Uncertainty and the NICU Experience: A Qualitative Evaluation of Family and Provider Perspectives.
Katharine Griffin GorskySaloni ButalaMadison HouseChelsea MoonSam CalvettiTenzin KhandoMichele KipkeAshwini LakshmananPublished in: Children (Basel, Switzerland) (2023)
There is limited information regarding caregiver and provider perspectives on uncertainty across the continuum of the neonatal intensive care unit (NICU) experience. Open-ended semi-structured interviews were conducted with providers and English- and Spanish-speaking caregivers of infants with a history of admission to a quaternary safety-net NICU. Major themes were generated using inductive-deductive thematic analysis. Seventy-six individuals participated in the study: 47 caregivers and 29 providers. The median gestational age of the infants was 29 weeks and 85% were classified as having chronic complex disease per the Pediatric Medical Complexity Algorithm. Most providers were neonatologists (37%) and nurses (27%) and more than half had over ten years of experience. A conceptual model of caregiver uncertainty was developed and key domains included drivers of uncertainty and its impact, and factors influencing coping and adaptation. Our analysis found a positive association between caregiver information gathering, clinical continuity, support systems, maternal mental health supports, and witnessing a child's progress and the development of adjustment to chronic uncertainty. These results suggest key areas for intervention that can promote parental adaptation to the uncertainty inherent in the NICU experience.
Keyphrases
- preterm infants
- mental health
- gestational age
- birth weight
- primary care
- healthcare
- randomized controlled trial
- palliative care
- preterm birth
- emergency department
- machine learning
- depressive symptoms
- health information
- pregnant women
- young adults
- social support
- physical activity
- drug induced
- pregnancy outcomes
- social media