ASSESSING BARRIERS AND FACILITATORS TO PARENTAL VISITATION AND PARENTING ACTIVITIES DURING INFANT HOSPITALIZATION IN A NEONATAL INTENSIVE CARE UNIT AND A SPECIAL CARE NURSERY

Abstract

Health and long-term outcomes of neonates hospitalized directly after birth are affected by the work of medical professionals and by parental involvement in care (Vergara, et al., 2006). Research shows that parental involvement in infant care during hospitalization in the Neonatal Intensive Care Unit (NICU) has positive effects on neurocognitive development (Reynolds, et al., 2013), parent-infant attachment (Mehler, et al., 2011), and feeding outcomes (Meyer, Coll, Lester, Boukydis, McDonough, and Oh, 1994). Occupational therapists working with infants in NICUs must consider family situations, priorities, and cultural beliefs in order to facilitate parental visitation and involvement in care (Vergara, et al., 2006). This study examined, primary barriers that hinder parental visitation and facilitators that promote visitation at the NICU and Special Care Nursery (SCN) in a Level 1 trauma hospital in rural eastern North Carolina. Additionally, parental involvement approaches in infant care during hospitalization were identified. Parent surveys were conducted at the infant's discharge from the NICU or SCN with consenting parents. Results indicated that the primary barriers to visitation were related to parental factors unrelated to the hospital environment or infant health. Parents reported that living far away, having other children at home, and household responsibilities, and work responsibilities were the most influential barriers. Positive relationships with staff were the primary facilitators to visitation. Overall, parent involvement was more passive in nature, as parents participated in observing the infant, talking or singing to the infant, engaging in eye contact with the infant, and touching or stroking the infant most frequently. Diaper changes, feeding, assisting the staff with procedures and holding was engaged in less often by parents. Overall, the results indicate that of occupational therapists and other medical professionals must provide support to parents when visiting to promote active participate in infant care. Staff were seen as a facilitator of presence so it is vital that NICU and SCN staff are providing proper education during interactions with parents and inviting parents to participate in direct infant care.