Family-Centered Care Improves Clinical Outcomes of Very-Low-Birth-Weight Infants: A Quasi-Experimental Study

Abstract

Background: Survival of very-low-birth-weight infants is improving in neonatology and family-centered-care might contribute to premature infants' clinical outcomes. Aim: To evaluate a family-centered care intervention on clinical outcomes of very-low-birth-weight infants. Methods: A quasi-experimental study was conducted in a Chinese NICU between June 2016 and June 2017. The intervention included parental education of basic care knowledge and skills followed by active participation in care for at least 4 h a day. A total of 319 very-low-birth-weight infants were recruited by convenience sampling; intervention group n = 156 and control group n = 163. Primary outcome measures were weight at discharge, length-of-stay, breastfeeding, nasal feeding, total parental nutrition, re-admission, hospital expenses. Secondary outcome measures were infant complications. Results: Infants' weight at discharge was higher in the interventions group (2,654 g vs. 2,325 g, p < 0.001). Nutritional outcomes improved significantly: breastfeeding rate 139 vs. 91, p < 0.001; days of total parental nutrition 25 d vs. 32 d, p < 0.001; gastric feeding days 23 d vs. 35 d, p < 0.001. Length-of-stay and hospital expenses did not differ between both groups. Improved infants' complications were bronchopulmonary dysplasia (32 vs. 51, p = 0.031), retinopathy of prematurity (between groups no/mild and moderate/severe, p = 0.003), necrotizing enterocolitis (6 vs. 18, p = 0.019), and re-admission rate (21 vs. 38, p = 0.023). No differences were observed in intraventricular hemorrhage and nosocomial infections. Conclusion: Very-low-birth-weight premature infants might experience improved clinical health outcomes when parents are present and caring from them. Family-centered care is as a beneficial care model for premature infants and should be recognized and implemented by NICUs where parents have currently limited access.

Turkish Adaptation and Validation of the EMpowerment of PArents in THe Intensive Care (EMPATHIC-30) Questionnaire to Measure Parent Satisfaction in Neonatal Intensive Care Units

“…Family-Centered Care (FCC) interventions have been developed and implemented to minimize stress and anxiety experienced by parents and accelerate the healing process of infants (4,5). An important element in maintaining the FCC approach is effective communication.…”

Management of Oral Feeding Challenges in Neonatal Intensive Care Units (NICUs): A National Survey in China

“…Unfortunately, in China, the biggest obstacle for breastfeeding in NICUs is the limited space around the incubators which restricts parental visits and involvement in their infant care. Fortunately, the family-centered care approach is gaining momentum among Chinese NICU clinicians ( 15 ) and changes of visit policy should be expected in the near future.…”

“…These differences are reflected in the varied indicators used to assess infants' readiness to start oral feeding, and the nature of their oral feeding difficulties. Meanwhile, as most Chinese NICUs do not allow parents to visit their infant(s), there is limited opportunity for breastfeeding and mother-infant nurturing and bonding ( 15 ). To the best of our knowledge, this is the first nationwide prospective survey conducted on the oral feeding management of high-risk infants in Chinese NICUs.…”

Parent Satisfaction With Care and Treatment Relates to Missed Nursing Care in Neonatal Intensive Care Units

“…Greater parental involvement in care is associated with better outcomes. For example, in a quasi-experimental study in a Chinese NICU, a parental educational intervention that encouraged active involvement in care for at least 4 h a day resulted in significantly better infant outcomes, including a higher breastfeeding rate and a lower readmission rate (7).…”