Abstract
The ongoing Coronavirus disease 2019 (COVID-19) pandemic is disrupting most specialized healthcare services worldwide, including those for high-risk newborns and their families. Due to the risk of contagion, critically ill infants, relatives and professionals attending neonatal intensive care units (NICUs) are undergoing a profound remodeling of the organization and quality of care. In particular, mitigation strategies adopted to combat the COVID-19 pandemic may hinder the implementation of family-centered care within the NICU. This may put newborns at risk for several adverse effects, e.g., less weight gain, more nosocomial infections, increased length of NICU stay as well as long-term worse cognitive, emotional, and social development. This article aims to contribute to deepening the knowledge on the psychological impact of COVID-19 on parents and NICU staff members based on empirical data from the literature. We also provided evidence-based indications on how to safely empower families and support NICU staff facing such a threatening emergency, while preserving the crucial role of family-centered developmental care practices.
Highlights
The ongoing pandemic of Coronavirus disease 2019 (COVID-19) has infected, at the time of writing this article, tens of millions of people and contributed to over one and a half million deaths globally
The COVID-19 pandemic has dramatically changed the lifestyle of people worldwide, while disrupting healthcare services and systems, including neonatal intensive care units (NICUs)
It is vital to deepen the understanding of how the pandemic has influenced familycentered care practices and dynamics in NICUs, gauging the psychological impact of COVID-19 on parents and frontline professionals
Summary
The ongoing pandemic of Coronavirus disease 2019 (COVID-19) has infected, at the time of writing this article, tens of millions of people and contributed to over one and a half million deaths globally (see https://covid19.who.int/). Pandemic-related factors such as (i) over-work or work with long shifts, (ii) wearing additional personal protective equipment, which has been described as necessary but timeconsuming and disruptive to clear communication with parents (Semaan et al, 2020; Cena et al, under review), (iii) being unable to act according to their own values, the values of the patient’s family, or the values of the family-centered care model (i.e., because of pandemic-related policies enforcing social distancing and other measures that are not typical in NICU patient care), (iv) difficulties in meeting the emotional needs of hospitalized infants and their families while safeguarding their own health, (v) anxiety and fear about their personal physical safety (Chang et al, 2020) as well as that of friends and family members (whom they could infect while asymptomatic), (vi) emotional pain for the loss of infected friends/relatives/colleagues, and (vii) restrictions on personal and social activities are contributing to increased psychological stress in these people It follows that these professionals are at higher than average risk for burnout (Profit et al, 2014; Crowe et al, 2020), a condition that poses additional challenges for family-centered care. If professionals do not have accessible resources and support to take care of their physical and mental health, they will not be able to deliver the appropriate care and critical services to the most vulnerable populations, including infants and NICU families, during this pandemic
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