Transition from hospital to home: Parents’ perception of their preparation and readiness for discharge with their preterm infant

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Parents of infants in the NICU commonly report anxiety, poor sleep, fatigue, depression, and helplessness.

“parents consistently report experiencing anxiety, sleep deprivation, fatigue, depression, and helplessness (Busse et al., 2013, Mackley et al., 2010).”

• cites Busse et al., 2013 sourcePartly supported

  The Results and Discussion report that NICU parents experienced anxiety, depression, fatigue, and sleep disturbance; the Introduction also describes short sleep duration among NICU mothers. The paper does not report helplessness as a parental response, so that part of the attributed claim is unsupported. (LLM, conf=0.88)

  Experimental — accuracy not yet measured
• cites Mackley et al., 2010 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

These feelings align with Stacey, Osborn, and Salkovskis (2015) and Turner, Winfeild, and Chur-Hansen (2013), who found parents felt unsure and confused when information transfer was missing or poor.

“These feelings are consistent with findings by Stacey, Osborn, and Salkovskis (2015) and Turner, Winfeild, and Chur-Hansen (2013) who suggest that parents felt unsure and confused when information transfer was absent or inadequate.”

• cites Stacey, Osborn, and Salkovskis (2015) sourceCould not verify

  The supplied passage contains only the paper’s title and author information. Searches for absent or inadequate information transfer and for parents feeling unsure or confused found no passage in our copy addressing that claim. (LLM, conf=0.72)

  Experimental — accuracy not yet measured
• cites Turner, Winfeild, and Chur-Hansen (2013)Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

May combine two claims.

Fathers had fewer chances to take part in their baby's care and to receive information directly from staff.

“In contrast fathers had fewer opportunities to participate in the care of their baby and receive information directly from staff”

May combine two claims.

Parents assessed staff competence from their actions, and this shaped whether they saw staff as professional, friendly, and supportive.

“Parents judged the clinical staff and assessed their competency based on their actions which determined whether they were perceived to be professional, friendly and supportive”

May combine two claims.

Parents grew more independent and could identify their community resources and where to find them.

“was about parents becoming more independent and being able to identify what and where their community resources were.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Frequent changes in nursing assignments and differing opinions among nurses frustrated parents.

“Nursing allocations changed frequently and different opinions from nursing staff was frustrating for parents.”

May combine two claims.

Parents wanted nurses to understand their needs and to know how involved they were and what support they still needed.

“Parents wanted nurses to understand their needs and felt that nursing staff should be aware where of their level of involvement with their baby and what continuing support was required.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Rural parents felt unsupported without the home visiting nurse and wanted better organisation of peripheral hospital staff and community support.

“Parents living in rural areas felt a lack of support without the home visiting nurse and would have liked peripheral hospital staff and community support to be better organised.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Phase one analysis produced four main themes and eleven subthemes.

“Data analysis from phase one revealed four major themes with eleven subthemes.”

May combine two claims.

Some parents felt overloaded with information and could not absorb everything they were given.

“In contrast, some felt there was 'information overload' and were not able to 'take in' all that was given to them”

May combine two claims.

Parents faced new challenges at home even though they were relieved to be there.

“New challenges became evident even though parents were relieved were in their home environment”

May combine two claims.

Some parents felt anxious because discharge was rushed and the NICU had been their home for many weeks.

“others had felt anxious because the experience was so rushed as the NICU had been their 'home' for many weeks.”

May combine two claims.

Other parents liked the independence of caring for their baby at home and felt more comfortable and in control.

“Other parents enjoyed the autonomy of caring for their baby at home, felt more comfortable and in control”

May combine two claims.

Parents found home different from hospital and only then realised what additional information they needed.

“Parents noted how being home is different from hospital and only then did they realise what further information was needed”

May combine two claims.

Some parents found internet information useful, but others distrusted it or found it overwhelming or negative.

“Some parents searched the internet and found it helpful although others didn't trust this information or found it overwhelming or negative”

May combine two claims.

Most parents felt well informed about their baby's care and progress, but some said they initially received little information and had to ask staff for more.

“Most parents felt well informed about the care and progress of their baby however some reported not being given much information initially and needing to ask clinical staff for more information.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Other parents were not worried and believed staff would give information nearer to discharge.

“Other parents were not concerned they felt that staff would provide information closer to the time of discharge.”

May combine two claims.

Mothers and fathers obtained information in different ways; mothers spent more time at the bedside, which gave them more contact with the multidisciplinary team and more information transfer.

“Mothers and fathers gathered information differently as mothers spent more time at the bedside facilitating more contact with the multidisciplinary team and information transfer.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Personality clashes between parents and nurses made involvement in care harder and less supported.

“Personality clashes between parents and the nurse was also challenging and not supportive of their involvement in care”

May combine two claims.

