Understanding barriers to collaboration between parents and healthcare professionals in the care of premature children

Abstract

Background: Parental closeness and relationship with premature children is acknowledged as a key element of positive child development. In hospital this proximity is often impeded by the way healthcare is provided and rooted in a perception of medical care delivery. Our objective was to understand parents’ and healthcare professionals’ (HCPs) perceptions regarding a potential involvement of parents in the medical decision process. Methods: Thematic secondary analyses of semi-structured interviews conducted with 20 fathers of premature children admitted in a neonatology intensive care unit (NICU), and 12 HCPs from the same unit were used to address collaboration issues between stakeholders. Two questionnaires surveys, which addressed parental involvement in nursing care and healthcare plan discussion at medical round, were also conducted with 35 families and 54 HCPs of the same NICU. Findings: Qualitative analyses show that parents and HCPs understand the importance of parental role in the healthcare of the child. However, parents perceive they are insufficiently supported by HCPs; and HCPs often feel judged by parents. Quantitative analyses show that even if 91% of parents reported they would like to participate in medical round, 40% “never/rarely†attend it. A majority of HCPs admitted parental attendance as beneficial for parents (67%) and for them (62%). Conversely, a majority perceived that parental attendance at medical round would: inhibit some discussions between staff (81%) increase round duration (77%) and generate anxiety in parents (64%). Discussion: This mixed method research suggests a need to use behaviour change theories to implement new healthcare practices.