Sepsis remains a leading cause of morbidity and mortality in the neonatal population, and at present, there is no unified definition of neonatal sepsis. Existing consensus sepsis definitions within ...paediatrics are not suited for use in the NICU and do not address sepsis in the premature population. Many neonatal research and surveillance networks have criteria for the definition of sepsis within their publications though these vary greatly and there is typically a heavy emphasis on microbiological culture. The concept of organ dysfunction as a diagnostic criterion for sepsis is rarely considered in neonatal literature, and it remains unclear how to most accurately screen neonates for organ dysfunction. Accurately defining and screening for sepsis is important for clinical management, health service design and future research. The progress made by the Sepsis-3 group provides a roadmap of how definitions and screening criteria may be developed. Similar initiatives in neonatology are likely to be more challenging and would need to account for the unique presentation of sepsis in term and premature neonates. The outputs of similar consensus work within neonatology should be twofold: a validated definition of neonatal sepsis and screening criteria to identify at-risk patients earlier in their clinical course. IMPACT: There is currently no consensus definition of neonatal sepsis and the definitions that are currently in use are varied.A consensus definition of neonatal sepsis would benefit clinicians, patients and researchers.Recent progress in adults with publication of Sepsis-3 provides guidance on how a consensus definition and screening criteria for sepsis could be produced in neonatology.We discuss common themes and potential shortcomings in sepsis definitions within neonatology.We highlight the need for a consensus definition of neonatal sepsis and the challenges that this task poses.
Aim
Prolonged hospitalisation in the neonatal intensive care unit (NICU) can emotionally tax newborn infants and their families, resulting in developmental adversities and inadequate parent–infant ...bonding. This study aimed to assess the feasibility and value of the Baby@Home program in reducing prolonged hospital stays.
Methods
This is a retrospective cohort study of 26 infants from a tertiary neonatology department, using qualitative data (gathered through interviews with parents (n = 15) and professionals (n = 5)) and quantitative data (retrieved from medical records and the Luscii application).
Results
Our study included 26 newborn infants. 76% were premature, born at an average term of 35 weeks and 2 days. During the study period, all infants thrived, and only two adverse events occurred (an allergic reaction and respiratory incident necessitating readmission). Interviews were conducted based on six major themes concerning the feasibility and value of the program. Despite the challenges of application utilisation, the program's overall value was evident.
Conclusion
The Baby@Home program effectively facilitated early discharge, promoted family reunification, and yielded favourable safety and health outcomes. Innovative solutions such as Baby@Home have the potential to pave the way for more sustainable and patient‐centred care models.
Aim
To explore parents’ experiences of parenting a child hospitalised with congenital heart disease (CHD) and undergoing surgery.
Methods
Five electronic databases were systematically searched for ...articles describing the experiences of parents with a child with a CHD. A thematic analysis approach was used to identify the most common themes.
Results
A total of 188 articles were identified. Eight studies were included in the review. Four themes emerged, including balancing the parental role, experiencing anticipatory grief, decreasing parental stress using coping strategies and professional support.
Conclusion
Having a child with CHD undergoing heart surgery is a stressful experience due to, among other things, the different situation‐related parenting role during the hospital stay and feelings of anticipatory grief. Healthcare professionals in the PICU have an essential role in supporting parents and understanding the needs that are crucial for the parents in order to provide better support and reduce stress and anxiety. More qualitative research regarding the pathway from the prenatal diagnosis through the early childhood period is warranted.
Aim
Admitting an infant to a neonatal intensive care unit (NICU) is stressful for parents. A great source of stress is the loss of their desired parental role. This study explores parents’ ...experiences and needs during a high‐risk pregnancy in preparation for their role as parents of a preterm infant.
Methods
An exploratory qualitative study was conducted among parents with a preterm infant admitted to two level‐III NICUs in the Netherlands. A thematic analysis was performed.
Results
Nineteen interviews were conducted with parents of preterm infants (26–34 weeks gestational age). Getting a grip in the middle of chaos was identified as the central theme. In the pre‐admission phase, coping with potential preterm parenthood was a theme, with coping strategies as subthemes that changed over time from avoidance to being ready to parent a preterm infant. The theme envisioning the NICU emerged in the NICU admission phase, with subthemes preterm care journey and opportunities for involvement fostering parental empowerment.
Conclusion
Timing and content of information about a parental role in the NICU should be tailored to the individual expectant parent. A customisable intervention bundle may provide a vision of the NICU and the parents’ active role in care.
Background
Insight into parental empowerment is important to understanding the impact of health care policy and to supporting and strengthening parents in the care of their child. The Family ...Empowerment Scale (FES) is a valid 24‐item instrument that measures parental empowerment. It was originally developed for parents of children with emotional disabilities. It has been translated from English into Dutch.
