Family-centred Care As a Mediator in the Relationship Between Parental Nurse Support and Parental Stress in Neonatal Intensive Care Units

Overview

Journal BMC Nurs

Publisher Biomed Central

Specialty Medical Education

Date 2024 Aug 16

PMID 39152458

Authors

Ahmed Loutfy

Mohamed Ali Zoromba

Mai Adel Mohamed

Heba Emad El-Gazar

Shaherah Yousef Andargeery

Ahmed Hashem El-Monshed

Corrien Van Belkum

Ahmed Salah Ali

Affiliations

Soon will be listed here.

Abstract

Background: Within the NICU, there is a delicate equilibrium between providing assistance to parents by nurses and prioritising family-centred care (FCC). The FCC assumes the role of a mediator, effectively conveying compassion. The intricate dynamics between FCC, parental nurse support, and parental stress in neonatal intensive care units (NICUs) necessitate comprehensive investigation.

Objective: This study examines the mediating effect of FCC on the relationship between parental nurse support and parental stress in NICUs.

Methods: This cross-sectional observational study used convenience sampling to select 223 parents (202 mothers) from Mansoura City hospitals in Egypt. Data were collected using the Nurse Parent Support Tool (NPST), Family-Centered Care Self-Assessment Tool (FCCS-NICU), and the Parental Stressor Scale: NICU (PSS: NICU). Mediation analysis was used to examine the relationships between variables.

Results: Nurse support was positively associated with FCC (β = 0.81, p < 0.001) and negatively related to parental stress (β=-1.156, p < 0.001). FCC was found to reduce parental stress (β=-0.18, p < 0.001). Mediation analysis confirmed that FCC partially mediated the relationship between nurse support and parental stress (indirect effect β = 0.145, 95% CI: 0.055-1.007).

Conclusions: This study highlights a significant association in the mediating role of FCC between nurse support and parental stress. Strengthening FCC practices can be an effective strategy for nurses to support parents and alleviate their stress in NICU settings.

Implications To Practice: NICUs should implement FCC-oriented training for nurses, foster a culture that supports FCC principles, and develop policies to establish FCC as a cornerstone of neonatal care.

Citing Articles

Multi-Professional Family Support Programme: A Collective Development at the Neonatal Intensive Care Unit.

Gomes de Souza B, Nascimento L, Fioresi M, Furieri L, Balbino F, Andrade L Int J Environ Res Public Health. 2025; 21(12.

PMID: 39767410 PMC: 11675881. DOI: 10.3390/ijerph21121568.

References

Rabie D, Provenzi L, Matta N, Montirosso R . Reliability and Validity of the Arabic Version of the Parental Stressor Scale and Nurse Parental Support Tool: Opening Up Research on Parental Needs in Neonatal Intensive Care Units in Egypt. Adv Neonatal Care. 2020; 21(4):E101-E109. DOI: 10.1097/ANC.0000000000000826. View

Miles M, Carlson J, Brunssen S . The nurse parent support tool. J Pediatr Nurs. 1999; 14(1):44-50. DOI: 10.1016/S0882-5963(99)80059-1. View

He S, Xiong Y, Zhu L, Lv B, Gao X, Xiong H . Impact of family integrated care on infants' clinical outcomes in two children's hospitals in China: a pre-post intervention study. Ital J Pediatr. 2018; 44(1):65. PMC: 5989344. DOI: 10.1186/s13052-018-0506-9. View

Ramezani T, Shirazi Z, Sabet Sarvestani R, Moattari M . Family-centered care in neonatal intensive care unit: a concept analysis. Int J Community Based Nurs Midwifery. 2014; 2(4):268-78. PMC: 4201206. View

DallOglio I, Mascolo R, Tiozzo E, Portanova A, Fiori M, Gawronski O . The current practice of family-centred care in Italian neonatal intensive care units: A multicentre descriptive study. Intensive Crit Care Nurs. 2018; 50:36-43. DOI: 10.1016/j.iccn.2018.07.005. View

Gomez-Cantarino S, Garcia-Valdivieso I, Moncunill-Martinez E, Yanez-Araque B, Ugarte Gurrutxaga M . Developing a Family-Centered Care Model in the Neonatal Intensive Care Unit (NICU): A New Vision to Manage Healthcare. Int J Environ Res Public Health. 2020; 17(19). PMC: 7579288. DOI: 10.3390/ijerph17197197. View

