Parental perceptions of newborn pharmacologic paralysis.

Abstract

This is a descriptive exploratory study of 9 parent-dyads who experienced pharmacologic paralysis of their newborn within a prior 6-month period. Perceptual responses included feelings, values, and needs related to the pharmacologic paralysis therapy. Newborns receiving pharmacologic paralysis had direct dependence to the caretaker for mechanical ventilation, precise monitoring of physiological parameters, and extensive life support due to altered sensory-motor function and breathing. The appearance of the immobile newborn and the protocols for the administration of paralyzing agents, which eliminate excessive stimulation and handling, were suspected of impacting parental interaction. The convenience sample of parents was representative of three newborn critical care units. Open-ended, retrospective interviews were completed in either the parents' home or in a private room of the critical care complex. Physiologic complications precluded use of a prospective interview technique. Chart reviews and a background questionnaire provided demographic data. Data collection consisted of a parent-directed interview. Data were subjected to content analysis and descriptive statistics. The mother's and father's responses were coded separately. The identified common perceptual themes within the pharmacologic paralysis experience were empathy, normalcy, acceptance, and sedative association. Ancillary experiences include the perinatal period and newborn illness. Analysis of ancillary experiences revealed continued themes of empathy and normalcy as well as guilt, separation, shock and anxiety, and uncertainty. Nurses may provide parents whose ill newborn undergoes pharmacologic paralysis a supportive team approach and guidance within a framework of their feelings, values, and needs.