Enhancing Parents' Well-Being after Preterm Birth-A Qualitative Evaluation of the "Transition to Home" Model of Care.

There are few programs available aimed at preventing short- and long-term negative consequences after preterm birth and covering the entire care continuum. The "Transition to Home (TtH)" model is such a program, offering structured, individual support for families with preterm infants before and after hospital discharge. This study gathers and examines the parents' views of receiving support from an interprofessional team under the TtH model of care during hospitalization and after discharge. Using a qualitative explorative design, 39 semi-structured interviews with parents were analyzed thematically. From this analysis, three main themes were identified: (1) TtH and the relevance of continuity of care; (2) Enhancement of parents' autonomy and self-confidence; (3) Perception of interprofessional collaboration. Within these themes, the most relevant aspects identified were continuity of care and the appointment of a designated health care professional to anchor the entire care continuum. Emotional support complemented by non-medical approaches, along with strength-based and family resource-oriented communication, also emerged as key aspects. Continuous, family-centered care and well-organized interprofessional collaboration promote the well-being of the family after a premature birth. If the aspects identified in this study are applied, the transition from hospital to home will be smoothened for the benefit of affected families.

Interprofessional Collaboration in a New Model of Transitional Care for Families with Preterm Infants - The Health Care Professional's Perspective.

BACKGROUND: Families with preterm infants find life after hospital discharge challenging and need tailored support to thrive. The "Transition to Home (TtH)"-model offers structured, individual support for families with preterm infants before and after hospital discharge. TtH improves parental mental health and competence, promotes child development and fosters interprofessional collaboration (IPC). AIM: Evaluate the TtH-models' structure and implementation process and its associated interprofessional collaboration from the healthcare professional's (HCP) perspective. METHODS: This qualitative explorative study thematically analyzed four focus group interviews (n=28 HCP) and an open-ended questionnaire with general pediatricians (n=8). RESULTS: The main themes of the thematic analysis were the benefits of the TtH-model, tailored parental support, the challenges of changing interprofessional collaboration, facilitators and barriers to successfully implementing the model, and feasibility and health economic limits. HCP acknowledge that continuous family-centered care led by an advanced practice nurse (APN) supports, strengthens, and relieves families with preterm infants in the transition from hospital to home. Families in complex situations benefit most. The TtH-model incorporates key aspects of integrated care like shared decision-making, considering family preferences, and defining the APN as the family's main contact. HCP want network collaboration but found communication, cooperation, and reorganization challenging in the new IPC process. IPC challenges and involving many HCP in family care can create parental oversupply, negatively affect treatment outcomes, and raise health care costs. CONCLUSION: These challenges need to be addressed to ensure sustainable implementation of the model. The roles and tasks of HCP should be clearly distinguished from each other, and HCP must have time to learn this new form of IPC. Learning requires time, effective communication strategies, and leadership support. Political action is also required to implement new models of care, including regulating advanced practice roles and developing new financing models.

Comparative Evaluation of Parental Stress Experiences Up to 2 to 3 Years After Preterm and Term Birth.

BACKGROUND: Parenting stress after preterm birth (PTB) has negative long-term effects on parenting. Research about parental experiences after PTB and on parenting stress in early childhood has focused on mothers. PURPOSE: To compare parenting stress between mothers and fathers 2 to 3 years after PTB and full-term birth (FTB) and to explore their memories about their stress experience, especially after PTB. METHODS: Fifty-four mothers and fathers in Switzerland whose children were PTB and 65 parents of FTB completed the Parenting Stress Index 2 to 3 years after birth. We compared scores between PTB and FTB and between mothers and fathers. A random subset of parents took part in semistructured interviews that began with photo-elicitation. We analyzed the data thematically. We cross-validated and corroborated qualitative and quantitative findings about parenting stress 2 to 3 years after birth. RESULTS: Preterm birth is stressful for parents who cannot take a child's health for granted, but stress experiences after FTB and PTB equalize within 2 to 3 years. Mothers were the primary caregivers and suffered more stress than fathers. For parents with PTB, positive communications from healthcare workers strengthened parental coping in neonatal intensive care unit and after discharge, but parents perceived discharges as early and inconsistent. IMPLICATIONS FOR PRACTICE AND RESEARCH: Interventions and new models of care improving communication with healthcare professionals, involving parents in infant care as early as possible, increasing staff support to help parents cope better, and optimizing the management of discharge need to be implemented into practice. Their impact on parenting stress on the long term needs to be investigated.