Volume 34, Issue 134 (February 2022)                   IJN 2022, 34(134): 2-17 | Back to browse issues page

XML Persian Abstract Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Hoseinpour S, Borimnejad L, Rasooli M, Hardani A K, Alhani F. The Effect of Implementing a Family-centered Empowerment Model on the Quality of Life of Parents of Premature Infants Admitted to a Neonatal Intensive Care Unit. IJN 2022; 34 (134) :2-17
URL: http://ijn.iums.ac.ir/article-1-3224-en.html
1- Department of Neonatal Intensive Care Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.
2- Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran.
3- Department of Biostatistic, School of Health, Iran University of Medical Sciences, Tehran, Iran.
4- Department of Pediatrics, School of Medicine, Abuzar Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
5- Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran. , alhani_f@modares.ac.ir
Full-Text [PDF 6529 kb]   (1321 Downloads)     |   Abstract (HTML)  (2306 Views)
Full-Text:   (1770 Views)
1. Introduction
Infant hospitalization in the Intensive Care Unit (ICU) is a psychological crisis that causes stress and disability for the family. In critical situations, the healthcare team’s knowledge is devoted to patient care, while it is necessary to emphasize the family’s needs. Numerous studies report a lack of support for family caregivers and a lack of attention to their needs. The health team should understand the responsibilities and requirements of caregivers and examine them in terms of physical, social, and psychological needs and supportive and financial problems. This study aimed to determine the impact of the family-centered empowerment model on parents’ Quality of Life (QoL) with premature infants admitted to a neonatal ICU (39).
2. Materials and Methods
This quasi-experimental controlled study was performed on 84 patients (parents) with healthy preterm infants admitted to the ICU. Samples were continuously targeted in both intervention and control groups. They received training sessions in 4 steps and 8 sessions:
Step 1 (understanding the threat through group discussion): During two 30-60-minute sessions, group discussion raises awareness about a healthy baby, including skincare, healthy eating, healthy sleep, and sensitizing parents to symptoms. The researcher posed a threat.
Step 2 (promoting self-efficacy through problem-solving): At the beginning of the third session, the ambiguities and questions of the parents were answered; then, during two 60-minute sessions, a group discussion and demonstration about correct breastfeeding positions, how to deal with colic or colic in infants and familiarity and how to deal with a trembling child were discussed.
Step 3 (Promoting self-esteem through educational participation): During three 30-60-minute group discussion sessions, clients were asked to teach their family members the lessons learned in the researcher’s presence to share their experiences. Leave other people in the group and ask questions to yourself or family members in the group and get the answer.
Step 4 (evaluation): In the last session, individuals’ level of knowledge and ability to transfer information from educational cases were examined. The power of the subjects was also assessed by the competency questionnaire (including the three dimensions: threat perception, self-efficacy, and self-esteem). 
A demographic questionnaire and WHOQOL-BREF QoL questionnaire once at the beginning of the study and again one month after completion. Intervention sessions were completed, and the data were analyzed using Chi-square, independent t-test, analysis of variance, and Spearman and Shapiro-Wilk correlation coefficient using SPSS software.
3. Results
There was no significant difference between the two groups regarding demographic characteristics, baseline competency scores (self-efficacy, self-esteem, severity, and sensitivity), and QoL. The total QoL score (P=0.041) in the intervention group was significantly higher than in the control group. In-group comparison, empowerment scores (self-esteem, self-efficacy (P<0.001)) of both groups and intensity and sensitivity scores (P<0.001) showed a significant increase only in the intervention group. In terms of QoL, in the psychological dimension (P=0.042), social (P=0.003), environmental, and total scores (P<0.001) in the intervention group and the total score dimension (P=0.41), There was a significant increase in environmental performance (P<0.001) in the control group.
4. Conclusion
The family-centered empowerment model has improved some QoL factors. Further studies are needed to meet a definitive conclusion in this regard. It is suggested that future researchers strengthen the family-centered empowerment program in less effective dimensions. Other studies should also be performed on using a family-centered empowerment program to empower pregnant women with the possibility of preterm delivery and its effectiveness after delivery.

Ethical Considerations
Compliance with ethical guidelines

This syudy was approved by the ethical committee of the Iran University of Medical Sciences (Code: IR.IUMS.REC.1394.165) and permission and referral letter have been obtained from Ahwaz University of Medical Sciences.

