Elsevier

The Journal of Pediatrics

Volume 157, Issue 2, August 2010, Pages 215-220.e3
The Journal of Pediatrics

Original Article
Perceptions of Parents, Nurses, and Physicians on Neonatal Intensive Care Practices

https://doi.org/10.1016/j.jpeds.2010.02.009Get rights and content

Objective

To identify satisfaction with neonatal intensive care as viewed by parents and healthcare professionals and to explore similarities and differences between parents and healthcare professionals.

Study design

A 3-round Delphi method to identify neonatal care issues (round 1) and to determine the importance of these issues (rounds 2 and 3) was conducted among nurses (n = 84) and physicians (n = 14), followed by an exploratory survey among parents (n = 259). Main outcome measures were 92 neonatal care-related items.

Results

Sixty-eight nurses and 13 physicians completed all 3 rounds. The first round yielded 419 neonatal care related statements, which were clustered into 92 items. The survey was completed by 148 (57%) parents. Parents rated 25 of 92 care items significantly higher than did the professionals (effect size of Cohen's d, 0.31 to1.14, P ≤ .02). Two items related to medication administration had the largest effect size. Professionals rated 7 items significantly higher than did parents (Cohen's d, −0.31 to −0.58, P ≤ .04). One of these was assigning a physician and a nurse to the parents. Three were related to multicultural care.

Conclusions

This study revealed disparities between parents and neonatal intensive care unit staff on a number of care issues reflecting incongruity in recognizing parents' desires.

Section snippets

Methods

The exploratory and descriptive studies were designed as a 3-round Delphi method for nurses and physicians and an exploratory survey method for parents. The Delphi study was conducted first. The results of this study were then used for the survey among parents. Both studies were completed between May 2007 and May 2008. The medical ethical review board of the Erasmus University Medical Centre gave approval for the study.

The setting was a 30-bed level III NICU in The Netherlands. The yearly

Results

Of the 98 healthcare professionals who consented to participate in the Delphi study, 81 (83%) completed all 3 questionnaires (68 nurses and 13 physicians). Table I presents characteristics of the participants in each Delphi round. NICU experience ranged from 0.50 to 27 years and professional experience ranged from 1 to 35 years. The demographic variables for nonrespondents and respondents in round 3 did not differ significantly.

The first round yielded 419 short statements on neonatal care

Discussion

Being more aware of family-centered care, healthcare professionals today strive to empower parents in the care of their child in the NICU. Insight into parental perceptions is available,3, 18, 19 but there appears to be a gap between knowledge and practice.20, 21 This is remarkable because the impact of family-centered care initiatives has positive effects on parental stress, comfort, and confidence.4 Thus, assessments of parental experiences and needs are warranted to improve our services

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    Supported in part by a grant from the Nuts OHRA foundation (SNO-T-0501114). The sponsor was not involved in the study design, data collection, analysis and interpretation of data, the manuscript, or the decision to submit the manuscript for publication. The authors declare no conflicts of interest.

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