Creating Opportunities For Parent Empowerment Research Articles

Promoting Developmental Outcomes of Premature Infants by Creating Opportunities for Parent Empowerment (COPE)

Objectives: Premature neonates are at greater risk of developmental problems such as cerebral palsy, developmental delays, and hearing and vision problems. The challenge of healthcare professionals who support preterm neonates and their parents is not only ensuring neonates’ survival but also optimizing infant development. Interventions to reduce adverse health outcomes are very important. The present study was focused on exploring the effect of the Creating Opportunities for Parent Empowerment (COPE) schedule on the developmental outcomes of premature infants Methods: The randomization process was done using a randomized block design, and neonates were assigned randomly to the treatment (n=20) and control (n=20) groups. Neonates in two groups were matched in gestational age, birth height, head circumference at birth, birth weight, Apgar scores (1 min, 5 min), prematurity, and new Ballard score. So, there was not a significant difference between them at the baseline. In the intervention group, the parents received a COPE schedule in a set of CD’s in conjunction with written instruction and supplemental activities (guidebook). COPE schedule was performed in 5 steps. In the control group, neonates received only routine services and interventions, and the research therapist performed no additional interventions. New Ballard examination was done in all neonates at the time of enrollment, followed by administration of Ages and Stages Questionnaire (ASQ) by an occupational therapist, who was double-blinded for the study, to any available parent (mostly mothers) at 6 months of corrected age. Results: The results showed more maturity in “communication”, “gross motor”, “problem-solving”, and “personal-social” in the intervention group, and the observed differences between the two groups in these outcomes were statistically significant (P<0.05). Discussion: This educational-behavioral intervention program could promote mothers’ knowledge about their neonates and improve the developmental aspects of premature infants during their first months of life.

Effect of a Parent Empowerment Program on Parental Stress, Satisfaction, and Length of Stay in the Neonatal Intensive Care Unit.

Parental stress is high when infants are admitted to a neonatal intensive care unit in community-based hospital. This quasi-experimental study explored the effect of implementing the "Creating Opportunities for Parent Empowerment" (COPE) program on parental stress, postpartum depression, parental satisfaction with care, and length of stay in a community-based hospital. A cohort of nurses completed a 1-day "COPE for HOPE" parent empowerment training session. A nurse implemented the COPE parent training at the bedside soon after birth and extended throughout hospitalization. The following instruments were used to collect data: a demographic data sheet, Parental Stress Scale: Neonatal Intensive Care Unit, Edinburgh Postnatal Depression Scale, and an investigator-designed parent satisfaction survey. Forty-nine parent sets participated in the study (29 in the intervention group, 20 in the comparison group). A significant difference was found between the groups related to lower parental stress. There was no difference in terms of parental depression scores or length of hospital stay. However, clear trends revealed that parents in the COPE group exhibited lower depression scores. Parents in both groups reported being greater than 95% satisfied with care across all items. These findings may motivate administrators in other community-based hospitals to implement this intervention.

Increasing Mothers' Confidence and Ability by Creating Opportunities for Parent Empowerment (COPE): A Randomized, Controlled Trial.

Premature neonates are at great risk forcerebral palsy, developmental delays, hearing problems andvisual impairments. Interventions to reduce the morbidities and adverse health outcomes in these neonates and improve parent-infant interaction are highly important. This study was conducted to determine the effect of the Creating Opportunities for Parent Empowerment (COPE) program on the perceived maternal parenting self-efficacy of premature parents. This was a randomized controlled trial with equal randomization (1:1:1 for 3 groups) and parallel group design. Forty-five preterm neonates were randomly allocated to treatment (n=15), supervision (n=15) and control (n=15) groups. COPE program was provided in the form of a 4-phase educational-behavioral intervention to the treatment and supervision groups. The primary outcome was parental self-efficacy, which was assessed by the Perceived Maternal Parenting Self-Efficacy inventory. All the measurements were performed pre- and post-completion with the valid equipment and by blind assessors. COPE mothers reported significantly stronger beliefs regarding their parental role and have more confidence to their ability in caring of neonates compared with control mothers (P-value <0.001). An educational-behavioral intervention would strengthen mothers' belief in themselves and knowledge about their neonates and would enhance premature mothers' ability to care for their neonates as well as parent-infant interaction.

The Effect of "Creating Opportunities for Parent Empowerment" Program on Parents of Children With Epilepsy and Other Chronic Neurological Conditions.

