Webcam use in German neonatological intensive care units: an interview study on parental expectations and experiences

Abstract

Background To bridge the physical distance between parents and children during a neonatal intensive care unit (NICU) stay, webcams are used in few German NICUs. They allow parents to view their infant even when they cannot be present on the ward. The aim of the study was to explore the factors for and against webcam use that parents with or without webcam use encountered. Methods Guideline-based, semi-structured qualitative interviews were conducted in the period from September 2019 to August 2020. Interview transcripts were analysed using a category-based content analysis. The categories were generated in a combined deductive–inductive procedure. Results We interviewed 33 mothers and seven fathers. Parents with webcam experience emphasised positive aspects concerning their webcam use. Factors that increased webcam acceptance included feeling certain about the child’s well-being and an increased sense of proximity. Only a few critical voices emerged from parents who had webcam experience, e.g. regarding privacy concerns. Parents who had no experience with webcam use showed ambivalence. On the one hand, they expressed a positive attitude towards the webcam system and acknowledged that webcam use could result in feelings of control. On the other hand, reservations emerged concerning an increase of mental stress or a negative influence on parental visitation behaviour. Conclusion In addition to the parents’ positive experiences with webcam use, results show a need within parents who lacked webcam experience. Despite some criticism, it was evident that webcam use was primarily seen as an opportunity to counteract the negative consequences of separation in the postnatal phase. Trial registration The Neo-CamCare study is registered at the German Clinical Trials Register. DRKS-ID: DRKS00017755. Date of Registration in DRKS: 25-09-2019.

Parental preference for webcams in neonatal intensive care units: an indicator of lacking trust?

“…Hence, other underlying factors must exist, such as parents’ beliefs regarding the advantages or disadvantages of webcam usage. Possible advantages mentioned by parents include improved involvement in their infant’s care and the need to check their infant’s condition when not in the ward [ 5 ].…”

“…Virginia Thompson et al argue in their model regarding trust development that vigilant behaviour and the need for continuous information are inherent in the parental role and relate to fulfilling the parents’ needs rather than symbolising mistrust [ 10 ]. Therefore, parents’ preference to use a webcam may indicate an anticipated increase in information concerning their infant’s condition [ 5 ]. Notably, the effect of webcam usage on parents may concern various aspects of parental wellbeing and could be both positive and negative.…”

“…However, it can be expected that webcams provide this reassuring effect only if the infant appears to be well through the webcam. A preterm infant’s mere physical appearance can be a stressor [ 25 – 27 ] and witnessing their infant in discomfort or in pain and being unable to intervene from afar may result in additional parental stress and feelings of powerlessness [ 5 , 7 ].…”

“…The questionnaire comprised validated scales as well as items that were developed based on literature review and on interviews conducted during the project [ 5 ]. The survey was critically reviewed by a neonatologist, a NICU nurse, and a parent representative.…”

“…Given that anxiety reflects a tendency to worry [ 18 ], we assumed that trait anxiety might be associated with the desire to permanently monitor the infant to gain a feeling of assurance and control [ 5 ]. Therefore, the personality trait anxiety was included in the models as a control variable.…”