Commentary: Factors Influencing Implementation of Family-Centered Care in Neonatal Intensive Care Units.

Abstract

Although strides have been made in the global implementation of family-centered care (FCC), progress has been uneven and many advancements are still incipient—sometimes rendering FCC implementation an elusive dream. The principal finding of the study conducted by Oude Maatman et al. (1) was the recognition by healthcare teams of parents as primary caregivers, a critical element in FCC practice and parental involvement in the care of their infants. The investigators recommended starting FCC implementation by changing the mindset of healthcare teams toward families in neonatal intensive-care units (NICUs). In Brazil, FCC implementation in NICUs faces a number of barriers: (i) health literacy is typically poor among families, who also tend not to be fully aware of their rights; (ii) healthcare teams often have long-held constraining beliefs (family not viewed as primary caregiver in NICU; family presence deemed to overstimulate infants or increase infection risks; parents seen as visitors, not partners); (iii) many healthcare teams are unfamiliar with the concept and practice of FCC; (iv) poor infrastructure precludes accommodating families in NICUs; (v) heavy workloads deprive nursing teams of having time to involve families in infant care (2–5). Although these and other barriers may stem from different backgrounds across the globe (6), in Brazil they result primarily from socioeconomic inequality, poor education, and the overall culture within the healthcare system.