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Abstract
Purpose
The aim of this study is to analyze the characteristics of family interventions based on a philosophy of family-centered care conducted in neonatal intensive care units through an integrative literature review.
Methods
We searched the PubMed, CINAHL, RISS, KISS, and DBpia databases; a total of 20 studies, published between January 2013 and May 2018, was selected according to our criteria.
Results
Mothers accounted for a greater proportion of participants in family interventions than did fathers. Family interventions described in the studies were categorized into four educational and sixteen non-educational interventions. Among non-educational interventions, skin-to-skin-contact interventions, such as kangaroo care, accounted for the highest proportion. Only one paper employed a theoretical framework.
Conclusion
More family interventions based on theoretical frameworksshould be conducted as these frameworks serve as guidelines for nursing research. As the stress patterns experienced by parents in neonatal intensive care units showed gender differences, more programs tailored for fathers are needed. Moreover, further research should be conducted to evaluate feasibility as an outcome variable, and studies of family interventions based on a philosophy of family-centered care should be performed more actively in the neonatal intensive care units in Korea.
References
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Table 1.
General Characteristics of the Reviewed Research (N=20
Table 2.
The Analysis of Family Interventions in Neonatal Intensive Care Units
| Author (year) | Research design | Participants (n) | Type of Interventions (education/non-education) | Period | Effects |
|---|---|---|---|---|---|
| Balbino et al.‡§ (2016) | Quasi-experimental study | Parents (132): pre (M 40/F 26) post (M 44/F 22) | (Non-education): others Program of the patient and family-centered care model | For 5 months | ‧ Stress and trauma∗ |
| Choi et al. (2014) | Quasi-experimental study | M (22): I (11)/C (11) | (Non-education): music Listening to recorded voice of mothers |
For 5 minutes for 10 days, 4 times a day |
‧ Physiological reactions (HR, RR, SpO2)∗ ‧ Behavioral state related to sleep∗ ‧ Bwt† |
| De Bernardo et al. (2017) | Non-randomized, prospective cohort study | Parents (96): I (M 24/F 24) C (M 24/F 24) | (Non-education): visit Open visiting |
C: for an hour I: for up to 8 hours |
‧ Parental satisfaction∗ ‧ Stress level∗ ‧ Bwt∗ |
| Dunlop et al. (2016) | Quasi-experimental study | M (80): I 40/C 40 | (Education) Health risks and health education |
For 45 to 60 minutes, Composed of 5 sessions |
‧ Attendance of the postpartum visit∗ ‧ Daily ingestion of folic acid∗ ‧ Correct and consistent use of a method of contraception∗ ‧ Unintended pregnancy∗ |
| Edéll-Gustafsson et al.‡ (2015) | Qualitative study | Parents (12): M 8/F 4 | (Non-education): others Single-bay family-rooms | For 24 hours a day |
‧ Sleep quality∗ ‧ Management tiredness∗ ‧ Loneliness of siblings∗ |
| Gingell Epstein, E. et al. (2015) | Mixed-method study | Parents (26): M 17/F 9 | (Non-education): others Daily skype or face time updates |
Once daily for 5 days, For about 3 to 10 minutes |
‧ Feasibility∗ ‧ Parents' understanding∗ |
| Kadivar et al. (2017) | Quasi-experimental study | M (70): I 33/C 37 | (Non-education): others Narrative writing |
At least 3 times, In 10 days of admission |
‧ Maternal stress level related to infant behavior and appearance∗ |
| Kadivar et al. (2017) | Quasi-experimental study | M (70): I 33/C 37 | (Non-education): others Narrative writing |
At least 3 times, In 10 days of admission |
