A comparative study of mothers of infants hospitalized in an open ward neonatal intensive care unit and a combined pod and single-family room design

Abstract

Background: The well-being of mothers of infants requiring Neonatal Intensive Care Unit (NICU) hospitalization may be affected by the architectural design of the unit. A few recent studies suggest there may be some drawbacks of single-family rooms (SFRs) for infants and their mothers, such as isolation of mothers and reduced exposure to auditory stimulation for infants. Purpose: To compare NICU-stress, symptoms of depression, perceptions of nurse-parent support and family-centered care, sleep disturbances, breastfeeding self-efficacy and readiness for discharge in mothers of infants cared for in an open ward (OW) to those cared for in a unit that includes both pods and SFRs. Methods: A pre-post quasi-experimental study was conducted in a Canadian level 3 unit before and after transitioning to a new unit of 6-bed pods and SFRs. OW data were collected in 2014 and pod/SFR data 1 year after the transition in 2017 to 2018. Mothers of infants hospitalized for at least 2 weeks completed questionnaires about stress, depressive symptoms, support, family-centered care, and sleep disturbances. In the week prior to discharge, they responded to breastfeeding self-efficacy and readiness for discharge questionnaires. They described their presence in the NICU at enrollment and again prior to discharge. Results: Pod/SFR mothers reported significantly less NICU-stress compared to OW mothers. OW mothers had greater sights and sounds stress and felt more restricted in their parental role. Pod/SFR mothers reported greater respect from staff. Controlling for maternal education, pod/SFR mothers perceived their infant's readiness for discharge to be greater than OW mothers. There were no significant differences between groups in depressive symptoms, nurseparent support, sleep disturbances, and breastfeeding self-efficacy. At enrollment and again in the weeks preceding discharge, pod/SFR mothers were present significantly more hours per week than OW mothers, controlling for maternal education. Conclusions: Further study of small pods is indicated as these units may be less stressful for parents, and enhance family-centered care, as well as maternal presence, compared to OWs.

Effects of single family room architecture on parent–infant closeness and family centered care in neonatal environments—a single-center pre–post study

“…[ 21 ] showed that mothers were more involved in infant care in the SFR unit than in the open unit, but the duration of mothers’ presence was not measured, and fathers’ participation was not studied. Feeley et al [ 22 ] compared mothers’ presence in an open unit, in a combined pod and in an SFR design and found that mothers spent 44 h per week in the open unit compared to 84 h per week in the SFR unit. Raiskila et al [ 23 ] showed that the duration of parents’ presence was significantly longer in units that provided parents an opportunity to stay overnight: a mean of 19.7 h per day in units with overnight accommodations versus a mean of 5.5 h in units without.…”

Factors Influencing Mothers’ Quality of Sleep during Their Infants’ NICU Hospitalization

“…Since this is a secondary analysis, the full data from the original study have been published previously (Feeley et al, 2020).…”

“…This study is a secondary analysis of data from a quasi-experimental pre-post study carried out between 2014 and 2017 (Feeley et al, 2020). The aim of the original study was to compare mothers' stress, symptoms of depression, perception of nurseparent support, family-centered care, sleep disturbances, breastfeeding self-efficacy and readiness for discharge of mothers whose infants were hospitalized in an open ward (OW) NICU to mothers whose infants were hospitalized in a NICU with pods and singlefamily rooms (pods/SFR).…”

“…These single-family rooms were equipped with recliner chairs where parents could sleep overnight. Full details of the design of the two units are presented in Feeley et al (2020).…”

Elucidating the context for implementing nonpharmacologic care for neonatal opioid withdrawal syndrome: a qualitative study of perinatal nurses

“…Pod-style NICUs do not provide private space for mothers to deliver nonpharmacologic care such as breastfeeding or skin-to-skin [ 31 – 33 ]. Further, pods often do not offer a welcoming or conducive environment for 24/7 visitation [ 22 – 34 ]. Private room NICUs are costly and may not be a realistic solution for many hospitals [ 30 , 31 ].…”