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Telemedicine in the neonatal intensive care unit (NICU): The potential and limitations of eHealth applications to support parents of hospitalised infants

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Anxiety and stress are common feelings for parents of newborns being hospitalised in the NICU, reducing their mental health. Subsequently, this can reduce the parents’ wellbeing and even negatively impact the development of the child. To support parents during this stressful time, telemedicine interventions have been investigated for their effect on parental mental health. A recent study evaluated all kinds of eHealth applications available to parents, such as bedside cameras, supportive apps, or the possibility of online chats and video calls with healthcare professionals from home. The results show a promising effect of telemedicine in reducing parents’ stress levels and anxiety. However, the study also warns that the applications should be introduced with great caution.

 

When a newborn is admitted to the NICU, the infant is not the only person in need of care. Parents also experience emotional needs, information needs, financial needs, involvement in decision making, and other practical needs to cope with the stressful and demanding situation. All of these needs contribute to parental wellbeing, which in turn affects their short and long-term psychological morbidities and even influences their child’s development.

One possible solution to support parents and address their needs is the use of telemedicine. Telemedicine is defined as remote delivery of healthcare and can include health apps, online chats with healthcare professionals, or video calls.

A recent study from the Netherlands investigated the potential benefits of telemedicine interventions for parental well-being. The scoping review included 50 international studies, predominantly from the United States and Scandinavia, that utilised different media channels to increase the parents’ self-efficacy, provide information about NICU discharge and transfer home, and reduce parental stress levels.

 

Examples of the use of telemedicine and its advantages

The different telemedical interventions to support parents have different benefits and limitations. The use of a bedside camera, for example, reduced parents’ stress and anxiety and showed positive bonding effects. However, technical problems occurred in more than half of the cases, and the unexpected unavailability of the video in turn triggered stress and fear for parents. Some even experienced hypervigilance because the ability to watch their infant around the clock did not allow them to rest. In addition, the camera raised concerns about privacy for both the infant and the NICU staff.

Smartphone and tablet-based applications were used to provide information about the NICU, discharge education and checklists, tracking milestones of the newborn, financial and insurance resources, and mental health services for parents. A chat feature allowed parents to ask questions to healthcare professionals. An example of this application is the My Brigham Baby app. This app had the potential to increase parents’ self-efficacy and discharge preparedness. Other applications that enabled telephone or video calls could reduce anxiety and stress in parents as well.

 

The potential and limitations of telemedicine

Overall, the analysis shows that telemedicine makes healthcare more accessible by saving travel time to the hospital, reducing costs for parents, and increasing parental sense of competence for discharge, as well as enabling remote follow-up from home and virtual family-centred rounds with experts.

However, the study points out that there is a lack of telemedicine interventions to support parents when the newborn is transferred between wards or hospitals. It concludes that telemedicine applications have more potential, and areas of utilisation than currently exploited.

 

Paper available at: https://pediatrics.jmir.org/2024/1/e60610

Ful list of authors: Josephine Wagenaar, Crystal Mah, Fredrik Bodell, Irwin Reiss, Maaike Kleinsmann, Sylvia Obermann-Borst, H Rob Taal

DOI: https://doi.org/10.2196/60610

Find out more about telemedicine services for parents here