Effect of Anticipatory Guidance on Parental Knowledge and Anxiety Prior to Discharge of Infant from the Neonatal Intensive Care Unit to Home
Year of Publication
Doctor of Nursing Practice
Dr. Debra Hampton
Dr. Kimberly Walker
Dr. Morgan Chojnacki
Background: Lack of adequate parental education and discharge readiness from the Neonatal Intensive Care Unit (NICU) increases the risk for poor infant outcomes, hospital readmissions, postpartum depression, parental anxiety, and post-traumatic stress disorder. One component of parental readiness at discharge is receiving anticipatory guidance from a trusted healthcare provider prior to discharge.
Purpose/Objectives: This study aimed to evaluate the effectiveness of provider-led anticipatory guidance to enhance parents’ knowledge regarding high-risk infant behaviors and decrease anxiety related to caring for their high-risk infant after NICU discharge. Additionally, this study aimed to assess parental opinions about the value of anticipatory guidance sessions.
Theoretical framework: Dorothy Johnson’s Behavioral System Model was utilized to guide this research study. This model provides a framework for psychosocial support to NICU parents/caregivers in order to reduce adverse outcomes and hospital readmissions for the high-risk infant.
Methods: A quasi-experimental controlled trial utilizing a one group pre-intervention, post-intervention survey design was used to examine the psychosocial effect of anticipatory guidance to parents of high-risk infants nearing hospital discharge from the NICU. Parental knowledge and concerns were assessed using a 5-point Likert scale within seven days of anticipated discharge. The same survey was provided immediately following the anticipatory guidance session to determine its’ effectiveness.
Results: The mean scores for all elements related to caregiver responsibilities decreased post-intervention, indicating that parental stress and concerns over these elements were decreased after anticipatory guidance was provided. Three elements were statistically significant including: overall feeding and nutrition goals, breastfeeding goals (if applicable), and who to contact for questions or concerns once discharged home from the hospital. Mean scores for parental stress/concerns over common high risk infant behaviors decreased after the intervention, but not to a significant level. One hundred percent of participants recommended that all NICU families receive anticipatory guidance and deemed the discussion valuable.
Conclusion: This study suggested that anticipatory guidance from a healthcare provider decreases parental anxiety and concerns over NICU discharge. Based on the results of this study, it is recommended that parents of high-risk infants receive anticipatory guidance before their infant is discharged.
Kelty, Stephanie, "Effect of Anticipatory Guidance on Parental Knowledge and Anxiety Prior to Discharge of Infant from the Neonatal Intensive Care Unit to Home" (2022). DNP Projects. 407.