Involvement of parents in the care of preterm infants: A pilot study evaluating a family-centered care intervention in a Chinese neonatal ICU

Abstract

Objectives: To evaluate the effectiveness and safety of a family-centered care intervention in a Chinese neonatal ICU. Design: Pilot study using a randomized controlled trial design to inform a main randomized controlled trial study. Setting: Stand-alone tertiary children’s hospital in China with a 60-bed neonatal ICU serving as a regional neonatal ICU center. Patients: Premature infants (n = 61) and their parents (n = 110). Interventions: Parent education program followed by parents’ participation in care as primary caregiver until discharge for a minimum of 4 hours per day. Measurements and Main Results: Primary outcomes were infants’ weight gain at discharge, length of stay, and readmission. Parental outcomes were stress, anxiety, satisfaction, and clinical knowledge. Infants in family-centered care group (n = 31) had higher weight gain (886g vs 542g; p = 0.013), less neonatal ICU length of stay in days (43 vs 46; p = 0.937), and decreased readmission rate at 1 week (41.9 vs 70.0; p = 0.045) and at 1 month (6.5% vs 50%; p < 0.001) compared with the control group (n = 30). Total Mean Parental Stress and Anxiety scores were lower in the family-centered care group (42 vs 59; p = 0.007), mean satisfaction rates in family-centered care group were higher compared with control group (96 vs 90; p < 0.001), and parents in the family-centered care group had better educational outcomes related to neonatal specialized care skills (p < 0.05). Conclusions: Involving parents in the care of their infant improved clinical outcomes of infants. Family-centered care also contributed to a better understanding of parent’s clinical education, decrease stress levels, and increased parental satisfaction. Our study suggests that involving parents in the daily care of their infants is feasible and should be promoted by neonatal ICU clinicians.