title: Trends in care practices reflecting parental involvement in neonatal care.
abstract: BACKGROUND
  Everyday care practices can facilitate or hinder parents' participation and involvement in neonatal care.
  
  
  OBJECTIVE
  To evaluate trends in family-centered care practices in the Neonatal Intensive Care unit in Turku University Hospital.
  
  
  METHODS
  In this retrospective study, the patient charts of very preterm infants were reviewed in 4 cohorts: 2001 to 2002 (n=72), 2006 to 2007 (n=69), 2009 to 2010 (n=76), and 2011 to 2012 (n=78).
  
  
  METHODS
  Care practices with parental involvement were evaluated: 1) thermoregulation; 2) nutrition and feeding; 3) the beginning and number of skin-to-skin care episodes. As safety measures, the length of stay and weight gain were recorded at discharge.
  
  
  RESULTS
  The significant trends included: a decrease in gestational age at the end of incubator care (mean 33.4 [standard deviation (SD) 1.36] to 31.6 [SD 1.1], p<0.001) and at the beginning of breast-feeding (35.3 [SD 1.34] to 33.1 [SD 1.89], p<0.001), bottle feeding (from 34.1 [SD 1.04] to 33.3 [SD 1.51], p=0.003) and skin-to-skin care (from 32.8 [SD 1.99] to 29.9 [SD 2.34], p<0.001). The changes were most remarkable in the infants below 28 weeks. In addition, weight gain increased from 110 g to 159 g per week (p<0.001).
  
  
  CONCLUSIONS
  The hospital care practices of very preterm infants developed during the study period support parental involvement. During the same time period, the weight gain of very preterm infants improved, significantly. These practices can serve as indicators of progressive trends in family centered care.
authors.affiliation: University of Turku, Finland. Electronic address: smrais@utu.fi.
authors.forename: Simo
authors.initials: S
authors.lastname: Raiskila
authors.affiliation: Department of Nursing Science, University of Turku, Finland.
authors.forename: Anna
authors.initials: A
authors.lastname: Axelin
authors.affiliation: University of Turku, Finland.
authors.forename: Saara
authors.initials: S
authors.lastname: Rapeli
authors.affiliation: University of Turku, Finland.
authors.forename: Ina
authors.initials: I
authors.lastname: Vasko
authors.affiliation: Department of Pediatrics, Turku University Hospital, University of Turku, Finland.
authors.forename: Liisa
authors.initials: L
authors.lastname: Lehtonen
mesh_terms: D001833:Body Temperature Regulation; D001942:Breast Feeding; D003256:Community Participation; D022143:Family Nursing / Q000639:trends; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D007363:Intensive Care Units, Neonatal / Q000639:trends*; D007902:Length of Stay; D008297:Male; D009752:Nutritional Status; D010290:Parents; D010351:Patient Discharge; D012189:Retrospective Studies; D016896:Treatment Outcome; D015430:Weight Gain
keywords: Breastfeeding; Family centered care; Growth; Skin-to-skin care