Published online June 2, 2008
PEDIATRICS Vol. 121 No. 6 June 2008, pp. 1111-1118 (doi:10.1542/peds.2007-1700)
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ARTICLE

Factors Influencing Parental Satisfaction With Neonatal Intensive Care Among the Families of Moderately Premature Infants

Marie C. McCormick, MD, ScDa,b, Gabriel J. Escobar, MDc,d, Zheng Zheng, BSb and Douglas K. Richardson, MD, MBAb,{dagger}

a Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, Massachusetts
b Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
c Kaiser Permanente Medical Care Program, Division of Research, Perinatal Research Unit, Oakland, California
d Department of Pediatrics, Kaiser Permanente Medical Center, Walnut Creek, California

OBJECTIVE. The goal was to examine the factors influencing parental satisfaction with neonatal intensive care for moderately premature infants in 10 hospitals in Massachusetts and California.

METHODS. A total of 677 infants without major anomalies or chromosomal disorders who were born between 30 and 34 weeks of gestation in the participating hospitals and discharged alive were included. Parental satisfaction with neonatal intensive care was ascertained 3 months after discharge by using a previously developed scale of 12 Likert items (scored 1–5), addressing such issues as perceptions regarding the staff providing emotional support, information, or education. The questionnaire, which was administered by telephone, also included parental ratings of child health and reports of subsequent health care use, sociodemographic characteristics, and history of infertility treatment. Data on the prenatal, perinatal, and neonatal course were abstracted from the medical charts, and the factors associated with parental satisfaction were analyzed.

RESULTS. Parental satisfaction with neonatal intensive care varied significantly across the 10 hospitals. The major predictors of satisfaction were sociodemographic characteristics, history of infertility treatment, and especially parental ratings of child health 3 months after discharge, rather than aspects of the perinatal or neonatal course. Controlling for these factors, differences across hospitals were not statistically significant. However, the variance explained by all of the measured factors, including child health rating, was modest (19%).

CONCLUSIONS. Although we included variables across the full spectrum of neonatal intensive care, we found that the major predictor of parental satisfaction with neonatal intensive care was child health at the time of the interview, followed by sociodemographic factors and previous infertility treatment. However, the variance explained was limited, which suggests that research is needed on the factors influencing satisfaction.

Key Words: infant • newborn • infant • premature • patient satisfaction • intensive care units • neonatal

Abbreviations: KCMCP—Kaiser Permanente Medical Care Program • PNR—patient/nurse ratio • SNAP-II—Score for Neonatal Acute Physiology II

Accepted Oct 23, 2007.


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