Family Support and Family-Centered Care in the Neonatal Intensive Care Unit: Origins, Advances, Impact
Section snippets
Origins of Neonatal FCC
Through the 1800s, the birth and care of infants born in the United States encompassed FCC naturally although the term had not yet been coined. Most infants were born at home with little involvement of physicians, and care was provided almost exclusively by the mother and extended—usually female—family members. During the course of the 19th century, infant deaths were accepted as a normal part of life, a “reflection of the natural order in which the strong outlived the weak.”4
From the later
NICU Staff
Staff members in all roles—even those not directly involved in patient care—can contribute to FCC. Formal training for physicians and nurses in how to explain medical concepts to families fully and compassionately has been shown to be important.8 Other examples of integration of FCC into the culture and functioning of the NICU include participation by families who have been through the NICU experience in teaching FCC to medical students through home visits, discussion groups, role playing, and
Parent Education
Educating parents about the NICU environment, their infant's condition, and relevant procedures helps facilitate their active participation in family-physician discussions.2, 11 Parent education sessions and materials on topics such as infant development, NICU conditions, the emotional strain associated with a NICU experience, transition to home, and supporting siblings are rated highly by parents as helping to reduce their stress and increase parental confidence.20 Best practice standards for
Supporting Families' Psychological Wellbeing
Various FCC initiatives have shown promising results in relation to improved parental mental health. Mothers who participated in the Creating Opportunities for Family Empowerment (ie, COPE) program, an audiotaped educational-behavioral program about how to engage with and care for their hospitalized infant, were less stressed than mothers who did not participate in the program.60 Mothers who had contact with a March of Dimes NICU Family Support Specialist reported less stress and higher
Conclusion and Recommendations for Further Study
Despite the significant need to support families with infants in intensive care and the clear benefits of such support, significant progress is needed in both uptake of FCC and family support and in building the base of evidence for discrete practices and for comprehensive FCC programs.
Numerous individual components of FCC have been demonstrated to be successful and several comprehensive program models have seen strong success in establishing FCC practices. Models and approaches noted for
Acknowledgments
The authors would like to acknowledge the assistance and dedication of Sarah Rand, March of Dimes volunteer research assistant, and Kelli Signorelli of the March of Dimes Chapter Program Support Department.
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