A Father-friendly Neonatal Intensive Care Unit

NCT05521620 | Completed

• 1 other identifier: 19/20297
• Study Type: interventional
• Target: 500
• Locations: 1 country
• Sites: 1

Brief Summary

An early parent-child relationship is important for a child's development, both intellectually and socially. The admission of premature or ill newborns to neonatal intensive care units (NICUs) may make the establishment of the parent-child relationship challenging due to parents' anxiety and despair. Traditionally, most healthcare professionals have mainly focused on infants and mothers, even though fathers often feel stressed, powerless, and helpless, and find it difficult to establish a father-child relationship. The aim of this study is to investigate the effect of a father-friendly NICU on infants, parents and staff.

Conditions

Stress; Self Efficacy; Perception, Self

Keywords

Father; Intensive Care Units, Neonatal; Parental support; Stress; Self-efficacy; Mothers; Nurse; Participatory reseach; Masculinity

Outcome Measures

Primary Outcomes (4)

• Stress (The Parental Stressor Scale: Neonatal Intensive Care Unit)

  The primary outcome was the difference in the overall stress score, determined using the Parental Stressor Scale: Neonatal Intensive Care Unit (PSS:NICU) score in both the control and intervention groups. Fathers were asked to rate their stress related to particular situations on a 5-point Likert scale, ranging from 1 (not at all stressful) to 5 (extremely stressful). Fathers who had not experienced a particular situation on an item indicated this with a "not relevant" response. The maximal score was 5, a high score indicating a high level of paternal stress.

  Measured on admission to the NICU (during the first 3 days of hospitalization), at the 14th day of hospitalization , and at the day of discharge from the NICU (up to 1/2 year)

• Parental Support (The Nurse Parent Support Tool)

  The primary outcome was the difference in fathers' perception of received staff support in the control group compared to the intervention group. The questionnaire included four dimensions of nurse support: 1) communication of information related to the infant's condition and care (nine items), 2) support mainly directed to enhance parental role (four items), 3) emotional support to help parents cope with their infant's sickness (three items), and 4) caregiving support concerning the quality of care provided to the infant (five items). For each item, the parents indicated the degree of support on a 5-point Likert scale ranging from 1 (never) to 5 (always) 19.

  Measured on admission to the NICU (during the first 3 days of hospitalization), and at the day of discharge from the NICU (up to 1/2 year)

• Nurses self-efficacy (Self-efficacy (SE))

  The primary outcome was the difference between the nurses' SE scores for father and mother questions in the intervention group in comparison with the control group The nurses were asked to evaluate own ability to guide and support the parents in different situations (Self-efficacy score). The SE score was rated on a scale ranging from 1, indicating "Not at all sure," to 10, indicating "Definitely sure".

  Before the start of the development of the intervention (August 2011) till 18 months after the implementation of the intervention (January 2015)

• Self-efficacy follow-up

  The primary outcome was the difference between the nurses' SE score on father and mother questions from after the implementation of the intervention to five years after. The nurses were asked to evaluate own ability to guide and support the parents in different situations (Self-efficacy score). The SE score was rated on a scale ranging from 1, indicating "Not at all sure," to 10, indicating "Definitely sure".

  After the implementation of the intervention (January 2015) to five years after (February 2021).

Study Arms (2)

Father-friendly NICU

ACTIVE COMPARATOR

* Fathers have skin-to-skin contact with their infants * Fathers participate in important situations * Fathers receive information and guidance directly * Both parents participate in meaningful conversations * The department organize mother and father groups * The families have the opportunity to have a close family member to support them * Older siblings have the opportunity to stay overnight. * The department offer counseling by a social worker

Behavioral: The father-friendly NICU

No Father-friendly NICU (baseline)

NO INTERVENTION

Baseline - before implementation of the intervention

Interventions

The father-friendly NICU BEHAVIORAL

* Fathers have skin-to-skin contact with their infants * Fathers participate in important situations * Fathers receive information and guidance directly * Both parents participate in meaningful conversations * The department organize mother and father groups * The families have the opportunity to have a close family member to support them * Older siblings have the opportunity to stay overnight. * The department offer counseling by a social worker

Father-friendly NICU

Eligibility Criteria

• Gender Eligibility Details: mother and father
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• fathers/mothers with infants admitted to the NICU were eligible
• nurses who work in Danish NICUs

You may not qualify if:

• fathers/mothers who did not understand verbal and written Danish
• fathers/mothers of critically ill newborn infants
• fathers of newborn infants whose mother was critically ill
• fathers/mothers of newborn infants admitted to the NICU from home.
• nurses without patient-contact, on maternity- or long-term sickness-leave

Sponsors & Collaborators

• Kolding Sygehus: lead

Study Sites (1)

Department of Paediatrics and Adolescent Medicine at the University Hospital of Southern Denmark, Kolding

Kolding, 6000, Denmark

Location

Related Publications (23)

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• Fegran L, Helseth S, Fagermoen MS. A comparison of mothers' and fathers' experiences of the attachment process in a neonatal intensive care unit. J Clin Nurs. 2008 Mar;17(6):810-6. doi: 10.1111/j.1365-2702.2007.02125.x.