Some parents felt rushed when leaving hospital and wanted more notice and a better plan from staff.

“Some felt rushed leaving the hospital and would have liked more notice and a better plan from the staff”

May combine two claims.

Parents faced barriers and interpersonal difficulties with nursing staff that affected their involvement in their baby's care.

“Parents commented on barriers and interpersonal challenges with nursing staff that affected their involvement in their baby's care.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Parents recommended keeping the same clinical staff because they felt better when they knew the nurse caring for their baby.

“Continuity of clinical staff caring for their baby was recommended as parents felt better when they 'knew' the nurse who was providing care.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Parents found the high-tech equipment overwhelming but liked the new, clean, well-organised environment.

“Parents commented that the presence of 'high-tech' equipment was overwhelming, however the new, clean and well organised environment was appealing”

May combine two claims.

Most parents felt ready to care for their baby at home, but some did not feel mentally or physically prepared.

“Most parents felt prepared to care for their baby at home however some explained they did not feel mentally or physically prepared”

Probably not a substantial claim: may not pass S3 (load-bearing).

Parents saw a need to improve how health professionals communicate with each other and with parents.

“Furthermore, they considered a need for improving the way health professionals communicate with each other and the parents.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Parents proposed that staff use a guideline or checklist listing achievements each baby must meet before discharge, to help with planning.

“Parents suggested that staff would benefit from a guideline or checklist of achievements that individual babies were required to meet before discharge to assist with planning.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Different opinions among staff could also help parents because each staff member provided new information.

“However, differing staff opinions could also be beneficial as each staff member offered new information.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Parents said they should be told about a non-threatening way to give feedback on staff or their experience.

“Parents also shared that they should be informed that there is a non-threatening feedback process for them to express their concerns about staff or their experience.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

In phase two, parents suggested more chances for day and night rooming-in and an extended home visiting nurse service.

“Phase two highlighted parent's suggestions to have more opportunity to provide day and night rooming in care along with extending the home visiting nurse service.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Phase two analysis produced three main themes and five subthemes.

“Analysis for the phase two resulted in three major themes and five subthemes.”

May combine two claims.

Parents had mixed feelings after admission: they were overwhelmed and scared, yet reassured by the well-equipped nursery and staff competence.

“They described feelings of being overwhelmed and scared but were impressed by the well-equipped nursery and perceived competence of clinical staff which reassured them that their baby was in safe hands”

May combine two claims.

Parents received inconsistent or conflicting information from staff, which made them frustrated and confused.

“Parents shared experiences where staff offered inconsistent or conflicting information which left them frustrated and confused”

May combine two claims.

Some parents looked for information outside the hospital, while others regarded hospital staff as the most trustworthy source.

“Some parents felt a need to seek information beyond the hospital to address their needs, whereas some felt that hospital staff were the most trusted source of information.”

May combine two claims.

Some had not heard the term before or did not understand it well.

“Some had not heard term before or it was not well understood.”

May combine two claims.

Parents saw their baby as fragile and were unsure how to interact with and care for them.

“They perceived their baby as fragile and they felt unsure of how to interact and care for their baby.”

May combine two claims.

WA parents said the skills they gained in hospital would let them care for their babies at home, and they knew about community resources after discharge.

“WA parents in this project acknowledged that the skills they acquired in hospital will enable them to care for their babies at home and were also aware of community resources to access when discharged.”

May combine two claims.

Parents wanted to be involved in their baby's care but knew their involvement depended on the baby's condition.

“Although parents wanted to be involved in their baby's care, they were acutely aware that the level of their involvement was guided by their baby's condition.”

May combine two claims.

WA parents said they learned skills by watching nursing staff, which helped them become independent carers.

“Our WA parents expressed how they learned skills from observing nursing staff which enabled them to become independent carers.”

May combine two claims.

Parents in the WA study wanted to do more during transition and said staff should understand their needs to enable more involvement.

“Parents within this WA study wanted to do more during the transitioning phase and expressed that staff should understand their needs to facilitate more involvement.”

May combine two claims.

Many parents felt rushed when leaving hospital and wanted more notice and a better plan from staff.

“Many parents felt rushed when the time finally came to leave hospital and would have liked more notice and a better plan from the staff.”

May combine two claims.

Parents said they felt rushed at discharge, often because beds had to be freed.

“The NICU environment changes frequently and parents expressed feeling rushed at the time of discharge often due to a requirement to make bed spaces available.”

May combine two claims.

Being involved was daunting; nurses' encouragement and support was valued but not always given.

“However, the reality of being involved was daunting and having encouragement and support by nurses was highly valued though not always given.”

May combine two claims.

Others liked the autonomy of caring for their baby at home and felt more comfortable and in control.

“However, others enjoyed the autonomy of caring for their baby at home and felt more comfortable and in control.”

May combine two claims.

