Metaethnographic Synthesis of Fathers’ Experiences of the Neonatal Intensive Care Unit Environment During Hospitalization of Their Premature Infants

Abstract

The needs of fathers to interact and be involved with their infants' care was a prominent factor that enhanced their experiences in the NICU. Staff in the NICU can play a key role in facilitating this interaction through encouragement and reassurance.

Fathers' Visitation of Very Low Birth Weight Infants in the Neonatal Intensive Care Unit during the First Week of Life

“…The analysis included 292 infants (49% males; median GA: 29 weeks [IQR: [26][27][28][29][30][31]). The characteristics of this sample are summarized in ►Table 1; infants were primarily insured by Medicaid (78%), 40% of mothers were single and did not live with the father, and 74% of mothers lived at least 25 km from the hospital.…”

“…[23][24][25] Particularly important is the perception by staff of the disconnect between paternal desire for involvement and a lack of appropriate opportunities. 26,27 The failure to recognize that the needs of mothers and fathers differ in the NICU environment, especially early on in the infant's course, likely contributes to this lack of emotional support for NICU fathers. 23,[27][28][29] When trying to understand the inability of fathers to visit the NICU, fathers consistently report balancing family priorities with work responsibilities and the health status of their infants.…”

Experiences of Mothers of Extremely Preterm Infants after Hospital Discharge

“…Here, infants are frequently tube-fed, their weight is closely monitored and they may receive oxygen therapy (Dellenmark-Blom & Wigert, 2014;Aagaard et al, 2015). These processes interrupt the preparation and expectations of the mother (Twohig et al 2016;Aydon et al, 2017) as well as the mother-infant bond and relationship (Tooten et al, 2014;Sisson et al, 2015). Although the presence of parents in the NICU has increased (Al Maqhaireh et al, 2016), the environment, work routines and the complex needs of these infants become obstacles that stand in the way of a mother's role (Sisson et al, 2015;Raines & Brustad, 2013).…”

“…These processes interrupt the preparation and expectations of the mother (Twohig et al 2016;Aydon et al, 2017) as well as the mother-infant bond and relationship (Tooten et al, 2014;Sisson et al, 2015). Although the presence of parents in the NICU has increased (Al Maqhaireh et al, 2016), the environment, work routines and the complex needs of these infants become obstacles that stand in the way of a mother's role (Sisson et al, 2015;Raines & Brustad, 2013). The fragility of an extremely preterm infant can reduce the participation of parents in their care (Aydon et al, 2017;Kerr et al, 2017), and the parents' separation from the child creates stress, anxiety and a weaker bond (Kerr et al, 2017;Segre et al, 2014;Spinelli et al, 2016;Neri et al, 2017).…”

What about the men? Perinatal experiences of men of color whose partners were at risk for preterm birth, a qualitative study

“…The dominant narrative from previous research has identified themes of role transition, mixed emotions, neglect, and unmet informational needs in fathers' experience of pregnancy and childbirth [8][9][10][11][12][13][14]. Specific to the experience of preterm birth, a metasynthesis of 24 qualitative studies of the experiences of fathers of preterm infants receiving care in the NICU identified common themes of proximity, parental autonomy, vulnerability, communication, and exclusion and isolation and highlighted the powerful role of NICU staff in creating opportunities or barriers to fathers' involvement in their infant's caregiving [36]. Another recent systemic review of 15 quantitative observational studies found that fathers of infants in NICUs experienced higher levels of stress than fathers of healthy infants, related to parental role alterations, infant appearance, environment and staff communication [37].…”