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Families are the primary source of support and strength in the care process of children with cancer. Family-centered care (FCC) is a healthcare delivery approach that considers parents as both partners and care recipients, characterized by providing care based on dignity and respect, information sharing, participation, and collaboration or partnership. This study aimed to describe the delivery of care based on the family-centered care approach at the Tikur Anbessa Specialized Hospital pediatric cancer unit. An exploratory, descriptive qualitative study was conducted from March 2023 to August 2023. Eighteen participants (thirteen parents and five health care providers) were interviewed using a semi-structured interview guide. All interviews were audio-recorded, transcribed verbatim, and translated into English. The translated transcripts were used for inductive, data-driven thematic analysis. ATLAS.ti 9 software was used to assist the analysis process. Two themes have emerged during the analysis. These are (1) Information sharing, and (2) Enabling and partnership. Under the information sharing theme, we described parents' understanding of child cancer, parents' information-related expectations, the process of obtaining information, adequacy of information received, and factors inhibiting information sharing. Under the enabling and partnership theme, we presented family participation in childcare, discussion among parents, parents' communication with healthcare providers and psychosocial support. Suboptimal implementation of family-centered care practice was identified at the pediatric oncology unit. The findings from this study indicate the need to strengthen the provision of child cancer-related information, improve communication, and strengthen family participation in childcare. [ABSTRACT FROM AUTHOR]

Jedidah Olayinka Johnson Department of Pediatrics, University of Sierra Leone Teaching Hospital Complex, Freetown, Sierra LeoneCorrespondence: Jedidah Olayinka Johnson, Department of Pediatrics, University of Sierra Leone Teaching Hospital Complex, Freetown, Sierra Leone, Tel +232 79533962, Email jedidahj18@gmail.comPurpose: To assess the feasibility of implementing family centered care and the impact this would have on parental satisfaction in a special care baby unit in Sierra Leone.Patients and Methods: A cross-sectional, mixed methods study was conducted at the Rokupa Government Hospital, Sierra Leone. 16 nursing staff of the Special Care Baby Unit and 7 caregivers of neonates admitted in the unit participated in the study. Quantitative data on feasibility was obtained from nursing staff using a five-point Likert scale administered to staff before and after implementation of family centered care in the unit. Qualitative data on perception of impact was obtained through focus group discussions for caregivers whose neonates had received family centered care and a control group who had received standard unit care. Quantitative data was analyzed using univariate analysis and thematic analysis was undertaken for qualitative data.Results: Before implementation, most nursing staff felt implementation of family centred care was not feasible (87.5%) and more than half of nursing staff either strongly agreed or agreed with each of the negative statements regarding the practice of family centred care indicating a generally negative perception. After implementation there was improvement in nursing staff perception of family centred care, however the majority still doubted the continued feasibility of this practice (68.8%). Qualitative discussions with caregivers demonstrated that caregivers whose babies received family centered care were less distressed and more satisfied during the period of admission than those who received routine care.Conclusion: Family centered care improved the experiences of caregivers in the unit. Nursing staff also demonstrated a better understanding of the benefits of family centered care after it was implemented. Concerns regarding understaffing and the unit being too small to accommodate caregivers and staff at the same time need to be addressed. There is need to integrate family centered care into hospital policy.Keywords: family centered care, neonates, nursing care, Sierra Leone

To determining level and factors affecting Family Centered Care (FCC) in pediatric oncology unit of Tikur Anbessa Specialized hospital (TASH), Ethiopia. A cross sectional study was conducted from June to December 2022. Three hundred ninety-three parents of children with cancer were consecutively interviewed using Measure of Processes of Care (MPOC-20). Multivariable linear regression was used to identify independent predictors of FCC. The total MPOC 20 means was 3.71(SD = 1.04). The mean score for respectful and supportive care, coordinated and comprehensive care, enabling and partnership, providing specific information and providing general information were found to be 4.8, 4.6, 3.7, 2.3 and 2.6, respectively. Family employment (−0.33(95% CI = −0.63, −0.03; P =.029)), low family education (−0.40 (95% CI = −0.70, −0.11; P =.008)), referral cases (−0.37(95% CI = −0.59, −0.14; P =.001)), shorter time spent in hospital (−0.49(95% CI = −0.85, −0.12; P =.010)) and psychological distress (−0.01(95% CI = −0.026, −0.001; P =.028)) were associated with lower mean score of FCC. The total FCC mean score was found to be low. From the five FCC components providing general and specific information scored the lowest mean level. Mechanism to improve information delivery that address parents from different background and referred from other health facility should be in place in order to improve FCC level. In addition, the FCC should be designed to address parents of children with different lengths of stay. • The overall level of family centered care was found to be low. • The subscale with highest mean score was providing respectful and supportive care. • The subscales with lowest mean score were providing general and specific information. • All domains reported at least one item less than five for >33% of respondents. [ABSTRACT FROM AUTHOR]

Studies exploring patient-centered care (PCC) in pediatric surgery have been disproportionately concentrated in high-income countries. This review aims to characterize the adoption of key PCC domains in low and lower-middle income countries (LMICs). Seven databases were searched from inception until January 2023 to retrieve relevant articles in pediatric surgery in LMICs. We focused on six key PCC domains: patient-reported outcomes (PROs), patient-reported experiences (PREs), shared decision-making (SDM), patient/parent education, patient/parent satisfaction, and informed consent. Of 8050 studies screened, 230 underwent full-text review, and 48 were finally included. Most were single-center (87.5%), cross-sectional studies (41.7%) from the South-East Asian (35.4%) and Eastern Mediterranean regions (33.3%). Studies most frequently focused on postoperative care (45.8%) in pediatric general surgery (18.8%), and included 1–3 PCC domains. PREs (n = 30), PROs (n = 16) and patient/parent satisfaction (n = 16) were most common. Informed consent (n = 2) and SDM (n = 1) were least studied. Only 13 studies directly elicited children's perspectives. Despite all studies originating in LMICs, 25% of first and 17.8% of senior authors lacked LMIC affiliations. The adoption of PCC in LMICs appears limited, focusing predominantly on PROs and PREs. Other domains such as informed consent and SDM are rarely addressed, and the voice of children and young people is rarely heard in their care. Opportunities to enhance PCC in LMICs abound, with the potential to improve the surgical care of children in resource-limited settings. III. • What is currently known about this topic? Patient-centered care approaches have been shown to promote the health and overall well-being of children and young people undergoing surgery. • What new information is contained in this article? To our knowledge, this article is the first to explore the extent of adoption of patient-centered care approaches in pediatric surgery in low and lower-middle income countries. [ABSTRACT FROM AUTHOR]