Parents taking care of children with epilepsy experience stress in their daily lives, which enhances their anxiety, changes their function, and eventually increases their children's behavioral problems. The present study aimed at investigating the effect of creating opportunities for parent empowerment (COPE) program on parents of children with epilepsy or other chronic neurological conditions. A quasi-experimental clinical trial was conducted on 88 mothers of hospitalized children with epilepsy aged 3 to 12 years. In the intervention group, the COPE program was conducted by the researcher in three phases and the usual care groupreceived usual healthcare. The mothers' anxiety was assessed in three phases in both groups. Results of the present study showed that the effect of time and group-time interaction on the state anxiety and trait anxiety was significant in the intervention group; however, the effect of time was not significant in the usual care group (P = 0.12). The differences of state anxiety and trait anxiety were not significant between the two groups (P = 0.136), which depended on the baseline level of anxiety. By analyzing the covariance after controlling the two variables at baseline, it was observed that the score variations in the state anxiety and trait anxiety were significant at all studied time points. The results of the current study indicated the positive effect of the COPE program on the anxiety of parents of children with epilepsy. Since this technique is non-pharmacological, convenient, easy-to-apply, and cost-effective, it can be used to reduce the parents' anxiety.

Effectiveness of early intervention programs for parents of preterm infants: a meta-review of systematic reviews

BackgroundVarious intervention programs exist for parents of preterm babies and some systematic reviews (SRs) have synthesised the evidence of their effectiveness. These reviews are, however, limited to specific interventions, components, or outcomes, and a comprehensive evidence base is lacking. The aim of this meta-review was to appraise and meta-synthesise the evidence from existing SRs to provide a comprehensive evidence base on the effectiveness of interventions for parents of preterm infants on parental and infant outcomes.MethodsWe conducted a comprehensive search of the following databases to identify relevant SRs: Cochrane library, Web of science, EMBASE, CINAHL, British Nursing Index, PsycINFO, Medline, ScienceDirect, Scopus, IBSS, DOAJ, ERIC, EPPI-Centre, PROSPERO, WHO Library. Additional searches were conducted using authors’ institutional libraries, Google Scholar, and the reference lists of identified reviews. Identified articles were screened in two stages against an inclusion criteria with titles and abstracts screened first followed by full-text screening. Selected SRs were appraised using the AMSTAR tool. Extracted data using a predesigned tool were synthesised narratively examining the direction of impact on outcomes.ResultsWe found 11 SRs eligible for inclusion that synthesised a total of 343 quantitative primary studies. The average quality of the SRs was ‘medium’. Thirty four interventions were reported across the SRs with considerable heterogeneity in the structural framework and the targeted outcomes that included maternal-infant dyadic, maternal/parental, and infant outcomes. Among all interventions, Kangaroo Care (KC) showed the most frequent positive impact across outcomes (n = 19) followed by Mother Infant Transaction Program (MITP) (n = 14). Other interventions with most consistent positive impact on infant outcomes were Modified-Mother Infant Transaction Program (M-MITP) (n = 6), Infant Health and Development Program (IHDP) (n = 5) and Creating Opportunities for Parent Empowerment (COPE) (n = 5). Overall, interventions with both home and facility based components showed the most frequent positive impact across outcomes.ConclusionsNeonatal care policy and planning for preterm babies should consider the implementation of interventions with most positive impact on outcomes. The heterogeneity in interventions and outcomes calls for the development and implementation of an integrated program for parents of preterm infants with a clearly defined global set of parental and infant outcomes.

The Effect of Creating Opportunities for Parent Empowerment Program on Parent’s Mental Health: A Systematic Review

ontext: Premature birth and the consequent neonatal intensive care unit (NICU) admission cause parents great distress, which makes them in need of support when their infant is hospitalized at the NICU. Objectives: The aim of this study was to determine the impact of creating opportunities for parent empowerment (COPE) program on parents’ mental health. This review emphasizes on mental disorders’ prevention. Data Sources: This systematic review was performed by searching the databases including Cochrane Library, PubMed, Scopus, Google Scholar, Proquest, Science Direct, SID, Magiran and Iranmedex databases for interventional papers from 2000 to 2015. Study Selection: The studies, which were considered for this review included, randomized controlled clinical trials and quasi- experimental studies on the impact of COPE program on the mental health of premature infants’ parents. Data Extraction: For determination of eligible studies, two authors extracted the data independently and discrepancies were re- solved through discussion or, if required, through consultation with a third author. Results: Only four studies conducted on the impact of COPE program on parents’ mental health were included in this systematic review. According to these studies, the implementation of COPE program for the parents of premature infants hospitalized at the NICU decreased stress significantly after the second phase of the COPE program (-1.72 (95% CI: -1.97, -1.47)) and state anxiety after first phase of program (-1.01 (95% CI: -1.48, -0.53)) in mothers. Conclusions: The studies suggested the positive impact of COPE programs on parents’ mental health; however, more studies are recommended on all aspects of mental health along with further involvement of fathers.