Skene C, Gerrish K, Price F, Pilling E, Bayliss P, Gillespie S . Developing family-centred care in a neonatal intensive care unit: An action research study. Intensive Crit Care Nurs. 2018; 50:54-62. DOI: 10.1016/j.iccn.2018.05.006. View

Elsheikh M, Moriyama M, Rahman M, Kako M, El-Monshed A, Zoromba M . Effect of a tailored multidimensional intervention on the care burden among family caregivers of stroke survivors: a randomised controlled trial. BMJ Open. 2022; 12(2):e049741. PMC: 8852666. DOI: 10.1136/bmjopen-2021-049741. View

Miles M, Funk S, Carlson J . Parental Stressor Scale: neonatal intensive care unit. Nurs Res. 1993; 42(3):148-52. View

10.

Heidari H, Mardani-Hamooleh M . Nurses' Perception of Family-Centered Care in Neonatal Intensive Care Units. J Pediatr Intensive Care. 2020; 9(1):16-20. PMC: 6978175. DOI: 10.1055/s-0039-1695060. View

11.

Sigurdson K, Profit J, Dhurjati R, Morton C, Scala M, Vernon L . Former NICU Families Describe Gaps in Family-Centered Care. Qual Health Res. 2020; 30(12):1861-1875. PMC: 8106872. DOI: 10.1177/1049732320932897. View

12.

Sidek S, Marup S, Zolkefli Y . Nurses' view of the nature of the support given to parents in the neonatal intensive care unit. Belitung Nurs J. 2023; 7(6):522-528. PMC: 10367982. DOI: 10.33546/bnj.1668. View

13.

Kocakabak C, van den Hoogen A, Rothfus M, Campbell-Yeo M, Kostenzer J, Axelin A . Identifying outcomes and outcome measures in neonatal family-centered care trials: a systematic review. Pediatr Res. 2024; 97(1):56-66. DOI: 10.1038/s41390-024-03293-2. View

14.

Akkas N, Geckil E . Family-Centered Care Scale in Neonatal Intensive Care Unit (FCCS-NICU): Development and psychometrics evaluation. J Pediatr Nurs. 2022; 72:168-176. DOI: 10.1016/j.pedn.2022.11.031. View

15.

van Veenendaal N, van der Schoor S, Broekman B, de Groof F, van Laerhoven H, van den Heuvel M . Association of a Family Integrated Care Model With Paternal Mental Health Outcomes During Neonatal Hospitalization. JAMA Netw Open. 2022; 5(1):e2144720. PMC: 8787602. DOI: 10.1001/jamanetworkopen.2021.44720. View

16.

Prasopkittikun T, Srichantaranit A, Chunyasing S . Thai nurses' perceptions and practices of family-centered care: The implementation gap. Int J Nurs Sci. 2020; 7(1):74-80. PMC: 7031120. DOI: 10.1016/j.ijnss.2019.09.013. View

17.

Kokorelias K, Gignac M, Naglie G, Cameron J . Towards a universal model of family centered care: a scoping review. BMC Health Serv Res. 2019; 19(1):564. PMC: 6693264. DOI: 10.1186/s12913-019-4394-5. View

18.

Kuo D, Houtrow A, Arango P, Kuhlthau K, Simmons J, Neff J . Family-centered care: current applications and future directions in pediatric health care. Matern Child Health J. 2011; 16(2):297-305. PMC: 3262132. DOI: 10.1007/s10995-011-0751-7. View

19.

Coats H, Bourget E, Starks H, Lindhorst T, Saiki-Craighill S, Curtis J . Nurses' Reflections on Benefits and Challenges of Implementing Family-Centered Care in Pediatric Intensive Care Units. Am J Crit Care. 2018; 27(1):52-58. PMC: 5959722. DOI: 10.4037/ajcc2018353. View

20.

Weber A, Harrison T . Reducing toxic stress in the neonatal intensive care unit to improve infant outcomes. Nurs Outlook. 2019; 67(2):169-189. PMC: 6450772. DOI: 10.1016/j.outlook.2018.11.002. View