Parental Presence Research Articles

Impact of COVID-19 Pandemic on the Health of Preterm Infants in Iran

Coronavirus disease 2019 (COVID-19) directly increases the risk of preterm delivery. Furthermore, the COVID-19 pandemic may indirectly impact the health status of preterm infants. In the present study we noted several views regarding the negative effects of this viral disease on postnatal health that need much consideration. Methods: A short communication study was carried out in 2020. Literatures indicating several adverse effects of COVID 19 pandemic on health of preterm neonates were reviewed. Results: Literature review has revealed that regarding the protecting newborns from infectious risk in the neonatal intensive care units (NICU), several policies have been implemented. Isolation of ill COVID-19 positive mother, mother-infant separation, interruption of skin to skin contact and breastfeeding, restrictions associated with the presence of parents in the NICUs are some of them. Moreover, postponing the follow-up consultations and lack of healthcare services are also other influencing problems. Conclusion: It seems urgent measures must be implemented to protect preterm neonates and their parents against severe consequences. Providing adequate and professional human resources in the NICUs, improvement of virtual communication for parent's involvement in the NICU admission period and postnatal follow-up appointments, promotion of exclusive breastfeeding for subjects without any contraindication, reminding vaccination schedule by calling or texting, reducing the family's financial burden by governmental support, improving mother-infant bonding with respiratory and hand hygiene are a few recommendations that could be beneficial.

Pediatric Transport Safety Collaborative: Adverse Events With Parental Presence During Pediatric Critical Care Transport.

In Canada, critically ill pediatric patients require transfer to a tertiary care center for definitive medical and surgical management. Some studies suggest that family accompaniment could compromise care; currently, limited research has examined patient safety and outcomes during pediatric critical care transport with family presence, and no Canada-specific data currently exists. The primary objective of this study was to compare the rate of adverse events during the transport of pediatric patients by a specialized pediatric critical care transport team with parental accompaniment to those without parental accompaniment. Secondary objectives included whether geographic or patient-specific factors affected rates of parental accompaniment and if parental presence during transport was related to patient outcomes. Retrospective cohort study in a pediatric critical care unit convenience sample at an academic children's hospital. Inclusion criteria constituted all patients younger than 18 years who were admitted to the pediatric critical care unit after interfacility transport by the London Health Sciences Center Neonatal Pediatric Transport Team between April 1, 2018, and April 30, 2020, inclusive. Adverse event rates, patient characteristics, and clinical outcomes were compared. There were 357 transports eligible for analysis. Of these, there were 180 transports with, and 177 without, parental accompaniment. The primary outcome was adverse event occurrence using the composite definition of adverse events, previously defined by a Canadian consensus process, which included patient-, transport provider-, laboratory-, and system/vehicle-related safety factors. The occurrence of adverse events was not significantly different between transports with and without parental accompaniment, 49.4% and 54.8%, respectively (odds ratio, 0.80; P = 0.311). This is the first study to compare the effect on adverse event rate and clinically relevant outcomes between transports with and without parental presence during interfacility pediatric critical care transport. Our study found no significant difference in the adverse event rate between transports with and without parental presence.

Socio-demographic factors related to parent engagement in the NICU and the impact of the SENSE program

BackgroundEarly parent engagement in the neonatal intensive care unit (NICU) is important for both parent and infant mental health and for improving developmental outcomes. It remains unclear how different programs, such as the Supporting and Enhancing NICU Sensory Experiences (SENSE) program, may empower parents from various socio-demographic groups to engage in the NICU. An improved understanding could aid in individualizing interventions for those at the highest risk for health disparities. AimsThis exploratory study, which was part of a larger study, sought to explore 1) socio-demographic factors related to parent presence and engagement in the NICU and 2) if the SENSE program related to increased parent presence and engagement among different socio-demographic groups. MethodsSeventy parent-infant dyads (born ≤ 32 weeks gestation) were randomized to SENSE programming (parent education and age-appropriate, positive sensory interventions for parents to conduct with their infants every day of hospitalization) or standard care after admission to the NICU. The amount of parent presence and participation in sensory activities was tracked using bedside logs, nursing records, and research team documentation. ResultsBeing married (p = 0.048; p = 0.01), having private insurance (p < 0.001; p = 0.01), and having fewer children (p = 0.004; p = 0.03) related to more parent presence and engagement respectively. Parents who were Black had less presence and engagement in the NICU (p = 0.04; p = 0.02). Participation in the SENSE program was related to more parent presence and engagement among younger mothers (p = 0.002; p ≤0.001) and among parents living farther distances from the hospital (p < 0.001; p = 0.004). ConclusionProgramming, such as the SENSE program, can improve parent engagement in the NICU among high-risk groups.

