| Abstract [eng] |
Neonatal intensive care units are a specific healthcare environment in which effective collaboration between parents, nurses, and physicians is an essential condition for high-quality neonatal care. Although collaboration between healthcare personnel and parents in neonatal intensive care units has been studied, only limited research internationally – and none in Lithuania – has examined collaboration among all three groups: parents, nurses, and physicians. The aim of the study was to determine the experiences of collaboration between parents, nurses, and physicians in the process of neonatal care in neonatal intensive care units. The objectives of the study were: 1. To identify the factors influencing partnership between parents, nurses, and physicians in the process of neonatal care in neonatal intensive care units. 2. To reveal the experiences of parents, nurses, and physicians related to the distribution of roles in the process of neonatal care in neonatal intensive care units. 3. To determine the experiences of parents, nurses, and physicians related to the coordination of neonatal care in neonatal intensive care units. Research methods. A qualitative research method based on a phenomenological approach was applied. Data were collected through semi-structured interviews with 22 participants: 8 nurses, 7 neonatologists, and 7 parents whose newborns were treated in neonatal intensive care units. Data were analyzed using inductive qualitative content analysis. Research results. The findings revealed that collaboration in neonatal intensive care units is a complex process shaped by three main dimensions: partnership, role distribution, and care coordination. It was found that partnership is not equal, as parents’ involvement is mostly limited to daily nursing activities, while physicians dominate decision-making processes. Trust between parents and healthcare professionals depends on communication and consistency of information. Although the distribution of roles is formally defined, in practice it is not always clear, and physician leadership has a significant influence on the involvement of other participants. Care coordination is not consistent, as separate shift handovers between nurses and physicians lead to inconsistent information sharing among team members. It was also found that emotional support for parents depends more on individual nurses’ initiative than on systematic organizational solutions. Conclusions: 1. The following factors influencing partnership were identified: opportunities for parents to be involved in daily neonatal care and decision-making, communication between parents and healthcare professionals, clarity and consistency of information, trust, and professional hierarchy. Parents are usually involved in daily nursing care; however, their participation in decision-making remains limited. 2. The study revealed hierarchically distinct roles among team members in neonatal intensive care units: physicians were mainly responsible for clinical decision-making, nurses for the daily care of the newborn and communication with parents, while parents were involved in practical nursing activities but not in treatment or care decision-making. 3. It was found that care coordination is characterized by inconsistent information sharing among team members, while emotional support for parents mostly depends on individual specialists’ initiative rather than consistently organized teamwork. Keywords: family-centered care, family integrated care, neonatal intensive care unit, parental involvement, interprofessional collaboration, communication. |
