This study was conducted to explore the experiences of parents in the NICU. The major identified themes were socio-economic, health facility related, parents-health care providers’ communication, maternal and child health related, and psycho-emotional factors and current occasions.
Financial constraint was one of the parental challenges presented in the NICU. These challenges include long stay in hospital and extra costs for buying stock out medicines and their daily expenses like transportation and food. The previous study supported that additional costs challenged NICU parents (26). This agreement might be linked with long time hospitalization and other expenses outside of the NICU.
In addition, parents complained that travelling long distance from home to health facilities affected their experiences in NICU. Consistent with this study, parents faced hardships associated with traveling long distances from their homes to the health facilities(26).This might be related to inaccessible NICU setting for parents.
Anxiety, stress, worry, and confusion were the common psychological problems that parents experienced in the NICU. Not only the parents, but also the whole family disturbed “my families are too much confused”. Comparably, the anxiety level of parents was high and had unforgettable moments (40). Most parents were depressed and stressed due to the NICU atmosphere (2, 41, 42). The more likely explanation of this similarity could be due to unfamiliar parents with NICU medical equipment.
In this study, sadness, crying and lack of self-control were emotional problems that felt by parents in the NICU. Other study revealed that parents felt broken heartedness, disappointment and fear. They perceived that “oxygen was bad because oxygen kills children”; it caused fears and worries for parents(22). Furthermore, the NICU fathers expressed that the situation was out of their control (23, 27). Others also found that the most stressful events for parents were attached medical equipment and continuous noise of alarms in the NICU(29).
Even though parents wanted to visit their child frequently, the hospital had limited visiting schedule. In line with this findings, reports showed that parents were challenged by strict visiting hours(26, 43). The service provided in NICU for neonates was delayed which might increase neonatal morbidity and mortality. Regarding the facility resources; shortage of space and sanitary situations of the facility were often overwhelming. Similarly, other studies showed that there were no private family rooms and lack waiting area(3, 26).
This study indicated that lack of compassionate and respectful care and unsupportive HCPs had negative consequences on parents, which mean the HCPs were not disciplined, lack of commitment and cooperative while they gave care in NICU. Other studies also showed that HCPs were unsupportive, careless and negligent(2, 3).
Although parents had no clear role and limited engagement to care the child, the interaction between HCPs and parents was good and supportive. Providing holistic information on the progress of the neonates’ health status for the parents had a positive impact on reducing their stress. This enhances parental service satisfaction in NICU. Other reports also substantiated that parents had gotten updated information about their infants’ health condition and their engagement also optimal(3, 13, 22, 26, 27, 43–46). In contrast, other studies reported that parents were not received adequate information from HCPs about their babies’ progress(26, 41).
Poor medical condition of the neonates contributed in aggravating parental stress. This situation made them worried if the life of their child ends up with complications and death due to poor medical progress. In accordance with this finding, the progress of infants’ medical condition influenced parental feeling (2).
The current situation, particularly COVID-19, threatens the parents and their family in terms of getting optimal care for severely ill neonates. It was related to poor HCPs approach. Other evidence showed that during the COVID-19 pandemic occasion, parents experienced higher stress than the usual time. And also, COVID-19 contagion had negative impact on parent–infant relationships(47).
This study has its own limitations; the interviews were conducted in the NICU, study participants might hide their feeling since they may perceive the care given to their child will compromise. This study also limited to include the health care providers perspective particularly in the parent- provider interaction.