Shifting healthcare of premature children from a paternalistic to a family- centered-care approach

Abstract

Background: Parent role in the development of premature children is acknowledged. Family-centered-care (FCC) approach supports parental involvement in the care of their baby by fostering respect and dignity, parent participation in the care and decisions concerning the baby, information sharing, and collaboration with professionals. Nevertheless, a paternalistic approach, which lets little room for parents, is generally applied in neonatology intensive care unit (NICU) in France. Our objective is to implement FCC in a French NICU to improve quality of healthcare. Methods: We chose the Intervention Mapping (IM) protocol, because changing healthcare delivery approach is complex and deserves an ecological perspective. IM provides tools to select social and behavioural sciences theories, bridge these theories with practice, develop and plan programme implementation and evaluation. IM involves multiple stakeholders to address the six-stages of the protocol. Preliminary results: At first stage, a needs assessment, using focus groups, interviews, quantitative surveys of professionals and parents, and literature search, was conducted .It stressed that emotional status of parents, interpersonal and organisational aspects, which facilitate parental presence and involvement in healthcare, are necessary to consider for improving children care. Finally, it helped listing parental behaviours, environmental conditions and behaviours that need to be modified. Current stage of work: The second stage has begun with a definition of multilevel objectives to implement FCC. Discussion: For the first time the IM protocol is used in France to implement change in healthcare delivery. First conclusion is promising, making the IM protocol relevant to change healthcare approach in NICU.