Sakonidou Susanna, Andrzejewska Izabela, Webbe James, Modi Neena, Bell Derek, Gale Chris
Neonatal Medicine, School of Public Health, Faculty of Medicine, Imperial College London, London, UK.
NIHR CLAHRC for Northwest London, London, UK.
BMJ Paediatr Open. 2020 Mar 15;4(1):e000613. doi: 10.1136/bmjpo-2019-000613. eCollection 2020.
Interventions improving parent satisfaction can reduce parent stress, may improve parent-infant bonding and infant outcomes. Our objective was to systematically review neonatal interventions relating to parents of infants of all gestations where an outcome was parent satisfaction.
We searched the databases MEDLINE, EMBASE, PsychINFO, Cochrane Central Register of Controlled Trials, CINAHL, HMIC, Maternity and Infant Care between 1 January 1946 and 1 October 2017. Inclusion criteria were randomised controlled trials (RCT), cohort studies and other non-randomised studies if participants were parents of infants receiving neonatal care, interventions were implemented in neonatal units (of any care level) and ≥1 quantitative outcome of parent satisfaction was measured. Included studies were limited to the English language only. We extracted study characteristics, interventions, outcomes and parent involvement in intervention design. Included studies were not sufficiently homogenous to enable quantitative synthesis. We assessed quality with the Cochrane Collaboration risk of bias tool (randomised) and the ROBINS-I tool (Risk Of Bias In Non-randomised Studies - of Interventions) (non-randomised studies).
We identified 32 studies with satisfaction measures from over 2800 parents and grouped interventions into 5 themes. Most studies were non-randomised involving preterm infants. Parent satisfaction was measured by 334 different questions in 29 questionnaires (only 6/29 fully validated). 18/32 studies reported higher parent satisfaction in the intervention group. The intervention theme with most studies reporting higher satisfaction was parent involvement (10/14). Five (5/32) studies reported involving parents in intervention design. All studies had high risk of bias.
Many interventions, commonly relating to parent involvement, are reported to improve parent satisfaction. Inconsistency in satisfaction measurements and high risk of bias makes this low-quality evidence. Standardised, validated parent satisfaction measures are needed, as well as higher quality trials of parent experience involving parents in intervention design.
CRD42017072388.
提高家长满意度的干预措施可减轻家长压力，可能改善亲子关系及婴儿预后。我们的目的是系统评价与所有孕周婴儿的家长相关的新生儿干预措施，其结局为家长满意度。
我们检索了1946年1月1日至2017年10月1日期间的MEDLINE、EMBASE、PsychINFO、Cochrane对照试验中心注册库、CINAHL、HMIC、母婴护理等数据库。纳入标准为随机对照试验（RCT）、队列研究及其他非随机研究，条件是参与者为接受新生儿护理婴儿的家长，干预措施在新生儿病房（任何护理级别）实施，且测量了≥1项家长满意度的定量结局。纳入研究仅限于英文文献。我们提取了研究特征、干预措施、结局以及家长在干预设计中的参与情况。纳入研究的同质性不足，无法进行定量综合分析。我们使用Cochrane协作网偏倚风险工具（随机对照试验）和ROBINS-I工具（非随机干预研究中的偏倚风险）（非随机研究）评估质量。
我们识别出32项有满意度测量结果的研究，涉及2800多名家长，并将干预措施分为5个主题。大多数研究为非随机研究，涉及早产儿。在29份问卷中，通过334个不同问题测量家长满意度（仅6/29经过充分验证）。18/32项研究报告干预组家长满意度更高。报告满意度更高的干预主题是家长参与（10/14）。5项（5/32）研究报告让家长参与干预设计。所有研究都有较高的偏倚风险。
据报道，许多干预措施（通常与家长参与有关）可提高家长满意度。满意度测量的不一致性和较高的偏倚风险导致证据质量较低。需要标准化、经过验证的家长满意度测量方法，以及涉及家长参与干预设计的家长体验的更高质量试验。
PROSPERO注册号：CRD42017072388。
