To avoid abiding by these mechanisms, adequate parental training and information are critical ( 2, 3, 14– 18). In addition to higher rates of family dysfunctions and economic problems reported, the parents' overprotective reactions toward the vulnerable child, partly motivated by the lack of security in their own abilities and that of the child, hinder the establishment of social relationships and the incorporation of the child into the labor market in adulthood ( 12, 13). In fact, the power of intense parental stress during the first years of a child's development can be just as important as the biological condition at birth ( 10, 11). In this context, parental stress, anxiety, and depression are frequently reported, and these may negatively impact normal bonding and the psychosocial evolution of the individual ( 1, 7– 9). Together, they can be referred to as high-risk neonates. ![]() This patient group, in addition to other preterm and non-preterm infants who suffer severe neonatal acquired diseases, congenital malformations subsidiary of complex surgery, or rare diseases, sees prolonged hospital stay and faces similar burdens and challenges ( 6). Leadership and continuous evaluation/refinement of implementation procedures are essential components to achieve the objectives.Įxtremely low gestational age neonates are at risk of developing short and long-term complications that can alter their life course ( 1– 5). The parents revealed educational manuals, workshops, and cot-side teaching sessions as essential for their training, and 100% said they would accept entry into the FICare program again.Ĭonclusions: The principles of the FICare model are suitable for all levels of care in NICUs. Observed time to reach proficiency by task was within the expected time in 70% of the program contents. Mothers spent more time in NICU than fathers ( p < 0.05) uninterrupted time spent by mothers in NICU was longer during the pre-pandemic period ( p < 0.01). All families, except for one who dropped out of the program, completed the agreed individualized training. No differences in acceptance rate (overall 86.4%) or in the number of infant-family dyads in the program per month were observed when considering the pre- and post-Covid-19 pandemic periods. In total, 76 families and 91 infants (74.7% preterm 18.7% complex surgery 6.6% others) were enrolled in the pilot. The FICare educational manual included two curricula: for healthcare professionals/staff (Training the trainers) and for families (Education of caregivers), the latter being categorized in two intervention levels (basic and advanced), depending on the infant care needs and parent's decision. Results: A rigorous but flexible protocol was edited. Step 3 involved piloting and evaluation with the aim to refine the procedure (July 2018 to December 2020). Step 2 as a dissemination strategy by FICare-IT acting as primary trainers and mentors to ensure the education of 90% of nursing staff (May 2018 to July 2018). ![]() Materials and Methods: Step 1 was the creation of the FICare implementation team (FICare-IT) and baseline analysis of current procedures for critical care to identify needs, wishes, and requirements we aimed for protocol elaboration tailored to our cultural, architectural, and clinical context (March 2017 to April 2018). Objectives: To scale up and adapt FICare to make it suitable in level IIIC NICUs, which care for extreme prematurity and other complex medical or surgical neonatal conditions. ![]() To this date, most reports on the feasibility of this model refer to stable preterm infants admitted to Neonatal Intensive Care Units (NICUs). Background: Family Integrated Care (FICare) integrates parents in the direct care of their child while the healthcare personnel act as teachers and guides.
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