Effect of presence and absence of parents on the emotional maturity and perceived loneliness in adolescents

The present study was conducted to examine the Emotional Maturity and Perceived Loneliness of adolescents with respect to the presence and absence of parents. It was hypothesized that the absence or presence of parents of adolescents would affect the level of emotional maturity and perceived loneliness among adolescents. The adolescent participants N=250 (males n=125 and females n=125; age range= 13-18; M=16.63; SD=0.87) were approached through purposive convenient sampling technique. Measures included the Emotional Maturity Scale and the UCLA loneliness scale V-III. Results indicated that adolescent who lived with their guardians had greater perceived loneliness than those who lived with their parents. However, adolescents who were living with their parents had lower Emotional Maturity. A significant negative but weak/moderate relationship was found between Perceived Loneliness and Emotional Maturity (r=-.28). The findings of this study can be useful in clinical settings to counsel adolescents who are facing conflicts with step- or absent- parents, or feel lonely in the presence of their parents as well as in therapies and have disrupted levels of emotional maturity. Moreover, it can benefit the psychological community by providing the opportunity to find solutions to relevant problems.

Parental presence at the bedside of critically ill children in the pediatric intensive care unit: A scoping review.

Parental presence at the bedside (PPB) of critically ill children in the pediatric intensive care unit (PICU) is necessary for operationalizing family-centred care. Previous evidence syntheses emphasize parent-healthcare provider interactions at rounds and resuscitation; our focus is the parent–child dyad. Prior to embarking on further study, we performed a scoping review to determine the breadth and scope of the literature addressing PPB of critically ill children in the PICU. We searched five online databases (MEDLINE, EMBASE, CINAHL, Cochrane Library, and PSYCHINFO) and the grey literature to identify English and French reports from January 1960 to June 2020 addressing physical parental presence with children (birth to 18 years) in intensive care units, without limitation by methodology. Screening, reference selection, and data extraction were performed by two independent reviewers. Data were extracted into a researcher-designed tool. We identified 204 publications (81 quantitative, 68 qualitative, 22 mixed methods, and 9 descriptive case or practice change studies, and a further 24 non-study reports). PPB was directly assessed in 78 (38%) reports, and was the primary objective in 64 (31%). Amount or quality of presence was addressed by 114 reports, barriers and enablers by 152 sources, and impacts and outcomes by 134 sources. While only 6 reports were published in the first two decades of our search (1960–1980), 17 reports were published in 2019 alone. Conclusions: A relatively large body of literature exists addressing PPB of critically ill children. Separate systematic evidence syntheses to assess each element of PPB are warranted. Scoping review protocol registration: Open science framework, protocol nx6v3, registered 9-September-2019. What is Known: • Parental presence at the bedside of critically ill children must be enabled to facilitate family centeredness in care. • Systematic evidence syntheses have focused on parental presence at rounds or resuscitation, rather than with the child throughout the intensive care journey. What is New: • Many reports (n=204) address parental presence at the bedside in the pediatric intensive care unit, though most do as incidental findings • Identifies studies addressing key elements of parental presence in the PICU including barriers and enablers to, amount and quality of, and impact and outcomes of parental presence, and demonstrates trends over time and geography. Supplementary InformationThe online version contains supplementary material available at 10.1007/s00431-021-04279-6.

Absentee Parents in Disney Feature-length Animated Movies: What are Children Watching?

