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Infant health determines parental satisfaction with neonatal intensive care

Parental satisfaction with the care their newborn infant receives in the neonatal intensive care unit (NICU) is primarily due to the infant's health 3 months after hospital discharge rather than to NICU treatments or neonatal complications, according to a new study. In contrast to what many clinicians might think, the infant's severity of illness and medical care received had far less impact, notes Marie C. McCormick, M.D., Sc.D., of the Harvard School of Public Health.

She and colleagues examined factors influencing parental satisfaction with NICU care for 677 moderately premature infants in 10 hospitals in Massachusetts and California. The infants had no major anomalies or chromosomal disorders and were born between 30 and 34 weeks of gestation. The parents were asked about care satisfaction 3 months after the infant's discharge and about issues such as the NICU staff's emotional support, information, or education. They were also asked to rate their child's health, subsequent care use, sociodemographic characteristics, and mother's history of infertility treatment. The researchers used medical charts to identify NICU interventions.

Of the 621 predominantly white, well-educated older mothers who completed the satisfaction survey, most were satisfied with the NICU care. However, satisfaction with care varied significantly by hospital. Neither infertility treatments, cesarean delivery, or other delivery-related treatments affected parental satisfaction. Most of the infants did not experience neonatal complications. Thus, there was little need for NICU interventions such as mechanical ventilation, which nevertheless were not associated with parental satisfaction.

All of the factors studied explained only a modest 19 percent of varied satisfaction rates among the 10 NICUs studied. This suggests the need for more studies to better understand factors affecting parental satisfaction with NICU care. The study was supported by the Agency for Healthcare Research and Quality (HS10131).

See "Factors influencing parental satisfaction with neonatal intensive care among the families of moderately premature infants," by Dr. McCormick, Gabriel J. Escobar, M.D., Zheng Zheng, B.S., and Douglas K. Richardson, M.D., M.B.A., in the June 2008 Pediatrics 121(6), pp. 1111-1118.

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