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Implementing modified family integrated care in a U.S. neonatal intensive care unit: nursing perspectives and effects on parents

Journal of Perinatology volume 43, pages 503–509 (2023)Cite this article

Subjects

Abstract

Objectives

(1) Assess effects of a modified Family Integrated Care (FICare) model on U.S. Neonatal Intensive Care Unit (NICU) parents; (2) Evaluate NICU nurses’ perspectives.

Design

Case -control design with parental stress assessed before and after NICU-wide FICare implementation using Parent Stressor Scale: NICU (PSS:NICU) questionnaire. In addition, stratification by degree of participation evaluated associations with parental stress, parental-staff communication and discharge readiness. Questionnaires captured nursing perspectives on FICare.

Results

79 parents (88%) participated prior to FICare; 90 (90%) after. Parent stress was lower (p < 0.001) with FICare. Parents learning 5–15 infant-care skills had lower stress compared to those learning <5 (p = 0.008). Parent utilization of an educational app was associated with improved communication frequency (p = 0.007) and quality (p = 0.012). Bedside NICU nurses reported multiple positive associations of FICare for parents and staff.

Conclusions

Any degree of FICare participation decreases parental stress; increased participation has multiple positive associations.

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Fig. 1: Study timeline and instruments.
Fig. 2: Parental stress levels prior and after FICare implementation.

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Data availability

The datasets generated during and analyzed during the current study are not publicly available due to IRB restrictions but are available from the corresponding author on reasonable request.

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Acknowledgements

We wish to thank the many parents who reviewed drafts of the materials contained in the FICare app as well as the neonatal nurse practitioners, NICU nurses, occupational therapists, speech language pathologists, lactation consultants, respiratory therapists, dieticians and pharmacists who created the FICare app contents. We also wish to thank Luke Poppish who moved the FICare app into production. In addition, we would like to thank NICU nurses and parents participating in the study.

Funding

There was no funding source for this project with the exception of financial support coming from the Department of Pediatrics at South Shore Hospital (Department Chair, Mark Waltzman, MD) limited to the following: a senior statistician from Institutional Centers for Clinical and Translational Studies at Boston Children’s Hospital, David N. Williams, MA, PhD received compensation for his involvement in all aspects from the initial questionnaire design, edits, data analysis.

Author information

Authors and Affiliations

  1. Department of Pediatrics, South Shore Hospital, Weymouth, MA, USA

    Zuzanna Kubicka, John Fiascone, Eyad Zahr, Amy Ditzel, Diana Perry, Tamara Rousseau, Molly Lacy & Bonnie Arzuaga

  2. Division of Newborn Medicine, Boston Children’s Hospital, Boston, MA, USA

    Zuzanna Kubicka, John Fiascone, Eyad Zahr, Amy Ditzel, Diana Perry, Tamara Rousseau, Molly Lacy & Bonnie Arzuaga

  3. Harvard Medical School, Boston, MA, USA

    Zuzanna Kubicka & David Williams

  4. Institutional Centers for Clinical and Translational Studies, Boston Children’s Hospital, Boston, MA, USA

    David Williams

Authors
  1. Zuzanna Kubicka
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Contributions

ZK and BA conceptualized and designed the study, designed the data collection instruments, coordinated and supervised data collection, recruited patients, collected data, drafted the initial manuscript, and reviewed and revised the manuscript. JF, EZ, AD, DP, TR and ML contributed to designing the study, participated in patient recruitment, data collection, and reviewed and revised the manuscript. DW conceptualized and designed the study, contributed to designing questionnaires, carried out the initial and final statistical analyses, and critically reviewed the manuscript for important intellectual content. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

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Correspondence to Zuzanna Kubicka.

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Kubicka, Z., Fiascone, J., Williams, D. et al. Implementing modified family integrated care in a U.S. neonatal intensive care unit: nursing perspectives and effects on parents. J Perinatol 43, 503–509 (2023). https://doi.org/10.1038/s41372-023-01601-y

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