Most parents felt ready to care for their baby at home, though some did not feel mentally or physically prepared.

“Most parents felt prepared to care for their baby at home although some did not feel mentally and/or physically prepared.”

May combine two claims.

Parents wanted to be informed about their baby's condition and needed that information to be involved in care.

“Parents wanted to feel informed about their baby's condition and needed this information to facilitate their involvement in the care of their baby.”

May combine two claims.

Mothers and fathers gather information differently: fathers spend less time at the bedside, miss chances to talk with staff, and get 'second-hand' information from their partner.

“Consistent with literature we found that mothers and fathers tend to gather information as fathers spend less time at their baby's bedside and miss opportunities to interact with clinical staff therefore receiving 'second-hand' information from their partner.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Regular team meetings were used to discuss emerging ideas, limit bias, and support the credibility of the analysis.

“Regular meetings provided opportunities to discuss ideas derived from the text to reduce bias and ensure credibility to the analysis process.”

May combine two claims.

This study and two earlier studies in Australia and the UK found similar experiences: parents felt not fully informed or included in discussions about their baby's care, treatment, and discharge timing.

“Findings from this study and two previous studies in Australia and the United Kingdom (UK) reflect similar experiences whereby parents felt they were not fully informed or included in discussions about their baby's care or treatment along with timing of discharge (Burger et al., 2014, Gardner , Barrett, Coonaan, Cox & Robertson, 2002).”

• cites Burger et al., 2014Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites Gardner , Barrett, Coonaan, Cox & Robertson, 2002Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing).

Member checking was used so participants could confirm that the themes matched their experiences.

“Member checking was used to ensure that participants agreed that themes reflected their experiences (Streubert & Carpenter 2011).”

• cites Streubert & Carpenter 2011Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

May combine two claims.

Canadian fathers reported confusion and felt less included than mothers.

“Canadian fathers reported confusion and felt they were not included as much as the mothers (Arickiosamy et al., 2008)”

• cites Arickiosamy et al., 2008Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing).

Six parents confirmed agreement with the findings after receiving a summary of the themes.

“Participants were emailed a short summary of the themes from each phase with six parents confirming agreement with the findings.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Sensory involvement by parents, such as touching and cuddling, supports bonding with a preterm infant.

“Parental involvement through sensory input facilitates the process of bonding and includes touching, cuddling, nurturing and caring activities (Tracy 2000).”

• cites Tracy 2000Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing).

Two members of the research team independently analysed the transcripts.

“The process of data analysis began with two team members conducting a separate analysis of transcriptions.”

Classified as probably not a substantial claim. May combine two claims.

The interviewers were clinical nurses known to parents but not involved in the babies' direct care, which the authors expected to reduce coercion bias and help parents speak freely.

“The two interviewers were clinical nurses and known to parents however they were not involved in direct care with any of the babies.We anticipate that this reduced potential bias from coercion and allowed parents to feel comfortable to share their thoughts or experiences.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Parents were interviewed separately so that one partner's account would not influence the other's.

“Interviews with parents were conducted separately to demonstrate the value of each person's experience without influencing or biasing their partners' experience.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Recruitment continued until data saturation was reached during analysis.

“The final sample size of parents recruited was determined when data saturation was reached during the analysis process (Polit & Beck 2010).”

• cites Polit & Beck 2010Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

May combine two claims.

Sharing information lowers parental stress and helps health care providers spot educational needs.

“Information sharing has been found to reduce parental stress and assist the health care provider identify educational needs (Burger King, & Tallet, 2015;Feeley et al. 2012).”

• cites Burger King, & Tallet, 2015Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites Feeley et al. 2012 sourceNot checked — no full text of the source

Classified as probably not a substantial claim.

The ideas behind the findings show the staff-parent relationship.

“Concepts that underpin our findings reflect the relationship between staff and parents.”

Classified as probably not a substantial claim.

Using two phases let a wider range of parents' experiences be captured.

“Conducting this project in two phases enabled a broader perspective to be shared across the spectrum of parent's experiences.”

May combine two claims.

A structured US program designed to improve parental education was linked to positive outcomes and better discharge readiness.

“positive outcomes have been reported from a structured program in the United States aiming to enhance parental education facilitating readiness for discharge (Melnyk et al., 2006).”

• cites Melnyk et al., 2006 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

Each interview was independently reviewed by three team members.

“Distributing the transcripts across five team members enabled each interview to be independently reviewed by three team members.”

May combine two claims.

Mothers and fathers may use different coping strategies and have different needs.

“The coping mechanisms of fathers and mothers can be different.”

• cites Matricardi , Agostino, Fedeli, Montirosso, 2013 sourceNot checked — no full text of the source

May combine two claims.

Fathers who go back to work soon after birth have less contact with their baby, which can reduce their chances to gain caregiving knowledge and may raise their stress.

