Facilitators and barriers to the practice of neonatal family integrated care from the perspective of healthcare professionals: a systematic review.

Objective: To conduct a systematic review of barriers and facilitators to the practice of neonatal Family Integrated Care (FICare) from the perspective of healthcare professionals (HCPs).

Design: A systematic search strategy was developed to identify qualitative studies exploring neonatal HCPs' views of any of the principles of FICare. Six literature databases (CINAHL, (Cumulated Index in Nursing and Allied Health Literature) Embase, Medline, PsycINFO, Scopus, Web of Science) were searched using the terms Healthcare Professionals, Neonatal, Environment, FICare, Education, Well-being, Culture, Partnership and Empowerment. Studies meeting the inclusion criteria were thematically analysed.

Results: 11032 titles and abstracts and 85 full-text papers were screened. Thirty-seven studies met the inclusion criteria and reported interviews with 1243 HCPs, predominantly nurses. Three themes were synthesised in relation to barriers and facilitators: (1) 'advocacy and acknowledgement', whereby HCPs are expected to advocate for the emotional and mental health of the whole family, not solely the baby's needs; (2) 'belief and behaviour', whereby the degree to which FICare is practised is dependent on HCPs' belief in its benefits in relation to other activities; (3) 'conditions and consistency', whereby a lack of space, resources, policy and consistent practice of FICare created apathy and contradictory approaches to care.

Conclusion: Although HCPs see value in FICare, successful implementation is multifactorial and requires the expectation to deliver FICare to be aligned with resourcing at the hospital, team and individual levels. Shifting the practice paradigm to FICare remains challenging for some HCPs. Greater understanding of HCPs' views on barriers, facilitators and how FICare practice impacts individuals is required.