Nurses’ Lived Experiences of Family-Centered Care in Neonatal Intensive Care Unit: A Hermeneutic Phenomenological Study.

Abstract

Introduction: NICU nurses have most important role in parents’ emotional support and implementing family-centered care (FCC) in the field of neonates. Recognizing and understanding nurses’ experiences can provide invaluable information to assist policy makers in decision makings around establishing FCC approach in NICUs of our country. The aim of this study was to explore the lived experiences of NICU nurses about FCC implementation. Methods: This qualitative study was conducted based on hermeneutic phenomenological approach. The study settings were 3 separate NICUs in three teaching hospitals affiliated with Tabriz University of Medical Sciences, which are the main referral centers for preterm infants located in the North-west of Iran. Eleven employed nurses with at least 3 years of work experiences in NICU participated in the study. The data were collected using semi-structured interviews and writing field notes during 11 months. For better managing, the data were entered in Word software and then analyzed using the seven-stage Diekelmann, Allen and Tanner approach (1989). Findings: Seven main themes were extracted from NICU nurses’ experiences on FCC including: “Mother’s centrality in the care chain”, “Father: the neglected ring of the care chain”, “Caring as walking on an insecure foundation”, “Disturbed calmness”, “Struggling with a tangled skein”, “Nourishing the seedling of incorporation” and “Towards the bright horizon”. Investigating relationship between main themes finally lead to the emergence of two constructive patterns. The first pattern entitled: “A chain with one dominant ring” unveiled the way of family members’ participation in caregiving to the infant. The second pattern entitled: “Amalgamation of hardship and satisfaction” shaped the structure of nurses’ experiences on FCC in NICU. Conclusion: Implementing FCC in the present condition of our country is challenging for nurses. Family members’ incomplete participation as fathers’ insensible role in caregiving to the infant and nurses’ complicated experiences in engaging parents indicated the interfering sociocultural factors and structural and managerial deficiencies. Systematic and warranted implementation of FCC in NICUs of Iran requires health officials and policymakers’ serious support.