Objective: We implemented an online visitation system named “telepresence” in the neonatal intensive care unit (NICU) for family members at home to communicate with their babies in real-time using video and audio. This study evaluated the impact of this system on families and medical staff. Methods: Nineteen families of babies admitted to the NICU between 2022 and 2023 and 65 medical staff participated. Each family experienced two weeks of virtual visits. Changes in parental depression and attachment were assessed. Result: Before and after telepresence, the median Edinburgh Postnatal Depression Scale score reduced from 6 to 4 (p = 0.026), and the Mother-to-Infant Bonding Scale score showed a decreasing trend, with both medians at 2 (p = 0.057). Eighty-nine percent of the parents and 97% of staff reported that telepresence did not increase parental stress, and 88% of parents felt positive changes in their baby's siblings. All parents wanted to visit their babies in person after seeing them on camera. Conclusion: Telepresence improved parental mental health, reduced family distress, and supported connection with their infants, making them eager to visit in person. Innovations: This technology potentially make parents want to visit more by helping them feel more connected to their infants.

Nutrition screening is the first step in most acute care pediatric nutrition care pathways. However, there is a lack of understanding of patient and families' perception of nutrition screening in pediatric populations. The objective of this study was to explore the potential perceptions, feelings, and opinions of families if pediatric nutrition screening were to be completed during hospital admission. Nine members of the Family Advisory Council at the Alberta Children's Hospital participated in a focus group to discuss questions around nutrition screening practices, malnutrition, and the pediatric nutrition screening tool. Transcripts were analyzed using MAXQDA and thematic analysis using the Braun and Clarke methodology. Two major themes emerged: screening may raise sensitive emotions and understanding the purpose of nutrition screening and the questions. Participants agreed discussions around growth and nutrition are vital to comprehensive medical care; however, the timing and approach of nutrition screening can lead to anxiety and feelings of judgement. A lack of understanding of the purpose of screening, next steps, and benefit to the individual patient could limit acceptance of nutrition screening. The findings of this study can inform training and education of healthcare professionals involved in nutrition screening. [ABSTRACT FROM AUTHOR]

This paper is part two of a series of papers written by the mothers of Neonatal Intensive Care Unit (NICU) graduates. The companion paper, "Parent Perspectives: Part 1—Considerations for Changing the NICU Culture", considers all aspects of the NICU experience and provides recommendations for interventions and improvements from a life-course perspective while families are in the NICU. In part two, the focus is the transition home post-NICU stay. The time after NICU discharge is a critical and sensitive developmental period for NICU babies and their families, and an important life course transition. This paper provides a parent's perspective of how to improve the transition home post-NICU stay. Our perspectives draw on the Life Course Health Development approach, which regards health as an active process that is developed over time based on a person's internal biologic and physiologic systems, their external environment and circumstances, and the interactions or relationships between them. This paper describes a collaborative care model where parents and their healthcare teams work together to develop shared care plans. It also describes how we can build trust and family capacity to support long-term care, ensure family well-being, and link families to needed resources and support that can ease the transition from the NICU back to the home and optimize family health trajectories. [ABSTRACT FROM AUTHOR]

Good communication is central to good healthcare. As a result of poor communication between parents and healthcare professionals (HCPs) in clinical settings, this study aimed to address this problem by developing a communication tool to empower parents and act as a prompt for HCPs to talk about the child's care and gather information at the point of admission to hospital about what is important to families, therefore supporting patient-centered communication. A design thinking process was used to develop a physical copy of Chloe's card and evaluate its use. Design thinking is a problem-solving approach, which uses an empathetic lens to integrate viewpoints of different stakeholders throughout the process of creating solutions. Design thinking involves five processes: (1) empathise—including a literature review and data synthesis, (2) define—by completing semi-structured interviews with parents about their experience of communication and HCPs perceptions of parent's experience of communication, (3) ideate—iterate the design of Chloe's card with parents and HCPs, (4) prototype—develop the design of Chloe's card, and (5) test—pilot test in clinical practice. Results from this initial study suggest that a small hand-held card, with emoticons and a place to write concerns, was acceptable to parents and feasible to use in clinical practice. Parents do not always feel heard by HCPs and a tool such as Chloe's card may help facilitate sharing of information about matters important to them and their child. However, some HCPs felt the need for a communication tool undermined their clinical skills. Feedback from HCP participants suggests that the idea of Chloe's card was acceptable and perceived as potentially being useful in clinical practice. Further work is required, as part of a larger study, to further refine this communication tool, identify those parents who would benefit most from Chloe's card, as well as to further refine the HCP process prior to implementing it into clinical settings. It was noted future iterations would benefit from a digital version linked with a child's electronic record, as well as multi-language versions and information for parents. [ABSTRACT FROM AUTHOR]

Purpose of review: The purpose of this review is to summarize the latest evidence regarding family presence at the bedside in the neuro-ICU. Benefits, drawbacks, and recommendations are provided to support family members of persons receiving neurocritical care. Recent findings: Family presence at the bedside can support positive outcomes for patients, family members, and health care staff. Recent findings suggest better satisfaction with care, reduced negative symptoms, and increased self-efficacy in families engaging in family-centered ICU care. The perceptions of health care staff regarding increased family presence at bedside is mixed and warrants further discussion and research. Summary: Family presence at the bedside in neurocritical care is a new and somewhat controversial concept in current literature. Studies outlined in this article have proven benefit for patients and family; however, future research must be done on how to protect family and prepare care staff in family-centered neuro-ICU care. Special consideration must be made in future research on how to integrate family into neuro-ICU care and minimize impediment of neuro-ICU workflow and standards. [ABSTRACT FROM AUTHOR]

In this qualitative study, we explored perspectives of patients in the intensive care unit (ICU) and their families on the Get to Know Me board (GTKMB). Of the 46 patients approached, 38 consented to participate. Of the 66 family members approached, 60 consented to participate. Most patients (26, 89%) and family members (52, 99%) expressed that GTKMB was important in recognizing patient's humanity. Most patients (20, 68%) and families (39, 74%) said that it helped to build a better relationship with the provider team. 60% of patients and families commented that the GTKMB was used as a platform by providers to interact with them. Up to 45 (85%) of the family members supported specific contents of the GTKMB. In structured interviews (11 patients, 7 family members), participants additionally commented on ways providers used the GTKMB to communicate, support patient's personhood, and on caveats in interacting with GTKMB. Critically ill patients and families found the GTKMB helpful in preserving personhood of patient, fostering communication, and building relationships with clinicians. [ABSTRACT FROM AUTHOR]

