Parent Activation in the Neonatal Intensive Care Unit

Ryan Skeens; Kerri L. Cavanaugh; Robert Cronin; QinGxia Chen; Yuhan Liu; Hannah Huth; Gretchen P. Jackson

doi:10.1055/s-0041-1736294

American Journal of Perinatology, Inhaltsverzeichnis

Am J Perinatol 2023; 40(13): 1413-1420
DOI: 10.1055/s-0041-1736294

Original Article

Parent Activation in the Neonatal Intensive Care Unit

Ryan Skeens

¹Division of Neonatology, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee

,

Kerri L. Cavanaugh

²Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee

³Vanderbilt Center for Effective Health Communication, Vanderbilt University Medical Center, Nashville, Tennessee

,

Robert Cronin

⁴Department of Medicine and Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee

⁵Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee

,

QinGxia Chen

⁶Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee

⁷Department of Ophthalmology and Visual Sciences, Vanderbilt University Medical Center, Nashville, Tennessee

,

Yuhan Liu

⁶Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee

,

Hannah Huth

⁸College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee

,

Gretchen P. Jackson

⁵Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee

⁹Department of Pediatric Surgery, Vanderbilt University Medical Center, Nashville, Tennessee

¹⁰IBM Watson Health, Cambridge, Massachusetts

› Institutsangaben

Abstract

Objective Patient activation is the knowledge, skills, and confidence to manage one's health; parent activation is a comparable concept related to a parent's ability to manage a child's health. Activation in adults is a modifiable risk factor and associated with clinical outcomes and health care utilization. We examined activation in parents of hospitalized newborns observing temporal trends and associations with sociodemographic characteristics, neonate characteristics, and outcomes.

Study Design Participants included adult parents of neonates admitted to a level-IV neonatal intensive care unit in an academic medical center. Activation was measured with the 10-item Parent version of the Patient Activation Measure (P-PAM) at admission, discharge, and 30 days after discharge. Associations with sociodemographic variables, health literacy, clinical variables, and health care utilization were evaluated.

Results A total of 96 adults of 64 neonates were enrolled. The overall mean P-PAM score on admission was 81.8 (standard deviation [SD] = 18), 88.8 (SD = 13) at discharge, and 86.8 (SD = 16) at 30-day follow-up. Using linear mixed regression model, P-PAM score was significantly associated with timing of measurement. Higher P-PAM scores were associated with higher health literacy (p = 0.002) and higher in mothers compared to fathers (p = 0.040). There were no significant associations of admission P-PAM scores with sociodemographic characteristics. Parents of neonates who had a surgical diagnosis had a statistically significant (p = 0.003) lower score than those who did not. There were no associations between discharge P-PAM scores and neonates' lengths of stay or other indicators of illness severity.

Conclusion Parental activation in the NICU setting was higher than reported in the adult and limited pediatric literature; scores increased from admission to discharge and 30-day postdischarge. Activation was higher in mothers and parents with higher health literacy. Additional larger scale studies are needed to determine whether parental activation is associated with long-term health care outcomes as seen in adults.

Key Points

Little is known about activation in parents of neonates.
Activation plays a role in health outcomes in adults.
Larger studies are needed to explore parent activation.

Keywords

activation - parent activation - P-PAM - neonatal intensive care unit - health care outcomes - health literacy

Volltext

Referenzen

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