{"title":"The risk factors of post-traumatic stress disorder among parents of neonatal intensive care unit infants: A systematic review","authors":"Fatimah Saad Alsallum , Breidge Boyle , Derek McLaughlin , Iain McGowan","doi":"10.1016/j.jnn.2025.101620","DOIUrl":"10.1016/j.jnn.2025.101620","url":null,"abstract":"<div><h3>Aim</h3><div>The aim of this review is to identify the risk factors for post-traumatic stress disorder (PTSD) in parents of infants admitted to the neonatal intensive care unit (NICU).</div></div><div><h3>Design</h3><div>A This study is a systematic review of articles examining PTSD risk factors in parents of NICU-admitted infants. PTSD diagnoses were made using the DSM-IV, DSM-5, ICD-11, or DSM-IV-TR A1 criteria. This review does not address PTSD risk factors in the general population, other family members, or NICU patients. Regardless of the child's gestational age or gender, the focus is exclusively on NICU parents or primary caregivers. All other family members are excluded from the review.</div></div><div><h3>Methods</h3><div>A comprehensive literature review was conducted using multiple search algorithms to identify all relevant studies. The databases PTSDpubs, CINAHL, PsycINFO, and Web of Science were systematically searched. The study selection process was documented using the PRISMA flow diagram. Each study was independently assessed using the Critical Appraisal Skills Programme (CASP) framework. The selected articles were critically evaluated, and data were extracted and synthesised for analysis.</div></div><div><h3>Results</h3><div>A total of 286 previously published papers met the inclusion and exclusion criteria. Of these, eight studies were included in the systematic evaluation of PTSD risk factors among parents of NICU-admitted infants. Five key risk factors were identified: (1) Being female, (2) Having, or perceiving to have, a sick newborn, (3) Parents with previous obstetric problems, (4) Having mental health-related problems/diagnosis, and (5), Lack of psychological Support in the NICU.</div></div><div><h3>Discussion</h3><div>The synthesis of the selected studies reveals a multifaceted risk landscape. Being female was the most commonly reported risk factor, consistent with broader research indicating that women are generally at higher risk of developing PTSD. The presence of a sick newborn significantly heightened parental risk, likely due to the acute stress associated with managing a child's severe health challenges. A history of obstetric complications also emerged as a significant predictor, with past traumas compounding the emotional burden of the NICU experience. Pre-existing mental health conditions further increased susceptibility to PTSD, underscoring the importance of addressing underlying psychological vulnerabilities. Crucially, the lack of psychological support in NICU settings was identified as a systemic deficiency, exacerbating parental stress. This finding highlights gaps in family-centred and family-integrated care strategies, which fail to sufficiently address parents' psychological needs during critical periods of their child's hospitalisation.</div></div><div><h3>Conclusion</h3><div>This review underscores the complex interplay of factors contributing to PTSD in NICU parents and offers important cl","PeriodicalId":35482,"journal":{"name":"Journal of Neonatal Nursing","volume":"31 2","pages":"Article 101620"},"PeriodicalIF":0.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143395982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The influence of facilitated tucking on behavioral and physiological outcomes in premature neonates undergoing endotracheal suctioning: A randomized control trial","authors":"Eman Wardany Abdelaal Mohamed , Rahma Soliman bahgat , Heba Ibrahem Mohamed","doi":"10.1016/j.jnn.2025.101619","DOIUrl":"10.1016/j.jnn.2025.101619","url":null,"abstract":"<div><h3>Background</h3><div>Premature neonates in hospitals often endure significant discomfort and stress due to illnesses and invasive procedures. Facilitated tucking helps ease this distress, aiding in developing self-regulation skills for managing pain and stress. <strong>This study aimed</strong> to determine the influence of facilitated tucking on behavioral and physiological outcomes in premature neonates undergoing endotracheal suctioning. <strong>Design</strong>: A randomized control trial with two parallel groups. <strong>Method:</strong> Forty premature neonates receiving endotracheal suctioning were randomly allocated to two groups. The study group was positioned in facilitated tucking, while the control group received traditional care during suctioning, with 20 neonates in each group. <strong>Setting:</strong> Neonatal Intensive Care Unit of Kafrelsheikh University Hospital, Egypt, from December 2022 to May 2023. Three tools were used: Characteristics of Premature Neonates Assessment, Premature Neonates' Physiological Assessment, and Anderson Behavioral State Scale.