No abstract

Background: Family-centered care (FCC) in neonatal intensive care units (NICUs) was initiated in 1992 to promote a respectful response to individual family needs and support parental participation in care and decision-making for their infants. Although benefits of FCC have been reported, changes in the maternal experience in the NICU are unknown. Purpose: The purpose of this study was to compare mothers' experiences in NICUs where FCC is the standard of care and to compare these with the experiences of mothers 2 decades ago. Methods: In this qualitative descriptive design, mothers of infants born under 32 weeks postconceptional age were asked to describe their experiences with their infant's birth and hospitalization. Open-ended probing questions clarified maternal responses. Saturation was reached after 14 interviews. Iterative coding and thematic grouping was used for analysis. Results: Common themes that emerged were: (1) visiting; (2) general caregiving; (3) holding; (4) feeding; and (5) maternal ideas for improvement. Findings indicated important improvements in privacy, mother–nurse relationship, ease of visiting, and maternal knowledge and participation in infant caregiving. Implications for Practice: Mothers suggested improvements such as additional comforts in private rooms, areas in the NICU where they can meet other mothers, and early information on back-transport. Better recognition and response for mothers without adequate social support would provide much needed emotional assistance. Implications for Research: Future research addressing benefits of webcams, wireless monitors, back-transport, maternity leave, and accommodations for extended visiting for siblings would address other needs mentioned by mothers.

OBJECTIVES: Evaluate the association between maternal social factors and maternal time spent in the NICU for very preterm infants admitted to 4 level III and IV NICUs. METHODS:In this prospective observational cohort study, we enrolled mother-infant dyads whose infants were born <32 weeks' gestation. Enrollment occurred after 2 weeks of NICU exposure, when maternal social factors and demographic information was collected. Maternal time spent in the NICU was abstracted from the electronic medical record and was dichotomized into 0 to 6 days and $6 days per week. Demographic differences between the 2 groups were compared by using v 2 tests. Logistic regression was used to assess the independent association between maternal social factors and the average number of days per week spent in the NICU.

No abstract

Parents of high-risk infants experience increased risk for perinatal mood and anxiety disorders and other behavioral health conditions, which have short- and long-term consequences for parent and infant outcomes. Integrated care is a promising strategy to address the behavioral health needs of high-risk infants and families in perinatal and pediatric settings. Systems change theories and core components of needs assessment and program evaluation provide guidance for fetal, neonatal, and neonatal intensive care unit follow-up providers wishing to implement integrated care. Understanding the importance of demonstrating the value of integrated care will help providers anticipate and respond to the reality of resource constraints as they reimagine services and programs. Through thoughtful design and evaluation, integrated care approaches hold potential to improve parent and infant health and developmental outcomes.