Evaluating the effectiveness of Parent Empowerment (COPE) program on participation of mothers of preterm infants hospitalized in NICUs of hospitals affiliated to Isfahan University of Medical Sciences and Health Services, 2009-2010

Abstract Background and aim: The birth of a preterm infant is a stressful event for parents. Because of special nature of the Neonatal Intensive Care Unit (NICU) environment, parents of infants admitted to a neonatal intensive care unit experience higher levels of tension, compared with parents of healthy infants the mother’s physical and psychological condition may negatively influence early and suitable mother–infant relationship, the mother’s participation in her infant care and the infant’s long-term developmental outcome. The purpose of this study was to evaluate the effectiveness of Creating Opportunities for Parent Empowerment (COPE) program on participation of mothers of preterm infants hospitalized in NICUs of hospitals affiliated to Isfahan University of Medical Sciences and Health Services. Method and material: A randomized clinical trial was conducted with 90 mothers of premature infants hospitalized in the neonatal intensive care units. COPE mothers received 2 intervention sessions of audiotaped and printed materials with workbook. This program consisted of information and behavioral activities about the appearance and behavioral characteristics of preterm infants and how best to parent them. Duration between sessions was 2 to 4 days. Data were collected by a questionnaire.The participation was evaluated just 2 to 4 days after second phase. Results: The mea score of mothers’ participation in experiment group was 9.14±0.84 and 9.43±1.06 for the first and second phase of post -test.Mothers in the Creating Opportunities for Parent Empowerment program reported significantly more participation in their infants care (p<0.001). Discussion and Conclusion: Creating Opportunities for Parent Empowerment program diminished mothers enhance the amount of mother’s participation. This study showed that early interventions during neonatal hospitalization and educational behavioral information in written form may have positive effect on maternal psychological condition and participation. Key words: nurse, parents’ empowerment , participation, preterm infant, randomized clinical trial

Speeding the Translation of Research into Evidence‐Based Practice and Conducting Projects That Impact Healthcare Quality, Patient Outcomes and Costs: The “So What” Outcome Factors

Speeding the Translation of Research into Evidence‐Based Practice and Conducting Projects That Impact Healthcare Quality, Patient Outcomes and Costs: The “So What” Outcome Factors

Family-centred care in the paediatric intensive care unit

The aim was to assess emotional support given to mothers of children in intensive care units (ICUs) and make recommendations to nurse managers regarding family-centred nursing care in paediatric ICUs in South Africa. Family-centred care is an essential component of paediatric care. Nurse managers should enhance implementation and sustainability to ensure quality care. A quantitative descriptive research design was used. Structured interviews using questionnaires were conducted with 62 mothers whose children were nursed in ICUs in Bloemfontein. Fifteen stressors for mothers were identified and emotional support for mothers in ICU's was assessed and described. Analysis indicated that COPE (Creating Opportunities for Parent Empowerment) can be used within the South African context to enhance family-centred paediatric nursing care. Competencies of nurse practitioners and other staff involved must be improved and the seriousness and importance of emotional support as part of family-centred care should be emphasized. Nurse managers should take responsibility for the training of staff in implementing COPE as a possible empowerment programme in Paediatric ICUs to ensure that emotional support is not neglected.

Reducing hospital expenditures with the COPE (Creating Opportunities for Parent Empowerment) program for parents and premature infants: an analysis of direct healthcare neonatal intensive care unit costs and savings.

More than 500,000 premature infants are born in the United States every year. Preterm birth results in a multitude of negative adverse outcomes for children, including extended stays in the neonatal intensive care unit (NICU), developmental delays, physical and mental health/behavioral problems, increased medical utilization, and poor academic performance. In addition, parents of preterms experience a higher incidence of depression and anxiety disorders along with altered parent-infant interactions and overprotective parenting, which negatively impact their children. The costs associated with preterm birth are exorbitant. In 2005, it is estimated that preterm birth cost the United States $26.2 billion. The purpose of this study was to perform a cost analysis of the Creating Opportunities for Parent Empowerment (COPE) program for parents of premature infants, a manualized educational-behavioral intervention program comprising audiotaped information and an activity workbook that is administered to parents in 4 phases, the first phase commencing 2 to 4 days after admission to the NICU. Findings indicated that the COPE program resulted in cost savings of at least $4864 per infant. In addition to improving parent and child outcomes, routine implementation of COPE in NICUs across the United States could save the healthcare system more than $2 billion per year.

