Health Care Professional Perceptions About a Proposed NICU Intervention: The Importance of Community and Aligning With Everyday Occupations

Abstract

The neonatal intensive care unit (NICU) is a dynamic system with multiple stakeholders and contextual factors impacting the implementation of novel practices. This qualitative study aimed to (a) define health care professionals’ perceptions on the feasibility of implementing a sensory intervention to study its efficacy, and (b) elaborate on transactions occurring between NICU health care professionals and the proposed research. Eleven NICU professionals participated in one of three focus groups that were audio-recorded, transcribed, and analyzed thematically in NVivo first descriptively and then interpretively through a transactionalism lens. The health care professionals implied the intervention was feasible, but provided multiple suggestions to enhance implementation. The modification of familiar occupational practices, ingrained habits, and the potential impact on the collective occupational performance of NICU community members arose. Understanding occupations within the NICU as transactional allows for a broader view of occupational engagement and enhances knowledge of the nuances related to implementing clinical changes.

Keywords

qualitative research neonate occupational engagement occupational science occupational performance

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References

Altimier

Phillips

R. M.

(2013). The neonatal integrative developmental care model: Seven neuroprotective core measures for family-centered developmental care. Newborn and Infant Nursing Reviews, 13(1), 9–22. https://doi.org/10.1053/j.nainr.2012.12.002

American Occupational Therapy Association. (2018). Occupational therapy’s role in the Neonatal intensive care unit. American Journal of Occupational Therapy, 72(2), 722410060p1–7212410060p9. https://doi.org/10.5014/ajot.2018.72S204

Bowen

D. J.

Kreuter

Spring

Cofta-Woerpel

Linnan

Weiner

Bakken

Kaplan

C. P.

Squiers

Fabrizio

Fernandez

(2009). How we design feasibility studies. American Journal of Preventive Medicine, 36(5), 452–457. https://doi.org/10.1016/j.amepre.2009.02.002

Braithwaite

Churruca

Long

J. C.

Ellis

L. A.

Herkes

(2018). When complexity science meets implementation science: A theoretical and empirical analysis of systems change. BMC Medicine, 16(1), 1–14. https://doi.org/10.1186/s12916-018-1057-z

Cutchin

M. P.

(2007). From society to self (and back) through place: Habit and transactional context. OTJR: Occupation, Participation and Health, 27(1), 50–59. https://doi.org/10.1177/15394492070270S107

de Jonge

Le Blanc

P. M.

Peeters

M. C. W.

Noordam

(2008). Emotional job demands and the role of matching job resources: A cross-sectional survey study among healthcare workers. International Journal of Nursing Studies, 45(10), 1460–1469. https://doi.org/10.1016/j.ijnurstu.2007.11.002

Dickie

Cutchin

M. P.

Humphry

(2006). Occupation as transactional experience: A critique of individualism in occupational science. Journal of Occupational Science, 13(1), 83–93. https://doi.org/10.1080/14427591.2006.9686573

Fiabane

Giorgi

Sguazzin

Argentero

(2013). Work engagement and occupational stress in nurses and other healthcare workers: The role of organisational and personal factors. Journal of Clinical Nursing, 22(17–18), 2614–2624. https://doi.org/10.1111/jocn.12084

Harris

Gibbs

Mangin-Heimos

Pineda

(2018). Maternal mental health during the neonatal period: Relationships to the occupation of parenting. Early Human Development, 120, 31–39. https://doi.org/10.1016/j.earlhumdev.2018.03.009

10.

Hignell

Carlyle

Bishop

Murphy

Valenzano

Turner

Sgro

(2020). The infant cuddler study: Evaluating the effectiveness of volunteer cuddling in infants with neonatal abstinence syndrome. Paediatrics and Child Health, 25(7), 414–418. https://doi.org/10.1093/pch/pxz127

11.

Hogan

D. L.

Logan

(2004). The Ottawa model of research use: A guide to clinical innovation in the NICU. Clinical Nurse Specialist, 18(5), 255–261. https://doi.org/10.1097/00002800-200409000-00010

12.

Insley

Tedesco

Litman

E. A.

Mangalapally

Gicewicz

Monaco-Brown

M. L.

(2021). The NICU cuddler curriculum: A service-learning curriculum for preclinical medical students in the neonatal intensive care unit. MedEdPortal: The AAMC Journal of Teaching and Learning Resources, 17, 11069. https://doi.org/10.15766/mep_2374-8265.11069

13.

Kraemer

S. B.

(2006). So the cradle won’t fall: Holding the staff who hold the parents in the NICU. Psychoanalytic Dialogues, 16(2), 149–164. https://doi.org/10.2513/s10481885pd1602_4

14.

Lavalley

(2017). Developing the transactional perspective of occupation for communities: “How well are we doing together?” Journal of Occupational Science, 24(4), 458–469. https://doi.org/10.1080/14427591.2017.1367321

15.

Law

Cooper

Strong

Stewart

Rigby

Letts

(1996). The person-environment-occupation model: A transactive approach to occupational performance. Canadian Journal of Occupational Therapy, 63(1), 9–23. https://doi.org/10.1177/000841749606300103

16.

Lisle

Buma

Smith

Richter

Satpute

Pineda

(2022). Maternal perceptions about sensory interventions in the neonatal intensive care unit: An exploratory qualitative study. Manuscript in preparation. Chan Division of Occupational Science and Occupational Therapy University of Southern California.

17.

May

Finch

Mair

Ballini

Dowrick

Eccles

Gask

MacFarlane

Murray

Rapley

Rogers

Treweek

Wallace

Anderson

Burns

Heaven

(2007). Understanding the implementation of complex interventions in healthcare: The normalization process model. BMC Health Services Research, 7, Article 148. https://doi.org/10.1186/1472-6963-7-148

18.

Milanaik

Sidhu

Spinazzola

(2019). NICU cuddlers: Prevalence and training requirements for therapeutic touch volunteers. Pediatrics, 144(2), 2–5. https://doi.org/10.1542/peds.144.2_MeetingAbstract.668

19.

Ohlinger

Brown

M. S.

Laudert

Swanson

Fofah

(2003). Development of potentially better practices for the neonatal intensive care unit as a culture of collaboration: Communication, accountability, respect, and empowerment. Pediatrics, 111(4), e471–e481. http://doi.org/10.1542/peds.111.SE1.e471

20.

Pineda

Guth

Herring

Reynolds

Oberle

Smith

(2017). Enhancing sensory experiences for very preterm infants in the NICU: An integrative review. Journal of Perinatology, 37(4), 323–332. https://doi.org/10.1038/jp.2016.179

21.

Pineda

Smith

Roussin

Wallendorf

Kellner

Colditz

(2021). Randomized clinical trial investigating the effect of consistent, developmentally-appropriate, and evidence-based multisensory exposures in the NICU. Journal of Perinatology, 41(10), 2449–2462. https://doi.org/10.1038/s41372-021-01078-7

22.

Pineda

Wallendorf

Smith

(2020). A pilot study demonstrating the impact of the supporting and enhancing NICU sensory experiences (SENSE) program on the mother and infant. Early Human Development, 144, Article 105000. https://doi.org/10.1016/j.earlhumdev.2020.105000

23.

Siccama

C. J.

Penna

(2008). Enhancing validity of a qualitative dissertation research study using NVivo. Qualitative Research Journal, 8(2), 91–103. https://doi.org/10.3316/QRJ0802091

24.

Smithson

(2000). Using and analysing focus groups: Limitations and possibilities. International Journal of Social Research Methodology, 3(2), 103–119. https://doi.org/10.1080/136455700405172