Introduction: Effective communication is a central tenet of family centered care, yet parent concerns are sometimes un- or underattended to by pediatric providers. This study aimed to explore the prevalence of, and factors related to, parental perceptions of concern dismissal by pediatric providers. Method: In Spring 2020, 270 community-recruited parents of children ages 6–12 years (74% White, 74% female, 69% married) responded to an online survey about perceived concern dismissal experiences with their children. Characteristics of concern dismissal, differences in concern dismissal occurrence by parent factors, and emotional and practical impacts were assessed and explored. Results: Thirty-three percent reported having experienced concern dismissal, most often in pediatric primary care settings. Concern dismissal was reported more frequently among parents employed in health care settings than those without health care employment histories. Most dismissed concerns related to the child's physical health and many incidents were characterized by provider impoliteness or provision of less testing or treatment than expected or desired. Many parents expressed disappointment in the health care system after experiences of concern dismissal. Discussion: Concern dismissal was found to be common and upsetting for community-recruited parents. Future research should incorporate child and provider perspectives with demographically diverse samples. Pediatric providers should continue to work toward implementation of family centered care to decrease the likelihood of perceived dismissal by thoroughly recognizing and responding to concerns presented by parents and caregivers of pediatric patients. Public Significance Statement: This study of community parents found that concern dismissal in the pediatric health care setting is common and upsetting. It is most often characterized by perceived provider impoliteness or the provision of less testing or treatment than desired by the parent. To promote family centered care and decrease the likelihood of concern dismissal, the pediatric health care system should prioritize improving communication with patient families. [ABSTRACT FROM AUTHOR]

BackgroundParents of infants in neonatal intensive care units (NICUs) are often unintentionally marginalized in pursuit of optimal clinical care. Family Integrated Care (FICare) was developed to support families as part of their infants' care team in level III NICUs. We adapted the model for level II NICUs in Alberta, Canada, and evaluated whether the new Alberta FICare™ model decreased hospital length of stay (LOS) in preterm infants without concomitant increases in readmissions and emergency department visits.MethodsIn this pragmatic cluster randomized controlled trial conducted between December 15, 2015 and July 28, 2018, 10 level II NICUs were randomized to provide Alberta FICare™ (n = 5) or standard care (n = 5). Alberta FICare™ is a psychoeducational intervention with 3 components: Relational Communication, Parent Education, and Parent Support. We enrolled mothers and their singleton or twin infants born between 32 0/7 and 34 6/7 weeks gestation. The primary outcome was infant hospital LOS. We used a linear regression model to conduct weighted site-level analysis comparing adjusted mean LOS between groups, accounting for site geographic area (urban/regional) and infant risk factors. Secondary outcomes included proportions of infants with readmissions and emergency department visits to 2 months corrected age, type of feeding at discharge, and maternal psychosocial distress and parenting self-efficacy at discharge.ResultsWe enrolled 654 mothers and 765 infants (543 singletons/111 twin cases). Intention to treat analysis included 353 infants/308 mothers in the Alberta FICare™ group and 365 infants/306 mothers in the standard care group. The unadjusted difference between groups in infant hospital LOS (1.96 days) was not statistically significant. Accounting for site geographic area and infant risk factors, infant hospital LOS was 2.55 days shorter (95% CI, - 4.44 to - 0.66) in the Alberta FICare™ group than standard care group, P = .02. Secondary outcomes were not significantly different between groups.ConclusionsAlberta FICare™ is effective in reducing preterm infant LOS in level II NICUs, without concomitant increases in readmissions or emergency department visits. A small number of sites in a single jurisdiction and select group infants limit generalizability of findings.Trial registrationClinicalTrials.gov Identifier NCT02879799 , retrospectively registered August 26, 2016.

Schizophrenia spectrum disorders (SSD) often show cognitive deficits (CD) impacting daily life. Family support has been shown to be protective against CD, yet the relationship between these in psychotic patients remains complex and not fully understood. This study investigated the association between a subdomain of family support, namely, family involvement (estimated through a proxy measure), cognitive functioning, and sex in first-episode psychosis (FEP) patients. The sample included 308 patients enrolled in the Program for Early Phases of Psychosis (PAFIP), divided into 4 groups based on their estimated family involvement (eFI) level and sex, and compared on various variables. Women presented lower rates of eFI than men (37.1% and 48.8%). Higher eFI was associated with better cognitive functioning, particularly in verbal memory. This association was stronger in women. The findings suggest that eFI may be an important factor in FEP patients' cognitive functioning. This highlights the importance of including families in treatment plans for psychotic patients to prevent CD. Further research is needed to better understand the complex interplay between family support, sex, and cognitive functioning in psychotic patients and develop effective interventions that target these factors. [ABSTRACT FROM AUTHOR]

BackgroundFamily Centered Care (FCC) has been widely adopted as the framework for caring for infants in the Neonatal Intensive Care Unit (NICU) but it is not uniformly defined or practiced, making it difficult to determine impact. Previous studies have shown that implementing the Family Integrated Care (FICare) intervention program for preterm infants in the NICU setting leads to significant improvements in infant and family outcomes. Further research is warranted to determine feasibility, acceptability and differential impact of FICare in the US context. The addition of a mobile application (app) may be effective in providing supplemental support for parent participation in the FICare program and provide detailed data on program component uptake and outcomes.MethodsThis exploratory multi-site quasi-experimental study will compare usual FCC with mobile enhanced FICare (mFICare) on growth and clinical outcomes of preterm infants born at or before 33 weeks gestational age, as well as the stress, competence and self-efficacy of their parents. The feasibility and acceptability of using mobile technology to gather data about parent involvement in the care of preterm infants receiving FCC or mFICare as well as of the mFICare intervention will be evaluated (Aim 1). The effect sizes for infant growth (primary outcome) and for secondary infant and parent outcomes at NICU discharge and three months after discharge will be estimated (Aim 2).DiscussionThis study will provide new data about the implementation of FICare in the US context within various hospital settings and identify important barriers, facilitators and key processes that may contribute to the effectiveness of FICare. It will also offer insights to clinicians on the feasibility of a new mobile application to support parent-focused research and promote integration of parents into the NICU care team in US hospital settings.Trial registrationClinicalTrials.gov, ID NCT03418870. Retrospectively registered on December 18, 2017.