Globally, Disney animated films integrate education into entertainment for families with children. This study uses the Social Capital Theory as the framework to support its focus on parental attention to children’s developmental learning needs. This exploratory study examines how Disney animated movies over the last eight decades portraited parents in the life of the leading child characters. With three inclusion criteria (figure-length, animated, and at least one child being the protagonist), we found 155 films for the general audience released between 1937 and 2020. We read relevant website-posted plots and themes of each selected movie from three major informational websites. Data included the leading child, parents or parental figures, and the central theme of the movie. Most of these 155 stories (n = 97, 61.3%) did not mention the child’s biological parents. Half of the 48 parental-presence films projected life in a single-headed family and the main characters' heroic image. The movies released during 2000–2020 showed a higher parental presence than the previous seven vicennial periods. Findings show that families could use Disney animated movies illustrating fantasy and reality. Parents can engage children in discussions about friendship and family relationships after watching a movie. If children continue consuming Disney movies, parental involvement is needed to facilitate discussions of real-life learning to help children develop communication skills.

Do Single-Family Rooms Increase Parental Presence, Involvement, and Maternal Well-Being in Neonatal Intensive Care?

Objectives of this study were to determine whether single-family room (SFR) design enhances parental presence, involvement, and maternal well-being during neonatal intensive care hospitalization. An observational cohort including mothers of infants was randomly assigned to receive care in a tertiary-level open-bay (OB) (n = 35) or SFR (n = 36). Mothers were asked to complete daily diaries documenting parental presence, involvement in care, and questionnaires examining maternal well-being. Mother and father mean presence (standard deviation) was significantly higher in the SFR-17.4 (5.2) and 13.6 (6.8)-compared to OB-11.9 (6.3) and 4.6 (3.7) hours/day. Total time spent in care activities did not differ for mothers, except SFR mothers spent more time expressing breast milk (EBM). SFR fathers had greater involvement with care activities. There were no other significant differences. The SFR was associated with greater maternal presence, but not greater involvement in care activities except for EBM, nor improved maternal well-being. The SFR appears to have greater impact on fathers' involvement in care and comforting activities, although the amount of time involved remained quite low compared with mothers. Further studies examining ways to enhance parental involvement in the neonatal intensive care unit are warranted.

AAP Publications Reaffirmed or Retired

Policy Statement. Nondiscrimination in pediatric health care. Pediatrics. 2007;120(4):922–923. Available at: https://pediatrics.aappublications.org/content/120/4/922. Reaffirmed May 2021Policy Statement. Global climate change and children's health. Pediatrics. 2015;136(5):992–997. Available at: https://pediatrics.aappublications.org/content/136/5/992. Reaffirmed May 2021Technical Report. Global climate change and children's health. Pediatrics. 2015;136(5). Available at: https://pediatrics.aappublications.org/content/136/5/e1468. Reaffirmed May 2021Clinical Report. Assessment and management of inguinal hernia in infants. Pediatrics. 2012;130(4):768–773. Available at: https://pediatrics.aappublications.org/content/130/4/768. Reaffirmed May 2021Clinical report. Parental presence during treatment of Ebola or other highly consequential infection. Pediatrics. 2016;138(3):e20161891. Available at: https://pediatrics.aappublications.org/content/138/3/e20161891. Reaffirmed March 2021Clinical report. The use of systemic and topical fluoroquinolones. Pediatrics. 2016;138(5):e20162706. Available at: https://pediatrics.aappublications.org/content/128/4/e1034. Reaffirmed March 2021Clinical report. Infectious complications with the use of biologic response modifiers in infants and children. Pediatrics. 2016;138(2):e20161209. Available at: https://pediatrics.aappublications.org/content/early/2016/07/14/peds.2016-1209. Reaffirmed March 2021Technical report. Nontherapeutic use of antimicrobial agents in animal agriculture: implications for pediatrics. Pediatrics. 2015;136(6):e1670-e1677. Available at: https://pediatrics.aappublications.org/content/136/6/e1670. Reaffirmed June 2021Clinical report. Evaluation and referral for developmental dysplasia of the hip in infants. Pediatrics. 2016;138(6): e20163107. Available at: https://pediatrics.aappublications.org/content/138/6/e20163107. Reaffirmed June 2021Clinical Report. Parent-provider-community partnerships: optimizing outcomes for children with disabilities. Pediatrics. 2011;128(4):795–802. Available at: https://pediatrics.aappublications.org/content/128/4/795. Retired May 2021

Parenting and Sibling Relationships in Family with Disruptive Behavior Disorders. Are Non-Clinical Siblings More Vulnerable for Emotional and Behavioral Problems?

