"What's helpful, what's problematic, what's missing" during your stay? Fathers' experiences of supports in NICU: A qualitative study.

Background: The birth of a premature or unwell baby results in the need for a neonatal admission and a period of stay within a Neonatal Intensive Care Unit (NICU). This ushers a period of time of uncertainty and stress for parents. Premature birth and hospitalisation are known to interrupt the normal attachment process. The attachment between parents and children is a precursor to the strengthening of parenting skills, the growth and development of the baby and an establishment of a bond between parent and child. (Fegran, Helseath & Fagermoen, 2008). Research to date into the experiences of parents within the NICU has placed an emphasis on mothers or the parents collectively. Very little is known on the experiences of fathers’, how they cope over a longer period of hospitalisation and what supports may assist them as fathers through this journey. Aim: The aim of this qualitative study was to hear first-hand from fathers their experiences of having a baby in the NICU. What they felt helped, was problematic or was missing in the way of supports and resources over a period of time. The purpose of this study aiming to inform NICU services and the professionals working within the NICU environment with further insight into and consideration of dedicated provision of supports and facilities for fathers’. Method: A Qualitative research approach was undertaken to explore and gain insight into the underlying reasons, opinions and experiences of the consented fathers. Semi structured individual interviews were completed with ten consented fathers. The participants were fathers with infants born less than thirty three weeks gestation and cared for in the Christchurch NICU. For this study a long term NICU stay was defined as being for a period of four weeks or more. Interviews were held at least one month post discharge. The participants’ interviews were audiotaped and in addition notes were taken to gather any further contextual material. Qualitative thematic analysis using Sandelowski’s (2000) qualitative descriptive approach to analysis was utilised to identify and explore the valuable information shared by the fathers. Findings: The rich data that emerged from the ten fathers’ stories, were analysed into a number of sub themes that could be categorised into four major themes. These major themes were categorised into; the facilities and the environment of the NICU. Communication and interaction with others. Through their eyes, the father’s perception of their role in the NICU and finally fathers’ supports experienced or suggested. Conclusion: The insight that was provided by these fathers’ highlights that fathers experiences of a NICU stay is different to that of mothers. That the experiences and supports required can alter over time and that when there is a need for support this should be tailored to and for fathers as discussed within this study. The findings and recommendations would locally offer the opportunity to explore improvements to or the introduction of dedicated supports for fathers. Dissemination at a national level could enable the wider neonatal community to reflect upon the findings and recommendations and consider wider provision of supports and facilities for fathers in the NICU