Reducing Premature Infants' Length of Stay and Improving Parents' Mental Health Outcomes With the Creating Opportunities for Parent Empowerment (COPE) Neonatal Intensive Care Unit Program: A Randomized, Controlled Trial

Although low birth weight premature infants and parents are at high risk for adverse health outcomes, there is a paucity of studies that test early NICU interventions with parents to prevent the development of negative parent-infant interaction trajectories and to reduce hospital length of stay. Our objective was to evaluate the efficacy of an educational-behavioral intervention program (ie, Creating Opportunities for Parent Empowerment) that was designed to enhance parent-infant interactions and parent mental health outcomes for the ultimate purpose of improving child developmental and behavior outcomes. A randomized, controlled trial was conducted with 260 families with preterm infants from 2001 to 2004 in 2 NICUs in the northeast United States. Parents completed self-administered instruments during hospitalization, within 7 days after infant discharge, and at 2 months' corrected age. Blinded observers rated parent-infant interactions in the NICU. All participants received 4 intervention sessions of audiotaped and written materials. Parents in the Creating Opportunities for Parent Empowerment program received information and behavioral activities about the appearance and behavioral characteristics of preterm infants and how best to parent them. The comparison intervention contained information regarding hospital services and policies. Parental stress, depression, anxiety, and beliefs; parent-infant interaction during the NICU stay; NICU length of stay; and total hospitalization were measured. Mothers in the Creating Opportunities for Parent Empowerment program reported significantly less stress in the NICU and less depression and anxiety at 2 months' corrected infant age than did comparison mothers. Blinded observers rated mothers and fathers in the Creating Opportunities for Parent Empowerment program as more positive in interactions with their infants. Mothers and fathers also reported stronger beliefs about their parental role and what behaviors and characteristics to expect of their infants during hospitalization. Infants in the Creating Opportunities for Parent Empowerment program had a 3.8-day shorter NICU length of stay (mean: 31.86 vs 35.63 days) and 3.9-day shorter total hospital length of stay (mean: 35.29 vs 39.19 days) than did comparison infants. A reproducible educational-behavioral intervention program for parents that commences early in the NICU can improve parent mental health outcomes, enhance parent-infant interaction, and reduce hospital length of stay.

Testing the Theoretical Framework of the COPE Program for Mothers of Critically Ill Children: An Integrative Model of Young Children's Post-Hospital Adjustment Behaviors

To test a theoretical model examining processes through which a parent-focused educational-behavioral intervention [Creating Opportunities for Parent Empowerment (COPE)] relates to children's post-hospital adjustment problems. Mothers (n = 143) and their 2-7-year-old children, unexpectedly hospitalized in two pediatric intensive care units, were randomized to COPE or control conditions. Maternal measures included parental beliefs, anxiety, negative mood, and child adjustment 3 months post discharge. Observers rated maternal support of their children during hospitalization. Structural equation modeling suggested that the model tested provided a reasonable fit to the data [chi2 (97 df) = 129.43; p = .016; root mean square error of approximation = .048; comparative fit index = .95]. COPE effects on children's post-hospital externalizing behaviors were indirect, via associations with parental beliefs and maternal negative mood state. Furthermore, COPE participation was associated with more maternal support of their children, which was also associated with less internalizing and externalizing behaviors 3 months post discharge. Implementing COPE may help avert future mental health problems in this high risk population. Understanding the processes by which an already empirically validated program relates to child outcomes is likely to aid clinicians and administrators in the widespread uptake of the COPE program.

Enhancing Coping Outcomes of Mothers and Young Children Following Marital Separation: A Pilot Study

The major purpose of this pilot study is to determine the feasibility of implementing a reproducible, preventive intervention program to enhance coping outcomes with mothers and their young children following marital separation. A two-group experiment was used with 21 mothers experiencing recent marital separation and their 3 to 6-year-old children. Experimental group mothers received the Creating Opportunitiesfor Parent Empowerment (COPE) Intervention Program, which consisted of audiotaped information and behavioral activities to enhance parenting effectiveness and coping outcomes in their children. Comparison group mothers received information and activities related to normal growth and development of preschool children. Trends in the data and effect sizes revealed positive short-term outcomes over a 3½-month study period on nearly all measures for mothers and children who received the COPE Intervention Program. Afull-scale study is now being planned to determine both short and long-term effects of the COPE Intervention Program.