ABSTRACT Importance Parent‐infant closeness and active parent participation in neonatal care are important for parent and infant health. Objective To give an overview of current neonatal settings and gain an in‐depth understanding of facilitators and barriers to parent‐infant closeness, zero‐separation, in 19 countries. Methods Neonatal intensive care unit (NICU) professionals, representing 45 NICUs from a range of geographic regions in Europe and Canada, were purposefully selected and interviewed June–December 2018. Thematic analysis was conducted to identify, analyze and report patterns (themes) for parent‐infant closeness across the entire series of interviews. Results Parent‐infant separation during infant and/or maternity care is very common (42/45 units, 93%), despite the implementation of family integrated care (FICare) practices, including parent participation in medical rounds (17/45, 38%), structured education sessions for parents (16/45, 36%) and structured training for healthcare professionals (22/45, 49%). NICU professionals encountered four main themes with facilitators and barriers for parent‐infant closeness on and between the hospital, unit, staff, and family level: Culture (jointly held characteristics, values, thinking and behaviors about parental presence and participation in the unit), Collaboration (the act of working together between and within different levels), Capacities (resources and policies), and Coaching (education to acquire and transfer knowledge and skills). Interpretation Implementing parent‐infant closeness in the NICU is still challenging for healthcare professionals. Further optimization in neonatal care towards zero‐separation and parent‐infant closeness can be achieved by enforcing the ‘four Cs for Closeness’: Culture, Collaboration, Capacities, and Coaching.

An important gap in the literature is how clinicians feel about patient-centered technologies and how clinicians experience patient-centered technologies in their workflows. Our goal was to identify clinician users' perspectives on facilitators (pros) and barriers (cons) to using 1 digital texting innovation to promote family centered care during patients' hospitalizations. This qualitative study was conducted at a tertiary care center in Houston, consisting of 7 hospitals (1 academic hospital and 6 community hospitals), involving analyzation of 3 focus groups of 18 physicians, 5 advanced practice providers, and 10 nurse directors and managers, as well as a content analysis of 156 real-time alerts signaling family dissatisfaction on the nursing unit/floor. Thematic analysis methods were used. We selected these participants by attending their regularly scheduled service-line meetings. Clinician feedback from focus groups resulted in 3 themes as facilitators : (a) texting platforms must be integrated within the electronic medical record; (b) texting reduces outgoing phone calls; (c) texting reduces incoming family phone calls. Clinician feedback resulted in 3 themes as barriers : (a) best practice alerts can be disruptive; (b) real-time alerts can create hopelessness; and (c) scale-up is challenging. The analyzation of facilitators (pros) and barriers (cons) pertains only to the clinician's feedback. We also analyzed real-time alerts signaling family dissatisfaction (defined as "service recovery escalation" throughout this manuscript). The most common selection for the source of family dissatisfaction, as reflected through the real-time alerts was, "I haven't heard from physicians enough," appearing in 52 out of 156 alerts (33%). The second most common selection for the source of dissatisfaction was "perceived inconsistent or incomplete information provided by team members," which was selected in 48 cases (31%). Our findings indicate that clinicians value inpatient texting, not only for its ability to quickly relay updates to multiple family members with 1 click, but also because, when used intentionally and meaningfully, texting decreases family phone calls. [ABSTRACT FROM AUTHOR]

Copyright of ProCare is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The role of the family in the theoretical system is as a caregiver for sick family members. Family involvement in client care is applied in care known as the Family Centered Care concept. The application of Family Centered Care can increase knowledge and attitudes of families in the care of clients who are hospitalized. The purpose of the study was to determine the level of application of Family Centered Care. The research method used is a descriptive study. The research sample was 100 respondents. The sampling technique used is accidental sampling. The data collection tool used is a family centered care questionnaire. The research analysis used univariate analysis in the form of a frequency distribution. The results showed that the application of family centered care was in the good category as many as 71 respondents (71%), and in the medium category as many as 29 respondents (29%). From the results of the study, it was stated that nurses had involved the family in care, where the family participated in making decisions on support plans, recovery and helping patients not to be anxious. The conclusion is that the application of family centered care is in the good category.

This paper is part two of a series of papers written by the mothers of Neonatal Intensive Care Unit (NICU) graduates. The companion paper, “Parent Perspectives: Part 1—Considerations for Changing the NICU Culture”, considers all aspects of the NICU experience and provides recommendations for interventions and improvements from a life-course perspective while families are in the NICU. In part two, the focus is the transition home post-NICU stay. The time after NICU discharge is a critical and sensitive developmental period for NICU babies and their families, and an important life course transition. This paper provides a parent’s perspective of how to improve the transition home post-NICU stay. Our perspectives draw on the Life Course Health Development approach, which regards health as an active process that is developed over time based on a person’s internal biologic and physiologic systems, their external environment and circumstances, and the interactions or relationships between them. This paper describes a collaborative care model where parents and their healthcare teams work together to develop shared care plans. It also describes how we can build trust and family capacity to support long-term care, ensure family well-being, and link families to needed resources and support that can ease the transition from the NICU back to the home and optimize family health trajectories.

Copyright of Medizinische Klinik: Intensivmedizin & Notfallmedizin is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

family-centred Care (FCC) is an effective intervention in reducing the impact of hospitalization. The aim of this literature review was to identify published research articles on the application of the FCC concept to the reduction of the impact of hospitalization in pediatric intensive care wards from the perspective of the parents. The literature review research took 14 journals from various databases published in 2015-2021. Searching for titles was obtained through identification and screening, entering inclusion criteria, so that 13 international journals and 1 national journal were obtained. The results of this study identified parental perspectives regarding the application of the core concepts of the FCC in reducing the impact of hospitalization, where each concept is accompanied by theme findings, for respect and dignity: a) the physical and cultural environment of the PICU, b) the expression of compassion and support from staff; sharing information: a) using understandable language, b) medical cycles, and c) satisfaction with communication; participation: a) parents as experts, b) how parents participate, c) environmental / staff impact on participation, and d) medical cycles; and Collaboration. This review reveals parents' reports that the implementation of the FCC concept in reducing the impact of hospitalization has not been fully fulfilled, as evidenced by the finding of positive and negative implementations related to the FCC concept.