</div></div><div><h3>Results</h3><div>Premature neonates in the study group exhibited greater physiological stability than the control group, with SpO2 (94.50 ± 1.19 vs. 94.15 ± 1.31), heart rate (151.00 ± 5.39 vs. 156.40 ± 1.54), and respiratory rate (49.60 ± 2.09 vs. 52.60 ± 2.96) at 2 min post-suction, all showing P < 0.001. No neonates in the study group showed restless activity or fussiness after suction, with significant differences in behavioral response between groups at 2 and 4 min post-suction across all three days (p < 0.001).</div></div><div><h3>Conclusion</h3><div>Facilitated tucking positively affects physiological and behavioral stability in premature neonates. <strong>Practice implications</strong>: the current research directs NICU nurses to include facilitated tucking in standard daily care during painful procedures for premature infants. As it assists premature neonates in developing self-regulation skills in managing pain and stress.</div></div>","PeriodicalId":35482,"journal":{"name":"Journal of Neonatal Nursing","volume":"31 2","pages":"Article 101619"},"PeriodicalIF":0.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143288941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mariam Kawafha , Duaa Al Maghaireh , Khitam Al-saqer , Heidar Sheyab , Abedelkader Al kofahi , Sara Khanfar , Rama Ashraf Al-Mushasha
{"title":"Stressors experienced by parents of hospitalized infants in the Neonatal intensive care unit","authors":"Mariam Kawafha , Duaa Al Maghaireh , Khitam Al-saqer , Heidar Sheyab , Abedelkader Al kofahi , Sara Khanfar , Rama Ashraf Al-Mushasha","doi":"10.1016/j.jnn.2025.101621","DOIUrl":"10.1016/j.jnn.2025.101621","url":null,"abstract":"<div><div>The hospitalization of an infant in the Neonatal Intensive Care Unit (NICU) presents significant stressors for parents, encompassing the physical environment, the infant’s appearance and behavior, and shifts in parental roles. This study aimed to investigate the association between parental stress levels and these stressors in the NICU setting. A quantitative, descriptive, cross-sectional survey design was utilized, involving a sample of 376 parents selected through convenience sampling. Data were collected using structured questionnaires, which included demographic variables and the Parental Stressor Scale: Neonatal Intensive Care Unit. The results revealed that the most significant source of stress for parents was the appearance and behavior of their infant (M = 3.76, SD = 0.914), whereas exposure to visual and auditory stimuli was identified as the least stressful factor (M = 3.56, SD = 0.918). In conclusion, parents of NICU-admitted infants experience substantial psychological distress due to multiple factors, including their infant’s medical condition, the NICU environment, interactions with healthcare providers, and alterations in parental roles. These findings underscore the profound emotional burden placed on parents during their infant’s hospitalization and highlight the need for targeted interventions to mitigate parental stress in the NICU.</div></div>","PeriodicalId":35482,"journal":{"name":"Journal of Neonatal Nursing","volume":"31 2","pages":"Article 101621"},"PeriodicalIF":0.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143352279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sound exposure in a purpose built, single room configured neonatal unit - A survey of clinical neonatal staff","authors":"Kobi Best , Karen New , Fiona Bogossian","doi":"10.1016/j.jnn.2024.101614","DOIUrl":"10.1016/j.jnn.2024.101614","url":null,"abstract":"<div><h3>Introduction</h3><div>Sound levels in neonatal units continue to exceed recommendations. Elevated sound exposures experienced by preterm infants may contribute to poorer neurodevelopmental outcomes.</div></div><div><h3>Method</h3><div>A 10-question survey assessed neonatal clinicians’ opinions and awareness of sound intensity and exposures in a single room configured neonatal unit; and sound level recommendations.</div></div><div><h3>Results</h3><div>Seventy-three of 122 (60%) clinicians responded to the survey. Respondents rated 12 equipment items or activities within the range of <em>moderately</em> to <em>extremely</em> loud, although 81% (n = 59) either <em>strongly</em> or <em>moderately agreed</em> single rooms reduced sound levels. Less than 50% <em>strongly agreed</em> that loud sounds disrupt growth and development. Only 41% (<em>n</em> = 30) and 27% (<em>n</em> = 20) were aware of recommended average and peak sound levels respectively.</div></div><div><h3>Conclusion</h3><div>Clinicians were able to subjectively rate sound intensity, however most lacked awareness of sound level recommendations. Sound levels and exposures were high with the prominent sources of excessive sound arising from essential neonatal equipment.</div></div>","PeriodicalId":35482,"journal":{"name":"Journal of Neonatal Nursing","volume":"31 2","pages":"Article 101614"},"PeriodicalIF":0.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143094814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anna Hickling , Libuse Mason , Vicky Chapman , Donna Barnes
