Parental participation in care during Neonatal Intensive Care Unit stay: a validation study

From Firenze University Press Journal: Infermieristica journal

Davide Scarponcini Fornaro, NICU — ASL Pescara

Carlo Della Pelle, Head Nurse, ASL 02 Lanciano-Vasto-Chieti

Emanuele Buccione, ASL Pescara

Although Neonatal Intensive Care Units (NICU) can offer lifesaving care for vulnerable newborns a$er birth, separation from the parents, pain, sleep disruptions, and environmental stressors may represent traumatic experiences for these critically ill newborns.

At the same time, the new parents can experience a situation they are not prepared for, such as separation from the newborn, and fear of the unknown, which, together disrupt the family ties, which are created and strengthened right during the moment of birth. The first thirty days of a child’s life represent a necessary period for correct psychophysical development; furthermore, the parents’ strong knowledge and adequate and responsible behavior are fundamental in improving outcomes and providing a more effective relationship with the healthcare services.

Family-Centered care is one of the strategies that can help infants and parents to cope with these traumatic experiences in the NICU4. Parental participation in care has positive outcomes for both infants and parents. Indeed, involvement in neonatal care reduces parents’ stress levels, increasing their self-esteem and interaction with the baby, thus reducing parents’ anxiety levels and improving their problem-solving skills.

Evaluating the participation of parents in neonatal care during their children’s NICU hospitalization allows healthcare professionals to highlight any gaps in the correct management of the baby by the parents, intervening, where necessary, with proper education and support. This study aims to validate the Italian version of “The Scale of Parental Participation in Care: Neonatal Intensive Care Unit” (PPCS: NICU).

Methods: The study was conducted in a 22-bed mixed (medical and surgical) NICU of a public hospital. The study participants comprised parents whose infants were admitted to the NICU from April to August 2022.

Results: A total of 128 parents were included in the study. Exactly half of the sample was female, and the average age was 33.43 ± 6.51 years; 31.25% (n=40) of the sample already had a first child. Those who had a history of previous abortion were 25% (n=32). Additionally, 3.12% (n=4) of parents experienced a previous death of their child. About the type of delivery, 54.69% (n=70) of the sample experienced vaginal birth, 17.19% (n=22) of them underwent an elective cesarean, and 28.12% (n=36) underwent an emergency cesarean. Item analysis was performed on all 16 items. The corrected total item correlation coefficients for the scale items were adequate between 0.408 and 0.821. Cronbach’s alpha was 0.926.

Conclusion: The Italian version of the PPCS: NICU shows high reliability and therefore, it can be used in the context of Italian NICUs to assess the degree of parental participation in neonatal care, allowing early identi!cation of critical issues by parents in the care of newborns admitted to NICU.


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The University of Florence is an important and influential centre for research and higher training in Italy