Abstract
BackgroundBecoming a parent of a preterm baby requiring neonatal care constitutes an extraordinary life situation in which parenting begins and evolves in a medical and unfamiliar setting. Although there is increasing emphasis within maternity and neonatal care on the influence of place and space upon the experiences of staff and service users, there is a lack of research on how space and place influence relationships and care in the neonatal environment. The aim of this study was to explore, in-depth, the impact of place and space on parents’ experiences and practices related to feeding their preterm babies in Neonatal Intensive Care Units (NICUs) in Sweden and England.MethodsAn ethnographic approach was utilised in two NICUs in Sweden and two comparable units in England, UK. Over an eleven month period, a total of 52 mothers, 19 fathers and 102 staff were observed and interviewed. A grounded theory approach was utilised throughout data collection and analysis.ResultsThe core category of ‘the room as a conveyance for an attuned feeding’ was underpinned by four categories: the level of ‘ownership’ of space and place; the feeling of ‘at-homeness’; the experience of ‘the door or a shield’ against people entering, for privacy, for enabling a focus within, and for regulating socialising and the; ‘window of opportunity’. Findings showed that the construction and design of space and place was strongly influential on the developing parent-infant relationship and for experiencing a sense of connectedness and a shared awareness with the baby during feeding, an attuned feeding.ConclusionsIf our proposed model is valid, it is vital that these findings are considered when developing or reconfiguring NICUs so that account is taken of the influences of spatiality upon parent’s experiences. Even without redesign there are measures that may be taken to make a positive difference for parents and their preterm babies.
Highlights
Becoming a parent of a preterm baby requiring neonatal care constitutes an extraordinary life situation in which parenting begins and evolves in a medical and unfamiliar setting
Another area which is being addressed in the actual design of physical places is in neonatal intensive care units (NICUs) [5]; in particular, there is a trend in some countries towards single family room design when building new units [5,6] increasingly replacing traditional open-bay design units
In each country one level 2 and one level 3 Neonatal Intensive Care Units (NICUs) were selected, representing variation in levels of intensive care, health care practices related to infant feeding, and use of space and place
Summary
Becoming a parent of a preterm baby requiring neonatal care constitutes an extraordinary life situation in which parenting begins and evolves in a medical and unfamiliar setting. There are moves to humanise the environments of care, for example the birth centre movement endeavours to provide a place like ‘home’ within a small maternity unit setting [11,12] Another area which is being addressed in the actual design of physical places is in neonatal intensive care units (NICUs) [5]; in particular, there is a trend in some countries towards single family room design when building new units [5,6] increasingly replacing traditional open-bay design units. There is a very large variation between NICUs as to the extent to which they offer such facilities [16]
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