NPICU nurses’ perspectives of family centred neonatal care in Malta : a qualitative study

Abstract

Background: The role of neonatal nurses entails a very challenging yet rewarding experience. Family Centred Care (FCC) is a concept applied in the Neonatal and Paediatric Intensive Care Unit (NPICU) so as to improve the infant’s and family care. The implementation of FCC differs in different healthcare systems, cultures, and circumstances in which it is used, while also being known to pose certain challenges on nurses implementing it. Aim: The overall purpose of this study is to promote and enhance better neonatal and family care and outcomes in a NPICU setting as a result of gathering an insight into the perceptions of the NPICU nurses. Design and Method: An exploratory descriptive qualitative approach through a phenomenological design was adopted. 9 participants were selected through purposive sampling and from a Maltese NPICU. In-depth semi structured interviews were carried out. Interviews were transcribed verbatim and data was analysed through thematic analysis. Rodgers’ Family Centred Theory and Roy’s Adaptation Model has guided the researcher in exploring and understanding the perspectives of NPICU nurses regarding FCC. Findings: Five emergent themes were identified: ‘Approaches to FCC’, ‘Challenges in FCC implementation’, ‘Factors facilitating FCC’, ‘Adaptation Strategies for FCC delivery’ and ‘Positive Outcomes of FCC’. Findings indicate that many participants perceive FCC positively despite the multiple challenges that they encounter. Conclusions: Although participants are well aware of FCC and its benefits, its’ implementation requires further improvement. Recommendations arising from this study address multiple challenges encountered including environmental layout adjustments and staffing levels. Recommendations for education and practice suggest to invest in further staff and parental training. Researching the phenomenon of FCC with diverse participants and in other paediatric settings is also recommended.