Fathers' Experiences of Family Integrated Care in The Neonatal Unit: a Systematic Review Study

Abstract

Objectives This systematic review aimed to examine any primary research reporting on the fathers' experiences of familyintegrated care in a neonatal unit (NU). Methods The protocol was registered on the PROSPERO database. 1 Eligibility criteria included primary research published after 2000 until October 2022. The studies needed to include at least 50% fathers and a minimum of 5 participants (qualitative studies welcomed) to ensure father-specific results would be reported. The database and trial registries were searched (KB). Then two independent researchers (RR & VP) screened the records at abstract and full-text level with disagreements resolved through discussion and third researcher mediation (NA). Data extraction was conducted using the Matrix Method.2 Results 306 records were identified from 7 databases and 2 trial registries (figure 1).3 10 records were included in the systematic review. The 3 qualitative studies all used semi-structured post-discharge interviews. The 7 quantitative studies used a combination of 13 different questionnaires. 448 fathers with 479 infants, from 25 NUs were included. Overall, when reported, 93.6% of fathers identified with the local culture/language, 98.1% were married/cohabiting with the mother and 86.0% were employed. The babies primarily required high-dependency or special care at the time of recruitment and were moderate to late preterms. The Parental Stressor Scale: Neonatal Intensive Care Unit (PSS:NICU) shows that FICare helped fathers assume their paternal role and reduce stress from the 'Relationship and Parental Role' domain p<0.001. Paternal self-efficacy/sense of competence and bonding appeared to be unchanged by FICare programmes. However, satisfaction was improved by some programmes. FICare also promoted better staff-parent communications (p<0.001) and collaborations. Increased involvement via single family rooms meant that fathers understood the 'unrelenting work' of breastmilk feeding their infant and were more present (p<0.001). Educational programmes significantly improved paternal 'Knowledge of Preterm Infant Behaviour' (p<0.001) and attachment (p<0.001), however no improvement in 'neonatal perception index' or stress as per PSS:NICU was seen in work from one Korean paper. Conclusion FICare helps fathers to be more present for their HDU/SCBU babies and develop a more satisfactory relationship and communication with neonatal staff. FICare reduces paternal stress, particularly in relation to their parental role, and understanding their infants' appearance and behaviour. However, further research is needed to explore the experiences of fathers of extremely premature babies and fathers from diverse backgrounds.