P3B343: Enhancing Family Communication in the NICU: A Qualitative Pilot Study

Purpose/Objectives: Siblings of infants admitted to the NICU can be significantly affected by the hospitalization, with less consideration often given to them at a time when focus is on the baby. As NICU visitation programs have become less commonplace due to COVID-19, parents must provide the majority of updates and information about the hospitalization. This can be a burden for parents who are dealing with the effects of a traumatic birth and uncertainty surrounding the condition of the infant, and they may have trouble relaying complex medical information to young siblings. We sought to identify how NICU parents currently communicate about the hospitalization and how such communication is received by siblings.

Design/Methods: A novel RedCap survey was administered in English and Spanish by research assistants to parents of NICU infants at Tulane-Lakeside Hospital over a 4-month period (n=13). The survey focused on general demographics, parent communication styles, and sibling attitudes towards the new infant. Data was exported and analyzed in Microsoft Excel.

Results: Most parents utilized a variety of communication strategies leveraging technology, with 50% having daily Facetime/Zoom calls and 81.8% sharing daily photos/videos. Due to COVID limitations, only 20% of siblings were reported to have visited the NICU in-person. Considering communication style, 90.9% of parents had daily conversations about the hospitalization; 9.1% had weekly conversations. 54.5% of parents reported discussions lasting an average of 5-15 minutes while 36.4% were < 5 minutes. 75% of parents reported that siblings were “extremely interested”, while 8% were “very interested,” and 16.7% were “not at all interested.” Sibling reactions varied from 28.6% being excited to see baby to 26.8% being upset they were not able to see the baby. 75% of parents thought siblings knew where they were when visiting baby, and 50% knew why infant was in hospital. Parents most frequently relayed messages focused on the infant being sick/needing to be taken care of in hospital, including specific medical challenges, and used pictures/videos to supplement conversation. 72.7% of parents reported facing no challenges in communication, while 27.3% were worried about the siblings’ understanding being limited by their age. 9.1% of parents avoided certain topics and 83.3% of parents provided examples of possible interventions to facilitate conversation. The most popular ideas included a video (77.8%) and an interactive doll/toy (77.8%).

Conclusion/Discussion: While parents frequently communicate with siblings about the NICU hospitalization, parents struggle most in having conversations with younger kids, likely secondary to developmental challenges in comprehension compared to older children. Such conversations are brief and heavily reliant upon technological supplementation. To best respond to parents’ self-reported needs, our team will be piloting interventions of informative, developmentally appropriate videos.