Transition to parenthood in the neonatal care unit: a qualitative study and conceptual model designed to illuminate parent and professional views of the impact of webcam technology

Abstract

BackgroundComplications during pregnancy, childbirth and/or the postnatal period may result in the admission of a baby to a neonatal unit (NNU). While the survival and long-term prospects of high-risk infants are enhanced by admission, the enforced separation of the parent and child may have psychological consequences for both. There is a need to develop and evaluate interventions to help parents ‘feel closer’ to their infants in circumstances where they are physically separated from them. In this paper we present findings from an in-depth, theoretically-driven, evaluation of a technological innovation designed to address this need. The study sought to explore parent and professional views of the impact of the technology, which transmits real-time images of the baby via a webcam from the NNU to the mother’s bedside in the post-natal care environment.MethodsA qualitative approach was adopted, guided by a critical realist perspective. Participants were recruited purposively from a NNU located in East-central Scotland. Thirty-three parents and 18 professionals were recruited. Data were collected during individual, paired and small group interviews and were analysed thematically. Following the initial analysis process, abductive inference was used to consider contextual factors and mechanisms of action appearing to account for reported outcomes.ResultsViews on the technology were overwhelmingly positive. It was perceived as a much needed and important advancement in care delivery. Benefits centred on: enhanced feelings of closeness and responsiveness; emotional wellbeing; physical recovery; and the involvement of family/friends. These benefits appeared to function as important mechanisms in supporting the early bonding process and wider transition to parenthood. However, for a small number of the parents, use of the technology had not enhanced their experience and it is important, as with any intervention, that professionals monitor the parents’ response and act accordingly.ConclusionsWith a current global increase in premature births, the technology appears to offer an important solution to periods of enforced parent-infant separation in the early post-natal period. The current study is one of a few world-wide to have sought to evaluate this form of technology in the neonatal care environment.

Parents’ and healthcare professionals’ perceptions of the use of live video recording in neonatal units: a focus group study

“…While the use of video is currently not common practice in neonatology, it has increased to meet new needs such as photoplethysmography, video laryngoscopy or webcams to enable virtual visit [7][8][9]. Webcams have been used [10][11][12][13][14] for several years either to limit the impact of parent-child separation or when parental presence is limited to promote early emotional bonding and reduce separation anxiety.…”

“…Healthcare professionals were concerned by their lack of familiarity with such a system, the risk of privacy breach, and the potential stress created due to the presence of the webcam. Kerr et al [13] found that parents and healthcare professionals consider parents' direct access to a recording of their newborn child an important improvement in neonatology.…”

Developmental Dimensions in Preterm Infants During the 1st Year of Life: The Influence of Severity of Prematurity and Maternal Generalized Anxiety

“…A preterm birth also negatively influences the transition to parenthood (Rieves et al, 2016;Kerr et al, 2017), as parents, especially mothers, feel disoriented and frightened and might experience feelings of guilt, grief and recurrent worries about their baby's survival and health (Mendelsohn, 2005;Korja et al, 2009Korja et al, , 2010Shah et al, 2011;Lasiuk et al, 2013;Ionio et al, 2019;Pisoni et al, 2019).…”

Experiences of Mothers of Extremely Preterm Infants after Hospital Discharge

“…Although the presence of parents in the NICU has increased (Al Maqhaireh et al, 2016), the environment, work routines and the complex needs of these infants become obstacles that stand in the way of a mother's role (Sisson et al, 2015;Raines & Brustad, 2013). The fragility of an extremely preterm infant can reduce the participation of parents in their care (Aydon et al, 2017;Kerr et al, 2017), and the parents' separation from the child creates stress, anxiety and a weaker bond (Kerr et al, 2017;Segre et al, 2014;Spinelli et al, 2016;Neri et al, 2017).…”