{"title":"Differences in infant safe sleep practice between the neonatal unit and the home environment: A systematised review","authors":"Anna Hickling , Libuse Mason , Vicky Chapman , Donna Barnes","doi":"10.1016/j.jnn.2025.101622","DOIUrl":"10.1016/j.jnn.2025.101622","url":null,"abstract":"<div><h3>Background</h3><div>Infant positioning in the neonatal unit differs from guidelines for home infant safe sleep practice. This qualitative systematised review aims to identify reasons behind the difference and the implications.</div></div><div><h3>Methods</h3><div>Five databases were searched (CINAHL complete, Pubmed, Embase, NICE Evidence Search, and Directory of Open Access Journals) for primary research published from 2011 to February 2022. Quality was assessed using the Critical Appraisal Skills Programme or Joanna Briggs Institute checklists. Thematic analysis with inductive coding was used to develop a narrative synthesis.</div></div><div><h3>Findings</h3><div>Searches returned sixty-two studies; seven were included. Four themes were identified: prone position, self-regulation, all positions (prone, supine, right and left lateral), and nesting.</div></div><div><h3>Conclusion</h3><div>Sleep positioning in the neonatal unit differs from infant safe sleep guidance to optimise holistic development for vulnerable infants. Once infants are medically stable, neonatal nurses should support parents with establishing a safe sleep environment compliant with infant safe sleep guidance.</div></div>","PeriodicalId":35482,"journal":{"name":"Journal of Neonatal Nursing","volume":"31 2","pages":"Article 101622"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143094720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ahmad Ismail, Salmah A. Alshomrani, Sahar M. Salaghor
{"title":"Knowledge, practice, and barriers to kangaroo mother care as perceived by neonatal intensive care unit nurses in Saudi Arabia","authors":"Ahmad Ismail, Salmah A. Alshomrani, Sahar M. Salaghor","doi":"10.1016/j.jnn.2024.07.016","DOIUrl":"10.1016/j.jnn.2024.07.016","url":null,"abstract":"<div><h3>Introduction</h3><div>The World Health Organization has recommended kangaroo mother care<span> (KMC) as a safe and cost-effective intervention for neonates. Limited research has been conducted to assess the knowledge, practice, and barriers to KMC in the Neonatal Intensive Care Unit (NICU) in Saudi Arabia.</span></div></div><div><h3>Aim</h3><div>To assess the knowledge, practice, and barriers to KMC in the NICU in Saudi Arabia as perceived by NICU nurses.</div></div><div><h3>Methods</h3><div>This study employed a cross-sectional correlational design. Data was collected from 97 NICU nurses in two hospitals in Jeddah, Saudi Arabia, using an online survey. The survey covered four main domains: demographic and work-related, knowledge about KMC, practice of KMC, and barriers to KMC. Independent <em>t</em>-test, One-way ANOVA, and Pearson Product-Moment Correlation were used to assess the relationship between study variables and KMC practice.</div></div><div><h3>Results</h3><div>Neonatal ICU nurses possessed a good knowledge level regarding KMC (0.74 ± 0.18). Most NICU nurses reported that KMC was practiced at their units (89%) with a mean of 1.6 times per shift. The mean number of KMC last shift was significantly higher with married NICU nurses (2.0, P ≤ 0.05) and NICU nurses who received training on KMC (1.8, P ≤ 0.05). Significant barriers to KMC were reluctance of the family, fear of accidental extubation<span> and vascular access dislodgement, inadequate time provided to the family, and the family's discomfort with exposing their chest (P ≤ 0.05).</span></div></div><div><h3>Conclusion</h3><div>Neonatal ICU nurses had adequate knowledge regarding KMC. The NICU nurses reported some barriers to KMC. Interventional programs are needed to overcome these barriers. More research is needed to gain more insights into KMC practice and the factors that influence it in Saudi Arabia.</div></div>","PeriodicalId":35482,"journal":{"name":"Journal of Neonatal Nursing","volume":"31 1","pages":"Pages 146-151"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141839281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Continuous glucose monitoring in well term and near-term babies for monitoring hypoglycaemia","authors":"Emma Blackbourn","doi":"10.1016/j.jnn.2024.09.001","DOIUrl":"10.1016/j.jnn.2024.09.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Advances in technology mean that continuous glucose monitoring (CGM) is becoming a standard of care for many patients requiring blood glucose monitoring. However, there is a paucity of evidence looking at the use of CGM in term babies where there is a great potential for this technology to improve care and long-term outcomes. This review aims to systematically examine the evidence around this topic.</div></div><div><h3>Methods</h3><div>Databases, grey literature and reference lists of included articles were searched systematically, and data was reported using narrative synthesis.</div></div><div><h3>Results</h3><div>Six papers were included, which found that CGM was not as accurate as blood glucose checks but identified episodes of hypoglycaemia missed by blood glucose checks and reduced the number of painful procedures required.</div></div><div><h3>Conclusion</h3><div>CGM has the potential to improve the care for babies at risk of hypoglycaemia, however this is based on low quality of evidence available. Further large trials are required.</div></div>","PeriodicalId":35482,"journal":{"name":"Journal of Neonatal Nursing","volume":"31 1","pages":"Pages 39-47"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143143264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Joana Guarda-Rodrigues , Mariana Prosperi Ferreira Calado Dias , Maria Matilde Rodrigues Fatela , Cristina Jeremias Rosa Jeremias , Miguel Pereira Gonçalves Negreiro , Odete Lemos e Sousa