The paper was extracted from the MSc. thesis of the first author, Department of Neonatal and Pediatric Nursing Faculty of Nursing, Iran University of Medical Sciences. 

Authors' contributions
All authors equally contributed to preparing this article. 

Conflict of interest
The authors declared no conflict of interest.

  1. Armanian AM, Barekatain B, Sohrabi F, Salehimehr N, Mansourian M. The prevalence of complications of prematurity among 1000 newborns in Isfahan, Iran. Adv Biomed Res. 2019; 8(12). [DOI:10.4103/abr.abr_84_18] [PMID] [PMCID]
  2. Vercruysse J, Mekasha S, Stropp LM, Moroney J, He X, Liang Y, et al. Chlamydia trachomatis infection, when treated during pregnancy, is not associated with preterm birth in an urban safety-net hospital. Infect Dis Obstet Gynecol. 2020; 2020: 8890619. [DOI:10.1155/2020/8890619] [PMID] [PMCID]
  3. Ghaderighahfarokhi S, Sadeghifar J, Mozafari M. A model to predict low birth weight infants and affecting factors using data mining techniques. J Basic Res Med Sci. 2018; 5(3):1-8. [DOI:10.29252/jbrms.5.3.1]
  4. Alinejad-Naeini M, Peyrovi H, Shoghi M. Emotional disorganization: The prominent experience of Iranian mothers with preterm neonate: A qualitative study. Health Care Women Int. 2021; 42(4-6):815-35. [DOI:10.1080/07399332.2020.1797040] [PMID]
  5. Dalir M, Mashouf S, Esmailpourzanjani S. [The effect of spiritual self-care education on the care burden of mothers with children hospitalized in intensive care units for open heart surgery (Persian)]. Complement Med J. 2020; 10(1):34-45. [DOI:10.32598/cmja.10.1.866.1]
  6. Rasti M, Aliabadi F F, Shafarodi N, Rafiee F, Kalani M. [Specification of the educational needs of parents with premature infants admitted to neonatal intensive care unit (Persian)]. J Mod Rehabil. 2014; 8(4):21-9. http://mrj.tums.ac.ir/article-1-5170-en.html
  7. Rinehimer MA. Investigating the needs of parents of premature infants’ interaction in the neonatal intensive care unit. New Jerse: Seton Hall University; 2017. https://scholarship.shu.edu/dissertations/2311/
  8. Petersen IB, Quinlivan JA. Fatherhood too soon. Anxiety, depression and quality of life in fathers of preterm and term babies: A longitudinal study. J Psychosom Obstet Gynecol. 2020; 42(2):162-7. [DOI:10.1080/0167482X.2020.1808620] [PMID]
  9. Amorim M, Silva S, Kelly-Irving M, Alves E. Quality of life among parents of preterm infants: A scoping review. Qual Life Res. 2018; 27(5):1119-31. [DOI:10.1007/s11136-017-1771-6] [PMID]
  10. Fumincelli L, Mazzo A, Martins JCA, Mendes IAC. Quality of life and ethics: A concept analysis. Nurs Ethics. 2019; 26(1):61-70. [DOI:10.1177/0969733016689815] [PMID]
  11. Skevington SM, Epton T. How will the sustainable development goals deliver changes in well-being? A systematic review and meta-analysis to investigate whether WHOQOL-BREF scores respond to change. BMJ glob health. 2018; 3(Suppl 1):e000609. [DOI:10.1136/bmjgh-2017-000609] [PMID] [PMCID]
  12. Hill PD, Aldag JC. Maternal perceived quality of life following childbirth. J Obstet, Gynecol Neonatal Nurs. 2007; 36(4):328-34. [DOI:10.1111/j.1552-6909.2007.00164.x] [PMID]
  13. Amorim M, Alves E, Kelly-Irving M, Ribeiro AI, Silva S. Quality of life of parents of very preterm infants 4 months after birth: A mixed methods study. Health qual life Outcomes. 2018; 16(1):178. [DOI:10.1186/s12955-018-1011-y] [PMID] [PMCID]
  14. Moura MR, Araújo CGA, Prado MM, Paro HB, Pinto RM, Abdallah VO, et al. Factors associated with the quality of life of mothers of preterm infants with very low birth weight: A 3-year follow-up study. Qual Life Res. 2017; 26(5):1349-60. [DOI:10.1007/s11136-016-1456-6] [PMID]
