Parents' and nurses' experiences of partnership in neonatal intensive care units: A qualitative review and meta-synthesis

AIMS AND OBJECTIVES: To explore how parents and nurses experience partnership in neonatal intensive care units and to identify existing barriers and facilitators to a successful partnership.

BACKGROUND: Family-centred care is recommended as a frame of reference for treatment and care in neonatal intensive care units. A key element in family-centred care is partnership. Such partnerships are characterised by complex interpersonal relationships and interactions between nurses and parents/families. Partnerships therefore appear to present a significant challenge.

DESIGN: A qualitative review and meta-synthesis.

METHODS: Comprehensive searching in ten databases: CINAHL, PubMed (MEDLINE), EMBASE, PsycINFO, Scopus and SweMed+, OpenGrey, MedNar, Google Scholar and ProQuest Dissertations & Thesis Global. A total of 1,644 studies (after removal of duplicates) were critically assessed, and 21 studies fulfilled the inclusion criteria. A meta-aggregation was used to synthesise the findings from the studies and was methodically quality assessed with QUARI/SUMARI and PRISMA.

FINDINGS: Through a meta-aggregative approach, two synthesised findings were developed: (a) co-creation of mutual knowledge and (b) developing competencies and negotiating roles. The first synthesis embraced the categories: being respected and listened to, trust and sharing knowledge, and the second synthesis embraced the categories: space to learn with guidance, encouraging and enabling, being in control. In constructing the categories, findings were identified as characteristics, barriers and facilitators to application.

CONCLUSION: A successful relationship between parents and nurses can be achieved through co-creation of mutual knowledge and development of competencies and negotiation of roles. Neonatal intensive care unit nurses are in a position where they exercise power, but they can change the culture if they are aware of what seems to facilitate or create a barrier to a partnership with parents.

RELEVANCE TO CLINICAL PRACTICE: This new evidence may inform a change in policies and guidelines which could be integrated into nurses' clinical practice in neonatal intensive care units.