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How parents and health professionals experience prematurity in an Italian neonatal intensive care: A grounded theory study

Published:August 17, 2022DOI:https://doi.org/10.1016/j.pedn.2022.07.020

      Highlights

      • Prematurity represents the leading cause of death in first weeks of life.
      • Parents face hard-hitting challenges and NICU may represent a place where their expectations are dashed.
      • Literature on prematurity is limited to distinct perspectives, leaving out the involved actors' process.
      • A Grounded Theory has been conceptualized to explain the parents and professionals' process around prematurity.
      • This study may improve perinatal care by suggesting integrating professionals into the family systems.

      Abstract

      Purpose

      The aim of this study was to explore prematurity as a psycho-social process from the point of view of both parents and healthcare professionals.

      Design and methods

      We conducted a Grounded Theory study through semi-structured interviews. Participants were from an Italian Neonatal Intensive Care Unit, including parents of premature children, and health professionals. Interviews were analyzed according to Grounded Theory coding strategies, to hypothesize a theoretical model.

      Results

      On one side, behaviors, emotions, and feelings of parental couples; on the other one, the activities and reactions of professionals have been interpreted in a four-phase negotiated process: 1) the initial breakup; 2) the floating family; 3) the event processing; 4) the reconstruction of a new family.

      Conclusions

      Managing prematurity is a negotiated process which could be better managed through a family-centered approach as fundamental in neonatal and pediatric services. Being open in listening, coherent in the given answers, and knowing the entire process and story of being suddenly parents of a premature child can make the difference in the future definition of a new family.

      Practice implications

      Perinatal care would benefit from the following suggested practical implications: i) reducing feelings of separation and solitude by integrating diverse professionals around the family systems; ii) expediting prematurity-related changes through peer-support during hospitalization and attention to rooms' organization; iii) enhancing information exchange between all professionals involved in the care of dyads/parents and new-borns, starting since the pregnancy and continuing after the child's birth by implementing multidisciplinary meetings or appropriate care pathways.

      Keywords

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