Department of Nursing, Brock University, Faculty of Applied Health Sciences, 1812 Sir Isaac Brock Way, St. Catharines, Ontario, L2S 3A1, Canada.
Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada.
BMC Pregnancy Childbirth. 2023 Apr 17;23(1):259. doi: 10.1186/s12884-023-05553-1.
The neonatal intensive care unit (NICU) is a complex care environment, with the NICU patient population among the most vulnerable in a hospital setting. Adolescent parents are a unique group within the broader NICU parent population and admission of their infant to the NICU contributes to an already complex situation as adolescent pregnancy and parenting is often associated with a range of psychosocial challenges. How the NICU care context influences care provision for adolescent parents is a significant gap in the NICU parenting and support discourse. Therefore, this study aimed to explore health and social care providers' perspectives of the NICU care context and how providers perceive the context as influencing the experiences of adolescent parents in the NICU.
This was a qualitative, interpretive description study design. In-depth interviews were conducted with providers, including nurses and social workers, caring for adolescent parents in the NICU. Data was collected between December 2019 and November 2020. Data were analyzed concurrently with data collection. Constant comparison, analytic memos, and iterative diagramming techniques were used to challenge developing analytic patterns.
Providers (n = 23) described how the unit context influenced care provision as well as experiences for adolescent parents. We learned that having a baby in the NICU was perceived by providers as a traumatic experience for parents - impacting attachment, parenting confidence and competence, and mental health. Environmental factors - such as privacy and time - and perceptions that adolescent parents are treated differently in the NICU were also seen as influencing this overall experience.
Providers involved in the care of adolescent parents in the neonatal intensive care unit described the distinctiveness of this group within the broader parent population and how quality of care may be impacted by contextual factors as well as experiences of age-related stigma. Further understanding of NICU experiences from the parents' perspectives are warranted. Findings highlight opportunities for strengthened interprofessional collaboration and trauma- and violence-informed care strategies within the neonatal intensive care environment to mitigate the potential negative influence of this experience and improve care for adolescent parents.
新生儿重症监护病房（NICU）是一个复杂的护理环境，其患者群体是医院环境中最脆弱的群体之一。青少年父母是 NICU 更广泛父母群体中的一个独特群体，他们的婴儿被收治到 NICU 会使情况更加复杂，因为青少年怀孕和育儿通常与一系列心理社会挑战有关。NICU 护理环境如何影响对青少年父母的护理提供，这是 NICU 育儿和支持讨论中的一个重要空白。因此，本研究旨在探讨卫生和社会保健提供者对 NICU 护理环境的看法，以及提供者如何感知环境会影响 NICU 中青少年父母的体验。
这是一项定性、解释性描述研究设计。对在 NICU 照顾青少年父母的护士和社会工作者等提供者进行了深入访谈。数据收集于 2019 年 12 月至 2020 年 11 月之间进行。数据收集与数据分析同时进行。采用恒比比较、分析备忘录和迭代图技术来挑战正在发展的分析模式。
提供者（n=23）描述了单位环境如何影响护理提供以及青少年父母的体验。我们了解到，提供者认为父母在 NICU 中生小孩是一种创伤性经历——影响依恋、育儿信心和能力以及心理健康。环境因素，如隐私和时间，以及认为青少年父母在 NICU 中受到不同待遇的看法，也被视为影响这种整体体验的因素。
参与 NICU 中青少年父母护理的提供者描述了这一群体在更广泛的父母群体中的独特性，以及环境因素和与年龄相关的耻辱感体验如何影响护理质量。从父母的角度进一步了解 NICU 的体验是有必要的。研究结果强调了在新生儿重症监护环境中加强跨专业合作和创伤与暴力知情护理策略的机会，以减轻这种体验的潜在负面影响，并改善对青少年父母的护理。
