Experiences and Perceptions of Hospital to Home Transitional Care for Parents of Premature Infants in Neonatal Intensive Care Unit: A Qualitative Meta-Synthesis

早产儿父母在新生儿重症监护室接受医院到家庭过渡护理的经验和看法:一项定性元综合研究

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Abstract

AIMS: To understand the experiences of parents of preterm infants as their babies transition from the neonatal intensive care unit (NICU) to home. DESIGN: A qualitative meta-synthesis. REVIEW METHODS: This review followed the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) checklist, focusing on studies exploring parental experiences during NICU-to-home transitions. A thematic synthesis approach was applied to analyse and interpret findings. DATA SOURCES: Five English-language databases (PubMed, Embase, CHNAHL, Cochrane Library, Web of Science) and three Chinese databases (CNKI, VIP, and Wanfang) were searched from inception until January 2024. Selected studies were critically appraised for quality. RESULTS: The synthesis identified five major themes based on the Meleis Transition Theory: (1) Nature of Transition: challenges in environmental and role changes, (2) Transition Conditions: Support Systems: the need for diverse and sustained support; Unmet Needs: a lack of spiritual, emotional, and informational support, (3) Patterns of Response: growth and adaptation alongside the infant, and (4) Nursing Therapeutics: reliance on healthcare teams for support and guidance. CONCLUSION: Parents of preterm infants experience significant emotional challenges and unmet needs during the transition from hospital to home. In particular, spiritual support, emotional guidance, and diverse support structures are essential yet often overlooked. IMPLICATION FOR THE PROFESSION AND/OR PATIENT CARE: Healthcare professionals should recognise parents' unique spiritual and emotional needs when transitioning their preterm infants from the NICU to home. Providing targeted guidance, resources, and support can reduce parental distress and promote a more positive adaptation process. IMPACT: What problem did the study address?: The transition from NICU hospitalisation to home is an emotional and uncertain process for parents of preterm infants. This study synthesises qualitative data to explore the parents' experiences during this transition and to understand their coping styles and needs. What were the main findings?: The review emphasises the difficulties parents encounter when transitioning to caring for preterm infants and the significance of spiritual care during the peri-discharge phase. It recommends that NICUs offer discharge preparation services and ongoing support to facilitate parental adaptation and promote the healthy development of preterm infants post-discharge. Where and on whom will the research have an impact?: These findings will help clarify the needs of parents of patients in NICUs, enhance the home care transition for infants in NICUs, promote neonatal health outcomes, improve the quality of life for infants and their families, and ensure high-quality home care. REPORTING METHOD: This study follows the PRISMA reporting guidelines in EQUATOR for research. PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution. REGISTRATION: PROSPERO Registration: CRD42024541018.

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