BACKGROUND: Neonatal nurses should provide timely and high-quality palliative care whenever necessary. It\'s necessary to investigate the knowledge, attitude and behavior of palliative care among neonatal nurses, to provide references and evidences for clinical palliative care.
METHODS: Neonatal intensive care unit (NICU) nurses in a tertiary hospital of China were selected from December 1 to 16, 2022. The palliative care knowledge, attitude and behavior questionnaire was used to evaluate the current situation of palliative nursing knowledge, attitude and behavior of NICU nurses. Univariate analysis and multivariate logistic regression analysis were used to analyze the influencing factors.
RESULTS: 122 nurses were finally included. The average score of knowledge in neonatal nurses was 7.68 ± 2.93, the average score of attitude was 26.24 ± 7.11, the score of behavior was 40.55 ± 8.98, the average total score was 74.03 ± 10.17. Spearman correlation indicated that score of knowledge, attitude and behavior of palliative care in neonatal nurses were correlated with the age(r = 0.541), year of work experience(r = 0.622) and professional ranks and titles(r = 0.576) (all P < 0.05). Age (OR = 1.515, 95%CI: 1.204 ~ 1.796), year of work experience (OR = 2.488, 95%CI: 2.003 ~ 2.865) and professional ranks and titles (OR = 2.801, 95%CI: 2.434 ~ 3.155) were the influencing factors of score of knowledge, attitude and behavior of palliative care (all P < 0.05).
UNASSIGNED: NICU nurses have a positive attitude towards palliative care, but the practical behavior of palliative care is less and lack of relevant knowledge. Targeted training should be carried out combined with the current situation of knowledge, attitude and practice of NICU nurses to improve the palliative care ability and quality of NICU nurses.

UNASSIGNED: Nurse perceptions of developmental care practices have been researched globally for almost 30 years. Yet, there is a lack of research exploring this subject in the specialised setting of the surgical neonatal intensive care unit (sNICU). This research explores the effect of developmental care education programs on sNICU nurses\' perceptions of developmental care.
UNASSIGNED: To determine perceptions and attitudes towards developmental care in a specialty neonatal setting.
UNASSIGNED: Cross-sectional study.
UNASSIGNED: Two surgical neonatal intensive care units in Australia.
UNASSIGNED: Registered nurses permanently employed at the study sites between May 2021 to April 2022.
UNASSIGNED: A modified electronic survey explored sNICU nurse perceptions of developmental care organised around three themes: effects of developmental care on parents and infants, application of developmental care, and unit practices. Associations between site, nurse characteristics, developmental care education and nurses\' perceptions were explored using logistic regression [odds ratios (OR) and 95 % confidence intervals (CI)].
UNASSIGNED: Of 295 sNICU nurses, 117 (40 %) participated in the survey. Seventy-five percent of respondents had attended a formal developmental care education program. High levels of agreement (>90 %) were reported regarding the benefits of developmental care for parents and infants. Exposure to developmental care education influenced perceptions of its application. Nurses without formal developmental care education were more likely to agree that it was consistently applied [OR:3.3, 95%CI:1.3-8.6], developmental care skills are valued [OR:2.7, 95%CI:1.1-6.8], and that their nursing peers offered support in its application ([OR:2.5, 95%CI:1.1-6.2].
UNASSIGNED: The results from our research suggest sNICU nurses have a high level of awareness of developmental care and its positive impacts. Despite differences between the surveyed units\' developmental care education programs, the value of developmental care in reducing stress for infants and supporting families was collectively recognised. Future research in this setting should focus on evaluating the application of developmental care in this setting.

UNASSIGNED: The main role of nurses is not only to inform about the disease and treatment of the patient but also to establish an effective therapeutic relationship to address concerns and provide empathy, comfort, and support. This issue is very prominent in neonatal intensive care units (NICUs) and doubles the importance of empathetic communication between nurses and parents and promoting empathy skills in nurses working in neonatal intensive care units.
UNASSIGNED: This study aimed to evaluate the effect of a support program on the empathy of neonatal intensive care nurses across the Iran.
UNASSIGNED: This study was conducted in 2021 as a semi-experimental intervention in a group of 166 nurses working in the neonatal department all over Iran who met the inclusion criteria. Jefferson\'s empathy questionnaire was completed electronically by the participants before and after the online education program start. Data were analyzed using SPSS software (V 24.0).
UNASSIGNED: The empathy score of nurses was 60.31 ± 5.76 before and 66.47 ±6.60 after the intervention. The empathy scores of nurses after the intervention increased statistically significantly.
UNASSIGNED: Nurses can communicate empathically with parents by training their verbal and nonverbal communication skills and gaining a common understanding of the feelings of parents of premature infants.

