Research

Research Papers

2022

Dien R, Benzies KM, Zanoni P, Kurilova J. Alberta Family Integrated Care™ and Standard Care: A Qualitative Study of Mothers’ Experiences of their Journeying to Home from the Neonatal Intensive Care Unit, 2022, Global Qualitative . Nursing Research Volume 9: 1–11

Labrie NHM, van Veenendaal NR, Ludolph  RA, Johannes C F, Ket JCF, van der Schoor SRD, van Kempen AAMW. Effects of parent-provider communication during infant hospitalization in the NICU on parents: A systematic review with meta-synthesis and narrative synthesis. Review, Patient Educ Couns. 2021 Jul;104(7):1526-1552.

Lorié ES, Wreesmann W-J W, van Veenendaal NR, van Kempen AAMW, Labrie  NHM. Parents’ needs and perceived gaps in communication with healthcare professionals in the neonatal (intensive) care unit: A qualitative interview study Patient Educ Couns. 2021 Jul;104(7):1518-1525. Free article

Moe AM, Kurilova J, Afzal AR, Benzies KM. Effects of Alberta Family Integrated Care (FICare) on Preterm Infant Development: Two Studies at 2 Months and between 6 and 24 Months Corrected Age Clin Med, 2022 Mar 18;11(6):1684

North K, MD, Whelan R, Folger LV,  Lawford H, Olson I, Driker S, Bass MB, Edmond K, Lee ACC, Family Involvement in the Routine Care of Hospitalized Preterm or Low Birth Weight Infants: A Systematic Review and Meta-analysis, PEDIATRICS Volume 150, number S1, August 2022 S7 

Ringham C, McNeil D, Benzies KM. The Work of Mothering in the NICU: A Critical Analysis of Alberta Family Integrated Care Parent Journals.  Adv Neonatal Care. 2022 Aug 1;22(4):E112-E119.

van Veenendaal NR, Labrie NHM, Mader S, van Kempen AAMW, van der Schoor SRD, van Goudoever JB, CROWN Study Group* An international study on implementation and facilitators and barriers for parent-infant closeness in neonatal units Pediatr Investig 2022; 00: 1–10 1

van Veenendaal NR, van Kempen A, Broekman B, de Groof F, van Laerhoven H, van den Heuvel M, et al. Association of a Zero-separation neonatal care model with stress in mothers of preterm infants. JAMA Netw Open. 2022;5:e224514. open

Wreesmann W-J W, Lorié ES, van Veenendaal NR, van Kempen AAMW, JCF, Labrie  NHM. The functions of adequate communication in the neonatal care unit: A systematic review and meta-synthesis of qualitative research Review: Patient Educ Couns. 2021 Jul;104(7):1505-1517.

Xiaoli Tang, Sha Sha, Qian Jin, Hong Lu. NICU Staff’s Perceptions and Attitudes Toward the Family Integrated Care (FICare) Model: A Chinese Cross-sectional Study Adv Neonatal Care. 2022 Oct 1;22(5):456-466.

2021

Kostenzer J, Hoffmann J, von Rosenstiel-Pulver C, Walsh A, Zimmermann L, Mader S. Neonatal care during the COVID-19 pandemic – a global survey of parents’ experiences regarding infant and family-centred developmental care. EClinMed. 2021;39:101056.

McNeil D.A, Benzies K. M, Zanoni P, Kurilova J. Alberta Family Integrated Care (FICare)™: From engaged clinicians in a cluster randomized controlled trial to health system partnership in scale and spread across a province. In: McCutcheon C, Reszel J, Kothari A, Graham ID, editors. How We Work Together: The Integrated Knowledge Translation Research Network Casebook. 2021, Volume 4, 16-19. Ottawa, ON: Integrated Knowledge Translation Research Network.

Murphy M, Shah V, Benzies K. Effectiveness of Alberta Family-integrated care on neonatal outcomes: a cluster randomized controlled trial. J Clin Med. 2021;10:5871.

