Premium
Mothers' and health care providers' perspectives of the barriers and facilitators to attendance at C anadian neonatal follow‐up programs
Author(s) -
Ballantyne M.,
Benzies K.,
Rosenbaum P.,
Lodha A.
Publication year - 2015
Publication title -
child: care, health and development
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.832
H-Index - 82
eISSN - 1365-2214
pISSN - 0305-1862
DOI - 10.1111/cch.12202
Subject(s) - attendance , feeling , vulnerability (computing) , thematic analysis , psychology , qualitative research , nursing , health care , developmental psychology , medicine , social psychology , social science , computer security , sociology , computer science , economics , economic growth
Abstract Background Despite the benefits of Neonatal Follow‐Up ( NFU ) programs for infants at risk for developmental problems subsequent to preterm birth, non‐attendance continues to be a problem within C anada and beyond. This study investigated the barriers and facilitators to attendance at C anadian NFU programs from mothers' and health care providers' ( HCP ) perspectives. Methods In this multi‐site qualitative descriptive study, we conducted semi‐structured individual interviews with 12 mothers, six from each of two NFU programs; and focus groups with 20 HCP s from nine NFU programs. Interviews were audio‐recorded and transcribed and then subjected to thematic analysis. Results The predominant barriers represented a complex interplay of cumulative factors: mothers' isolation and feeling overwhelmed, with limited support, experiencing difficulty attending because of limited resources, who viewed NFU as not needed until problems arose for their child. Other barriers included vulnerability and fear of bad news. Mothers reported the need to protect their vulnerable child from risks, whereas HCP s reported creating vulnerability by monitoring the child's development over time. HCP s perceived fear of bad news as a barrier, whereas mothers viewed that impending bad news increased their need to attend to address the issue. The predominant facilitators were support, family centred‐care and mothers with adequate resources. Conclusions Attendance is most problematic for mothers with limited support, capacity and resources. First and foremost, targeted approaches to NFU service provision are needed to address the cumulative barriers and improve experiences for mothers who find it difficult to attend NFU . A continuous relationship with a single point of contact is needed and merits further investigation – a provider who works across the traditional silos of neonatal intensive care, NFU and community services, minimizes duplication and navigates transitions.