A newborn\'s admission to the Neonatal Intensive Care Unit (NICU) can be both stress inducing and frightening for a parent or caregiver. With nursing being a constant calming presence, a trusting bond between the parents and nurses often becomes the lifeline to survive the NICU journey. This bond impacts not only the baby and family, but also promotes the institution\'s reputation within the community. In today\'s climate of healthcare professional shortages, the power of the nurses\' connections to families cannot be overlooked. It is critical in all neonatal units, especially where parents are being approached to enroll their infant in clinical research.

Low birth weight (LBW) is associated with short and long-term consequences including neonatal mortality and disability. Effective linkages in the continuum of care (CoC) for newborns at the health facility, community (primary care) and home care levels have a high tendency of minimizing adverse events associated with LBW. But it is unclear how these linkages work and what factors influence the CoC process in Ghana as literature is scarce on the views of health professionals and families of LBW infants regarding the CoC. Therefore, this study elicited the drivers influencing the CoC for LBW infants in Ghana and how linkages in the CoC could be strengthened to optimize quality of care.
A constructivist grounded theory study design was used. Data was collected between September 2020 to February 2021. A total of 25 interviews were conducted with 11 family members of LBW infants born in a secondary referral hospital in Ghana, 9 healthcare professionals and 7 healthcare managers. Audio recordings were transcribed verbatim, analyzed using initial and focused coding. Constant comparative techniques, theoretical memos, and diagramming were employed until theoretical saturation was determined.
Emerging from the analysis was a theoretical model describing ten major themes along the care continuum for LBW infants, broadly categorized into health systems and family-systems drivers. In this paper, we focused on the former. Discharge, review, and referral systems were neither well-structured nor properly coordinated. Efficient dissemination and implementation of guidelines and supportive supervision contributed to higher staff motivation while insufficient investments and coordination of care activities limited training opportunities and human resource. A smooth transition between care levels is hampered by procedural, administrative, logistics, infrastructural and socio-economic barriers.
A coordinated care process established on effective communication across different care levels, referral planning, staff supervision, decreased staff shuffling, routine in-service training, staff motivation and institutional commitment are necessary to achieve an effective care continuum for LBW infants and their families.

To describe parents\' past and present experiences of their newborn infant\'s therapeutic hypothermia (TH) treatment after perinatal asphyxia 10-13 years after the event.
Newborn infants are treated with TH following perinatal asphyxia to improve neurodevelopmental outcomes.
A qualitative descriptive design using focus groups (FGs).
Twenty one parents to 15 newborn infants treated with TH between 2007 and 2009 participated in five FGs. The FGs were transcribed verbatim and analysed using framework approach. The SRQR checklist was followed for study reporting.
Two main categories were identified: hardships and reliefs during TH treatment and struggles of everyday life. Both categories include three subcategories, the first: (1) concern and gratitude for the unrecognized treatment, (2) insufficiency of information and proposed participation and (3) NICU nurses instilled security and hope. The second with subcategories: (1) unprocessed experiences of the TH treatment, (2) later challenges at school and (3) existential and psychological challenges in everyday life.
TH of their newborns affected the parents psychologically not only during the treatment, but lasted months and years later. Information and communication with health care professionals and school management were inefficient and inadequate. The parents\' concerns could be prevented by an improved identification and understanding of the problems and the needs of the infants and their families before discharge.
Through more personalized and efficient preparation and communication by the nursing staff before discharge, many of the parents\' worries and problems could be reduced. Check-up of parents\' needs of psychosocial support before and after discharge and offering counselling should become routine. Also, nurses at Well-Baby Clinics and in school health care should receive knowledge about TH treatment and the challenges the children and the parents experience.
Participation of parents was limited to the data provided through interviews.

UNASSIGNED: The measurement of the coping difficulties of parents of premature infants after discharge provides objective data for nurses to prepare infants for discharge. However, no Chinese scale has been developed to measure parents\' coping difficulties after their premature infants are discharged.
UNASSIGNED: To translate the parent version of the Post-Discharge Coping Difficulty Scale (Ped-PDCDS) from English to Chinese and test the reliability and validity of the Chinese version in parents of premature infants.
UNASSIGNED: A multicenter cross-sectional study of 356 parents of premature infants was conducted. The scale was symmetrically translated. Validity was evaluated in terms of content, construct, discriminant, and convergent validities. Reliability was assessed in terms of internal consistency, split-half reliability, and test-retest reliability.
UNASSIGNED: The Chinese Ped-PDCDS finally contained 11 items. Exploratory and confirmatory factor analyses results showed that the Chinese Ped-PDCDS had three dimensions, and the convergent and discriminant validities of the scale was satisfactory. The overall reliability, split-half reliability, and test-retest reliability of the scale was 0.85, 0.92, and 0.84, respectively.
UNASSIGNED: The Chinese Ped-PDCDS has adequate psychometric properties, and is an easy and appropriate instrument for measuring parents\' difficulty in coping with premature infants.

