Midtveisevaluering - Bente Silnes Tandberg
Abstract: Impact of Family Centered Care on Premature infants and their Parents (The FCC Study).
Background: Family Centered Care (FCC) - with parents may be present and participate in care of their premature infant in single room at all times during the hospital stay - is a new international paradigm in care, but benefits and unwanted effects, e.g. in relation to parental stress, hospital staff and infant health, have not been tested.
Methods: The overall aim with the thesis is to examine whether differences in Neonatal Intensive Care unit (NICU) design, i.e. standard care in an open bay unit and a family centered care (FCC) unit with single rooms, have impact on health outcomes of the premature infant and on coping by their parents, and on nurses’ attitudes towards supporting and involving parents.
The thesis comprises two studies. The first study describes nurses’ attitude towards supporting and involving parents, and the parents’ evaluation of perceived support and encouragement to be involved in their preterm infants care during hospitalization. Further, the study examines whether the NICU design has impact on both the parents’ and the nurses’ evaluation of support and involvement. The assessments will be conducted by web-questionnaires to the nurses and by SMS-questionnaires to the parents.
The second study evaluates possible impact of two different NICU designs, the traditional open bay NICU care and FCC, in terms of the preterm infant's growth and health, and their parents’ experience of psychosocial stress and confidence in caring for their infants. Infants born at 28-32 weeks’ of pregnancy and their parents will be included and followed throughout their hospitalization, at discharge, at term and at 4 months’ corrected age. For the premature infant the primary outcome will be gain in weight, body length and head circumference. Secondary outcomes will be duration of ventilation and oxygen treatment, time to obtain full enteral feeds and breastfeeding, length of stay in the NICU and neonatal morbidity. For the parents, experience of psychosocial stress and confidence in caring for their infants will be assessed by validated questionnaires.
Results: A change from traditional NICU to FCC with single rooms requires extensive changes in organization of care, how NICUs are designed and operated, and how physicians and nurses are supposed to work. From this study we can gain knowledge on how different NICU designs may affect preterm infants’ health and development and their parents’ wellbeing, and also on how the extent of parental involvement may have an effect on the infants and the parents themselves. Many hospitals are in the process of deciding on how to organize NICUs. It is therefore of paramount importance to examine pros and cons for FCC and other forms of organization.