  15. Santos Jr H, Yang Q, Docherty SL, White-Traut R, Holditch-Davis D. Relationship of maternal psychological distress classes to later mother-infant interaction, home environment, and infant development in preterm infants. Res Nurs Health. 2016; 39(3):175-86. [DOI:10.1002/nur.21719] [PMID] [PMCID]
  16. Khanjari S, Mosavipoor S, Oskouie F, Haghani H. [Quality of life and sense of coherence in the mothers with term and preterm infants (Persian)]. Iran J Nurs. 2017; 30(106):57-67. [DOI:10.29252/ijn.30.106.57]
  17. Zareinejad S, Norouzi K, Saajedi F, Rahgooy A, Norouzi M, Hemmati A. [Evaluation of the relationship between self-efficacy and quality of life in mothers with preterm Infants in Kamali hospital of Karaj, Iran, 2015 (Persian)]. Iran J Rehabil Res. 2018; 4(3):54-61. http://ijrn.ir/article-1-246-en.html
  18. Haddad S, Dennis C-L, Shah PS, Stremler R. Sleep in parents of preterm infants: A systematic review. Midwifery. 2019; 73:35-48. [DOI:10.1016/j.midw.2019.01.009] [PMID]
  19. Heidari M, Alhani F, Kazemnejad A, Moezzi F. [The effect of empowerment model on quality of life of Diabetic adolescents (Persian)]. Iran J Pediatr. 2007; 17(s1):87-94. https://tspace.library.utoronto.ca/bitstream/1807/58441/1/pe07026.pdf
  20. Mahmoud FK, Mahmoudirad GH, Shahraki E. The Effect of Family-Centered Empowerment on the Life of Patients with Asthma. J Med Res Health Sci. 2019; 4(2):22-31. https://sciarena.com/storage/models/article/kV2H0qh4TaeJzVia.pdf
  21. Masoodi R, Alhani F, Rabiei L, Majdinasab N, Moghaddasi J, Esmaeili S, et al. [The effect of family-centered empowerment model on quality of life and self efficacy of multiple sclerosis patients family care givers (Persian)]. Iran J Nurs Res. 2012; 7(27):32-43. http://ijnr.ir/browse.php?a_code=A-10-1-92&slc_lang=en&sid=1
  22. Meiers SJ, Eggenberger SK, Krumwiede N. Development and implementation of a family-focused undergraduate nursing curriculum: Minnesota state university, Mankato. J Fam Nur. 2018; 24(3):307-44. [DOI:10.1177/1074840718787274] [PMID]
  23. Rajaei A, Jensen JF. Empowering patients in integrated behavioral health-care settings: A narrative approach to medical family therapy. Fam J. 2020; 28(1):48-55. [DOI:10.1177/1066480719893958]
  24. Funk LM, Stajduhar KI, Giesbrecht M, Cloutier D, Williams A, Wolse F. Applying the concept of structural empowerment to interactions between families and home-care nurses. Nurs Inq. 2020; 27(1):e12313. [DOI:10.1111/nin.12313] [PMID]
  25. Moradi H, Borimnejad L, Seyed Fatemi N, Haghani H, Moradi M. The effect of the empowerment program on the chronic sorrow of the parents of premature newborn in neonatal intensive care units. Iran J Nurs. 2019; 32(121):94-106. [DOI:10.29252/ijn.32.121.94]
  26. Sajadi H, Akhoundzadeh G, Hojjati H. The effect of empowerment program on participation of mothers with premature infants hospitalized in neonatal intensive care unit of Sayyed Shirazi hospital in Gorgan, in 2018. Indian J Forensic Med Toxicol. 2020; 14(2):1269-76. file:///C:/Users/m.jamshidi/Downloads/ojsadmin,+274.pdf
  27. Rezvani A. [The implementation of empowerment program to promote hope in parents of preterm infants hospitalized in Neonatal Intensive Care Unit (NICU) in 2019: Faculty of Nursing and Midwifery, Kerman University of Medical Sciences (Persian)] [MA thesis]. Kerman: Kerman University of Medical Sciences; 2020. http://eprints.kmu.ac.ir/34984/1/7856.pdf
  28. Montirosso R, Tronick E, Borgatti R. Promoting neuroprotective care in neonatal intensive care units and preterm infant development: Insights from the neonatal adequate care for quality of life study. Child Dev Perspect. 2017; 11(1):9-15. [DOI:10.1111/cdep.12208]