Disruptive Behavior Disorders (DBD) are the most common mental health disorders in the school-aged child population. Although harsh parenting is a key risk factor in the shaping of DBD, studies neglect the presence of siblings and differential parenting. This study aims to compare: (1) parenting style and sibling relationship in sibling dyads of clinical families, composed of a DBD child and a non-clinical sibling, with control families composed of two non-clinical siblings; (2) parenting style, sibling relationship, and emotional and behavioral problems in DBD child, non-clinical sibling, and non-clinical child of control group. Sixty-one families (composed of mother and sibling dyads), divided into clinical (n = 27) and control (n = 34) groups, completed the APQ, SRI, and CBCL questionnaires. Results indicated differential parenting in clinical families, compared to control group families, with higher negative parenting toward the DBD child than the sibling; no difference emerged in sibling relationship within sibling dyads (clinical vs. control). Finally, externalizing and internalizing problems were higher in DBD children and their siblings, compared to control, indicating DBD sibling psychopathology vulnerability. Findings suggest inclusion of siblings in the clinical assessment and rehabilitative intervention of DBD children, given that the promotion of positive parenting could improve mental health in the offspring.

Clinical Issues-October 2021.

Parental presence protocols Key words: anxiety reduction, parental presence, pediatric patients, induction, emergence. Music in the OR Key words: music intervention, headphones, patient anxiety, music selection, personal music delivery device. Transfusion regulations Key words: blood transfusion, documentation requirements, blood product administration, plasma. Clinical blood product transfusions Key words: adverse transfusion reaction, patient assessment, patient blood management, incompatibility, blood products.

COVID-19 lockdown impacts the wellbeing of parents with infants on a Dutch neonatal intensive care unit

PurposeParents of infants admitted to a neonatal intensive care unit (NICU) experience additional stress due to restrictions on their presence and visits by other family members during the COVID-19 pandemic. Our study aims to describe how this impacted parents and how NICU staff could support them. Design and methodsThis was a cross-sectional study in which 25 parents (16 mothers, 9 fathers) of infants admitted to our NICU during the first COVID-19 lockdown completed online questionnaires with socio-demographic questions, the Parental Stressor Scale:NICU (PSS:NICU) and questions related to COVID-19. ResultsBeing separated from, and not being able to hold their infant at all times were among the most important PSS:NICU stressors. Parents experienced additional stress because other family members were not allowed to visit. They indicated that NICU staff could support them by clearly explaining the reasons for visitor restrictions and by ensuring that they felt heard. Most parents supported the restrictions, but also mentioned that less strict measures would really help them. ConclusionsParents who participated in this study found it very stressful that they could not be with their infant together with their partner and other family members. Furthermore, parents recommended the hospital management to continuously reconsider whether particular restrictions could be lifted in case of a new lockdown. Together with clear communication, this would result in less parenteral stress. Practice implicationsHospital management should be cautious on restricting the presence of parents and other family members and scale restrictions back whenever possible.

Exploring Barriers to Participation in Pediatric Rehabilitation: Voices of Children and Young People with Disabilities, Parents, and Professionals.

In order to develop suitable support for participation in pediatric rehabilitation, it is important to understand what barriers need to be bridged from the perspectives of both children and adults. The aim of this study was to explore barriers to participation in pediatric rehabilitation services, according to children and young people with disabilities, parents to children with disabilities, and professionals. Data was collected in individual interviews (n = 48) and focus groups (n = 8), which were analyzed with qualitative content analysis to extract barriers to participation. Identified barriers include three categories: (1) insufficient access (controlling adults, adult-centered healthcare); (2) insufficient trust (low level of trust in adults, low level of trust in children, low self-confidence in children); and (3) insufficient involvement (norms of non-participation, low level of commitment in children). The participant groups had divergent conceptions of where and how barriers originate, and for what situations child participation is appropriate. Adult-centered healthcare and parental presence were described as barriers by all participant groups. Understanding differences in the perceptions of barriers and their origins is crucial when striving to change norms of non-participation. The findings can inform the development of new support tools and participatory formats in pediatric rehabilitation.

