Assessing Family-Centered Care in Iranian NICUs from Perspective of Neonatal Individual Developmental Care

Document Type : Original Article


1 Ali Asghar Children’s Hospital, Iran University of Medical Sciences, Tehran, Iran

2 Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

3 Neonatal Research Center, Paediatric Department, Shiraz University of Medical Sciences, Shiraz, Iran

4 Department of Epidemiology, School of Health, Arak University of Medical Sciences, Arak, Iran

5 Children Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran


Background: Preterm deliveries and premature babies are among challenges for families and communities. A family-centered care model is a model that helps families become less challenged by preterm birth and learn how to care for their premature infants. The aim of this study was to evaluate the implementation of family-centered care in the Iranian neonatal intensive care units (NICUs).
Methods: This national cross-sectional study was conducted on a total of 23 NICUs of 9 universities of medical sciences, where students were trained in the neonatology fellowship course, in seven provinces of Iran. Family-centered developmental care was assessed in six different domains, including the philosophy of nursery, family communication, family support, family resources, admission and discharge planning, and decision-making. In addition, a total of 29 items were asked. The data were analyzed using Stata software (version 13) using descriptive statistical tests.
Results: The mean scores in all domains were weak, and the total score for all domains was 34.18 (95% CI: 33.75-34.60) out of 100. The mean scores were 30 in the philosophy of nursery, 43.47 in family communication, 26.71 in family support, 35 in family resources, 45 in admission and discharge planning, and 25 in decision-making. The lowest score was reported for decision-making, and the highest score was reported for admission and discharge planning.
Conclusion: Since family-centered developmental care in Iran is not favorable, the obtained findings suggest the development of a suitable plan to upgrade family-centered developmental care as well as comprehensive NICU care, including developmental care, with regard to other domains.


1. Hall SL, Phillips R, Hynan MT. Transforming NICU care to provide comprehensive family support. Newborn Infant Nurs Rev. 2016; 16(2):69-73.
2. Pritchard VE, Montgomery-Honger A. A comparison
of parent and staff perceptions of setting-specific and everyday stressors encountered by parents with very preterm infants experiencing neonatal intensive care. Early Hum Dev. 2014; 90(10):549-55.
3. Samra HA, McGrath JM, Fischer S, Schumacher B, Dutcher J, Hansen J. The NICU parent risk evaluation and engagement model and instrument (PREEMI) for neonates in intensive care units. J Obstet Gynecol Neonatal Nurs. 2015; 44(1):114-26.
4. Woodward LJ, Bora S, Clark CA, Montgomery-Honger A, Pritchard VE, Spencer C, et al. Very preterm birth: maternal experiences of the neonatal intensive care environment. J Perinatol. 2014; 34(7):555-61.
5. Baia I, Amorim M, Silva S, Kelly-Irving M, de Freitas C, Alves E. Parenting very preterm infants and stress in Neonatal Intensive Care Units. Early Hum Dev. 2016; 101:3-9.
6. Gooding JS, Cooper LG, Blaine AI, Franck LS, Howse JL, Berns SD. Family support and family-centered care in the neonatal intensive care unit: origins, advances, impact. Semin Perinatol. 2011; 35(1): 20-8.
7. Cooper LG, Gooding JS, Gallagher J, Sternesky L, Ledsky R, Berns SD. Impact of a family-centered care initiative on NICU care, staff and families. J Perinatol. 2007; 27(Suppl 2):S32-7.
8. Westrup B, Stjernqvist K, Kleberg A, Hellström-Westas L, Lagercrantz H. Neonatal individualized care in practice: a Swedish experience. Semin Neonatol. 2002; 7(6):447-57.
9. ArshadiBostanabad M, NamdarArshatnab H, Balila M, Asghari Jafarabadi M, Ravanbakhsh K. Effect of family-centered intervention in neonatal intensive care unit on anxiety of parents. Int J Pediatr. 2017; 5(6):5101-11.
10. Aliabadi F, Kamali M, Borimnejad L, Rassafiani M, Rasti M, Shafaroodi N, et al. Supporting-emotional needs of Iranian parents with premature infants admitted to Neonatal Intensive Care Units. Med J Islam Repub Iran. 2014; 28:53.
11. Balbino FS, Balieiro MM, Mandetta MA. Measurement of family-centered care perception and parental stress in a neonatal unit. Rev Lat Am Enfermagem. 2016; 24:e2753.
12. Eskandari Z, Razavi Nejad M, Akrami F, Almasi-Hashiani A, Heidarzadeh M. Assessing staff-oriented care with developmental support approach in Iranian NICUs. J Matern Fetal Neonatal Med. 2019; 32(6):1009-13.
13. Razavi Nejad M, Eskandari Z, Heidarzadeh M, Afjeh A, Almasi-Hashiani A, Akrami F. Assessing infant-oriented care with developmental support approach in Iranian NICUs. J Matern Fetal Neonatal Med. 2018; 31(14):1851-5.
14. Razavi Nejad M, Heidarzadeh M, Mohagheghi P, Akrami F, Almasi-Hashiani A, Eskandary Z. Assessment of physical environment of Iran’s neonatal tertiary care centers from the perspective of the neonatal individualized developmental care. Iran J Neonatol. 2017; 8(4):20-5.
15. Kleberg A, Hellstrom-Westas L, Widstrom AM. Mothers' perception of Newborn Individualized Developmental Care and Assessment Program (NIDCAP) as compared to conventional care. Early Hum Dev. 2007; 83(6):403-11.
16. Wielenga JM, Smit BJ, Unk LK. How satisfied are parents supported by nurses with the NIDCAP model of care for their preterm infant? J Nurs Care Qual. 2006; 21(1):41-8.