Communication Barriers to Implementation of Family-Centered Care from Perspective of Mothers and Personnel of Neonatal Intensive Care Unit: A Qualitative Study

Abstract

Background: Positive communication between staff and parents is considered a basic principle for the successful implementation of family-centered care (FCC) and the formation of a good relationship between parents and neonates. Moreover, involvement in care depends on the communication and interaction of parents with healthcare providers, and cooperation between them leads to high-quality care for neonates. However, interaction and communication are still considered major challenges in the neonatal intensive care unit (NICU) environment. Since these challenges and communication barriers are different in various cultures and environments, they should be identified in the field. A literature review shows that no study has assessed the views of different members of the treatment team and parents on communication barriers in Iran. Objectives: The present study aimed to investigate the communication barriers related to personnel and parents for implementing FCC from the perspective of parents, physicians, nurses, and nursing managers. Methods: A qualitative study was conducted in 2021 - 2022 using the conventional content analysis approach in a NICU in Tehran, Iran. In this study, 26 semi-structured interviews and 10 field notes were used to collect data to reach data saturation. Results: Data analysis led to the emergence of two themes. The first theme was the unprofessional relationships of personnel, including two main categories of inappropriate professional behavior and lack of attention to personnel and working conditions of the ward. The second theme was mutually ineffective relationships between personnel and parents, including two main categories of the inappropriate attitude of personnel and parents toward each other and unsympathetic communication between personnel and parents. The themes showed the participants’ experiences of communication barriers to the implementation of FCC in NICUs in Iran. Conclusions: Removing communication barriers between healthcare providers and parents requires developing a coherent, comprehensive, and unified training program to prepare and create integrated coordination among the treatment team and the family, creating a positive attitude toward FCC and the presence of parents, improving relationships, and giving further attention and support by managers to personnel and the conditions of the ward.