Discursive struggles in “real” families: Korean adoptees, adoptive parents, and birth family reunions

AbstractObjectiveThis study explores transnational Korean adoptees' interactions with their adoptive families surrounding birth family reunion.BackgroundUsing relational dialectics theory as a guide, this study takes an adoptee‐centered approach to understanding the broader cultural and relational discourses that interplay with adoptee and adoptive parent messages surrounding birth family reunions.MethodIn‐depth interviews with 19 Korean adult adoptees from the United States and Denmark were conducted to explore adoptive family interactions surrounding reunion.ResultsMost participants reported that their adoptive parents responded supportively to reunion. Still, participants' responses revealed two main discourses surrounding their own communication with their adoptive family surrounding reunion: reassuring their adoptive family and holding back affection or questions toward the birth family in the presence of an adoptive parent. Cultural discourses about having only one set of “real” parents and other adoptees' experiences interplayed with the discourses of reassurance and holding back. Adoptees whose parents were open about their birth family from a young age tended recall reassuring their parents.ConclusionEven with adoptive parent support, adoptees may still feel the need to reassure their adoptive parents and hold back affection and curiosity toward the birth family.ImplicationsHolding back may prevent adoptees from engaging with their birth families fully. Reassuring turns the focus toward the adoptive parents. Practitioners should encourage ongoing communication about the birth family, and adoptive parents should show active support for the reunion and interest in the birth family afterward.

Parental presence after significant procedures and medical events in the neonatal intensive care unit

Purpose Very low birth weight (VLBW) and extremely preterm (EPT) infants typically experience multiple significant medical events, while in the neonatal intensive care unit (NICU), we aimed to identify how major medical and procedural events were associated with parental presence in this patient population. Materials and methods We retrospectively identified VLBW/EPT neonates at a single center and determined parental presence in the first 60 days of hospitalization based on routine documentation in the electronic medical record. The presence on each day was regressed on medical events and procedures occurring within the previous day using mixed-effects logistic regression. Results The analysis included 174 infants contributing 8750 days (observations), including 6061 days (69%) with parental presence, and 607 days (7%) with major medical events or procedures. The occurrence of a medical event or procedure within the past day increased the odds of parental presence by 28% (odds ratio: 1.28; 95% confidence interval: 1.04, 1.57; p = .018). Further analysis found this association was limited to severe (versus moderate) events and procedures, and was absent when considering events over the past week (versus the past day). Conclusions Major medical events or procedures are associated with increased parental presence in the NICU. Future studies are needed to determine how interventions around the time of major medical events can support parental presence in the NICU and involvement in the child’s care.

Effect of parental presence on anxiety during induction of anaesthesia in children undergoing elective day case surgery

BackgroundSurgical operation and anaesthesia induction are fearful events which may interfere with the smooth conduct of anaesthesia and postoperative recovery in children. Indeed, the fear of needles, syringes and unknown hospital environment often compound their anxiety. Various modalities such as use of clowns, music, low intensity light in the induction room, pharmacological agents and parental presence during induction of anaesthesia have been utilized with the aim of gaining the cooperation of the children during induction. However, their use has yielded conflicting results. This prospective study was conducted among children whose ages were between 2 and 15 years. They were randomized into parental presence and parental absence (un-accompanied) or control groups. The anxiety levels of children and parents in both groups were compared at baseline, separation and during induction of anaesthesia.ResultsThe ages of the children ranged between 2 and 15 years with a mean age of 6.78 ± 2.50 years. The mean age of patients in the parental presence at induction (PPIA) was 7.14 ± 3.68 years while in the control group was 6.42 ± 3.31 years. The difference was not statistically significant, p < 0.05. The mean anxiety score of patients in the PPIA at reception, separation and induction of anaesthesia were 26.6 ± 9.2, 38.4 ± 18.3 and 54.1 ± 22.8 compared to 27.3 ± 8.04, 41.4 ± 21.7 and 58.6 ± 23.1 in the control group respectively, p < 0.05. The mean anxiety score of parents in the PPIA at reception, separation and induction of anaesthesia were 52.2 ± 6.7, 51.7 ± 7.8 and 51.9 ± 7.9 compared to 53.0 ± 6.5, 52.4 ± 6.2 and 52.9 ± 7.9 in the control group respectively, p < 0.05. Among the cohort of preschool age group, children in the control group were more anxious at induction compared to the PPIA group, p = 0.01. As the age increases, the anxiety state of the children decreases, t = − 0.398, p < 0.001. The mean score of parental satisfaction in the PPIA and the control groups were comparable, 8.1 ± 7.1 vs 7.3 ± 1.1 respectively, p = 0.395.ConclusionThe presence of parents during induction of anaesthesia did not influence the anxiety states of children in our study. Anxiety at induction tends to reduce as the age of patients increases.

