Nurses and Parental Support in Neonatal Intensive Care Unit Relational Impact and Care Strategies

Abstract

Introduction: Admission to the Neonatal Intensive Care Unit (NICU) is an extremely stressful experience for parents, who are confronted with the vulnerability of their newborn in a highly medicalized context. Communication and emotional support provided by nursing staff are fundamental elements to improve the parents’ experience and encourage their involvement in neonatal care. However, the quality of communication and the variability of emotional support can have a significant impact on the psychological well-being of families. This study evaluates the parents’ experience in the NICU, focusing on the influence of nursing support, the quality of communication and the level of parental participation in the care of the newborn.

Objective: To evaluate the qualitative and quantitative impact of nursing care provided to parents of patients admitted to the Neonatal Intensive Care Unit (NICU).

Methods: The study adopted a mixed research design, which combined quantitative and qualitative data collection techniques to provide a complete and comprehensive view of the parents’ experience in Neonatal Intensive Care (NICU). The mixed approach was chosen because it allows to integrate the robustness and relevance of quantitative data with the depth and context of individual experiences explored through the qualitative approach. The study sample was selected through a non- probability sampling with purposive selection, involving 86 parents of newborns admitted to a Neonatal Intensive Care unit. For the qualitative study, 10 semi-structured interviews with parents who had previously completed the questionnaire were selected. Data were collected through two main tools: a structured questionnaire and semi-structured interviews. The quantitative questionnaire, administered to all participants, collected information regarding parents’ perception of the quality of care received, with particular attention to the behavior of nursing and medical staff, emotional support, communication and parental involvement in care. The answers, with numerical and Likert questions, were analyzed using descriptive statistics. The semi-structured interviews, conducted with 10 parents, allowed us to explore in depth their emotional and relational experiences during the hospitalization of their newborn. The testimonies were analyzed using thematic analysis to identify the main themes emerging from the answers.
Participants and research context: The study sample was selected by involving 86 parents of newborns hospitalized in a Neonatal Intensive Care Unit.

Ethical Considerations: This sampling was chosen to ensure the inclusion of parents who had direct experience with NICU admission, providing a solid basis for exploring perceptions and experiences related to nursing support and communication during the hospitalization of the newborn.

Results: The sociodemographic data of the participants revealed that 93% of the respondents were female and 7% were male. Regarding education, 45.3% of the parents had a university degree, 44.2% had a high school diploma, and only 9.3% had a middle school diploma. In relation to the experience in the NICU, 74.4% of the parents perceived the medical staff as kind and helpful, while 70.9% positively evaluated the behavior of the nursing staff. 65.1% of the parents stated that they received information on the status of the newborn mainly from doctors, while 33.7% received information from nurses. Regarding breastfeeding support, 69.8% of the mothers received help from nurses, while 65.1% of the newborns were breastfed. Kangaroo Therapy was practiced by 66.3% of the parents, but 33.7% stated that they had not had access to this practice. Qualitative analysis confirmed that nursing staff play a crucial role in emotional support and managing parental anxiety, with 52.3% of parents stating that the behavior of healthcare staff significantly influenced their perception of the experience.

Conclusions: The results suggest that nursing support has a significant impact on parents’ psychological well-being during NICU stay. Empathic and continuous communication is essential to reduce anxiety and improve parental involvement. However, variability in nurses’ approach may negatively impact parents’ experience, with some perceiving variable availability. Furthermore, Kangaroo Therapy and breastfeeding support are considered crucial aspects, but not always guaranteed uniformly. Hospital policies should promote standardization of care practices, improve nurses’ training on empathic communication and ensure greater parental involvement in newborn care. Staff shortages and heterogeneity in nurses’ attitudes are issues that require intervention, particularly in SubNICU settings, to improve the quality of support provided.