Before using the translated FES in another context, the aim of this study was to assess the content validity of the Dutch FES in the context of children with a chronic condition in a children's hospital, according to parents and nurses.
Method
This content validity study has a convergent, mixed‐methods design. The content validity index was used to examine the relevance, according to 22 parents and 12 nurses quantitatively, on a scale and item level. The qualitative part assessed the comprehensiveness and comprehension of the FES through cognitive interviewing with eight parents and four nurses. The results of both analyses were converged to determine content validity.
Results
The scale‐content validity index was 0.88; three items scored < 0.78 on the item level. For 10 (of 24) items, issues were noticed about the tone and clarity of wording. Participants considered the FES to be not only an instrument of research but also an instrument that could be used to give insight into the personal degree of parental empowerment.
Conclusion
The content validity of the Dutch FES for parents of children with a chronic condition can be considered sufficient. Resolving some minor translation issues in some of the items is advised. The FES can be used in further research to examine the value of the FES in health care services, aiming to support the needs of parents and to increase their empowerment.
Background
Admission of an infant to a neonatal intensive care unit (NICU) is often a stressful experience for parents and can be associated with feelings of inadequacy to fulfil the desirable ...parental role. The values, opportunities, integration, control, and evaluation (VOICE) programme was developed to engage parents in care, to decrease stress, and to increase empowerment.
Aim
To explore the experiences of parents regarding involvement in the VOICE programme during admission of their infant to the NICU.
Design
The VOICE programme includes at least five personal structured meetings between parents, nurses, and other health care professionals throughout the pathway from birth, NICU, and follow up. A qualitative design was adopted using semi‐structured interviews. Interviews with 13 parents of 11 infants born at <27 weeks' gestational age were conducted: nine mothers and two couples of father and mother. Thematic analysis was deployed.
Results
The findings have been described in one overarching theme: “parental empowerment.” Parents felt strengthened and were empowered in the development of their role as primary caretaker by the VOICE programme. The parental empowerment theme emerged from four related interpretive themes that were derived: (a) involvement in care, (b) personalized information and communication, (c) transition to a parental role, and (d) emotional support.
Conclusion
The VOICE programme can be a structured approach used to implement family support in a NICU to empower parents to become a partner in the care of their infant and feel confident.
Relevance to clinical practice
This study encourages health care professionals to provide parental support through a structured intervention programme, which contributes to the empowerment of parents in the NICU and encouraged them to participate in care and decision‐making.
Objective To examine construct and criterion validity of the Dutch SCREENIVF among women and men undergoing a fertility treatment. Design A prospective longitudinal study nested in a randomized ...controlled trial. Setting University hospital. Patient(s) Couples, 468 women and 383 men, undergoing an IVF/intracytoplasmic sperm injection (ICSI) treatment in a fertility clinic, completed the SCREENIVF. Main Outcome Measure(s) Construct and criteria validity of the SCREENIVF. Result(s) The comparative fit index and root mean square error of approximation for women and men show a good fit of the factor model. Across time, the sensitivity for Hospital Anxiety and Depression Scale subscale in women ranged from 61%–98%, specificity 53%–65%, predictive value of a positive test (PVP) 13%–56%, predictive value of a negative test (PVN) 70%–99%. The sensitivity scores for men ranged from 38%–100%, specificity 71%–75%, PVP 9%–27%, PVN 92%–100%. A prediction model revealed that for women 68.7% of the variance in the Hospital Anxiety and Depression Scale on time 1 and 42.5% at time 2 and 38.9% at time 3 was explained by the predictors, the sum score scales of the SCREENIVF. For men, 58.1% of the variance in the Hospital Anxiety and Depression Scale on time 1 and 46.5% at time 2 and 37.3% at time 3 was explained by the predictors, the sum score scales of the SCREENIVF. Conclusion(s) The SCREENIVF has good construct validity but the concurrent validity is better than the predictive validity. SCREENIVF will be most effectively used in fertility clinics at the start of treatment and should not be used as a predictive tool.
To explore the needs of women during decision-making about treatment for miscarriage.
Descriptive qualitative design.
University and teaching hospitals in the Netherlands.
We selected a purposive ...sample of 16 women who needed treatment for miscarriage from an electronic patient file system. We ensured maximum variation by sampling in different hospitals and selecting women with different ages, numbers of children, miscarriage histories, treatment types, and educational levels.
We conducted face-to-face individual, semistructured interviews and used thematic analysis to identify, analyze, and describe themes.
We identified one overarching theme, Decision Based on Reason and Emotion, and three related subthemes: Certainty, Information, and SupportFrom Environment.
Health care professionals should be aware of how women’s decision-making is structured in the context of treatment choices for miscarriage, and discussion regarding treatment should address reason and emotion.
Health care professionals can support women in the decision-making process regarding treatment for miscarriage by addressing rational and emotional factors.
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