals in Nepal for a period of 18 months. Using a semi-structured questionnaire based on the typology of mistreatment during childbirth, information on childbirth experience was gathered from women (n = 62,926) at the time of discharge. Using those variables, principal component analysis was conducted to create a single mistreatment index. Bivariate and multivariate linear regression analyses were conducted to assess the association of the mistreatment index with sociodemographic, obstetric and newborn characteristics. Result A total of 62,926 women were consented and enrolled in the study. Of those women, 84.3% had no opportunity to discuss any concerns, 80.4% were not adequately informed before providing care, and 1.5% of them were refused for care due to inability to pay. According to multivariate regression analysis, women 35 years or older (beta, - 0.3587; p-value, 0.000) or 30-34 years old (beta,- 0.38013; p-value, 0.000) were less likely to be mistreated compared to women aged 18 years or younger. Women from a relatively disadvantaged (Dalit) ethnic group were more likely to be mistreated (beta, 0.29596; p-value, 0.000) compared to a relatively advantaged (Chettri) ethnic group. Newborns who were born preterm (beta, - 0.05988; p-value, 0.000) were less likely to be mistreated than those born at term. Conclusion The study reports high rate of some categories of mistreatment of women during childbirth. Women from disadvantaged ethnic group, young women, and term newborns are at higher risk of mistreatment. Strengthening health system and improving health workers' readiness and response will be key in experience respectful care during childbirth.

Place, publisher, year, edition, pages
BioMed Central (BMC)BMC, 2022
Keywords
Mistreatment during childbirth, Respectful care at birth, Disadvantaged ethnic group, Health system and Nepal
National Category
Obstetrics, Gynecology and Reproductive Medicine Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-473764 (URN)10.1186/s12884-022-04639-6 (DOI)000782607200002 ()35421934 (PubMedID)
Funder
Swedish Research Council
Available from: 2022-05-04 Created: 2022-05-04 Last updated: 2024-01-15Bibliographically approved
Lehtonen, L., Lillieskold, S., De Coen, K., Toome, L., Gimeno, A., Caballero, S., . . . Axelin, A. (2022). Parent-infant closeness after preterm birth and depressive symptoms: A longitudinal study. Frontiers in Psychology, 13, Article ID 906531.
Open this publication in new window or tab >>Parent-infant closeness after preterm birth and depressive symptoms: A longitudinal study
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2022 (English)In: Frontiers in Psychology, E-ISSN 1664-1078, Vol. 13, article id 906531Article in journal (Refereed) Published
Abstract [en]

Background: Preterm birth increases the risk for postpartum depression in both mothers and fathers, calling for strategies to alleviate and prevent depressive symptoms in parents of preterm infants. The aim of this study was to assess the association between early parent-infant closeness and later depressive symptoms among parents of preterm infants. We hypothesized that longer duration of closeness associate with fewer depressive symptoms in both parents.

Methods: This prospective cohort study included 23 neonatal intensive care units (NICUs) from 15 countries in 2018 to 2020. Each unit recruited families with preterm infants aiming to 30 families. The total duration of parents' presence in the NICU, and separately parent-infant skin-to-skin contact and holding, were measured using a Closeness Diary up to 14 days. The Edinburgh Postnatal Depression Scale (EPDS) was used at discharge and at 4 months corrected age of the infant.

Results: The study included 684 mothers and 574 fathers. The median presence was 469 min (Q1 258 and Q3 1,087) per 24 h for the mothers and 259 min (Q1 100 and Q3 540) for the fathers; mean EPDS scores were 9.2 (SD 5.0) and 6.3 (SD 4.4) at discharge and 6.6 (4.7) and 4.3 (4.2) at 4 months, respectively. Parents' presence and depressive symptoms varied greatly between the units. Parents' presence as the total measure, or skin-to-skin contact and holding separately, did not associate with depressive symptoms in either mothers or fathers at either time point (adjusted).

Conclusion: No association was found between the duration of parent-infant closeness in the neonatal unit and parents' depressive symptoms. The beneficial effects of family-centered care on parents' depression seem to be mediated by other elements than parent-infant physical closeness. More research is needed to identify the critical elements which are needed to alleviate parents' depression after NICU stay.

Place, publisher, year, edition, pages
Frontiers Media S.A., 2022
Keywords
preterm birth, parenting, postpartum depression, skin-to-skin contact, neonatal intensive care unit
National Category
Pediatrics
Identifiers
urn:nbn:se:uu:diva-488324 (URN)10.3389/fpsyg.2022.906531 (DOI)000876084200001 ()36237668 (PubMedID)
Available from: 2022-12-05 Created: 2022-12-05 Last updated: 2023-02-02Bibliographically approved
Kainiemi, E., Flacking, R., Lehtonen, L., Pasanen, M. & Axelin, A. (2022). Psychometric Properties of an Instrument to Measure the Quality of Family-Centered Care in NICUs. Journal of Obstetric, Gynecologic and Neonatal Nursing, 51(4), 461-472
Open this publication in new window or tab >>Psychometric Properties of an Instrument to Measure the Quality of Family-Centered Care in NICUs
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2022 (English)In: Journal of Obstetric, Gynecologic and Neonatal Nursing, ISSN 0884-2175, E-ISSN 1552-6909, Vol. 51, no 4, p. 461-472Article in journal (Refereed) Published
Abstract [en]