{"title":"Culturally competent nursing care as a promoter of parental empowerment in neonatal unit: A scoping review","authors":"Joana Guarda-Rodrigues , Mariana Prosperi Ferreira Calado Dias , Maria Matilde Rodrigues Fatela , Cristina Jeremias Rosa Jeremias , Miguel Pereira Gonçalves Negreiro , Odete Lemos e Sousa","doi":"10.1016/j.jnn.2024.08.007","DOIUrl":"10.1016/j.jnn.2024.08.007","url":null,"abstract":"<div><h3>Problem</h3><div>In neonatal units, a significant number of newborns and their respective parents and families are hospitalized, each with culturally distinct practices and perspectives that require specialized knowledge. However, the literature lacks comprehensive evidence depicting culturally competent nursing care that concurrently promotes parental empowerment in the neonatal units.</div></div><div><h3>Eligibility criteria</h3><div>The review was conducted following the methodology recommended by the Joanna Briggs Institute and in accordance with the Preferred Reporting Items for Systematic Reviews - Scoping Reviews (PRISMA-ScR) guidelines. Searches were performed on MedLine, CINAHL, Psychology and Behavioral Science Collection, MedicLatina, Scopus, Web of Science, the Scientific Open Access Repository of Portugal (RCAAP), Mednar, and Google Scholar. Study eligibility criteria were defined based on the PCC mnemonic.</div></div><div><h3>Sample</h3><div>A total of 608 records were identified for title and abstract screening, with 30 selected for full-text review. Ten studies met the inclusion criteria.</div></div><div><h3>Results</h3><div>The studies, published between 2002 and 2023, focused on the following cultures: Lumbee, Chinese, Jewish, Ghanaian, Nigerian, Ugandan, Mexican, Taiwanese, Iranian, and Aboriginal. Culturally competent nursing care promoting parental empowerment is categorized into: the relationship between parents and healthcare professionals, the care process, alignment of needs with community resources, alignment of needs with healthcare, and receiving information and emotional support.</div></div><div><h3>Conclusions</h3><div>Culturally competent care, rooted in family-centered care, promotes parental empowerment, which can consequently translate into improved quality of nursing care.</div></div><div><h3>Implications</h3><div>Recommendations for clinical practice, education, and research are suggested, emphasizing the importance of identifying cultural determinants and needs perceived by parents with children admitted to neonatal care units, specific to each culture present in different countries.</div></div>","PeriodicalId":35482,"journal":{"name":"Journal of Neonatal Nursing","volume":"31 1","pages":"Pages 31-38"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143143263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Development of a web-based individualized supportive developmental care (Web-DevCare) program for newborns, evaluation of content quality and usability","authors":"Nihal Tuncer , Şerife Tutar","doi":"10.1016/j.jnn.2024.08.004","DOIUrl":"10.1016/j.jnn.2024.08.004","url":null,"abstract":"<div><div>This study aimed to develop a web-based Individualized Supportive Developmental Care program for newborns and evaluate the quality of its content and usability. This methodological study was conducted with nurses (n:40). The development of the study website consisted of two phases: submission to experts and evaluation. The website developed in the study received 72.30 ± 9.12 points from DISCERN with the evaluation of the expert group. As a result of the participants' evaluation, the website received 85.05 ± 9.35 points on the System Usability Scale. It was found that the developmental care components (43%) were the sections that attracted the most attention and benefitted researchers on the website. Assessing and managing pain and stress (29%), creating a healing environment (26%), family-centred care (23%), and maintaining sleep (22%) were the most visited sections within this domain. It was found that the content information quality, reliability, and usability of this website developed for newborns were high.</div></div>","PeriodicalId":35482,"journal":{"name":"Journal of Neonatal Nursing","volume":"31 1","pages":"Pages 216-222"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143143691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}