Thai nurses' perceptions and practices of family-centered care: The implementation gap

Objectives:This study was conducted to examine the differences between perceptions and practices of family-centered care among Thai pediatric nurses.Methods:This mixed-methods study consisted of two phases,in the first phase,a descriptive comparative design using the Family-Centered Care Questionnaire-Revised(FCCQ-R)was administered to 142 pediatric nurses from a university hospital in Bangkok,Thailand.in the second phase,qualitative interviews were conducted with 16 pediatric nurses to gather complementary information regarding the major findings from the first phase.Results:The results revealed that family strengths and individuality were rated the highest as the most important elements and the most frequent practices.Parent/professional collaboration was perceived as the least important element,while the design of the heath care delivery system was rated as the least frequent practice.The qualitative data revealed that the major reasons for suboptimal implementation included a common perception that family-centered care is a Western concept,nurses'weak attitudes towards their roles,and a shortage of nurses.Conclusions:Nurses agreed that the identified elements of family-centered care were necessary but that they did not incorporate the concepts into their daily nursing practice to maintain their endorsement of the family-centered care model.Further study is needed to explore how family-centered care is understood and operationalized by Thai nurses and how hospital administration and environments can be modified to support this care model.

Evaluation of a complex couplet care intervention in a neonatal intensive care unit:A mixed methods study protocol

Background:Families with an infant in need of intensive care most often experience a harmful separation after birth.This is due to a division of medical specialties into neonatal care and maternal care.Therefore,a couplet care intervention is implemented for mother-infant dyads in a neonatal intensive care unit.This study protocol provides a comprehensive evaluation of the intervention.The aim is to evaluate the effect and implementation of a complex couplet care intervention to promote zero separation between mother and infant.Methods:The couplet care intervention is a family-centered model of care,where treatment-requiring mother-infant dyads will be admitted together and receive couplet care by neonatal nurses.The study adheres to the framework of the Medical Research Council and will use a mixed methods embedded design comprising a quasi-experimental trial and a qualitative process evaluation.Finally,a health economic evaluation will be conducted to assess the cost-effectiveness of this complex couplet care intervention.Discussion:Separation of mother-infant dyads after birth has an adverse impact on family health and well-being.This study protocol evaluates a complex couplet care intervention.With this study,a first step is taken to help bridge the gap between current practices and a new care model to prevent the separation of mothers and their infants.

Breaking down barriers: enabling care-by-parent in neonatal intensive care units in China

Background:Denying parents access to their infant in the Neonatal Intensive Care Unit (NICU) is a standard practice in most hospitals across China.Visitation is not usually permitted or may be strictly limited,and NICU care for most neonates is provided by health-care professionals with little participation of the parents.An exception to this rule is the level 2 'Room-In' ward in Qilu Children's Hospital,Shandong University,where parents have 24-hour access to their infants and participate in providing care.Methods:This retrospective cohort study compared the outcomes of infants who were admitted to the NICU and remained there throughout their stay (NICU-NICU group,n=428),admitted to the NICU and then transferred to the Room-In ward (NICU-RIn group,n=1018),or admitted straight to the Room-In ward (RIn only group,n=629).Results:There were no significant differences in the rates of nosocomial infection,bronchopulmonary dysplasia,intraventricular hemorrhage,and retinopathy of prematurity between the NICU-NICU and NICURIn groups.The rate of necrotizing enterocolitis was significantly lower in the NICU-RIn group (P=0.04),while weight gain and duration of hospital stay were significantly higher (both P<0.001).Rates of adverse outcomes were lower in RIn-only infants due to their low severity of illness on admission.Conclusions:Allowing parents access to their infant in the NICU is feasible and safe in China,and may result in improvements in infant outcomes.Further studies are required to generate stronger evidence that can inform changes to neonatal care in China.