An educational intervention for NICU staff decreased maternal postpartum depression

Ahlqvist‐Björkroth, Sari; Axelin, Anna; Korja, Riikka; Lehtonen, Liisa

doi:10.1038/s41390-019-0306-y

Cited by 26 publications

(37 citation statements)

References 30 publications

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“…The Close Collaboration with Parents Training Program is a systematic education program lasting 12 months with trainer mentors and an additional 6 months independently by the units. It was initially developed and carried out at Turku University Hospital between 2009 and 2012, where it was shown to promote staff skills, positive attitudes toward FCC [14], and decreased depression symptoms among the mothers of very preterm infants [25]. The training consisted of four theoretical phases lasting 4 to 5 months each.…”

Section: Methodsmentioning

confidence: 99%

Key factors supporting implementation of a training program for neonatal family- centered care – a qualitative study

Toivonen

Lehtonen

Ahlqvist‐Björkroth

et al. 2019

BMC Health Serv Res

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Background Traditionally, the care of infants in neonatal care units has been professionally centered, paying less attention to family support. In recent years, many interventions have been developed to improve family-centered care and thereby parent and infant outcomes. Understanding the key factors of implementation of these interventions would help improve clinical practice. The aim of this study was to describe the staff’s perceptions of the implementation of the Close Collaboration with Parents Training Program and to identify the barriers and facilitators of the implementation. Methods A descriptive qualitative interview study was conducted in eight neonatal intensive care units in Finland. Nineteen unit managers and 32 nurses were interviewed after their unit had finished the 1.5-year training program. Data were analyzed using thematic content analysis. Results Key factors facilitating the implementation of the training program were multidisciplinary commitment and the staff’s motivation to change their professional role to work as the parents’ facilitator. Observable benefits promoted the implementation, as well as experiential learning as a facilitation method. The role of mentor was remarkable as a facilitator. In addition, contextual elements such as support from leadership and proper timing were important. Conclusions Implementation of family-centered care is facilitated by staff who is prepared to accept parents as partners and adopt a new professional role. Enough time for preparation, readiness for the change, solid support from the leadership, and a multidisciplinary approach are needed as well. Mentoring was found to be one of the key factors facilitating the change. Electronic supplementary material The online version of this article (10.1186/s12913-019-4256-1) contains supplementary material, which is available to authorized users.

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Section: Methodsmentioning

confidence: 99%

Key factors supporting implementation of a training program for neonatal family- centered care – a qualitative study

Toivonen

Lehtonen

Ahlqvist‐Björkroth

et al. 2019

BMC Health Serv Res

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“…In one study, parent education and use of a structured infant progress chart by both the clinical team and parents was effective in improving communication, collaboration, and shared decision‐making for low‐income ethnically diverse mothers (Penticuff & Arheart, ). Further program development and research are being conducted to facilitate communication between parents and the clinical team using multimodal techniques such as relational communication (Benzies, ) or structured education programs such as provided in “close collaboration with parents” training (Ahlqvist‐Björkroth et al, ; Ahlqvist‐Björkroth, Axelin, Korja, & Lehtonen, ).…”

Section: Interventions To Support Nicu Parentsmentioning

confidence: 99%

“…The main focus of the model is enabling nurses and other members of the healthcare team to redefine their role in relation to parents as active partners in infant care and to transform the traditional professional approach to infant caregiving so that it is more collaborative with parents and process guided, instead of task or procedure oriented (Axelin, Ahlqvist‐Björkroth, Kauppila, Boukydis, & Lehtonen, ). The Close Collaboration model has been shown to be effective in a single site, pre–post implementation study to decrease the incidence of postpartum depression in parents of preterm infants (Ahlqvist‐Björkroth et al, ). Future research should focus on multisite implementation feasibility and fidelity, comparative effectiveness with other models and evaluation of the long‐term effect on infant outcomes.…”

Section: Models Of Nicu Carementioning

confidence: 99%

The evolution of family‐centered care: From supporting parent‐delivered interventions to a model of family integrated care

Franck

O’Brien

2019

Birth Defects Research

227

223

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There is increasing recognition that parents play a critical role in promoting the health outcomes of low birthweight and preterm infants. Despite a large body of literature on interventions and models to support family engagement in infant care, parent involvement in the delivery of care for such infants is still restricted in many neonatal intensive care units (NICUs). In this article, we propose a taxonomy for classifying parent‐focused NICU interventions and parent‐partnered care models to aid researchers, clinical teams, and health systems to evaluate existing and future approaches to care. The proposed framework has three levels: interventions to support parents, parent‐delivered interventions, and multidimensional models of NICU care that explicitly incorporate parents and partners in the care of their preterm or low birthweight infant. We briefly review the available evidence for interventions at each level and highlight the strong level of research evidence to support the parent‐delivered intervention of skin‐to‐skin contact (also known as the Kangaroo Care position) and for the Kangaroo mother care and family integrated care models of NICU care. We suggest directions for future research and model implementation to improve and scale‐up parent partnership in the care of NICU infants.

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“…A true family centered approach is one that promotes family autonomy, parent-infant closeness, and shared-decision making [6], all of which may come into conflict with lactation when it is singularly framed as an end for health. Parents of preterm infants are already at an increased risk of mental health difficulties, which can have long-term impacts on neurodevelopmental and behavioral outcomes of preterm born children [65–67]. Therefore, strategies that promote family well-being should be at the forefront of neonatal research.…”

Section: Discussionmentioning

confidence: 99%

A qualitative cross-cultural analysis of NICU care culture and infant feeding in Finland and the U.S.

Holdren

Fair

Lehtonen

2019

BMC Pregnancy Childbirth

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Background: The benefits of family-centered care for the health and well-being of preterm infants and their families include increased parent-infant closeness, improved lactation, and positive mental health outcomes; however, it is known that the extent to which family-centered care is adopted varies by unit. This study aimed to understand how differences in neonatal care culture in two units in Finland and the U.S. were translated to parents' infant feeding experiences in the hope of improving relationally focused feeding practices in both locations. Methods: This qualitative, cross-sectional study utilized narrative methodologies to understand the lived experiences of 15 families hospitalized in a tertiary neonatal intensive care unit in Finland (n = 8) and the U. S (n = 7). Results: A global theme of lactation as a means or an end showed that lactation and infant feeding were framed differently in each location. The three supporting themes that explain families' perceptions of their transition to parenthood, support as a family unit, and experience with lactation include: universal early postnatal challenges; culture and space-dependent nursing support; and controlled or empowering breastfeeding experiences. Conclusions: Care culture plays a large role in framing all infant caring activities, including lactation and infant feeding. This study found that in the unit in Finland, breastfeeding was one method to achieve closeness with an infant, while in the unit in the U.S., pumping was only an end to promote infant nutritional health. Therefore, breastfeeding coupled with closeness was found to be supportive of a salutogenic, or health-promoting, care approach for the whole family.

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An educational intervention for NICU staff decreased maternal postpartum depression

Cited by 26 publications

References 30 publications

Key factors supporting implementation of a training program for neonatal family- centered care – a qualitative study

Key factors supporting implementation of a training program for neonatal family- centered care – a qualitative study

The evolution of family‐centered care: From supporting parent‐delivered interventions to a model of family integrated care

A qualitative cross-cultural analysis of NICU care culture and infant feeding in Finland and the U.S.

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