Family integrated care reduces stress in transferred parents of preterm infants, but not across all families: a stepped-wedge cluster-randomized trial

Abstract

Objective: To assess whether Family Integrated Care (FICare) model including Family-Centered Rounds (FCR) reduces parental stress in neonatal wards.

Study design: A multicenter, stepped-wedge cluster-randomized trial was conducted in ten level II neonatal wards in The Netherlands (March 2022-December 2023). Participants included parents of 613 infants hospitalized for ≥7 days. The primary outcome was parental stress at discharge (PSS:NICU scale). Secondary outcomes included parental participation, anxiety, trauma, depression, shared decision-making, and bonding.

Results: FICare significantly increased parental participation (P < 0.001) but did not reduce overall stress at discharge (FICare 61.2 vs. SNC 62.5, P = 0.21). Trauma symptoms in partners decreased (P = 0.03), and parents of transferred infants showed reduced stress (P = 0.01).

Conclusion: While FICare improved parental involvement, overall stress reduction was limited, with benefits seen in reduced trauma symptoms in partners and a reduction of stress in parents of transferred infants.

Trial registration: The trial has been registered at Clinical Trials.gov under registration number NCT05343403.