Newnam KM, Muñoz LRPurposeful Language Exposure by Neonatal Nurses and Caregivers in the NICU Adv Neonatal Care2021 Oct 1;21(5):407-417

van Veenendaal NR, Deierl A, Bacchini F, O’Brien K, Franck LS. Supporting parents as essential care partners in neonatal units during the SARS-CoV-2 pandemic. Acta Paediatr. 2021;110:2008-2022.

van Veenendaal NR, Auxier JN, van der Schoor S, Franck LS, Stelwagen MA, de Groof F, et al. Development and psychometric evaluation of the CO-PARTNER tool for collaboration and parent participation in neonatal care. PLoS One. 2021;16:e0252074.

Waddington C, van Veenendaal NR, O’Brien K, Patel N. Family integrated care: Supporting parents as primary caregivers in the neonatal intensive care unit. Pediatr Investig. 2021;5:148-154.

Zanoni, P, Scime, NV, Benzies, KM, McNeil DA, Mrklas, K. Facilitators and barriers to implementation of Alberta Family Integrated Care (FICare) in Level II Neonatal Intensive Care Units (NICU): a qualitative process evaluation sub-study of a multi-centre cluster randomized controlled trial (cRCT) using the Consolidated Framework for Implementation Research (CFIR). BMJ, 2021 Oct 18;11(10):e054938. 

2020

Benzies, K. M., Aziz, K., Shah, V., Isaranuwatchai, W., Scotland, J. Larocque, J., Mrklas, K. J., Naugler, C., Stelfox, H. T., Chari, R., Soraisham, A., Akierman, A. R., Phillipos, E., Amin, H., Hoch, J., Zanoni, P., Kurilova, J., Lodha, A., and the Alberta Family Integrated Care Team. (2020, November 20). Effectiveness of Alberta Family Integrated Care in Level II Neonatal Intensive Care Units (NICU) on infant and maternal outcomes: a provincial, pragmatic, cluster randomized controlled trial. BMC Pediatrics, 20:535. 

GLANCE Chair Committee. Zero separation. Together for better care! 

Oude Maatman SM, Bohlin K, Lilliesköld S, Garberg HT, Uitewaal-Poslawky I, Kars MC, et al. Factors influencing implementation of Family-centered care in a neonatal intensive care unit. Front Pediatr. 2020;8:222.

Stelwagen M, van Kempen A, Westmaas A, Vet E, Scheele F. Parents’ experiences with a model of integrated maternity and neonatal care designed to empower parents. J Obstet Gynecol Neonatal Nurs. 2021;50:181-192.

2019

Aija A, Toome L, Axelin A, Raiskila S, Lehtonen L. Parents’ presence and participation in medical rounds in 11 European neonatal units. Early Hum Dev. 2019;130:10-16.

Benzies KM, Shah V, Aziz K, Lodha A, Misfeldt R. The health care system is making ‘too much noise’ to provide family-centred care in neonatal intensive care units: Perspectives of health care providers and hospital administrators. Intensive and Critical Care Nursing. Intensive Crit Care Nurs. 2019 Feb;50:44-53.

de Salaberry J, Hait V, Thornton K, Bolton M, Abrams M, Shivananda S, et al. Journey to mother baby care: Implementation of a combined care/couplet model in a Level 2 neonatal intensive care unit. Birth Defects Res. 2019;111:1060-1072.

Franck LS, O’Brien K. The evolution of family-centered care: From supporting parent-delivered interventions to a model of family integrated care. Birth Defects Res. 2019 Sep 1;111(15):1044-1059. Review.

Klawetter S, Neu M, Roybal KL, Greenfield JC, Scott J, Hwang S. Mothering in the NICU: A qualitative exploration of maternal engagement Soc Work Health Care2019 Sep;58(8):746-763.

Stelwagen MA, van Kempen A, Westmaas A, Blees YJ, Scheele F. Integration of maternity and neonatal care to empower parents. J Obstet Gynecol Neonatal Nurs. 2020;49:65-77.

