Discharging the Premature Infant: Family Issues and Implications for Intervention

Abstract

When premature infants are discharged from a hospital's Neonatal Intensive Care Unit (NICU), parents are confronting the long-term implications of their child's prematurity, assuming the day-to-day caregiving responsibility for their child, regaining control over their lives, and locating appropriate community resources and services for their infant and family. Implications of these issues for providing support for families during this life cycle transition include capitalizing on family strengths and resources in order to empower parents to make informed decisions, creating opportunities for parent-to-parent contact, developing a range of service delivery and support options, and focusing intervention goals on parent-identified needs and on developing mutually satisfying parent-child interactions. A key to providing this comprehensive support is to begin providing services to families in the hospital before the infant's discharge from the NICU. In this way, families are supported throughout the transition and have uninterrupted access to professional services.

Parents' Conceptions of Participating in a Home Care Programme from NICU: A Qualitative Analysis

“…If any questions arose, they could just ask any of the healthcare professionals. Parents need honest, complete and accurate information about their child's condition, as this information often leads to better adaptation and makes parents feel that the healthcare professionals are committed to the child and its family (10). This is in line with the present study, where the parents reported that other questions arose when they had been at home for some time.…”

“…A healthcare professional who has contact with parents prior to discharge and who makes follow-up visits in the home can assist parents to feel confident in caring for their infant. This contact in the hospital also helps provide a sense of continuity for parents' (10). In a home visit program for breastfeeding by Johnson et al (11), the nurses noted that parents were unable to absorb all the information provided while the mother and infant were at the hospital.…”

Maternal Stress and Efficacy for Latina Mothers with Infants in Neonatal Intensive Care

“…A body of research has established that the birth of a newborn infant requiring an admission to the NICU is stressful for families (Hughes et al, 1994;Miles, Carlson, & Funk, 1996;Simons, Ritchie, & Mullett, 1998;Young et al, 1997). The psychological distress for parents in the NICU is associated with a medical crisis and the forced separation from their baby at birth (Oehler, Hannan, & Catlett, 1993;Seideman et al, 1997), the infant's physical appearance (Miles, 1989;Oehler et al, 1993), parental role alteration (Affleck & Tennen, 1993;Seideman et al, 1997), access to information and communication with health care providers (Seideman et al, 1997;Young et al, 1997), linguistic and cultural barriers (Denney et al, 2001;Santarelli, Denney, Singer, & Singer, 2000), and parental concerns with the NICU-to-home transition (Affleck, Tennen, & Rowe, 1991;Barry & Singer, 2001;Bruder & Walker, 1990;Hanline & Deppe, 1990;Miles & Holditch-Davis, 1997;Sheikh, O'Brien, & McCluskey-Fawcett, 1993;Singer, Davillier, Bruening, Hawkins, & Yamashita, 1996;Singer et al, 1999). However, little is known about the psychological stress that Latino parents experience in the NICU and their perceptions regarding competently caring for their infants in the intensive care nursery.…”

Transitions and critical events in the family life cycle: Implications for providing support to families of children with disabilities

“…Critical events and times of transition that often result in increased stress for families who have a child with a disability have been identified as follows: when the diagnosis is made, the age at which the child should begin to walk or talk, when a younger sibling developmentally surpasses the child who is disabled, the child's entry into public school, the onset of puberty, the child's 21st birthday, when a child-management or medical crisis occurs, and when placement outside the home is considered (Bray, Coleman, & Bracken, 1981;Fewell, 1986;Marion, 1981;Wikler, 1981;Wikler, Wasow, & Hatfield, 1981). In addition, transitions between educationaVservice delivery programs and transitions between professionals providing services are often challenging for families (Hanline & Deppe, 1990;Hanline & Halvorsen, 1989;Hanline & Knowlton, 1988;Healy, Keesee, & Smith, 1989).…”