“fathers who return to work early after the birth to support the family, look after other children and attempt to retain some 'normality' may have limited contact time with the baby.This contributes to fewer opportunities to acquire similar knowledge to the mother which may increase their stress levels (Mackley et al., 2010).”

• cites Mackley et al., 2010 sourceNot checked — no full text of the source

May combine two claims.

International literature identifies factors that affect parents' move from NICU to home, but it does not cover parents' views of their readiness before and after discharge.

“Reviewing international literature highlights factors influencing parents transitioning from NICU to their home; however, they do not report on parents' impression and perceptions of readiness before and after discharge.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Interaction between parent and preterm baby supports the baby's wellbeing and development.

“Parent baby interaction is known to facilitate baby wellbeing and development (Feeley et al. 2013, Griffin & Abraham 2006).”

• cites Feeley et al. 2013 sourceNot checked — no full text of the source
• cites Griffin & Abraham 2006 sourceNot checked — no full text of the source

Classified as probably not a substantial claim.

In-depth interviews gave parents a voice about their experiences.

“In-depth interviews allowed parents to have a voice around their experiences that must be listened to.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Adama, Bayes, and Sundin (2016) reported that knowing, being involved in care, and confidence are linked in international literature.

“Adama , Bayes, and Sundin (2016) reported that the relationship between knowing, being involved in care and confidence are consistent within international literature.”

• cites Adama , Bayes, and Sundin (2016) sourceNot checked — no full text of the source

May combine two claims.

The findings come from one WA tertiary neonatal unit and forty parents' experiences of going home.

“It must be acknowledged that our findings represent one Western Australian (WA) tertiary neonatal clinical care unit where the experiences of forty parents' transitioning to home have been reported.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Parents were interviewed by researchers who are clinical staff in the NICU.

“Parents in this study were interviewed by researchers who work as clinical staff in the NICU.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Jefferies (2014) discusses how ongoing discharge preparation during transition can reduce parental stress and anxiety.

“More recently, Jefferies (2014) discusses the importance of ongoing preparation for discharge during the transition period to reduce parental stress and anxiety should this scenario occur.”

• cites Jefferies (2014)Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Classified as probably not a substantial claim.

The WA study findings show a need for strategies to improve NICU transition and discharge for parents.

“Our findings from this WA study reflect a necessity to develop strategies to improve the NICU transition and discharge experience for parents.”

• AssumptionRests on an assumption: Active involvement in caring for their baby is necessary for parents to learn and build skills.

May combine two claims.

Even though parents had mixed feelings about not always being fully informed in hospital, they generally felt ready to take their baby home.

“Therefore, it appears that despite mixed feelings about not always being fully informed during their hospital stay, parents generally felt prepared to take their baby home.”

May combine two claims.

Parents learn skills and knowledge gradually with nurses' supervision; giving them chances to be the primary caregiver builds confidence and readiness for responsibility to shift to them.

“Parents gradually learn skills and acquire knowledge with nurses' supervision and guidance: Facilitating opportunities to be the 'primary' care giver can build confidence and readiness for the transfer of responsibility to the parents (Griffin & Abraham 2006;Skene, Franck, Curtis, & Gerrish, 2012).”

• cites Griffin & Abraham 2006 sourceNot checked — no full text of the source
• cites Skene, Franck, Curtis, & Gerrish, 2012 sourceNot checked — no full text of the source

May combine two claims.

All couples recruited were traditional mother-father pairs, though this was not an exclusion criterion.

“Additionally, all couples recruited represented a traditional parenting pair with mother and father although this was not an exclusion criterion.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Danish nurses have used strategies to improve communication with parents and reported early positive results.

“Danish nurses have implemented strategies to improve communication with parents and have noted early positive outcomes (Weis, Zoffman, & Egerod, 2013).”

• cites Weis, Zoffman, & Egerod, 2013Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S2 (checkable).

Parents' stories reinforce the need for a multidisciplinary team to better meet parents' needs in the NICU.

“Learning from their stories reinforces the need to involve a multidisciplinary team approach to better address parents needs within NICU.”

• AssumptionRests on an assumption: Active involvement in caring for their baby is necessary for parents to learn and build skills.

Probably not a substantial claim: may not pass S3 (load-bearing).

During the study, the interviewers did not provide direct care for the babies.

“During the study period, they were not responsible for direct care of the babies.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Qualitative analysis depends on data saturation within a specific parent group.

“Qualitative analysis relies on data saturation applied to a specific group of parents.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Interaction with clinical staff is seen as key to improving communication and parental understanding through information sharing.

“Furthermore, interaction with clinical staff has been suggested as key to promoting communication that can enhance parental understanding through information sharing (Feeley 2012).”

• cites Feeley 2012Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

These nurses had neonatal training and extensive experience working with parents.

“These nurses have specific training in the neonatal field and extensive experience working parents.”