2018

Patel N, Ballantyne A, Bowker G, Weightman J, Weightman S; Helping Us Grow Group (HUGG). Family Integrated Care: changing the culture in the neonatal unit. Arch Dis Child. 2018 May;103(5):415-419.

Platonos K, Aloysius A, Banerjee J, Deier A. Integrated family delivered care project: Parent education programme, IFDC Core Group, Neonatal Unit, Imperial College Healthcare NHS Trust, Du Cane Road, London, W12 0HS, UK Journal of Neonatal Nursing 24 (2018) 29e34

2017

Benzies KM, Shah V, Aziz K, Isaranuwatchai W, Palacio-Derflingher L, Scotland J, Larocque J, Mrklas K, Suter E, Naugler C, Stelfox HT, Chari R, Lodha A; Alberta FICare Level II NICU Study Team.Trials. 2017 Oct 10;18(1):467. doi: 10.1186/s13063-017-2181-3.PMID: 29017578 Free PMC article. Clinical Trial.

Raiskila S, Axelin A, Toome L, Caballero S, Tandberg BS, Montirosso R, et al. Parents’ presence and parent-infant closeness in 11 neonatal intensive care units in six European countries vary between and within the countries. Acta Paediatr. 2017;106:878-888.

2016

Benzies, K. M. Relational communications strategies to support family-centered neonatal intensive care. Journal of Perinatal and Neonatal Nursing. 2016, 30(3), 233-236. 

2015

Evaluation of the Family Integrated Care model of neonatal intensive care: a cluster randomized controlled trial in Canada and Australia.

O’Brien K, Bracht M, Robson K, Ye XY, Mirea L, Cruz M, Ng E, Monterrosa L, Soraisham A, Alvaro R, Narvey M, Da Silva O, Lui K, Tarnow-Mordi W, Lee SK.

BMC Pediatr 2015 Dec 15;15:210.  doi: 10.1186/s12887-015-0527-0.

Evaluation of the Family Integrated Care model of neonatal intensive care: a cluster randomized controlled trial in Canada and Australia.

O’Brien K, Bracht M, Robson K, Ye XY, Mirea L, Cruz M, Ng E, Monterrosa L, Soraisham A, Alvaro R, Narvey M, Da Silva O, Lui K, Tarnow-Mordi W, Lee SK.BMC Pediatr. 2015 Dec 15;15:210. doi: 10.1186/s12887-015-0527-0.PMID: 26671340 Free PMC article. Clinical Trial.

2014

Parents as practitioners in preterm care.

Jiang S, Warre R, Qiu X, O’Brien K, Lee SK.Early Hum Dev. 2014 Nov;90(11):781-5. doi: 10.1016/j.earlhumdev.2014.08.019. Epub 2014 Sep 20.PMID: 25246323 Review.

Parents as primary caregivers in the neonatal intensive care unit.

Lee SK, O’Brien K.CMAJ. 2014 Aug 5;186(11):845-7. doi: 10.1503/cmaj.130818. Epub 2014 Apr 7.PMID: 24710910 Free PMC article.

2013

Implementing family-integrated care in the NICU: a parent education and support program.
Bracht M, OʼLeary L, Lee SK, OʼBrien K.Adv Neonatal Care. 2013 Apr;13(2):115-26. doi: 10.1097/ANC.0b013e318285fb5b.PMID: 23532031

Implementing family-integrated care in the NICU: educating nurses.

Galarza-Winton ME, Dicky T, OʼLeary L, Lee SK, OʼBrien K.Adv Neonatal Care. 2013 Oct;13(5):335-40. doi: 10.1097/ANC.0b013e3182a14cde.PMID: 24042139

Implementing family-integrated care in the NICU: engaging veteran parents in program design and delivery.

Macdonell K, Christie K, Robson K, Pytlik K, Lee SK, OʼBrien K.Adv Neonatal Care. 2013 Aug;13(4):262-9, quiz 270-1. doi: 10.1097/ANC.0b013e31829d8319.PMID: 23912018

A pilot cohort analytic study of Family Integrated Care in a Canadian neonatal intensive care unit.

