J Obstet Gynecol Neonatal Nurs. 2021 Mar;50(2):181-192. doi: 10.1016/j.jogn.2020.11.001. Epub 2021 Jan 8.
To explore the experiences of parents with an integrated maternity and neonatal ward designed to empower parents by providing family-integrated care (FICare) to mother-newborn couplets in single-family rooms.
A qualitative analysis with a contextual constructivist approach.
An integrated maternity and neonatal level 2 ward designed to empower parents in a teaching hospital in Amsterdam, the Netherlands. Maternity and neonatal care, up to and including highly complex care, is provided to mother-newborn couplets in single-family rooms according to the principles of FICare.
Twenty-seven mothers and nine fathers of newborns who were hospitalized for at least 7 days.
We held four focus group discussions and eight semistructured interviews 1 to 3 months after discharge of the newborn to explore which experiences (mechanisms) facilitated or impeded aspects of parent empowerment (outcomes) under which specific conditions of the integrated infrastructure (contexts). We used the realist evaluation model to analyze the data.
Our analysis revealed five themes of parent empowerment (outcomes): Feeling Respected, Gaining Self-Management Tools, Insights Into the Newborn's Condition, Perceived Control, and Self-Efficacy. For each theme, participants reported facilitating and impeding experiences (mechanisms) that were initiated and influenced by the combination of single-family rooms, couplet care, rooming-in, and FICare (contexts). Unrestricted physical proximity to their newborns, 24 hours per day, in a safe private environment offered parents intensive learning experiences through active participation in care. It helped them to achieve independent parenthood at the time of discharge, but it also generated challenges such as power conflicts with the staff; prioritizing care for themselves, siblings, or the newborn; feelings of isolation; and lack of sleep.
Providing FICare to mother-newborn couplets in single-family rooms offers parents an intensive learning context for independent parenthood at the time of discharge. Health care professionals should be aware of the challenges and facilitators experienced by parents in the context of close physical proximity to their newborns 24 hours per day in single-family rooms. This awareness will allow them to better support parents in their empowerment process toward independent parenthood at the time of discharge.
探索在提供家庭一体化护理（FICare）的单间病房中为母婴提供一体化护理，以增强父母能力的经验，这些父母的孩子在新生儿科住院。
定性分析，具有语境建构主义方法。
荷兰阿姆斯特丹的一家教学医院的一体化母婴和新生儿 2 级病房，旨在增强父母的能力。根据 FICare 的原则，为母婴提供单间病房，包括母婴护理，直到并包括高度复杂的护理。
27 位母亲和 9 位新生儿父亲，他们的孩子住院至少 7 天。
我们在新生儿出院后 1 至 3 个月内进行了 4 次焦点小组讨论和 8 次半结构化访谈，以探讨在一体化基础设施（背景）的特定条件下，哪些经验（机制）促进或阻碍了父母赋权（结果）的哪些方面。我们使用现实主义评估模型对数据进行分析。
我们的分析揭示了父母赋权（结果）的五个主题：感到受尊重、获得自我管理工具、了解新生儿的状况、感知控制和自我效能。对于每个主题，参与者报告了促进和阻碍经验（机制），这些经验是由单间病房、双床护理、母婴同室和 FICare 的结合（背景）引发和影响的。在安全的私人环境中，父母可以 24 小时无限制地接近他们的新生儿，这为他们提供了密集的学习体验，通过积极参与护理来实现。这有助于他们在出院时实现独立的父母身份，但也带来了一些挑战，例如与工作人员的权力冲突；优先照顾自己、兄弟姐妹或新生儿；孤立感；和睡眠不足。
在单间病房中为母婴提供 FICare 可以为父母提供一个密集的学习环境，以便在出院时实现独立的父母身份。医疗保健专业人员应该意识到父母在 24 小时无限制地与新生儿在单间病房中近距离接触的背景下所经历的挑战和促进因素。这种意识将使他们能够更好地支持父母在出院时实现独立的父母身份的赋权过程。
