Enhancing Parents’ Well-Being after Preterm Birth—A Qualitative Evaluation of the “Transition to Home” Model of Care

Abstract

There are few programs available aimed at preventing short- and long-term negative consequences after preterm birth and covering the entire care continuum. The “Transition to Home (TtH)” model is such a program, offering structured, individual support for families with preterm infants before and after hospital discharge. This study gathers and examines the parents’ views of receiving support from an interprofessional team under the TtH model of care during hospitalization and after discharge. Using a qualitative explorative design, 39 semi-structured interviews with parents were analyzed thematically. From this analysis, three main themes were identified: (1) TtH and the relevance of continuity of care; (2) Enhancement of parents’ autonomy and self-confidence; (3) Perception of interprofessional collaboration. Within these themes, the most relevant aspects identified were continuity of care and the appointment of a designated health care professional to anchor the entire care continuum. Emotional support complemented by non-medical approaches, along with strength-based and family resource-oriented communication, also emerged as key aspects. Continuous, family-centered care and well-organized interprofessional collaboration promote the well-being of the family after a premature birth. If the aspects identified in this study are applied, the transition from hospital to home will be smoothened for the benefit of affected families.

Cuidado da família à criança prematura: metassumarização sistemática qualitativa

“…As etapas da metassumarização permitem que ocorra uma melhor compreensão dos sentimentos que permeiam entre as famílias de crianças prematuras (53)(54)(55)(56) . No estudo em tela, os principais impactos estão relacionados à quebra de vínculo devido à redução da comunicação entre pais e profissionais que não permitem um envolvimento maior dos pais nesse processo, além dos obstáculos na comunicação.…”

Nordic survey showed wide variation in discharge practices for very preterm infants

“…The discharge process should optimally be tailored to the needs of the family, with respect to socioeconomic factors, competence, supporting network and ability to communicate. 3,5,13,25,26,30 Our survey showed that this is currently not the case, as many families were excluded from early discharge to neonatal home care because of limited language skills. This discriminatory practice occurred in a majority of Swedish and Danish units, but was not reported from Finland.…”

“…1,5,8 Earlier discharge to home-based care could be beneficial but requires an understanding of the criteria and preparations important for safe discharge, and of how to assess infant and parent readiness. 3,[9][10][11][12][13][14][15] Cardiorespiratory stability 14,16 is considered a prerequisite for discharge and determines when continuous monitoring of heart rate or oxygen saturation can be discontinued. 12 Clinical evaluation of cardiorespiratory stability is usually done by bedside observation and documentation of apnoeas and bradycardias, sometimes complemented with more formal pre-discharge tests.…”

“…17 Other parameters, such as the infant's ability to feed and grow, are often evaluated in discharge planning but should not postpone discharge since home care may potentially improve breastfeeding. 5,13 Transitioning to home-based care might add to parental stress if discharge planning and preparations are not well executed. 3,[18][19][20][21][22] Parental pre-discharge preparation programmes ensure that parents administer medications and other therapies correctly, are able to safely manage non-acute medical problems, and know when to seek medical attention.…”

The AIMS home-video method: parental experiences and appraisal for use in neonatal follow-up clinics

“…Actively involving parents in neonatal follow-up perhaps contributes to Family Centred Care (FCC), which is supposed to enhance (motor) outcomes of premature infants [ 42 ]. This is also seen in the transition from the NICU stay to the family’s home, where FCC principles and interprofessional collaboration promote the well-being of the family by enhancing parents’ autonomy and self-confidence [ 43 ]. In our study, recordings made parents aware of their infant’s motor development, which may enhance empowerment and allows for increased confidence in parenting [ 44 , 45 ].…”