Primary Care Research Centre, School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK.
University of Manchester, Manchester, UK.
J Adv Nurs. 2024 Oct;80(10):3937-3954. doi: 10.1111/jan.16166. Epub 2024 Mar 25.
To explore parents' experiences of unsettled babies and medical labels.
Qualitative systematic review, thematic synthesis and development of a conceptual model.
Systematic review and thematic synthesis of primary, qualitative research into parents' experiences of unsettled babies <12 months of age. 'Unsettled' was defined as perception of excessive crying with additional feature(s) such as vomiting, skin or stool problems. The Critical Appraisal Skills Programme (CASP) checklist was used to assess trustworthiness.
Structured searches completed in CINAHL, Medline, Embase, PsychINFO and CochraneCT on 23 March 2022 and rerun on 14 April 2023.
Ten eligible studies were included across eight countries contributing data from 103 mothers and 24 fathers. Two analytical themes and eight descriptive themes were developed. Firstly, parents expressed fearing judgement, feeling guilty and out of control as a result of babies' unsettled symptoms and seeking strategies to construct an 'Identity as a "Good Parent"'. This desire for positive parenting identity underpinned the second analytical theme 'Searching for an explanation' which included seeking external (medical) causes for babies' unsettled behaviours.
Parents can become trapped in a cycle of 'searching for an explanation' for their baby's unsettled behaviours, experiencing considerable distress which is exacerbated by feelings of guilt and failure.
Insight gained from this review could inform interventions to support parents, reducing inaccurate medicalization. Health visiting teams supporting parents with unsettled baby behaviour could focus on supporting a positive parenting identity by managing expectations, normalizing the continuum of infant behaviours, reducing feelings of guilt or uncertainty and helping parents regain a feeling of control.
ENTREQ guidelines were adhered to in the reporting of this review.
Parent input was crucial in the design phase; shaping the language used (e.g., 'unsettled babies') and in the analysis sense-checking findings.
探讨父母对婴儿不安和医疗标签的体验。
定性系统评价、主题综合和概念模型的发展。
对 12 个月以下父母对不安婴儿（定义为过度哭泣并有呕吐、皮肤或粪便问题等附加特征）的体验进行初步定性研究的系统评价和主题综合。使用批判性评估技巧计划 (CASP) 检查表评估可信度。
2022 年 3 月 23 日在 CINAHL、Medline、Embase、PsychINFO 和 CochraneCT 上进行结构化搜索，并于 2023 年 4 月 14 日重新运行。
来自 8 个国家的 10 项合格研究共纳入 103 名母亲和 24 名父亲的数据。开发了两个分析主题和八个描述性主题。首先，父母因婴儿不安的症状而表达了害怕评判、内疚和失控的感受，并寻求策略来构建“好父母”的身份。这种对积极育儿身份的渴望是第二个分析主题“寻找解释”的基础，其中包括为婴儿不安的行为寻找外部（医疗）原因。
父母可能会陷入对婴儿不安行为寻找解释的循环中，感到相当大的痛苦，这种痛苦因内疚和失败感而加剧。
从本次综述中获得的见解可以为支持父母的干预措施提供信息，减少不准确的医学化。支持有不安婴儿行为的父母的健康访问团队可以通过管理期望、使婴儿行为的连续体正常化、减少内疚或不确定性的感觉以及帮助父母重新获得控制感，来支持积极的育儿身份。
本综述报告遵循 ENTREQ 指南。
父母的投入在设计阶段至关重要；塑造使用的语言（例如，“不安的婴儿”）和分析中对发现进行确认。