Socio-Ecological Correlates of Physical Activity in Children with Autism Spectrum Disorder: A Cross-Sectional Study in Spain

ABSTRACT This study aims to analyse the Physical Activity(PA) levels of a group of children with ASD and explore certain socio-ecological variables that may be correlated with these levels. The participants of this cross-sectional study were 20 boys and 5girls with ASD, aged between 4 and 14 years. A socio-demographic questionnaire was designed expressly to obtain socio-demographic data, and PA levels were measured with a triaxial accelerometer (ActiGraph, wGT3X-BT).After performing a descriptive analysis, we analysed the relationship between the variables through Spearman correlations and performed the Kruskal Wallis test to compare the results of moderate, vigorous and very vigorous PA according to the following factors: age, gender, PA of their parents or tutors, curricular adaptations, medication, number of siblings, attention deficit, impulsiveness hyperactivity, inattentive-ness, inability to achieve success, movement difficulties, learning difficulties and fearfulness. Finally, we performed logarithmic 4th-order regression analysis for the practice of moderate-intensity activity according to the participants’ age. The findings show that variables in the individual domain (i.e. gender, age, co-morbidity/features of ASD and curricular adaptations) and family domain (i.e. presence of siblings and parents’ PA) may be related to the PA levels of ASD children. This investigation shows the importance of considering socio-demographic aspects in children with ASD in order to promote healthy and active lifestyles.

Viabilidad y Aceptabilidad del Tratamiento Integral Virtual en Trastornos Alimentarios: Perspectiva de Pacientes, Padres y Terapeutas Durante la Pandemia por COVID-19

BackgroundLockdowns and social distancing as a result of the COVID-19 pandemic have brought about the need to continue treatment virtually in patients with Eating Disorders (ED). ObjectiveTo evaluate feasibility, acceptability and adherence to virtual treatment in patients, families and therapists. MethodsFourteen patients, 10 family members and eight therapists from an intensive outpatient program for ED answered online surveys and a SWOT analysis was performed with the responses. ResultsVirtual treatment during lockdown was considered feasible and useful by all respondents. Fear of contagion and the presence of parents in the home were identified as strengths. Parents reported problems with nutritional plan compliance, especially in anorexia patients. Therapists highlighted the importance of methodological adaptations in sessions to improve participation. Adherence to sessions was 100% for family members and 90% for patients. ConclusionsAdaptation to a virtual program is a valid and useful option during lockdowns. It improves family participation, but does not replace face-to-face treatment.

Changes of Infant- and Family-Centered Care Practices Administered to Extremely Preterm Infants During Implementation of the NIDCAP Program.

