Meanings, beliefs and attitudes of the neonatal unit staff in México about the parents' participation in a neonatal unit: A qualitative approach

Abstract

Background and context: The two most important factors and determinants of morbidity and mortality of the newborn are prematurity and low birth weight, children are admitted in neonatal unit and require many specialized therapeutic interventions, thus, a medical and technical focus is predominating. The staff of neonatal unit has a challenge in provide support to parents´ participation in the care of their child. The study was performed in a public hospital offering second-level care in San Luis Potosí, México.

Purpose: To identify and analyze the meanings, beliefs and attitudes of the neonatal unit staff about the Mexican parents' participation in the care of hospitalized preterm neonates.

Design and Methods: A qualitative research study was conducted at a neonatal unit in México. Data collection consisted of semi-structured and recorded in-person interviews with staff who signed an informed consent. The analysis method used was content analysis in its thematic mode.

Results: The results summarize the most relevant information of the meanings, beliefs and attitudes of the health professionals- benefits, barriers, encouragement-, about the parents’ participation in a Mexican neonatal unit. Three themes emerged: The parental participation benefits the hospitalized premature infants; restriction and barriers for parents’ participation; encouragement of parents’ participation.

Conclusions: The staff considered parental participation to be important, and they therefore proposed certain changes to promote participation based on a system of teamwork and a transformation of the hospital rules, emphasizing the experiences of parents in the NU and supporting their emotional responses and feelings. The participants thought that they should be teaching about childcare. However, controversy was revealed among the practitioners regarding parental involvement with respect to gender, particularly the idea that the mother should be the main presence whereas the father should be a recipient of information, despite expressing a positive view of the father’s inclusion and his right to take care of his child.

Summary: The hospitalization of premature neonates produces separation from their families. Parental visit to NUs in México depends on factors such as human milk production, neonate clinical conditions and medical treatment. It also depends on the meanings, beliefs, attitudes of the health team concerning the parents´ participation. This study provides information on parental participation to promote unrestricted access to the neonatal unit.

Potential implications: The construction of a model of family participation based on a framework of parental participation in the NICU.