Participatory Action Research in the Field of Neonatal Intensive Care: Developing an Intervention to Meet the Fathers' Needs. A Case Study

Betty Noergaard, Helle Johannessen, Jesper Fenger-Gron, Poul-Erik Kofoed, Jette Ammentorp, Betty Noergaard, Helle Johannessen, Jesper Fenger-Gron, Poul-Erik Kofoed, Jette Ammentorp

Abstract

Background: In neonatal intensive care units (NICUs) health care professionals typically give most of their attention to the infants and the mothers while many fathers feel uncertain and have an unmet need for support and guidance. This paper describes and discusses participatory action research (PAR) as a method to improve NICUs' service for fathers. Our goal is to develop a father-friendly NICU where both the needs of fathers and mothers are met using an approach based on PAR that involves fathers, mothers, interdisciplinary healthcare professionals, and managers.

Design and methods: This PAR process was carried out from August 2011 to July 2013 and included participant observations, semi-structured interviews, multi sequential interviews, workshops, focus groups, group discussion, and a seminar. The theoretical framework of validity described by Herr and Anderson's three criteria; process-, democratic-, and catalytic validity were used to discuss this PAR.

Results: Twelve fathers, 11 mothers, 48 health professionals and managers participated in the PAR process. The collaboration ensured the engagement for viable and constructive local changes to be used in designing the concept of the father friendly NICU.

Conclusions: This paper contributed new knowledge of how PAR can be used to ensure that participants engaged in the field are involved in the entire process; consequently, this will ensure that the changes are feasible and sustainable.

Keywords: father; participatory design; patient involvement; quality improvement.

Conflict of interest statement

the authors declare no potential conflict of interest.

Figures

Figure 1.
Figure 1.
The activities and the researchers involved in the PAR process. Primary investigator (BN) was in charge of the activities which are marked with blue colours, the master student in the green activities and the service designer in red activities.