‧ Maternal satisfaction level∗ |
| Kardaş et al. (2017) | Quasi-experimental study | F (47) | (Education) First phase: information about the NICU and the condition of babies Second phase: visiting their babies |
First phase: for 30 minutes Second phase: for 30 minutes |
‧ Paternal stress level∗ |
| Kim et al. (2017) | Quasi-experimental study | F (40): I 20/C 20 | (Non-education): Skin-to-skin-contact Tactile stimulation |
For 10minutes each, For 5 consecutive days |
‧ SpO2 level, HR and RR∗ ‧ Paternal attachment scores∗ |
| Lee et al. (2013) | Historical comparison study | F (69): I 34/C 35 | (Non-education): others Booklet about premature babies that a father must know and nurses' guidance | During admission periods |
‧ Paternal stress∗ ‧ Fathering ability in the NICU∗ ‧ Perceived nurse's support∗ |
| Lee et al. (2014) | One group pre-post test | Parents (24): M 18/F 6 | (Non-education): Skin-to-skin-contact Kangaroo care |
For 60 minutes a session, Composed of 15 sessions |
‧ Physiologic responses† ‧ Parents' anxiety∗ ‧ Nurses' perception regarding the kangaroo care† |
| Lee et al. (2016) | Quasi-experimental study | M (38): I 19/C 19 | (Non-education): Skin-to-skin-contact Kangaroo care |
3 times a day, 10 times in total, For 60minutes once |
‧ Physical development (Bwt, Ht, HC)† ‧ Adaptation to environment (BT†, HR†, SpO2∗) ‧ Confidence as a mother† |
| Lim et al. (2015) | Historical comparison study | Preterm infants (45) and their parents | (Non-education): Skin-to-skin-contact Kangaroo care | Once daily, For an hour |
‧ Normal vital signs (BT, PR, BP, SpO2) ‧ Bwt, sepsis, retinopathy of prematurity† ‧ Duration of the hospitalization∗ ‧ Anxiety†, maternal attachment∗ ‧ Depression in self-happiness score∗ |
| Park et al. (2013) | Quasi-experimental study | Infants (48): I 24/C 24 and their mothers | (Non-education): music Using mother's recorded song |
For 5 days, For 20 minutes |
‧ HR†, RR∗, SpO2† ‧ Behavioral state∗ ‧ Neurobehavioral scale† |
| Segre et al. (2016) | One group pre-post test | M (23) | (Non-education): others Depression care |
For 50 minutes every 2 to 3 days, Over a month Composed of 6 sessions, |
‧ Treatment satisfaction about the providers and intervention∗ |
| Shin et al. (2018) | Quasi-experimental study | M (44) | (Education) Preterm baby, feeding, maternal attachment relationship | For 60 minutes, 7 times in total |
‧ Stress level∗ ‧ Depression level∗, ‧ Anxiety level† ‧ Confidence of nurture∗ |
| Turner et al. (2015) | Qualitative research | M (9) | (Non-education): others NICU parent support group program | Weekly |
‧ Positive relationships with the midwives and nursing staff on the NICU ‧ Mothers' ability to cope with their experience of the NICU∗ |
| Verma et al. (2017) | Randomized controlled trial | Parents (295): I 148/C 147 | (Education) Personal hygiene, hand washing, danger signs recognition and feeding of sick neonate | For 2 hours each, Composed of 4 session |
‧ Nosocomial infections rate† ‧ Duration of hospitalization† ‧ Mortality† ‧ Breastfeeding rate∗ |
| Welch et al. (2013) | Randomized controlled trial | M (150): I 78/C 72 | (Non-education): others The family nurture intervention: Scent cloth exchange, sustained touch, vocal soothing, eye contact, wrapped or skin-to-skin holding, and engagement of mothers in care | For more than 10 days |
‧ Length of stay† ‧ Safety∗ |
| BP=Blood pressure; BT=Body temperature; Bwt=Body weight; C=Control group; F=father; HR=Heart rate; I=Intervention group; M=Mother; | |||||
| NICU=Neonatal intensive care unit; PR=Pulse rate; RR=Respiratory rate; SpO2=Oxygen saturation. | |||||
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