Parents’ experiences of communication with neonatal intensive-care unit staff: an interview study

BMC Pediatrics

Kristina Bry¹  Michaela Dellenmark Blom³  Helena Wigert² 

[1] Department of Pediatrics, The Sahlgrenska Academy at University of Gothenburg, Gothenburg 416 85, Sweden;Division of Neonatology, Sahlgrenska University Hospital, Gothenburg 416 85, Sweden;Department of Pediatric Surgery, Sahlgrenska University Hospital, Gothenburg 416 85, Sweden

关键词: Parental experience;    Neonatal intensive care;    Hermeneutic lifeworld approach;    Communication;   

Others  :  1224679
DOI  :  10.1186/s12887-014-0304-5

 received in 2014-09-18, accepted in 2014-11-28,  发布年份 2014

【 摘 要 】

Background

An infant’s admission to a neonatal intensive-care unit (NICU) inevitably causes the parents emotional stress. Communication between parents and NICU staff is an essential part of the support offered to the parents and can reduce their emotional stress. The aim of this study was to describe parents’ experiences of communication with NICU staff.

Methods

A hermeneutic lifeworld interview study was performed with 18 families whose children were treated in the level III NICU at a university hospital in Sweden. The interviews were analysed to gain an interpretation of the phenomenon of how parents in the NICU experienced their communication with the staff, in order to find new ways to understand their experience.

Results

Parents’ experience of communication with the staff during their infant’s stay at the NICU can be described by the main theme ‘being given attention or ignored in their emotional situation’. The main theme derives from three themes; (1) meeting a fellow human being, (2) being included or excluded as a parent and (3) bearing unwanted responsibility.

Conclusions

This study shows that parents experienced communication with the NICU staff as essential to their management of their situation. Attentive communication gives the parents relief in their trying circumstances. In contrast, lack of communication contributes to feelings of loneliness, abandonment and unwanted responsibility, which adds to the burden of an already difficult situation. The level of communication in meetings with staff can have a decisive influence on parents’ experiences of the NICU.

The staff should thus be reminded of their unique position to help parents handle their emotional difficulties. The organization should facilitate opportunities for good communication between parents and staff through training, staffing and the physical health care environment.