Despite previous studies suggesting that developmental care can provide benign stimulation to promote neural development of newborns, more evidence is needed regarding the other clinical benefits of developmental care. To evaluate the effect of implementing developmental care on the length of hospital stay, the improvement of care practice in neonatal intensive care units, as well as the short-term outcome of very low birth weight infants. Cluster-randomized controlled trial. From March 1, 2021 to March 1, 2022, 1400 very low birth weight infants were recruited from 14 tertiary neonatal intensive care units in China. We assigned 14 neonatal intensive care units to either developmental care or standard care. The length of hospital stay of the infants was the primary outcome analyzed at the individual level. Secondary outcomes were family centered care practice including parental involvement, the skin to skin care, exclusive breast milk, oral immune therapy and breastfeeding. The environmental management (noise and light) and the short-term outcomes were also evaluated. The length of hospital stay for the developmental care group was 65 % as long as that for the control group (HR: 0.65, 95 % CI, 0.451–0936, p = 0.021). After controlling the covariables, the adjusted HR = 0.755 (95 % CI, 0.515 to 1.107, p = 0.150). When compared to the control group, the developmental care group had greater access to SSC, with 22 infants (3.8 %) in the developmental care group compared to 13 infants (1.7 %) in the standard care group (p = 0.013). A greater proportion of infants in the developmental care group were fed at the breast, than those in the standard care group (136 [23.6 %] vs 9 [1.1 %]; p = 0.029). Compared to the control group, exclusively breast milk was significantly more favorable in the developmental care group (435 [75.6 %] vs 114 [15.0 %]; p = 0.001). The difference remained significant even after adjusting for covariates. However, the rate of oral immune therapy and parental involvement was similar in the two groups. The average noise and light levels in the developmental care group were significantly lower than those in the standard care group. After adjusting for confounders, the difference remained significant. There were no significant differences among groups in the mortality and major morbidity. Developmental care might have developed an accumulated effect over time on the length of hospital stay among very low birth weight infants. The implementation of developmental care can greatly improve family centered care practices and the neonatal intensive care unit environment. ClinicalTrials.gov NCT05166720. Registration date: 1 March, 2021. [ABSTRACT FROM AUTHOR]

Good communication is central to good healthcare. As a result of poor communication between parents and healthcare professionals (HCPs) in clinical settings, this study aimed to address this problem by developing a communication tool to empower parents and act as a prompt for HCPs to talk about the child’s care and gather information at the point of admission to hospital about what is important to families, therefore supporting patient-centered communication. A design thinking process was used to develop a physical copy of Chloe’s card and evaluate its use. Design thinking is a problem-solving approach, which uses an empathetic lens to integrate viewpoints of different stakeholders throughout the process of creating solutions. Design thinking involves five processes: (1) empathise—including a literature review and data synthesis, (2) define—by completing semi-structured interviews with parents about their experience of communication and HCPs perceptions of parent’s experience of communication, (3) ideate—iterate the design of Chloe’s card with parents and HCPs, (4) prototype—develop the design of Chloe’s card, and (5) test—pilot test in clinical practice. Results from this initial study suggest that a small hand-held card, with emoticons and a place to write concerns, was acceptable to parents and feasible to use in clinical practice. Parents do not always feel heard by HCPs and a tool such as Chloe’s card may help facilitate sharing of information about matters important to them and their child. However, some HCPs felt the need for a communication tool undermined their clinical skills. Feedback from HCP participants suggests that the idea of Chloe’s card was acceptable and perceived as potentially being useful in clinical practice. Further work is required, as part of a larger study, to further refine this communication tool, identify those parents who would benefit most from Chloe’s card, as well as to further refine the HCP process prior to implementing it into clinical settings. It was noted future iterations would benefit from a digital version linked with a child’s electronic record, as well as multi-language versions and information for parents.

Background: Parents of babies admitted to the neonatal unit experience considerable stress related to the neonatal environment and condition of the neonate. During admission, care is provided by healthcare providers and parents only visit their neonates during scheduled times. In family-integrated neonatal care parents are primary caregivers in neonatal health. Aim: The aim of the study was to develop and implement strategies of family integrated neonatal care in a district hospital of Limpopo. Design: Action research, Piggot Irvine Problem Resolving Action Research model was utilized in the study. Methods: A quantitative tool was utilized to collect data on the well-being of the neonates. Two focus groups were held to explore the experiences of health care providers on provision of neonatal care in Limpopo Province. Data analysis: Descriptive statistics was used to analyse quantitative data and the Tesch eight steps of data analysis was used to analyse qualitative data. Results: Six sub themes emerged during the focus groups, namely,1) HIV-positive mothers’ unwillingness to breastfeed; 2) failure of the HIV-positive mothers to disclose their status to partners 3) failure of the mother to sustain kangaroo mother care after discharge; 4) incorrect Apgar scoring by midwives and medications by doctors in the labour ward; 5) shortage of resources in the neonatal unit; and 6) roles of family members in the neonatal unit. On assessment of the neonates’ well-being, it was found that most lost weight, while some neonates had a prolonged stay in the neonatal unit.Strategies of implementation of family integrated neonatal Care were developed by a steering committee. Conclusion: The conducted situational analysis highlighted the need for implementation of family integrated neonatal care, in which parents would become primary caregivers for their own neonates. Further research is required to explore the experiences of mothers during the implementation of family integrated neonatal care.

Patient and family advisory councils (PFACs) advance patient- and family-centered care within children’s hospitals but may not reflect the diversity of the communities they serve. We sought to assess PFAC diversity among children’s hospitals and explore barriers, drivers, and enablers of recruitment, retention, and engagement of patient and family advisors (PFAs) with diverse perspectives and backgrounds. We performed a mixed methods study to evaluate structure, composition, recruitment, and engagement strategies of children’s hospital PFACs. Individuals likely to have knowledge of or responsibility for PFACs at each Children’s Hospital Association (CHA) member hospital were asked to complete an electronic questionnaire. A subset of respondents from hospitals varying in size and region participated in 1-hour virtual interviews. We received valid responses from 166 (73%) of 228 CHA member hospitals. Eighty-eight percent reported having at least one PFAC. Only 21% selected “definitely true” when asked if their PFACs reflected the racial and ethnic diversity of the community served. Twelve respondents from various children’s hospitals participated in qualitative interviews. Five themes emerged: 1) Importance of Diversity in PFAC Membership; 2) Targeted, Personalized Recruitment and Engagement Strategies Facilitate Diverse PFACs; 3) Importance of Supporting PFAs from Diverse Backgrounds; 4) Ample Opportunities to Engage PFAs in Institutional Diversity, Equity, and Inclusion Efforts; and 5) External Factors as Drivers for Change within PFACs. Many PFACs are working to increase diversity, equity, and inclusion, but opportunities to close gaps remain. Findings may inform strategies to promote diversity, equity, and inclusion within PFACs across hospital systems. Experience Framework This article is associated with the Patient, Family & Community Engagement lens of The Beryl Institute Experience Framework (https://www.theberylinstitute.org/ExperienceFramework). Access other PXJ articles related to this lens. Access other resources related to this lens.