  29. Jaekel J, Pluess M, Belsky J, Wolke D. Effects of maternal sensitivity on low birth weight children’s academic achievement: A test of differential susceptibility versus diathesis stress. J Child Psychol Psychiatry. 2015; 56(6):69 3-701. [DOI:10.1111/jcpp.12331] [PMID]
  30. Allahyari A, Alhani F, Kazemnejad A, Izadyar. [The effect of family-centered empowerment model on the Quality of Life of school-age B-thalassemic children (Persian)]. Iran J Pediatr. 2006; 16(4):455-61. https://tspace.library.utoronto.ca/bitstream/1807/58351/1/pe06061.pdf
  31. Pilevar N, Ramezani M, Malek A, Behnam Vashani H. Effect of implementing family-centered empowerment model on the quality of life in school-age children diagnosed with rheumatoid arthritis. Evid Based Care J. 2019; 9(2):65-73. [DOI:10.22038/ebcj.2019.39702.2046]
  32. Barnes CR, Adamson-Macedo EN. Perceived Maternal Parenting Self-Efficacy (PMP S-E) tool: Development and validation with mothers of hospitalized preterm neonates. J Adv Nurs. 2007; 60:550-60. [DOI:10.1111/j.1365-2648.2007.04445.x] [PMID]
  33. Aliabadi F, Borimnejad L, Kamali M, Rassafiani M, Nazi S. Perceived maternal parenting self-efficacy (PMP SE) tool: Translation and face validation with Iranian mothers of hospitalized preterm neonates. Iran Rehabil J. 2013; 11:7-10. https://applications.emro.who.int/imemrf/Iran_Rehabil_J/Iran_Rehabil_J_2013_11_Special_Issue_7_10.pdf
  34. Rosenberg M. Society and the adolescent self-image. New Jersey: Princeton university press; 2015. [DOI:10.1515/9781400876136]
  35. Morris Rosenberg, Ciarrochi J, L B. Rosenberg Self-Esteem scale (RSE). Wollongong-Australlia: University of Wollongong; 1995. 332 p.
  36. Rosenberg M. Rosenberg self-esteem scale (RSE). In: Ciarrochi J, Bilich L, editors. Acceptance and commitment therapy. Measures package: Process measures of potential relevance to ACT. Wollongong: University of Wollongong; 2006. https://www.google.com/books/edition/Acceptance_and_Commitment_Therapy_Measur/JDENjwEACAAJ?hl=en
  37. Greenberger E, Chen C, Dmitrieva J, Farruggia SP. Item-wording and the dimensionality of the rosenberg self-esteem scale: Do they matter? Personal individ dif. 2003; 35(6):1241-54. [DOI:10.1016/S0191-8869(02)00331-8]
  38. Rajabi Gh, Behlool N. [Assessing the reliability and validity of rosenberg self-esteem scale of first year students of Shahid Chamran University (Persian)]. Educ Psychol Res. 2007; 3(2):33-48. https://www.sid.ir/fa/journal/ViewPaper.aspx?ID=138197
  39. WHOQOL-BREF. Introduction, administration, scoring and generic version of the assessment: Field trial version, December 1996. Geneva: World Health Organization; 1996. https://apps.who.int/iris/bitstream/handle/10665/63529/WHOQOL-BREF.pdf?sequence=1
  40. WHOQOL User Manual: Programme on mental health. Geneva: World Health Organization; 1998. https://books.google.com/books?id=3HMJtwAACAAJ&dq=WHOQOL+User+Manual&hl=en&sa=X&ved=2ahUKEwirwcjrnPr1AhWqQvEDHdAoCrMQ6AF6BAgDEAE
  41. Nejat S, Montazeri A, K. H. [Standardization of WHO’s life quality questionnaire; Translation & psychometry of the Iranian type (Persian)]. J Health Fac Health Res. 2006; 4(4):1-12. http://sjsph.tums.ac.ir/article-1-187-en.html
  42. Gill FJ, Wilson S, Aydon L, Leslie GD, Latour JM. Empowering parents of australian infants and children in hospital: Translation, cultural adaptation, and validation of the empowerment of parents in the intensive care-30-AUS questionnaire. Pediatr Crit Care Med. 2017; 18(11):e506-e13. [DOI:10.1097/PCC.0000000000001309] [PMID]
