Neonatal nurses’ understanding of the factors that enhance and hinder early communication between preterm infants and their parents: A narrative inquiry study.

Background: Infants born preterm are at high risk of facing difficulties with acquiring speech, language and communication skills. Research on the direct benefits of parent-infant communication in neonatal units is limited. This study recognises that although neonatal nurses regard early communication as important, there is scope to develop a wider range of resources and approaches to help support professionals’ understanding of the importance of communication in neonatal care.
Aim: To explore neonatal nurses’ understanding of factors that can enable or hinder early communication and interaction between preterm infants and parents within a neonatal unit setting.
Methods & Procedures: This study employed a narrative inquiry approach with nine neonatal nurses, selected through purposive sampling. Narrative interviews investigated nurses’ views and understanding of the enablers and challenges to communication in this patient group, along with their role in enhancing early communication between infants and parents. The reporting of the data followed the guidelines provided by the Enhancing the QUAlity and Transparency of Health Research (EQUATOR) framework.
Outcomes and Results: Narrative analysis revealed four themes: The importance of education and experience in neonatal care; supporting parents of infants receiving neonatal care; encouraging communication strategies; the impact of limiting parental presence and wearing facemasks.
Conclusions & Implications: Nurses working within a neonatal unit commented that using early communication strategies with infants and supporting parents to learn how to communicate directly with their infant is essential. However, none of the nurse participants were able to fully describe what the key components of early communication were from a linguistic perspective, nor were they able to give specific examples beyond skin-to-skin care, bonding, reading infant cues and hearing familial voices during conversation and when being read to. Although these are important antecedent skills that can provide a framework for developing appropriate communication development, they are not always a direct means of communication. Infants born preterm are at high risk of poor speech, language and communication development; there is therefore an urgent need for neonatal nurses to develop methods to support communication, rooted in linguistic theory, for parents and their infants. This support can enable the development of positive communication for parents and infants which can be enriched and extended after leaving the neonatal unit.