Conceptualizing Parent–Infant Co-Occupations in the Neonatal Intensive Care Unit for Measurement: A Delphi Study

Abstract

Co-occupations among parents and their infants have been studied for nearly three decades, yet may be incompletely understood. An emphasis on parental subjective perspectives of their co-occupational experiences and lack of tools to equitably generate data regarding infants’ experiences may contribute to gaps in understanding and measuring co-occupations. The study aimed to generate an objective rating scale for use in research contexts to quantify parent–infant co-occupations while in the neonatal intensive care unit (NICU). The Delphi method was utilized to obtain expert opinion on a proposed rating scale. Twelve occupational therapy and science expert reviewers achieved consensus at >90% agreement on the accuracy of three subscales after two survey rounds, with changes made between rounds based on expert feedback. The proposed rating scales may offer a novel measure to quantify co-occupations in the NICU. Further research is warranted to psychometrically evaluate the tool before considering clinical applications.

Plain Language Summary

A Study Helping Occupational Therapists Understand How Parents and Their Babies Engage Together in the Hospital When Born Early

When babies are born early, they need a lot of medical attention. Just as medicine is important for healing, babies being with and interacting with their parents is important for healing. Sometimes, parents are unsure how to interact with their babies while they are in the hospital. Occupational therapists can help parents do things with their babies, like hold them skin-to-skin, change their diaper, or feed them. To do the best job they can, occupational therapists need to evaluate whether the interaction between the parent and baby is going well or not. Researchers have studied this for many years, but much of the research has been done by interviewing parents about their experiences with caring for their baby in the hospital. There is not much research about what the baby is experiencing, because it is challenging to understand an infant’s point of view. The researchers began by developing a suggested tool to rate parent and infant interactions. The tool was reviewed by experts in the field of occupational therapy who work with parents and infants. The experts gave feedback and suggestions to improve the tool and make it more accurate. The experts were able to agree on the content of the tool with more than 90% agreement after reviewing it twice. In the end, the researchers created a tool that occupational therapists might use in the future to rate how well the parent and infant are interacting together. More studies must be completed by researchers first to ensure the tool is accurate and ready to use by clinicians in the NICU.