  43. Vanderkerken L, Heyvaert M, Onghena P, Maes B. The relation between family quality of life and the family-centered approach in families with children with an intellectual disability. J Policy Pract Intellect Disabil. 2019; 16(4):296-311. [DOI:10.1111/jppi.12317]
  44. Crespo C, Santos S, Tavares A, Salvador Á. “Care that matters”: Family-centered care, caregiving burden, and adaptation in parents of children with cancer. Fam Syst Health. 2016; 34(1):31-40. [DOI:10.1037/fsh0000166] [PMID]
  45. McDonald CM, Haberman D, Brown N. Self-efficacy: Empowering parents of children with cystic fibrosis. J Cyst Fibros. 2013; 12(5):538-43. [DOI:10.1016/j.jcf.2012.11.014] [PMID]
  46. Tabari F, Pedram Razi S, Asadi Gharabaghi M, Torabi S, Mehran A, Mohamadinejad F, et al. Effect of education based on family-centered empowerment model on the quality of life of elderly patients with chronic obstructive pulmonary disease (COPD). Med Sci. 2018; 22(91):301-11. http://www.discoveryjournals.org/medicalscience/current_issue/v22/n91/A8.pdf
  47. Ramazanian Z, Alhani F, Anoosheh M. [The effect of family centered empowerment model on mothers’ qol of girls under six years old with uti (Persian)]. J Health Promot Manage. 2014; 3(3):7-15. http://jhpm.ir/article-1-259-en.html
  48. Vahedian-Azimi A, Rahimi Bashar F, Amini H, Salesi M, Alhani F. [Effect of family-centered empowerment model on quality of life in adults with chronic diseases: A systematic review and meta-analysis study (Persian)]. J Hayat. 2018; 24(2):152-73. https://hayat.tums.ac.ir/article-1-2451-en.pdf
  49. Modanloo S, Rohani C, Farahani AS, Vasli P, Pourhosseingholi A. General family functioning as a predictor of quality of life in parents of children with cancer. J Pediatr Nurs. 2019; 44:e2-e8. [DOI:10.1016/j.pedn.2018.08.013] [PMID]
  50. Teymouri F, Alhani F, Kazemnejad A. [The effect of the family-centered empowerment model on the quality of life in parents of children with asthma (Persian)]. Sci J Hamadan Nurs Midwifery Fac. 2014; 22:5-14. http://nmj.umsha.ac.ir/article-1-1150-en.pdf
  51. Rajabi R, Forozy M, Fuladvandi M, Eslami H, Asadabady A. [The effect of family-centered empowerment model on the knowledge, attitudes and self-efficacy of mothers of children with asthma (Persian)]. J Nurs Educ. 2016; 5(4):41-50. [DOI:10.21859/jne-05046]
  52. Atashzadeh_Shoorideh H, Arshi S, Atashzadeh_Shoorideh F. [The effect of family-centered empowerment model on the life style, self-efficacy and HbA1C of diabetic patients (Persian)]. Iran J Endocrinol Metab. 2017; 19(4):244-51. http://ijem.sbmu.ac.ir/article-1-2258-en.html
  53. Liu CH, Chao YH, Huang CM, Wei FC, Chien LY. Effectiveness of applying empowerment strategies when establishing a support group for parents of preterm infants. J Clin Nurs. 2010; 19(11-12):1729-37. [DOI:10.1111/j.1365-2702.2009.03082.x] [PMID]
  54. Hedayati B. The effect of implementation of family-centered empowerment model on the self-esteem of the old people with hypertension. J Educ Health Promot. 2015; 4:74. [DOI:10.4103/2277-9531.171787] [PMID][PMCID]
  55. Teymouri F, Alhani F, Kazemnejad A. The effect of family-centered empowerment model on self-efficacy and self-esteem of the children with asthma. Prev Care Nurs Midwifery J. 2017; 7(1):18-26. https://zums.ac.ir/nmcjournal/article-1-452-en.pdf

Type of Study: Research | Subject: nursing
Received: 2020/11/17 | Accepted: 2022/02/20 | Published: 2022/03/1

Add your comments about this article : Your username or Email:

Send email to the article author

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2015 All Rights Reserved | Iran Journal of Nursing

Designed & Developed by : Yektaweb