Family Centered Care (FCC) in Neonatal Intensive Care Units (NICUs) included family involvement in the care process of newborns and infants. Staff perceptions of FCC may influence clinical practice and management strategies in NICUs, with an impact on quality and humanization of the care. The Family-Centred Care Questionnaire-Revised (FCCQ-R) was adapted for the NICU setting, therefore the FCCQ-R@it-NICU was developed and used for the present study in 32 Italian NICUs. We calculated internal consistency using Cronbach's alpha correlation between Current and Necessary dimensions of the scale using the Pearson correlation coefficient. Furthermore, we investigated which characteristics could influence staff perceptions of FCC in NICUs. 921 NICU professionals participated in the study. The FCCQ-R@it-NICU revealed good internal consistency (0.96) and good correlation between dimensions (p < 0.05). Statistical and significant differences in Current and Necessary dimensions were found and some demographic characteristics were found predictable on FCC practice. The FCCQ-R@it-NICU is a valid tool to investigate staff perceptions about FCC in NICU settings. Profession, education level and work experience seem to positively influence the perception of what is required for FCC practice within NICUs. [ABSTRACT FROM AUTHOR]

Importance: Parent‐infant closeness and active parent participation in neonatal care are important for parent and infant health. Objective: To give an overview of current neonatal settings and gain an in‐depth understanding of facilitators and barriers to parent‐infant closeness, zero‐separation, in 19 countries. Methods: Neonatal intensive care unit (NICU) professionals, representing 45 NICUs from a range of geographic regions in Europe and Canada, were purposefully selected and interviewed June–December 2018. Thematic analysis was conducted to identify, analyze and report patterns (themes) for parent‐infant closeness across the entire series of interviews. Results: Parent‐infant separation during infant and/or maternity care is very common (42/45 units, 93%), despite the implementation of family integrated care (FICare) practices, including parent participation in medical rounds (17/45, 38%), structured education sessions for parents (16/45, 36%) and structured training for healthcare professionals (22/45, 49%). NICU professionals encountered four main themes with facilitators and barriers for parent‐infant closeness on and between the hospital, unit, staff, and family level: Culture (jointly held characteristics, values, thinking and behaviors about parental presence and participation in the unit), Collaboration (the act of working together between and within different levels), Capacities (resources and policies), and Coaching (education to acquire and transfer knowledge and skills). Interpretation: Implementing parent‐infant closeness in the NICU is still challenging for healthcare professionals. Further optimization in neonatal care towards zero‐separation and parent‐infant closeness can be achieved by enforcing the 'four Cs for Closeness': Culture, Collaboration, Capacities, and Coaching. [ABSTRACT FROM AUTHOR]

In the current study, we aimed to explore the lived experience of Israeli parents who engaged in musical dialogues with their preterm infants during music therapy (MT) after being discharged from the neonatal intensive care unit (NICU), as a part of the multinational LongSTEP RCT. Seven participants of the main trial were invited to engage in semi-structured in-depth interviews intertwining listening to audio recordings from their music therapy sessions in an adapted interpersonal process recall (IPR) procedure. The interviews were transcribed and analyzed using interpretative phenomenological analysis (IPA). We understood the participants' experiences to reflect two main themes: 1) Music therapy as a potential means of transformation in communication skills, resourcefulness and sense of agency; and 2) emotional and musical preconditions for parental engagement in MT. The findings illustrate how a specific group of Israeli parents experienced MT as offering them a means of expanding their relationship with their preterm infants after discharge. Based on our findings, we recommend that music therapists consider parents' musical and emotional resources during post-discharge MT to meet the individual needs of families. [ABSTRACT FROM AUTHOR]

Introduction Child hospitalization is a difficult event in the life for the whole family, probably worst for families coming from far away, specially for accommodation. Ronald McDonald Houses (RMH) created in the immediate proximity of pediatric departments of hospitals, allows hospitalized children to benefit from the presence of his family nearby. The hypothesis that the family is stronger when it is grouped together (the “family-centered-care” concept) remains difficult to demonstrate (Cochrane, 2012). In France, there is no study describing the interest of such places, and families experiences. Objectives Our objectives are to describe the experience of parents in French RMH. Methods A cross-sectional study conducted between February and April 2016, invited 50 families to participate in the 9 French RMH, by feeling an anonymous questionnaire (socio-demographic characteristics, items related to hospitalization, anxiety and depression scale -HADS, conditions of stay at the house). Descriptive statistics presented mothers and fathers experience. Results Parents of 333 hospitalized child participated : 320 mothers, 246 fathers. 44.1% of child were aged less than one year. Services more represented were : intensive care unit, oncology and neonatal. Parents were socially rather disadvantaged, living mainly in couples, with an estimated mean home-hospital time of 2 hours. They reported financial problems (>40%), sleep deprivation (>1.5 hours), and anxiety-depressive disorders: anxiety (>50%) and depression (>20%). Satisfaction staying in the house was extremely high (>95%). Conclusions We observe an undeniable added value of the RMH in the care. Nevertheless, the high level of psychological suffering shows the importance of offering help at the psycho-social level. Disclosure No significant relationships.

Background and SignificanceAdvances in pediatric intensive care have led to markedly improved survival rates in critically ill children. Approximately 70% of those children survive with varying forms of complex chronic diseases or impairment/disabilities. Length of stay, length of mechanical ventilation and number of interventions per patient are increasing with rising complexity of underlying diseases, leading to increasing pain, agitation, withdrawal symptoms, delirium, immobility, and sleep disruption. The ICU-Liberation Collaborative of the Society of Critical Care Medicine has developed a number of preventative measures for prevention, early detection, or treatment of physical and psychiatric/psychological sequelae of oftentimes traumatic intensive care medicine. These so called ABCDEF-Bundles consist of elements for (A) assessment, prevention and management of pain, (B) spontaneous awakening and breathing trials (SAT/SBT), (C) choice of analgesia and sedation, (D) assessment, prevention and management of delirium, (E) early mobility and exercise and (F) family engagement and empowerment. For adult patients in critical care medicine, research shows significant effects of bundle-implementation on survival, mechanical ventilation, coma, delirium and post-ICU discharge disposition. Research regarding PICS in children and possible preventative or therapeutic intervention is insufficient as yet. This narrative review provides available information for modification and further research on the ABCDEF-Bundles for use in critically ill children.Material and MethodsA narrative review of existing literature was used.ResultsOne obvious distinction to adult patients is the wide range of different developmental stages of children and the even closer relationship between patient and family. Evidence for pediatric ABCDEF-Bundles is insufficient and input can only be collected from literature regarding different subsections and topics.ConclusionIn addition to efforts to improve analgesia, sedation and weaning protocols with the aim of prevention, early detection and effective treatment of withdrawal symptoms or delirium, efforts are focused on adjusting ABCDEF bundle for the entire pediatric age group and on strengthening families' decision-making power, understanding parents as a resource for their child and involving them early in the care of their children.

