A framework synthesis reviewing the impact of neonatal care unit admission on early caregiver–infant relationships. (15th October 2020)

• Record Type: Journal Article
• Authors: Carton, Amelia Myri; Cordwell, Jacinta; Steinhardt, Karen
• Is Part Of: Journal of advanced nursing. Volume 76:Number 12(2020)
• Page Start: 3258
• Page End: 3272
• Publication Date: 2020-10-15
• Subjects: attachment -- bonding -- caregivers -- framework synthesis -- neonatal care -- nursing -- qualitative meta‐synthesis -- systematic review; Nursing -- Periodicals; 610.7305
• DOI: 10.1111/jan.14538
• Languages: English
• ISSNs: 0309-2402

Abstract

Abstract: Aims: To critically review and synthesize qualitative research pertaining to the establishment of early caregiver–infant relationships in the neonatal care unit (NCU). Background: It is well‐established that bonding and attachment, established across the prenatal and early childhood periods, affect child cognitive and behavioural development. Proximity, reciprocity, and commitment are key to the formation of these early relationships. It is intuitively likely that an admission to the NCU may affect early reciprocal caregiver–infant relationships. Design: A qualitative best‐fit framework synthesis. Data sources: A systematic search of four databases (PsycINFO, MEDLINE, British Nursing Index and CINAHL) was conducted, from January 2000–December 2018. Review Methods: The RATS quality appraisal tool was used to evaluate study quality. To ensure reliability, 20% of studies were randomly selected for independent rating. A "best‐fit" synthesis approach using an existing framework of early parent–infant attachment and bonding was adopted to synthesize the review findings. Findings: Twenty studies, from an original 3, 526 unique articles, were included in the review. Studies varied in the extent to which they demonstrated transparency of procedures and in the quality of recruitment information provided. The meta‐synthesis demonstrated that proximity, reciprocity, and commitment were affected by admission to a NCU and identified that parental reflections on bonding and the role of staff in this process, were important factors to consider. Conclusions: Caregiver–infant relationships are affected by admission to the NCU. The review theoretically supports moves to Family Integrated Care. Units should evaluate caregiver emotional state and consider the role of peer support. Impact: The synthesis revealed that areas typically implicated in the formation of attachment and bonds were affected by admission to a NCU. Results have implications on the clinical care delivered as part of neonatal care. 摘要: 目的: 为了严格审查和汇总有关在新生儿监护病房(NCU)建立早期护理者与婴儿关系的定性研究 背景: 众所周知, 在产前和幼儿期建立的纽带和依恋关系会影响儿童的认知和行为发展。亲近、相互作用和承诺是形成这些早期关系的关键。直观地看, 入住新生儿监护病房可能会影响早期相互作用的护理者与婴儿的关系。 设计: 最佳拟合的定性综合框架。 数据来源: 2000年1月至2018年12月期间, 对4个数据库(PsycINFO、MEDLINE、British Nursing Index和CINAHL)进行了系统检索。 审查方法: 采用RATS质量评价工具对研究质量进行评估。为确保可靠性, 随机选择20%的研究进行独立评级。采用"最佳拟合"综合方法, 利用现有的父母‐婴儿早期依恋和纽带框架, 对审查结果进行汇总。 调查结果: 审查中包括了20项研究(来自最初的3526篇独特文章)。各项研究在表明程序的透明度和提供的招聘信息的质量方面各不相同。荟萃综合研究表明, 入住新生儿监护病房会对亲近、相互作用和承诺造成一定影响, 并确定"父母对纽带关系的反思以及工作人员在这一过程中的角色"是需要考虑的重要因素。 结论: 入住新生儿监护病房会对护理者与婴儿的关系造成一定影响。审查从理论上支持转向家庭综合护理。监护病房应评估护理者的情绪状态, 并考虑同伴支持的作用。 影响: 综合显示, 通常牵涉到依恋和纽带关系形成的区域受到入住新生儿监护病房的影响。这些结果对作为新生儿护理的一部分而提供的临床护理具有影响。