NICU Parents Research Articles

The Postpartum Worry Scale-Revised: continuing validation with a sample of NICU mothers.

This study represents the second validation phase of the Postpartum Worry Scale-Revised (PWS-R). As the PWS-R includes items tapping infant health and development concerns, we compare its psychometric properties with a sample of NICU mothers and the online sample used in the initial validation. We conduct a confirmatory factor analysis (CFA) to fit the latent factor structure previously validated with the online sample to the NICU sample. We also examine the reliability and construct validity of the PWS-R when used with a NICU sample. The PWS-R's reliability remains good and moderate concurrent correlations with theoretically similar constructs are shown with the newly created PWS-R factors. Model testing with the NICU sample reveals a different three factor structure than the four factor structure previously revealed with the online sample. The psychometric findings for the PWS-R provide continuing support for its use as a measure of postpartum worry; however, the differences in factor structure suggest that the PWS-R scores of high risk samples such as NICU parents should not be compared to those of community samples. Next steps in the iterative validation process and recommendations for use are considered, particularly with regard to high-risk samples.

Improving family-centered care practices in the NICU.

Family presence and participation in care in the NICU is fundamental to the recovery and well-being of the sick neonate and family. However, some NICU visitation policies are not supportive of families. A new visitor-management program was initiated at a local hospital. The program included open visitation for parents and others chosen by parents to be a support during their hospital stay. This quality-improvement project evaluated if there was any improvement in parents' perceptions and experiences of family-centered care after the implementation of the new visitor-management program. The NICU parent survey data revealed a modest positive difference in parent responses after the implementation of the program.

Audiovisual Presentations on a Handheld PC Are Preferred As an Educational Tool by NICU Parents

Health literacy is critical for understanding complex medical problems and necessary for the well being of the patient. Printed educational materials (PM) have limitations in explaining the dynamics of a disease process. Multimedia formats may be useful for enhancing the educational process. To evaluate whether a printed format or animation with commentary on a handheld personal computer (PC) is preferred as an educational tool by parents of a baby in the NICU. PARENTS EVALUATED TWO FORMATS: A 1-page illustrated document from the American Heart Association explaining patent ductus arteriosus (PDA) and animation with commentary on a handheld PC that explained the physiology of PDA in 1 minute. The reading grade level of the PM was 8.6 versus 18.6 for the audio portion of the animated presentation. Parents viewed each format and completed a four-item questionnaire. Parents rated both formats and indicated their preference as printed, animation, or both. Forty-six parents participated in the survey. Parents preferred animation over PM (50% vs. 17.4%. p = 0.02); 39.1% expressed that the animation was excellent; whereas 4.3% expressed that the PM was excellent (p<0.001). The order of presentation of formats, sex, age, and educational level of parents did not influence the method preferred (p>0.05). Parents preferred animation on a small screen handheld PC despite a much higher language level. Because handheld PCs are portable and inexpensive, they can be used effectively at the bedside with low-cost animation to enhance understanding of complex disease conditions.

NICU Parents’ Top Ten Worries at Discharge

AN INFANT’S DISCHARGE FROM the NICU creates a flurry of activity on the part of both the parents and the professionals. Though everyone has been planning for this day, its exact timing and requirements often remain elusive until the day comes. So much has happened, and so much more will happen going forward. The parents are often in a tailspin as to how to handle their growing anxiety. Although they rarely verbalize their fears, NICU parents universally experience them.

Information needs of parents of children admitted to a neonatal intensive care unit: A review of the literature (1990–2008)

Objective This literature review focuses on information and communication needs of parents of children admitted to the NICU and on their use of information sources in the illness trajectories at NICU. Methods Literature search in 4 electronic databases (Ovid Medline, PsycINFO, CINAHL and Sociological Abstracts), covering 1990–March 2008. Results The seventy-eight included articles revealed that NICU parents have high information needs. The illness trajectory mediates parental information needs and induces a changing pattern in information use and information needs. Most attention is paid to the prenatal and acute phases, while information behaviour in sudden events and later phases receives limited attention. Conclusions In-depth studies on information needs and corresponding use of information sources are lacking. More longitudinal studies are needed, taking the illness trajectory into account and investigating the determinants and outcomes of the information and communication needs of NICU parents. Practice implications Healthcare professionals should adapt their information provision along the illness trajectory. The development of guidelines of information provision during the illness trajectory at NICU would support all professionals.

Parental Perception of Neonates, Parental Stress and Education for NICU Parents

The purpose of this study was to conduct a comparative analysis between the perception of parents with premature infants in the NICU and parents with full-term newborns, and in the process to evaluate the effects of NICU educational support on parents with regard to their perception of neonate and parental stress. A mixed quantitative design was employed to compare parental perception of neonates using the Neonatal Perception Index (NPI) between the parents of 26 full-term infants (full-term group) and the parents of 22 premature infants in the NICU (NICU group), and also to evaluate the effect of NICU educational support on NPI and parental stress using the Parental Stress Scale (PSS) between the mothers and fathers in the NICU group. NICU mothers showed the lowest NPI score among full-term and NICU parents. However, no difference in direction of NPI scores was observed between parents in either the full-term or NICU group. NICU education improved NPI and decreased PSS in fathers but not in mothers. Environmental modifications of the nursery setting, particularly its remote location to the NICU, could improve mothers' perception of full-term neonates. NICU mothers, as the principal care- givers, may suffer from culturally-grounded, psychoemotional disturbances after giving birth to a sick infant, which may not be applicable to fathers. The quality of family-centered care in the NICU environment, parental role alteration, and the condition of infants need to be improved to decrease parental stress in the NICU. Fathers may have significant potential in caring for mothers and sick infants during the transition to parenthood. Education for NICU parents should be done for both mothers and fathers in the acute postpartum period.

SAFETY AND EFFICACY OF INTERMITTENT HOME GAVAGE FOR NICU INFANTS.† 1909

We base our NICU discharge decisions on physiologic criteria (rather than on weight or postconceptual age). Since establishment of oral feedings had previously delayed discharge in otherwise stable infants, we developed a teaching and evaluation program to examine prospectively the safety and efficacy of intermittent, in-home gavage feedings by NICU parents.

Facing Tragic Decisions with Parents in NICU: Clinical Perspectives

To the Editor.— As a primary care physician I read with great interest the article by Dr Jellinek et at1 about the tragic decisions in neonatal intensive care units. Their perspective seems to be very worthwhile and helpful both to physicians, parents, and patients. I was disappointed, however, that the family's primary care pediatrician was relegated to the next to the last paragraph, almost an afterthought. Family pediatricians have a great perspective on the interaction between families and their children.

Care of Parents in NICU

Care of Parents in NICU

33 A NICU PARENT BOOKLET AND ITS EVALUATION

This paper discusses the origins and content of a NICU parent orientation booklet and its evaluation. The booklet (NICU) is given to parents at the time of transport, or birth, of their infant. Its effectiveness was evaluated by questionnaire to 100 parents within two weeks after their neonate's admission. 98 parents read the booklet; 90% of those who read the booklet found it helpful in understanding therapy, routine and special procedures. 74% found it helpful in understanding terms used by the staff. 94% understood visiting and their care-taking roles upon their first visit. 85% found the booklet helpful knowing what to expect and to feel more comfortable during their first visit. 98% felt comfortable in asking questions freely after being prompted to do so by the booklet. Less than 5% felt the pictures made them feel worse. 83% of the transport team, 30% of staff nurses and 20% of housestaff used the booklet to supplement their orientation of families to the NICU. We concluded that a family orientation booklet to a NICU is helpful in preparing families for the events of a NICU admission of their neonate.