Abstract Background Children with medical complexity (CMC) require the expertise of many care providers spanning different disciplines, institutions, and settings of care. This leads to duplicate health records, breakdowns in communication, and limited opportunities to provide comprehensive, collaborative care. The objectives of this study were to explore communication challenges and solutions/recommendations from multiple perspectives including (i) parents, (ii) HCPs – hospital and community providers, and (iii) teachers of CMC with a goal of informing patient care. Methods This qualitative study utilized an interpretive description methodology. In-depth semi-structured interviews were conducted with parents and care team members of CMC. The interview guides targeted questions surrounding communication, coordination, access to information and roles in the health system. Interviews were conducted until thematic saturation was reached. Interviews were audio-recorded, transcribed verbatim, and coded and analyzed using thematic analysis. Results Thirty-two individual interviews were conducted involving parents (n = 16) and care team members (n = 16). Interviews revealed 2 main themes and several associated subthemes (in parentheses): (1) Communication challenges in the care of CMC (organizational policy and technology systems barriers, inadequate access to health information, and lack of partnership in care) (2) Communication solutions (shared systems that can be accessed in real-time, universal access to health information, and partnered contribution to care). Conclusion Parents, HCPs, and teachers face multiple barriers to communication and information accessibility in their efforts to care for CMC. Parents and care providers in this study suggested potential strategies to improve communication including facilitating communication in real-time, universal access to health information and meaningful partnerships.

To shorten the hospital stay in preterm infants, it is important to understand the factors extending the length of stay. To understand how different discharge criteria affect the length of stay in preterm infants. A retrospective comparison study. Preterm infants born at 28 to 31 gestational weeks in 2020–2021 in a Level IV NICU in Japan (n = 22) and a Level III NICU in Finland (n = 49). We compared the most common last discharge criteria and the postmenstrual age (PMA) between the two NICUs. The potential extending effects of each discharge criterion on the length of stay were also evaluated. The discharge criteria were classified into six categories: temperature, respiration, feeding, examination, weight limit, and family readiness. The PMA at discharge was significantly higher in Japan than in Finland: median 40.7 (interquartile range 39.9–41.3) vs. 37.9 (36.9–39.0) weeks; r = 0.58; p < 0.001. The most common last discharge criterion was the family criterion in Japan (n = 19; 86 %) and the respiration criterion in Finland (n = 43; 88 %). In Japan, the length of stay was extended by 7.9 (standard deviation [SD] 7.0) days due to a lack of family readiness for discharge and 8.7 (SD 8.7) days due to not having discharged home with a feeding tube as a common practice. The length of stay of preterm infants in Japan could be notably reduced by supporting the parents' earlier readiness for discharge and allowing tube feeding at home. • The impact of discharge criteria on the length of stay was evaluated. • The length of stay in preterm infants was three weeks longer in Japan than Finland. • Lack of parents' readiness extended the hospital stay in Japan by 7.9 days. • Different feeding management extended the hospital stay in Japan by 8.7 days. • Family-centered care interventions could effectively shorten the length of stay. [ABSTRACT FROM AUTHOR]

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Abstract Background Parent-infant closeness during hospital care of newborns has many benefits for both infants and parents. We developed an educational intervention for neonatal staff, Close Collaboration with Parents, to increase parent-infant closeness during hospital care. The aim of this study was to evaluate the effectiveness of the intervention on parent-infant closeness in nine hospitals in Finland. Methods Parents of hospitalized infants were recruited in the hospitals during 3-month periods before and after the Close Collaboration with Parents intervention. The data were collected using daily Closeness diaries. Mothers and fathers separately filled in the time they spent in the hospital and the time of skin-to-skin contact with their infant during each hospital care day until discharge. Statistical analyses were done using a linear model with covariates. Results Diaries were kept before and after the intervention by a total of 170 and 129 mothers and 126 and 84 fathers, respectively. Either parent was present on average 453 min per day before the intervention and 620 min after the intervention in the neonatal unit. In the adjusted model, the increase was 99 min per day (p = 0.0007). The infants were in skin-to-skin contact on average 76 min per day before the intervention and 114 min after the intervention. In the adjusted model, skin-to-skin contact increased by 24 min per day (p = 0.0405). Conclusion The Close Collaboration with Parents intervention increased parents’ presence and skin-to-skin contact in nine hospitals. This study suggests that parent-infant closeness may be one mediating factor explaining benefits of parenting interventions. Trial registration ClinicalTrials.gov NCT04635150 . Retrospectively registered.

Abstract Background Parents of infants in neonatal intensive care units (NICUs) are often unintentionally marginalized in pursuit of optimal clinical care. Family Integrated Care (FICare) was developed to support families as part of their infants’ care team in level III NICUs. We adapted the model for level II NICUs in Alberta, Canada, and evaluated whether the new Alberta FICare™ model decreased hospital length of stay (LOS) in preterm infants without concomitant increases in readmissions and emergency department visits. Methods In this pragmatic cluster randomized controlled trial conducted between December 15, 2015 and July 28, 2018, 10 level II NICUs were randomized to provide Alberta FICare™ (n = 5) or standard care (n = 5). Alberta FICare™ is a psychoeducational intervention with 3 components: Relational Communication, Parent Education, and Parent Support. We enrolled mothers and their singleton or twin infants born between 32 0/7 and 34 6/7 weeks gestation. The primary outcome was infant hospital LOS. We used a linear regression model to conduct weighted site-level analysis comparing adjusted mean LOS between groups, accounting for site geographic area (urban/regional) and infant risk factors. Secondary outcomes included proportions of infants with readmissions and emergency department visits to 2 months corrected age, type of feeding at discharge, and maternal psychosocial distress and parenting self-efficacy at discharge. Results We enrolled 654 mothers and 765 infants (543 singletons/111 twin cases). Intention to treat analysis included 353 infants/308 mothers in the Alberta FICare™ group and 365 infants/306 mothers in the standard care group. The unadjusted difference between groups in infant hospital LOS (1.96 days) was not statistically significant. Accounting for site geographic area and infant risk factors, infant hospital LOS was 2.55 days shorter (95% CI, − 4.44 to − 0.66) in the Alberta FICare™ group than standard care group, P = .02. Secondary outcomes were not significantly different between groups. Conclusions Alberta FICare™ is effective in reducing preterm infant LOS in level II NICUs, without concomitant increases in readmissions or emergency department visits. A small number of sites in a single jurisdiction and select group infants limit generalizability of findings. Trial registration ClinicalTrials.gov Identifier NCT02879799 , retrospectively registered August 26, 2016.

