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Mazlan N.M.1, Sherwood S.-A.1
1KK Women's and Children's Hospital, Physiotherapy, Singapore, Singapore
Background: Increasing survival rates of premature infants has shifted medical focus from prolonging survival to improving quality of life. Many studies have recognised the influence of parents in hastening the recovery of these fragile infants, bringing about a faster weight gain and lesser infections thus reducing hospitalisation. Parents are also observed to be more competent and confident in handling their infants.
Purpose: Family integrated care (FIC) is a predominantly western trialled concept where parents are more involved in caring for their infant. The purpose of this ongoing pilot project is to primarily assess its effects on parental stress, parental competency and service satisfaction within a culturally diverse group having distinct postnatal traditions. Secondly, it seeks to determine if FIC reduces length of stay, recurrent admissions and improves long term neurodevelopmental outcomes of these premature infants.
Methods: This project is being piloted in the largest childrens hospital in Singapore and South East Asia.
All very low birth weight infants i.e. infants born at less than 37 weeks gestational age and weighing 1500 grams and less at birth are eligible for recruitment. Informed consent is taken one week after NICU admission or when medically stable. If consented, they are enrolled in the project until discharge or up to a maximum of 75 days of hospitalisation.
Parents are required to provide in-unit caregiving for at least 20 hours a week and attend weekly education sessions conducted by various medical and allied health professionals. Parents are also given a journal to document their infants journey or note important points during education sessions.
Parents are given two questionnaires to fill in upon enrolment- the Parental Stress Scale NICU version and Parental Sense of Competency. Prior to discharge they are required to complete the same two questionnaires with an additional Measure of Processes of Care.
Results: To date, there are 6 families enrolled into the FIC pilot project with 2 families having completed. The targeted number of participants is 40 over one year.
Preliminary results indicate that 60% of families initially approached for participation were unable to begin within the first month of admission because of confinement - a tradition where women are typically required to stay indoors in order to recuperate post-delivery. A further 30% were unable to commit to the hours because of early return to work or other family commitments.
Results of the questionnaires completed by these families are awaiting data analysis.
Conclusion(s): This project shows that the FIC model can be implemented in an acute hospital serving a diverse population but requires some modifications to meet their needs. Among the considerations are removing designated visiting hours to accommodate parents who are returning to work and allowing grandparents who would typically be considered integral to the family unit in Singapore to participate in the care of the baby during confinement periods.
Implications: FIC should be implemented in all neonatal units as the benefits are not only for parents and infants, but extended to the hospital and community as well.
Funding acknowledgements: KKH Neonatal Department
Topic: Paediatrics
Ethics approval: Centralised Institutional Review Board, Singapore Health Services
All authors, affiliations and abstracts have been published as submitted.