O’Brien K, Bracht M, Macdonell K, McBride T, Robson K, O’Leary L, Christie K, Galarza M, Dicky T, Levin A, Lee SK.BMC Pregnancy Childbirth. 2013;13 Suppl 1(Suppl 1):S12. doi: 10.1186/1471-2393-13-S1-S12. Epub 2013 Jan 31.PMID: 23445639 Free PMC article.

Randomized Control Trial

Number of centers enrolled: 19 Canadian, 6 Australian, and 1 New Zealand NICUs randomized to FICare or current standard-of-care (13 intervention sites/13 control sites). Teams from the intervention sites received a 2-day workshop on how FICare was to be implemented at their sites.

Intervention sites:

  • All intervention sites were expected to: train nursing staff to support FICare, provide an ongoing parent education program, develop and provide opportunities for veteran parent/peer-to-peer support, and develop environmental and policy supports for FICare
  • Each site had a visit by research staff to support and assess the implementation of the model

Inclusion Criteria:

Infants born < 33 weeks gestation, on low level respiratory support, a primary caregiver parent, willing and able to commit to spending 6 hours per day with their baby between the hours of 0700 and 2000, parental consent.

Exclusion Criteria:

Palliative care, severe congenital anomaly, critical illness (unlikely to survive), on high level of respiratory support, parental request for early transfer, parental inability to participate.

Outcomes Being Measured:

The primary outcome is weight gain. Secondary outcomes include breastfeeding rates, clinical outcomes, safety, parental stress and anxiety, and resource use.

Key outcomes of the cRCT:

Improved weight gain, decreased parent stress and anxiety, improved breast feeding

Research paper:

Evaluation of the Family Integrated Care model of neonatal intensive care: a cluster randomized controlled trial in Canada and Australia.
O’Brien K, Bracht M, Robson K, Ye XY, Mirea L, Cruz M, Ng E, Monterrosa L, Soraisham A, Alvaro R, Narvey M, Da Silva O, Lui K, Tarnow-Mordi W, Lee SK.

BMC Pediatr 2015 Dec 15;15:210.  doi: 10.1186/s12887-015-0527-0.

Pilot Study Details  *

The FICare model was originally developed by a team of doctors, nurses, parents and other health professionals at Mount Sinai Hospital in Toronto.

Our group has conducted and published the results of a pilot study investigating the impact of FICare on infants and parents. The study is summarized below. We have also completed a cluster randomised controlled trial investigating outcomes observed under the FICare model in 19 Canadian, 6 Australian and 1 New Zealand NICUs (13 intervention sites, 13 control sites) also summarized below.  Click here for a list of participating sites.

Pilot start date: March, 2011
Length of study: 12 months
Number of patients enrolled: 40 patients
Location: 4 bed spaces reserved in Level II FICare area
Time Commitment for Parents: Minimum 8 hours each day – during day

Inclusion Criteria:

< 35 weeks gestation, on low level respiratory support, a primary caregiver parent, willing and able to commit to spending 8 hours per day with their baby between the hours of 0700 and 2000, parental consent.

Exclusion criteria:

Palliative care, severe congenital anomaly, critical illness (unlikely to survive), parental request for early transfer, parental inability to participate.

Subjects:

The pilot study enrolled 42 mothers (4 sets of twins), 17 (40%) of whom had other children at home. The majority (22, 55%) were Canadian born; 11 lived in Canada >10 years. All subjects had at least grade 10 high school education; and 27 (71%) were employed outside the home. The subjects varied in age from 23-45 years (mean 33 years).

Key Outcomes of the Pilot Study:

Improved weight gain, fewer nosocomial infections, increased breastfeeding rates, less ROP, and fewer incident reports were filed. Parents also reported decreased parental stress.

* A pilot cohort analytic study of Family Integrated Care in a Canadian neonatal intensive care unit. BMC Pregnancy Childbirth, Volume 13 Suppl 1:S12, 2013