Introduction: Many studies have evaluated the Neonatal Individualized Developmental Care and Assessment Program (NIDCAP), but few studies have assessed changes in infant- and family-centered developmental care (IFCDC) practices during its implementation.Objectives: The primary objective of this single center study was to investigate the impact of the implementation of the NIDCAP program on IFCDC practices used for management of extremely preterm infants (EPIs). The secondary objective was to determine during implementation the impact of this program on the short-term medical outcomes of all EPIs hospitalized at our center.Methods: All EPIs (<28 weeks gestational age) who were hospitalized at Strasbourg University Hospital from 2007 to 2014 were initially included. Outborn infants were excluded. The data of EPIs were compared for three time periods: 2007 to 2008 (pre-NIDCAP), 2010 to 2011, and 2013 to 2014 (during-NIDCAP implementation) using appropriate statistical tests. The clinical and caring procedures used during the first 14 days of life were analyzed, with a focus on components of individualized developmental care (NIDCAP observations), infant pain management (number of painful procedures, clinical pain assessment), skin-to-skin contact (SSC; frequency, day of initiation, and duration), and family access and involvement in the care of their children (duration of parental presence, parental participation in care). The short-term mortality and morbidity at discharge were evaluated.Results: We examined 228 EPIs who received care during the three time periods. Over time, painful procedures decreased, but pain evaluations, parental involvement in care, individualized observations, and SSC increased (all p < 0.01). In addition, the first SSC was performed earlier (p = 0.03) and lasted longer (p < 0.01). There were no differences in mortality and morbidity, but there were reductions in the duration of mechanical ventilation (p = 0.02) and the time from birth to first extubation (p = 0.02), and an increase of weight gain at discharge (p = 0.02).Conclusion: NIDCAP implementation was accompanied by progressive, measurable, and significant changes in IFCDC strategies. There were, concomitantly, moderate but statistically significant improvements in multiple important outcome measures of all hospitalized EPI.

Parental and staff experiences of restricted parental presence on a Neonatal Intensive Care Unit during COVID-19.

AimThe COVID‐19 pandemic had a significant impact on parental presence in the Neonatal Intensive Care Unit (NICU) during the first wave. The NICU team at the Rosie Hospital, Cambridge, endeavoured to explore the impact on parent and staff experiences of supporting parents throughout the period when visiting was restricted, between 13th August and 11th September 2020.MethodsBespoke surveys were designed following the first lockdown to gather information on the impact on staff and parents. The questions were developed in the context of initial observations and conversations with staff and parents.ResultsThe findings of this study have illustrated the extent of the restrictions on parental wellbeing and mood, with the restrictions having had an adverse effect on these. In addition, the findings illustrate the adverse effect that the parents reported due to the restricted presence in terms of their babies’ wellbeing, parent‐infant bonding, partners’ wellbeing, parental confidence, the ability to breastfeed confidently and parents’ access to the medical teams.ConclusionThe findings of this study have a number of clinical implications for parents and staff. Namely, the data supported the decision not to close NICU again during the second and third waves.

Nurse anesthetist attitudes towards parental presence during anesthesia induction- a nationwide survey.

To describe nurse anesthetists' attitudes towards the importance of parental presence during their child's anaesthesia induction and to explore associating factors. A cross-sectional design. Nurse anesthetists from 55 Swedish hospitals were asked to participate (n=1,285). A total of 809 completed the questionnaire, Families' Importance in Nursing Care-Nurses' Attitudes (FINC-NA) during 2018. Data were analysed by descriptive statistics and multiple linear regression analysis. Nurse anesthetists generally had a positive attitude towards the importance of parental presence. They reported a more positive attitude in family as a resource in nursing care (median=40) followed by family as a conversational partner (median=25), family not as a burden (median=17) and family as its own resource (median=13). Multiple linear regression analyses showed that working in a district hospital, working only with children, having routines/memorandum about parental presence, being a woman, allowing both parents to be present in their child's anaesthesia and greater experience of children's anesthesia, were associated with a more positive attitude. This nationwide survey contributes important knowledge for understanding nurse anesthetists' attitudes and the result shows that nurse anesthetists generally have a positive attitude towards the importance of parents. Areas of improvement were, however, identified; the nurses tend to not value family as its own resource and family as a conversational partner highly. Nurse anesthetists have a crucial role in children's anesthesia care since the quality of parental presence experience depends on a positive attitude from the nurses. Parental involvement is important to establish a child-centered anaesthesia care, which should be highlighted in the education of nurse anesthetists. Parental involvement should also be addressed in healthcare policies and routines should be established.