【 授权许可】

   
2014 Wigert et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Bond EA, Obeidat HM, Callister LC: The parental experience of having an infant in the newborn intensive care unit. J Perinat Educ 2009, 18(3):23-29.
• [2]Fenwick J, Barclay L, Schmied V: Craving closeness: a grounded theory analysis of women’s experiences of mothering in the Special Care Nursery. Women Birth 2008, 21:71-85.
• [3]Guillaume S, Michelin N, Amrani E, Benier B, Durrmeyer X, Lescure S, Bony C, Danan C, Baud O, Jarreau PH, Zana-Taieb E, Caeymaex L: Parents’exextions of staff in the a early bonding process with their premature babies in the intensuve care setting: a qualitative multicenter study with 60 parents. BMC Pediatr 2013, 13:18. BioMed Central Full Text
• [4]Watson G: Parental liminality: a way of understanding the early experiences of parents who have a very preterm infant. J Clin Nurs 2011, 20(9–10):1462-1471.
• [5]Wigert H, Hellström AL, Berg M: Conditions for parents’ participation in the care of their child in neonatal intensive care – a field study. BMC Pediatr 2008, 23:8:3.
• [6]Eriksson BS, Pehrsson G: Emotional reactions of parents after the birth of an infant with extremely low birth weight. J Child Health Care 2005, 9(2):122-136.
• [7]Jackson K, Ternestedt BM, Schollin J: From alienation to familiarity: experiences of mothers and fathers of preterm infants. J Adv Nurs 2003, 43:120-129.
• [8]Kowalski WJ, Leef KH, Mackley A, Spear ML, Paul DA: Communicating with parents of premature infants: who is the informant? J Perinatol 2006, 26(1):44-48.
• [9]Kuo DZ, Houtrow AJ, Arango P, Kuhlthau KA, Simmons JM, Neff JM: Family-centered care: current applications and future directions in pediatric health care. Matern Child Health J 2012, 2012(16):297-305.
• [10]Turner M, Chur-Hansen A, Winefield H: The neonatal nurses’ view of their role in emotional support of parents and its complexities. J Clin Nurs 2014, 23:3156-3165.
• [11]Wigert H, Dellenmark MB, Bry K: Strengths and weaknesses of parent – staff communication in the NICU: a survey assessment. BMC Pediatr 2013, 23:13:71.
• [12]National Encyklopedin (Dictionary of National Encyclopedia). Available at http://www.ne.se Accessed 7 July 2014.
• [13]Watzlawick P, Beavin JH, Jackson DD: Pragmatics of Human Communication: A Study of Interactional Patterns, Pathologies, and Paradoxes. Norton, New York; 1967.
• [14]Orzalesi M, Aite L: Communication with parents in neonatal intensive care. J Matern Fetal Neonatal Med 2011, 24(1):135-137.
• [15]Payot A, Gendron S, Lefebvre F, Doucet H: Deciding to resuscitate extremely premature babies: how do parents and neonatologists engage in the decision? Soc Sci Med 2007, 64:1487-1500.
• [16]Weiss S, Goldlust E, Vaucher YE: Improving parent satisfaction: an intervention to increase neonatal parent-provider communication. J Perinatol 2010, 30(6):425-430.
• [17]Fegran L, Helseth S, Slettebø A: Nurses as moral practitioners encountering parents in neonatal intensive care units. Nurs Ethics 2006, 13:52-64.
• [18]Harrison TM: Family-centered pediatric nursing care state of the science. J Pediatr Nurs 2010, 25:335-343.
• [19]Alderson P, Hawthorne J, Killen M: Parents’ experiences of sharing neonatal information and decisions: consent, cost and risk. Soc Sci Med 2006, 62:1319-1329.
• [20]Latour JM, Hazelzet JA, Duivenvoorden HJ, van Goudoever JB: Perceptions of parents, nurses, and physicians on neonatal intensive care practices. J Pediatrics 2010, 157:215-220. e213
• [21]Mok E, Leung SF: Nurses as providers of support for mothers of premature infants. J Clin Nurs 2006, 15(6):726-734.
• [22]Dahlberg K, Dahlberg H, Nyström M: Reflective Lifeworld Research. Lund, Studentlitteratur; 2008.
• [23]Gadamer HG: Truth and Method. 3rd edition. Continum, New York; 2004.
• [24]Stark AR: Levels of neonatal care. Pediatrics 2004, 114(5):1341-1347.
• [25]Dessy E: Effective communication in difficult situations: preventing stress and burnout in the NICU. Early Hum Dev 2009, 85:39-41.
• [26]Dunn DJ: The intentionality of compassion energy. Holist Nurs Pract 2009, 23:222-229.
• [27]Florian B, Andreas F: Ethics consultation and empathy. HEC Forum 2011, 23:247.
• [28]Halpern J: What is clinical empathy? J Gen Intern Med 2003, 18:670-674.
• [29]Morse JM, Bottorff J, Anderson G, O’Brien B, Solberg S: Beyond empathy: expanding expressions of caring. J Adv Nurs 1992, 17:809-821.
• [30]Engler AJ, Cusson RM, Brockett RT, Cannon-Heinrich C, Goldberg MA, West MG, Petow W: Neonatal staff and advanced practice nurses’ perceptions of bereavement/end-of-life care of families of critically ill and/or dying infants. Am J Crit Care 2004, 13:489.
• [31]Monterosso L, Kristjanson L, Sly PD, Mulcahy M, Holland BG, Grimwood S, White K: The role of the neonatal intensive care nurse in decision-making: advocacy, involvement in ethical decisions and communication. Int J Nurs Pract 2005, 11:108-117.
• [32]Boss RD, Hutton N, Donohue PK, Arnold RM: Neonatologist training to guide family decision making for critically ill infants. Arch Pediatr Adolesc Med 2009, 163:783-788.
• [33]Fegran L, Fagermoen MS, Helseth S: Development of parent–nurse relationships in neonatal intensive care units – from closeness to detachment. J Adv Nurs 2008, 64(4):363-371.
• [34]Younger JB: The alienation of the sufferer. Adv Nurs Sci 1995, 17:53.
• [35]Schantz ML: Compassion: a concept analysis. Nurs Forum 2007, 42:48-55.
• [36]Von Dietze E, Orb A: Compassionate care: a moral dimension of nursing. Nurs Inquiry 2000, 7:166-174.
• [37]Martinsen K: Care and Vulnerability. Oslo, Akribe; 2006.
• [38]Håkonsen-Martinsen E: Care for nurses only? Medicine and the perceiving eye. Health Care Anal 2011, 19:15-27.
• [39]Fenwick J, Barclay L, Schmied V: ‘Chatting’: an important clinical tool in facilitating mothering in neonatal nurseries. J Adv Nurs 2001, 33:583-593.
• [40]Ward FR: Parents and professionals in the NICU: communication within the context of ethical decision making – an integrative review. Neonatal Netw 2005, 24:25-33.
• [41]Brinchmann BS, Vik T: Parents’ involvement in life-and-death decisions in neonatal intensive care: Norwegian attitudes. Newborn Infant Nurs Rev 2005, 5:77-81.