Experiences of the Iranian Neonatal Intensive Care Unit Nurses in Implementing Family-Centered Care: Walking on an Insecure Foundation

Abstract

Background: Most of the nurses have accepted family-centered care (FCC) as a standard model of care; however, they meet difficulties using this model. The aim of this study was to explore the perception of Neonatal Intensive Care Unit (NICU) nurses about the implementation of FCC. Methods: This qualitative study was carried out on 11 in-service NICU nurses with at least three years of work experience using an interpretative phenomenological approach. The study setting was three separate NICUs of three teaching hospitals affiliated with Tabriz University of Medical Sciences, Tabriz, Iran. Data collection was performed through semi-structured interviews and field notes. The data were analyzed using the seven-stage Diekelmann, Allen, and Tanner approach. Results: One of the important themes emerging in this study was "Walking on an insecure foundation" that included three subthemes of "Inappropriate base", "A pathway with no lines" and "Unequal encounter". The nurses described a lack of facilities, inadequate space, and staff's specific instruction in encouraging parents' engagement, as well as high work pressure due to short staffing as factors that affected their ability to provide an ideal FCC. Conclusion: As the findings indicated, the lack of essential substructures and absence of a systematic program to engage parents in the care process of their infants have resulted in different operations by the nurses and discontinuous FCC implementation in NICUs. Officials and policy-makers should consider basic requirements, adequate workforce, and explicit guidelines to contextualize and guarantee the continuity of FCC.