Effectiveness of an intervention to improve parent-professional collaboration in neonatal intensive care

Abstract

Objective: This study tested the effect of an intervention to strengthen parent-professional collaboration by increasing the accuracy of parents' understanding of medically relevant information and providing parent-professional meetings to plan infants' care.

Methods: A tri-ethnic sample of mothers of 154 very-low-birth-weight infants participated, with parents of 77 infants in a control group and parents of 77 infants in an intervention group. Comprehension of infant medical condition and satisfaction with collaboration in treatment decisions in the 2 groups were measured 3 times during the first 28 days after admission using 9 collaboration scales. Intervention effects were analyzed with ANOVA and ANCOVA.

Results and conclusions: Statistically significant change was found in 6 of 9 scales used to measure collaboration and accuracy of parents' understanding. The intervention group had fewer unrealistic concerns (P = .018), and less uncertainty about infant medical conditions (P = .003); less decision conflict (P < or = .001), more satisfaction with the process by which medical decisions were made (P = .012) and with the amount of decision input they had (P = .058), and reported more shared decision making with professionals (P = .010). There were no statistically significant differences between the groups in satisfaction with infants' care, satisfaction with relationships with physicians and nurses, and satisfaction with the decisions made for their infants' treatment. Infant birth weight and gestational age and maternal demographic characteristics were found to influence collaboration results. The intervention was especially effective in improving understanding and collaboration in low-income, young, minority mothers.