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• Sullivan JR. Development of father-infant attachment in fathers of preterm infants. Neonatal Netw. 1999 Oct;18(7):33-9. doi: 10.1891/0730-0832.18.7.33.

  PMID: 10808886 BACKGROUND

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  PMID: 20697219 BACKGROUND

• Pohlman S. Fathering premature infants and the technological imperative of the neonatal intensive care unit: an interpretive inquiry. ANS Adv Nurs Sci. 2009 Jul-Sep;32(3):E1-16. doi: 10.1097/ANS.0b013e3181b0d68c.

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  PMID: 14700179 BACKGROUND

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• Ortenstrand A, Westrup B, Brostrom EB, Sarman I, Akerstrom S, Brune T, Lindberg L, Waldenstrom U. The Stockholm Neonatal Family Centered Care Study: effects on length of stay and infant morbidity. Pediatrics. 2010 Feb;125(2):e278-85. doi: 10.1542/peds.2009-1511. Epub 2010 Jan 25.

  PMID: 20100748 BACKGROUND

• Johnson AN. Engaging fathers in the NICU: taking down the barriers to the baby. J Perinat Neonatal Nurs. 2008 Oct-Dec;22(4):302-6. doi: 10.1097/01.JPN.0000341361.37822.34.

  PMID: 19011495 BACKGROUND

• Arockiasamy V, Holsti L, Albersheim S. Fathers' experiences in the neonatal intensive care unit: a search for control. Pediatrics. 2008 Feb;121(2):e215-22. doi: 10.1542/peds.2007-1005. Epub 2008 Jan 8.

  PMID: 18182470 BACKGROUND

• Novak JC. Facilitating nurturant fathering behavior in the NICU. J Perinat Neonatal Nurs. 1990 Sep;4(2):68-77. doi: 10.1097/00005237-199009000-00009.

  PMID: 2391649 BACKGROUND

• Levy-Shiff R, Hoffman MA, Mogilner S, Levinger S, Mogilner MB. Fathers' hospital visits to their preterm infants as a predictor of father-infant relationship and infant development. Pediatrics. 1990 Aug;86(2):289-93.

  PMID: 2371105 BACKGROUND

• Bogdan R, Brown MA, Foster SB. Be honest but not cruel: staff/parent communication on a neonatal unit. Hum Organ. 1982 Spring;41(1):6-16. doi: 10.17730/humo.41.1.03x7x4214201v7p2. No abstract available.

  PMID: 10254504 BACKGROUND

• Ammentorp J, Kofoed PE. Coach training can improve the self-efficacy of neonatal nurses. A pilot study. Patient Educ Couns. 2010 May;79(2):258-61. doi: 10.1016/j.pec.2009.08.015. Epub 2009 Sep 27.

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• Reid M, Lloyd D, Campbell G, Murray K, Porter M. Scottish neonatal intensive care units; a study of staff and parental attitudes. Health Bull (Edinb). 1995 Sep;53(5):314-25.

  PMID: 7490204 BACKGROUND

• Noergaard B, Ammentorp J, Garne E, Fenger-Gron J, Kofoed PE. Fathers' Stress in a Neonatal Intensive Care Unit. Adv Neonatal Care. 2018 Oct;18(5):413-422. doi: 10.1097/ANC.0000000000000503.

  PMID: 29746269 RESULT

• Noergaard B, Ammentorp J, Fenger-Gron J, Kofoed PE, Johannessen H, Thibeau S. Fathers' Needs and Masculinity Dilemmas in a Neonatal Intensive Care Unit in Denmark. Adv Neonatal Care. 2017 Aug;17(4):E13-E22. doi: 10.1097/ANC.0000000000000395.

  PMID: 28749826 RESULT

• Noergaard B, Johannessen H, Fenger-Gron J, Kofoed PE, Ammentorp J. Participatory Action Research in the Field of Neonatal Intensive Care: Developing an Intervention to Meet the Fathers' Needs. A Case Study. J Public Health Res. 2016 Dec 21;5(3):744. doi: 10.4081/jphr.2016.744. eCollection 2016 Dec 9.

  PMID: 28083521 RESULT

MeSH Terms

Conditions

Masculinity

Condition Hierarchy (Ancestors)

Social Behavior; Behavior

Study Officials

• Betty Noergaard, Ph.d

  Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital,Kolding

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: SUPPORTIVE CARE
• Intervention Model: SEQUENTIAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Model Details: A before- and-after intervention study

Study Record Dates

• First Submitted: August 24, 2022
• First Posted: August 30, 2022
• Study Start: December 1, 2011
• Primary Completion: January 31, 2015
• Study Completion: February 11, 2021
• Last Updated: August 31, 2022

Record last verified: 2022-08

Data Sharing

• IPD Sharing: Will share
• Shared Documents: SAP
• Time Frame: Ending 5 years following article publication.

Locations

DK (1)