Objective: To examine the psychometric properties of the Digi Family-Centered Care-Parent Version (DigiFCC-P), which was developed to measure parents' perceptions of family-centered care (FCC) in NICUs. Design: Cross-sectional psychometric study. Setting: Twenty-three NICUs in 15 countries in Europe, Canada, and Australia. Participants: Mothers (n = 565) and fathers (n = 406) of preterm infants hospitalized in NICUs.

Methods: Participants reported their perceptions of the quality of FCC during their infants' hospitalizations by answering one DigiFCC-P question delivered to their mobile phones every evening. Nine questions rotated in random order. Participants responded on a 7-point Likert scale. We evaluated the instrument's internal consistency, construct and concurrent validity, and sensitivity.

Results: The internal consistency of the DigiFCC-P was satisfactory; the Cronbach's alpha coefficient was .74 (95% confidence interval [.71, .77]), and all the corrected item-total correlations were greater than .30. We identified that the items formed two factors, support from staff and the parent's active participation, and observed no strong item cross-loadings on the two factors. We discovered some items with weak interitem correlations, and the two factors explained 35.2% of the variance. Scores on the DigiFCC-P and Family-Centered Care Questionnaire were significantly correlated (r = .59, p < .001) and supported the convergent validity of the instrument. In addition, changes were discovered in the participants' ratings over time, which indicated that the instrument was sensitive to detect changes in their evaluations.

Conclusion: The psychometric testing of the DigiFCC-P provided initial support for the convergent validity and reliability of the instrument. The instrument was also sensitive in detecting changes in the evaluations of FCC over time. However, there is a need for further development of the content validity of the instrument.

Place, publisher, year, edition, pages
Elsevier, 2022
Keywords
exploratory factor analysis, family-centered care, instrument assessment, NICU, psychometric properties, reliability, validity
National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-487230 (URN)10.1016/j.jogn.2022.04.004 (DOI)000861802500012 ()35598704 (PubMedID)
Available from: 2022-11-14 Created: 2022-11-14 Last updated: 2022-11-14Bibliographically approved
Axelin, A., Feeley, N., Cambell-Yeo, M., Silnes Tandberg, B., Szczapa, T., Wielenga, J., . . . Lehtonen, L. (2022). Symptoms of depression in parents after discharge from NICU associated with family-centred care. Journal of Advanced Nursing, 78(6), 1676-1687
Open this publication in new window or tab >>Symptoms of depression in parents after discharge from NICU associated with family-centred care
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2022 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 78, no 6, p. 1676-1687Article in journal (Refereed) Published
Abstract [en]

AIMS: The aim of this study was to examine the potential association of family-centred care as perceived by parents during a NICU stay with parents' depressive symptoms at discharge and at 4 months corrected for infant age.

DESIGN: A longitudinal, multicentre cohort study was conducted from 2018 to 2020 in 23 NICUs across 15 countries.

METHODS: Parents (n = 635 mothers, n = 466, fathers) of infants (n = 739) born before 35 weeks of gestation and admitted to the participating NICUs were enrolled to the study during the first weeks of their infants' hospitalizations. They responded to Digi-FCC daily text messages inquiring about their perception of family-centred care provided by NICU staff. In addition, they completed a questionnaire assessing their overall perception of family-centred care at discharge. Parents' depressive symptoms were measured by the Edinburgh Postnatal Depression Scale at discharge and again after discharge when their infants were at 4 months corrected for age.

RESULTS: The mothers' and the fathers' perceptions of family-centred care were associated with their depressive symptoms at discharge and at 4 months corrected age, controlling for gestational age, multiple birth, parent education and relationship status. Parents' participation in infant care, care-related decisions and emotional support provided to parents by staff explained the variation in the parents' perceptions of family-centred care. The factors facilitating the implementation of family-centred care included unlimited access to the unit for the parents and for their significant others, as well as amenities for parents.

CONCLUSIONS: Our study shows that family-centred NICU care associates with parents' depressive symptoms after a NICU stay.

IMPACT: Depression is common in parents of preterm infants. The provision of family-centred care may protect the mental well-being of parents of preterm infants.

Place, publisher, year, edition, pages
John Wiley & SonsWiley, 2022
Keywords
depression, family-centred care, health promotion, intensive care units, longitudinal study, neonatal parents, nursing, predictive research, preterm infant, prospective cohort
National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-463831 (URN)10.1111/jan.15128 (DOI)000729480500001 ()34897769 (PubMedID)
Available from: 2022-01-11 Created: 2022-01-11 Last updated: 2024-01-15Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-2743-3589

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