Parental involvement in neonatal comfort care

Abstract

Objective: To explore how parents interact with their infants and with nurses regarding the provision of comfort care in a Neonatal Intensive Care Unit (NICU).

Design: Focused ethnography.

Setting: A regional NICU in the United Kingdom.

Participants: Eleven families (10 mothers, 8 fathers) with infants residing in the NICU participated in the study.

Methods: Parents were observed during a caregiving interaction with their infants and then interviewed on up to four occasions. Twenty-five periods of observation and 24 semistructured interviews were conducted between January and November 2008.

Results: Five stages of learning to parent in the NICU were identified. Although the length and duration of each stage differed for individual parents, movement along the learning trajectory was facilitated when parents were involved in comforting their infants. Transfer of responsibility from nurse to parents for specific aspects of care was also aided by parental involvement in pain care. Nurses' encouragement of parental involvement in comfort care facilitated parental proximity, parent/infant reciprocity, and parental sense of responsibility.

Conclusion: Findings suggest that parental involvement in comfort care can aid the process of learning to parent, which is difficult in the NICU. Parental involvement in infant comfort care may also facilitate the transfer of responsibility from nurse to parent and may facilitate antecedents to parent/infant attachment.