Identifying barriers and facilitators to care for infants with bronchopulmonary dysplasia after NICU discharge: a prospective study of parents and clinical stakeholders

J Perinatol. 2024 Jul;44(7):970-978. doi: 10.1038/s41372-024-01880-z. Epub 2024 Jan 26.

Abstract

Objective: Understand barriers and facilitators to follow-up care for infants with bronchopulmonary dysplasia (BPD).

Methods: Qualitative study of parents and clinical stakeholders caring for infants with BPD. The interview guide was developed by a mother of a former 23-week preterm infant, neonatologist, pulmonologist, nurse, and qualitative researcher. Purposive sampling obtained a heterogenous sociodemographic and professional cohort. Subjects discussed their experience with BPD, barriers to care, caregiver quality of life and health education. Interviews were audio-recorded, transcribed and coded. Thematic analysis was used.

Results: Eighteen parents and 20 stakeholders completed interviews. Family-level themes included pragmatic barriers like transportation being multi-faceted; and caregiving demands straining mental health. System-level themes included caregiver education needing to balance immediate caregiving activities with future health outcomes; and integrating primary care, specialty, and community supports.

Conclusions: Individual and system barriers impact follow-up for infants with BPD. This conceptual framework can be used to measure and improve care.

MeSH terms

  • Adult
  • Bronchopulmonary Dysplasia* / therapy
  • Caregivers* / psychology
  • Female
  • Health Services Accessibility
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Intensive Care Units, Neonatal*
  • Interviews as Topic
  • Male
  • Parents* / psychology
  • Patient Discharge*
  • Prospective Studies
  • Qualitative Research*
  • Quality of Life