References

    1. Provenzi L, Santoro E. The lived experience of fathers of preterm infants in the Neonatal Intensive Care Unit: a systematic review of qualitative studies. J Clin Nurs 2015;24:1784-94.
    1. Reinicke K. Drenge og mænd i krise? Perspektiver og indsatsområder. Hans Reitzels Forlag, København: 2012.
    1. Arockiasamy V, Holsti L, Albersheim S. Fathers’ experiences in the neonatal intensive care unit: a search for control. Pediatrics 2008;121:e215-22.
    1. Hynan MT. Supporting Fathers during stressful times in the nursery: an evidence-based review. Newborn Infant Nurs Rev 2005;5:87-92.
    1. Ahn YM, Kim NH. Parental Perception of neonates, parental stress and education for NICU parents. Asian Nurs Res 2007;1:199-210.
    1. Gimenez EC, Sanchez-Luna M. Providing parents with individualised support in a neonatal intensive care unit reduced stress, anxiety and depression. Acta Paediatr 2015;104:e300-5.
    1. Kaaresen PI, Ronning JA, Ulvund SE, Dahl LB. A randomized, controlled trial of the effectiveness of an early-intervention program in reducing parenting stress after preterm birth. Pediatrics 2006;118:e9-19.
    1. Maguire CM, Bruil J, Wit JM, Walther FJ. Reading preterm infants’ behavioral cues: an intervention study with parents of premature infants born <32 weeks. Early Hum Develop 2007;83:419-24.
    1. Matricardi S, Agostino R, Fedeli C, Montirosso R. Mothers are not fathers: differences between parents in the reduction of stress levels after a parental intervention in a NICU. Acta Paediatr 2013;102:8-14.
    1. Melnyk BM, Feinstein NF, Alpert-Gillis L, et al. Reducing premature infants’ length of stay and improving parents’ mental health outcomes with the Creating Opportunities for Parent Empowerment (COPE) neonatal intensive care unit program: a randomized, controlled trial. Pediatrics 2006;118:e1414-27.
    1. Ravn I, Lindemanna R, Smebyb NA, et al. Stress in fathers of moderately and late preterm infants: a randomised controlled trial. Early Child Develop Care 2012;537-52.
    1. Weis J, Zoffmann V, Greisen G, Egerod I. The effect of person-centred communication on parental stress in a NICU: a randomized clinical trial. Acta Paediatr 2013;102:1130-6.
    1. Ireland J, Minesh K, Cescutti-Butler L, et al. Experiences of fathers with babies admitted to neonatal care units: a review of the literature. J Neonat Nurs 2016;22:171-6.
    1. Fegran L, Helseth S, Fagermoen M. A comparison of mothers’ and fathers’ experiences of the attachment process in a neonatal intensive care unit. J Clin Nurs 2008;17:810-6.
    1. Lundqvist P, Westas L, Hallstrom I. From distance toward proximity: fathers lived experience of caring for their preterm infants. J Pediatr Nurs 2007;22:490-7.
    1. Pohlman S. Fathering premature infants and the technological imperative of the neonatal intensive care unit: an interpretive inquiry. ANS Adv Nurs Sci 2009;32:E1-16.
    1. Ignell Mode R, Mard E, Nyqvist KH, Blomqvist YT. Fathers’ perception of information received during their infants’ stay at a neonatal intensive care unit. Sex Reprod Healthc 2014;5:131-6.
    1. Pohlman S. The primacy of work and fathering preterm infants: findings from an interpretive phenomenological study. ANS Adv Nurs Sci 2005;5:204-16.
    1. Lindberg B, Axelsson K, Ohrling K. Adjusting to being a father to an infant born prematurely: experiences from Swedish fathers. Scand J Caring Sci 2008;22:79-85.
    1. Johnson AN. Engaging fathers in the NICU: taking down the barriers to the baby. J Perinat Neonatal Nurs 2008;22:302-6.
    1. Discenza D. Dads of premature infants are important too. Neonatal Netw 2010;29:125-6.
    1. Mundy CA. Assessment of family needs in neonatal intensive care units. Am J Crit Care 2010;19:156-63.
    1. Reason P, Bradley RH. Introduction. Reason P, Bradbury H, eds. The SAGE Handbook of Action Research Participatory Inquiry and Practice. Thousand Oaks, CA: Sage; 2008. pp 1-10.
    1. Herr K, Anderson GL. The Action Research Dissertation: a Guide for Students and Faculty. Thousand Oaks, CA: Sage; 2015.
    1. Bergold J, Thomas S. Participatory research methods: a methodological approach in motion. Forum Qualitative Sozialforschung/Forum: Qualitative Social Research, 13(1) Art 30, 2012. Available from:
    1. Committee AAoP. Levels of neonatal care. Pediatrics 2012;130:587-97.
    1. Emerson R, Fretz RI, Shaw LL. Writing Ethnographic Fieldnotes. Chicago: Chicago University Press; 1995. pp 1-16.
    1. Hammersley M, Atkinson P. Research design: problems, cases, and samples. Ethnography: Principles in Practice. New York: Routledge; 2007. pp 20-40.
    1. Brinkmann S, Tanggaard L. Kvalitative Metoder: En Grundbog. Hans Reitzels Forlag; 2010.
    1. Kvale S. Interview. En introduktion til det kvalitative forskningsinterview Hans Reitzels Forlag. 1997.
    1. Oliffe J, Mróz L. Men interviewing men about health and illness: ten lessons learned. J Men Health Gender 2005;2:257-60.
    1. Charmaz K. Qualitative interviewing and grounded theory analysis. Gubrium JF, Holstein JA, eds. Handbook of interviewing reseach. Context and method. Thousand Oaks: Sage; 2002.
    1. Halkier B. Fokusgrupper. [Focus Groups]. Samfundslitteratur & Roskilde Universitetsforlag, Narayana Press, Gylling: 2002. Danish.
    1. Sanders EBN, Brandt E, Binder T. A framework for organizing the tools and techniques of participatory design. Proceeding: PDC ‘10 Proceedings of the 11th Biennial Participatory Design Conference. 2010;195-8.
    1. Swantz M. Participatory action research as practice. Reason P, Bradbury H. The SAGE Handbook of Action Research Participatory Inquiry and Practice. Thousand Oaks: Sage; 2008. pp 31-48.
    1. Craig P, Dieppe P, Macintyre S, et al. Developing and evaluating complex interventions:the new Medical Research Council guidance. BMJ 2008;25:979-83.
    1. Brydon-Miller M. Ethics and Action research: deepining our commitment to principles of social justice and redefining systems af democratic practice. Reason P, Bradbury H. The SAGE Handbook of Action Research Participatory Inquiry and Practice. Thousand Oaks: Sage; 2008. pp 199-210.
    1. Rahman MA. Some Trends in the Praxis of Particpatory Action Research. I Reason P, Bradbury H. The SAGE Handbook of Action Research Participatory Inquiry and Practice. Thousand Oaks: Sage; 2008. pp 49-62.
    1. Reinicke K. Den hele mand – manderollen i forandring. Det Schønbergske Forlag; 2002.

Source: PubMed

3
구독하다