Parents' experiences of emotional closeness to their infants in the neonatal unit: A meta-ethnography

Abstract

Background:Physical and emotional parent-infant closeness activate important neurobiological mechanisms involved in parenting. In a neonatal care context, most research focuses on physical (parental presence, skin-to-skin contact) aspects; insights into emotional closeness can be masked by findings that overemphasise the barriers or challenges to parenting an infant during neonatal care.Aim: To explore existing qualitative research to identify what facilitates and enables parents' experiences of emotional closeness to their infants while cared for in a neonatal unit. Study design:A systematic review using meta-ethnographic methods. Search strategy involved searches on six databases, author runs, and backward and forward chaining.Reciprocal translation was used to identify and compare key concepts of parent-infant emotional closeness.Results: Searches identified 6,992 hits, and 34 studies from 17 countries that involved 670 parents were included. Three overarching themes and associated sub-themes were developed.'Embodied connections' describes how emotional closeness was facilitated by reciprocal parent-infant interactions, spending time as a family, and methods for parents to feel connected while physically separated. 'Inner knowing' concerns how knowledge about infant and maternal health and understanding the norms of neonatal care facilitated emotional closeness.'Evolving parental role' relates to how emotional closeness was intertwined with parental identities of contributing to infant health, providing direct care, and being acknowledged as a parent. Conclusion:Parent-infant closeness evolves and is facilitated by multifaceted biopsychosocial factors. Practice implications include creating private and uninterrupted family time, strategies for parents to maintain an emotional connection to their infant when separated, and neurobiology education for staff.

An international study on implementation and facilitators and barriers for parent‐infant closeness in neonatal units

“…Especially, we were unable to explore the perception of emotional closeness and the pathways towards emotional closeness that might be facilitated in the included units from parents’ perspectives. 32 Also, the exact roles parents play in the infant's care team and their potential added role within multidisciplinary teams remains to be elucidated.…”

“… 6 Previous studies have mainly described access policies for families in the NICU, availability of single bed units, compliance with the baby‐friendly hospital initiative, and actual parental presence, SSC, or participation in medical rounds. 26 , 27 , 28 , 29 , 30 , 31 Other work has focused on the concept, pathways, and feelings of closeness from parents’ perspectives, 4 , 22 , 32 insights into perceptions and aspirations of highly motivated medical staff to physical closeness 33 and facilitators and barriers for family‐centered care from staff employed in hospitals from three European countries. 34 To our knowledge, no data or qualitative analysis is currently available considering facilitators to implement parent‐infant closeness and achieve zero‐separation in neonatal care covering a vast majority of European countries.…”

Association of a Zero-Separation Neonatal Care Model With Stress in Mothers of Preterm Infants

“…For instance, research studies could qualitatively focus on the perception of emotional closeness and the pathways toward emotional closeness that might be facilitated in our FICare model from parents’ perspectives. 55 …”

“…Additional research can also focus on an exact definition of zero separation in this context, as one can still feel emotionally connected without being physically present. For instance, research studies could qualitatively focus on the perception of emotional closeness and the pathways toward emotional closeness that might be facilitated in our FICare model from parents’ perspectives …”

Irmãos de bebês recém-nascidos internados em unidades de neonatologia: revisão bibliográfica

“…(18) Desta forma, a cultura do cuidado poderia ser um facilitador fundamental para a presença e participação dos pais, permitindo a construção de um ambiente de "cuidado neonatal" centrado na família, (19) que está associado a impactos positivos em seus relacionamentos e bem-estar. (20,21) Existem programas estruturados de visitação de irmãos nas áreas de terapia intensiva, a fim de aumentar os níveis de conforto do pessoal ao lidar com crianças e diminuir a resistência a eles. "Uma política de irmãos permite à enfermeira tomar decisões clínicas sólidas baseadas no conhecimento do crescimento e desenvolvimento; teoria de sistemas familiares; e literatura atual aplicada de forma hábil, solidária, consistente e individualizada, não apenas dobrando as regras quando parece justificado".…”