Parental presence is believed to improve outcomes for infants hospitalized in the neonatal intensive care unit (NICU). As a result, NICU policies and procedures have evolved to support parental presence, and a growing number of studies examine the role of parental presence in the NICU. However, the measurement of parental presence is not standardized, complicating assessment of its impact on child and parent outcomes across studies. We reviewed 29 studies that presented 27 distinct methods of quantifying parental presence in the NICU and reported associations of presence with patient demographics, parental engagement in the NICU, and outcomes for both infants and parents. This overview provides a foundation for standardizing and improving routine measurement of parental presence in the NICU. Key Points NICUs encourage visiting ill newborns. Measurement of presence is not standardized. A uniform method to assess presence is needed. [ABSTRACT FROM AUTHOR]

Objectives: The caregiving experiences and unique health needs of male caregivers of children and youth with special health care needs (CYSHCN) are not well described. This study seeks to understand potential unmet health needs and attitudes toward supportive resources from the perspective of a sample of male caregivers of CYSHCN. Methods: This mixed-methods study recruited a convenience sample of 30 men with CYSHCN who receive care for a chronic medical condition from primary care medical homes in Pennsylvania. We conducted semi-structured interviews (SSI), administered quantitative surveys to caregivers, and produced a thematic analysis. The SSI explored the health needs of male caregivers, assessed attitudes toward and preferences regarding supportive resources, and garnered their advice to other caregivers regarding parenting and health care system navigation. Results: Participants' median age is 41 years (IQR: 33, 44), and most (80%) reside full time with their CYSHCN. Most male caregivers deprioritized their own emotional, mental, and physical health needs to support the needs of their families. Many male caregivers articulated interest in seeking emotionally supportive resources (not time-intensive). They advised other male caregivers to remain involved in the medical care and wellbeing of their CYSCHN and to openly seek and receive emotional support despite the daily challenges they face. Conclusions for Practice: Male caregivers of CYSHCN experience intense daily stress and express the need for emotionally supportive resources. Programs designed to facilitate such support may benefit from flexible formats (time and location) and involve male caregivers of CYSHCN as both facilitators and participants. [ABSTRACT FROM AUTHOR]

Abstract Background Family Centered Care (FCC) has been widely adopted as the framework for caring for infants in the Neonatal Intensive Care Unit (NICU) but it is not uniformly defined or practiced, making it difficult to determine impact. Previous studies have shown that implementing the Family Integrated Care (FICare) intervention program for preterm infants in the NICU setting leads to significant improvements in infant and family outcomes. Further research is warranted to determine feasibility, acceptability and differential impact of FICare in the US context. The addition of a mobile application (app) may be effective in providing supplemental support for parent participation in the FICare program and provide detailed data on program component uptake and outcomes. Methods This exploratory multi-site quasi-experimental study will compare usual FCC with mobile enhanced FICare (mFICare) on growth and clinical outcomes of preterm infants born at or before 33 weeks gestational age, as well as the stress, competence and self-efficacy of their parents. The feasibility and acceptability of using mobile technology to gather data about parent involvement in the care of preterm infants receiving FCC or mFICare as well as of the mFICare intervention will be evaluated (Aim 1). The effect sizes for infant growth (primary outcome) and for secondary infant and parent outcomes at NICU discharge and three months after discharge will be estimated (Aim 2). Discussion This study will provide new data about the implementation of FICare in the US context within various hospital settings and identify important barriers, facilitators and key processes that may contribute to the effectiveness of FICare. It will also offer insights to clinicians on the feasibility of a new mobile application to support parent-focused research and promote integration of parents into the NICU care team in US hospital settings. Trial registration ClinicalTrials.gov, ID NCT03418870. Retrospectively registered on December 18, 2017.

Objective: We implemented an online visitation system named "telepresence" in the neonatal intensive care unit (NICU) for family members at home to communicate with their babies in real-time using video and audio. This study evaluated the impact of this system on families and medical staff., Methods: Nineteen families of babies admitted to the NICU between 2022 and 2023 and 65 medical staff participated. Each family experienced two weeks of virtual visits. Changes in parental depression and attachment were assessed., Result: Before and after telepresence, the median Edinburgh Postnatal Depression Scale score reduced from 6 to 4 ( p  = 0.026), and the Mother-to-Infant Bonding Scale score showed a decreasing trend, with both medians at 2 ( p  = 0.057). Eighty-nine percent of the parents and 97% of staff reported that telepresence did not increase parental stress, and 88% of parents felt positive changes in their baby's siblings. All parents wanted to visit their babies in person after seeing them on camera., Conclusion: Telepresence improved parental mental health, reduced family distress, and supported connection with their infants, making them eager to visit in person., Innovations: This technology potentially make parents want to visit more by helping them feel more connected to their infants., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors. Published by Elsevier B.V.)

Problem: Family‐centered care (FCC) is a concept used to describe an approach to caring for children and their families within health services. This study compared mothers and nurses' perceptions of barriers to FCC. Methods: This cross‐sectional study was conducted in an educational hospital affiliated to Kerman University of Medical Sciences at the southeast of Iran in 2019. Using a researcher‐designed questionnaire, we assessed mothers' and nurses' perceptions of barriers to FCC with a census method (60 nurses and 82 mothers). Findings: Mothers (49.8 ± 21.1) and nurses' (49.2 ± 16.4) mean scores of the perception of FCC barriers were at a moderate level. No significant difference was found between mothers' and nurses' perceptions of barriers to FCC. A significant relationship was observed between age, child's admission history, and the perception of FCC barriers in the mothers' group. Conclusion: Findings suggest that national and regional policies of educational hospitals should assess factors contributing to the FCC barriers, focus on how to reduce these barriers, and provide appropriate collaborative care by nurses and the family of patients. [ABSTRACT FROM AUTHOR]