Importance::Parent-infant closeness and active parent participation in neonatal care are important for parent and infant health.Objective::To give an overview of current neonatal settings and gain an in-depth understanding of facilitators and barriers to parent-infant closeness, zero-separation, in 19 countries.Methods::Neonatal intensive care unit (NICU) professionals, representing 45 NICUs from a range of geographic regions in Europe and Canada, were purposefully selected and interviewed June–December 2018. Thematic analysis was conducted to identify, analyze and report patterns (themes) for parent-infant closeness across the entire series of interviews.Results::Parent-infant separation during infant and/or maternity care is very common (42/45 units, 93%), despite the implementation of family integrated care (FICare) practices, including parent participation in medical rounds (17/45, 38%), structured education sessions for parents (16/45, 36%) and structured training for healthcare professionals (22/45, 49%). NICU professionals encountered four main themes with facilitators and barriers for parent-infant closeness on and between the hospital, unit, staff, and family level: Culture (jointly held characteristics, values, thinking and behaviors about parental presence and participation in the unit), Collaboration (the act of working together between and within different levels), Capacities (resources and policies), and Coaching (education to acquire and transfer knowledge and skills). Interpretation::Implementing parent-infant closeness in the NICU is still challenging for healthcare professionals. Further optimization in neonatal care towards zero-separation and parent-infant closeness can be achieved by enforcing the 'four Cs for Closeness’: Culture, Collaboration, Capacities, and Coaching.

Parent-infant closeness;Family centered care;Family integrated care;Couplet-care;Neonatalogy;Parent-collaboration;Zero-separation

van Veenendaal Nicole R.;Labrie Nanon H.M.;Mader Silke;van Kempen Anne A. M. W.;van der Schoor Sophie R. D.;van Goudoever Johannes B.;CROWN Study Group

Department of Pediatrics and Neonatology, OLVG, Amsterdam, The Netherlands;Amsterdam UMC, location Vrije Universiteit and location University of Amsterdam, Department of Pediatrics, Emma Children’s Hospital, Amsterdam, The Netherlands;Department of Language, Literature and Communication, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands;European Foundation for Care of Newborn Infants, Munich, Germany

儿科学研究（英文）

[1]van Veenendaal Nicole R.;Labrie Nanon H.M.;Mader Silke;van Kempen Anne A. M. W.;van der Schoor Sophie R. D.;van Goudoever Johannes B.;CROWN Study Group-.An international study on implementation and facilitators and barriers for parent-infant closeness in neonatal units)[J].儿科学研究（英文）,2022(03):179-188

facilitators,NICUs,Coaching,Couplet,Neonatalogy

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