Healthcare practitioners’ experiences and relationship issues in the neonatal intensive care unit context

Abstract

Background: Breastfeeding and skin-to-skin contact are key determinants in the care of premature infants. Thus, parents become key actors and care partners in neonatal intensive care units (NICU). Also, parents feel extremely vulnerable in this context, and are in need of support from health professionals. In turn, NICU healthcare practitioners (HCPs) are highly exposed to stressful and difficult situations. Objectives are to understand how HCPs perceive parents, as well as to explore practices and issues encountered throughout the care of premature babies and the support of families. Methods: A qualitative study was carried out in a NICU in Brest university hospital, France. Semi-structured interviews were conducted with 26 HCPs, including physicians, residents, nurses, healthcare managers, and a social worker, all of whom worked in the unit. Interviews were analysed using Alceste textual data analysis software. Findings: The Alceste program produced a dendogram showing two main networks of classes. The first one focuses on HCPs’ practices, along with their descriptions of the babies’ difficulties and the issues encountered by parents (e.g., breastfeeding, skin-to-skin contact). The second one focuses on the difficulties that HCPs have in dealing with traumatic experiences, misrepresentations of premature babies, and relationships with parents. Sharing emotions, receiving support from others as well as gaining respite are some coping strategies used by HCPs to face painful experiences. Discussion: Understanding HCPs experiences and perceptions in a NICU allows to enhance healthcare and HCPs’ wellbeing. It also helps to adequately support families.