A scoping review of satisfaction of parents of babies in NICU units

Purpose

Parental Satisfaction plays a pivotal role in healthcare and can lead to greater adherence to treatment and communication between parents and healthcare workers in the paediatric setting. However, there is a lack of understanding of what can be done to improve Satisfaction and the limitations in place. This scoping review highlight highlighted what factors influence the satisfaction levels of parents whose infants are in the NICU or SCBU setting and how addressing these factors may increase Satisfaction. By looking at what influenced Satisfaction, we also became aware of what caused dissatisfaction and how this could have impacted both the infants and their parents. Parents who were dissatisfied experienced higher levels of emotional distress and did not feel as comfortable caring for their children, all of which would have a long-term impact on the family unit.

Methods

The Arksey & O'Malley methodological framework was used to conduct this scoping review. Ovid Medline, Embase, APA PsycINFO, UK & Ireland Reference Centre, CINHAL and PubMed databases were used to search for eligible articles. All articles were screened by two researchers. Articles were included if they focused on the Satisfaction of parents or guardians related to the care of their baby in the NICU and were published as full-text articles in English. Data including Title, Author, Year, Country, Research Method, Participant Information, ICU Type, Severity of Illness, and Factors Associated with Satisfaction were extracted and input to a table and thus synthesised to create a table summarising the principal findings related to parental Satisfaction.

Results

A total of 5387 articles were initially identified; after duplicates were removed, 2598 were included for the initial screening process. 45 of these were selected for full text screening and from this, 29 were included in the study. These studies had a wide range of sample sizes, from 10 to 1277. The majority of respondents recorded in these studies were mothers. These were across a diverse geographical range of 18 countries, the most common being the USA and Ethiopia. Six primary factors were identified as factors affecting Satisfaction: needs of parents, associated factors, communication, the infant, nursing care, and the NICU environment. These were input to a modified EMPATHIC-N framework to include Care and Treatment (as delivered by any healthcare professional employed in the NICU), Organisation, Parental Participation and Individual Condition, Information and Infant Condition.

Conclusions

This scoping review has shown that what affects parents' Satisfaction is multifaceted but modifiable. The most prevalent modifiable factor found was that of the sights and sounds in the NICU. Parental involvement in infant care and communication with healthcare staff were also found to be important modifiable factors that impacted parental Satisfaction. There were also some non-modifiable factors such as the age and gender of the parents. Being aware of these factors and improving on what is modifiable will likely increase the Satisfaction of parents whose infants are in the NICU for any length of time.