This study examined the effects of a virtual reality simulation for advanced infection control education in neonatal intensive care units (VR_AICENICU) on nurses\' infection control knowledge and performance confidence. We examined nurses\' presence, empathy, and program satisfaction using a non-equivalent control group pre-post design. Nurses were divided into an experimental group (n = 20) experiencing VR simulation and routine NICU practice and a control group (n = 20) with routine NICU practice. The VR_AICENICU program comprised three scenarios: high-risk medication with lipid solution, dressing and management for peripheral inserted central line, and aspiration prevention and skincare management during ventilator use for premature infants. Data were collected between February and July 2022. The experimental group showed significantly greater improvements in infection control knowledge and performance confidence compared to the pre-test. The average scores of presence, empathy, and program satisfaction of the experimental group were 4.39 ± 0.36, 4.33 ± 0.75, and 4.90 ± 0.31, respectively. The VR_AICENICU program has implications for the education needs of nurses working in NICUs and enhances their knowledge and performance of infection control. Future studies should apply the VR_AICENICU program to different severity grades of NICU patients and develop additional VR programs.

BACKGROUND: Neonatal pain assessment (NPA) represents a huge global problem of essential importance, as a timely and accurate assessment of neonatal pain is indispensable for implementing pain management.
OBJECTIVE: To investigate the consistency of pain scores derived through video-based NPA (VB-NPA) and on-site NPA (OS-NPA), providing the scientific foundation and feasibility of adopting VB-NPA results in a real-world scenario as the gold standard for neonatal pain in clinical studies and labels for artificial intelligence (AI)-based NPA (AI-NPA) applications.
METHODS: A total of 598 neonates were recruited from a pediatric hospital in China.
METHODS: This observational study recorded 598 neonates who underwent one of 10 painful procedures, including arterial blood sampling, heel blood sampling, fingertip blood sampling, intravenous injection, subcutaneous injection, peripheral intravenous cannulation, nasopharyngeal suctioning, retention enema, adhesive removal, and wound dressing. Two experienced nurses performed OS-NPA and VB-NPA at a 10-day interval through double-blind scoring using the Neonatal Infant Pain Scale to evaluate the pain level of the neonates. Intra-rater and inter-rater reliability were calculated and analyzed, and a paired samples t-test was used to explore the bias and consistency of the assessors\' pain scores derived through OS-NPA and VB-NPA. The impact of different label sources was evaluated using three state-of-the-art AI methods trained with labels given by OS-NPA and VB-NPA, respectively.
RESULTS: The intra-rater reliability of the same assessor was 0.976-0.983 across different times, as measured by the intraclass correlation coefficient. The inter-rater reliability was 0.983 for single measures and 0.992 for average measures. No significant differences were observed between the OS-NPA scores and the assessment of an independent VB-NPA assessor. The different label sources only caused a limited accuracy loss of 0.022-0.044 for the three AI methods.
CONCLUSIONS: VB-NPA in a real-world scenario is an effective way to assess neonatal pain due to its high intra-rater and inter-rater reliability compared to OS-NPA and could be used for the labeling of large-scale NPA video databases for clinical studies and AI training.

OBJECTIVE: Preparing parents to care for their preterm children is one of the principal challenges faced by nursing professionals within the neonatal care contexts. This process seeks for parents to acquire the skills to safely provide the differential care required by children at home given their prematurity condition. The preparation for discharge is complex and multidimensional, involving aspects that have to do with the knowledge, skills for caring, security, and trust to transit and take care of the children at home. This process is conducted in the neonatal unit gradually, in function of the clinical evolution of the children and the adaptation of the parents to the situation, considering their individual, family, social, and cultural characteristics. This article describes the principal aspects related with the preparation for discharge and the transition to the home, contents of the education that must be provided to the parents or principal caregivers, and the recommendations for the professional practice regarding these types of educational processes, aimed at making visible and facilitating the nursing role and follow up of results in the health and wellbeing of the preterm children, their parents, and families.