title: Telemedicine in Neonatal Home Care: Identifying Parental Needs Through Participatory Design.
abstract: BACKGROUND
  For the majority of preterm infants, the last weeks of hospital admission mainly concerns tube feeding and establishment of breastfeeding. Neonatal home care (NH) was developed to allow infants to remain at home for tube feeding and establishment of breastfeeding with regular home visits from neonatal nurses. For hospitals covering large regions, home visits may be challenging, time consuming, and expensive and alternative approaches must be explored.
  
  
  OBJECTIVE
  To identify parental needs when wanting to provide neonatal home care supported by telemedicine.
  
  
  METHODS
  The study used participatory design and qualitative methods. Data were collected from observational studies, individual interviews, and focus group interviews. Two neonatal units participated. One unit was experienced in providing neonatal home care with home visits, and the other planned to offer neonatal home care with telemedicine support. A total of 9 parents with preterm infants assigned to a neonatal home care program and 10 parents with preterm infants admitted to a neonatal unit participated in individual interviews and focus group interviews, respectively.
  
  
  RESULTS
  Three overall themes were identified: being a family, parent self-efficacy, and nurse-provided security. Parents expressed desire for the following: (1) a telemedicine device to serve as a "bell cord" to the neonatal unit, giving 24-hour access to nurses, (2) video-conferencing to provide security at home, (3) timely written email communication with the neonatal unit, and (4) an online knowledge base on preterm infant care, breastfeeding, and nutrition.
  
  
  CONCLUSIONS
  Our findings highlight the importance of neonatal home care. NH provides parents with a feeling of being a family, supports their self-efficacy, and gives them a feeling of security when combined with nursing guidance. Parents did not request hands-on support for infant care, but instead expressed a need for communication and guidance, which could be met using telemedicine.
authors.affiliation: Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark. kristina.holm@rsyd.dk.
authors.forename: Kristina
authors.identifier: http://orcid.org/0000-0002-2730-1167
authors.initials: K
authors.lastname: Garne
authors.forename: Anne
authors.identifier: http://orcid.org/0000-0002-5029-9480
authors.initials: A
authors.lastname: Brødsgaard
authors.forename: Gitte
authors.identifier: http://orcid.org/0000-0003-4440-2362
authors.initials: G
authors.lastname: Zachariassen
authors.forename: Jane
authors.identifier: http://orcid.org/0000-0002-6127-1010
authors.initials: J
authors.lastname: Clemensen
keywords: neonatal home care; participatory design; preterm infant; telemedicine