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Family Centered CareNCT05286983

Multidimensional Assessment of Infant, Parent and Staff Outcomes During a Family Centered Care Enhancement Project

An observational study of Family Centered Care, run by University of Giessen at 2 sites in Germany.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

This prospective single centre longitudinal cohort study enrols preterm infants ≤32+0 weeks of gestation and/or birthweight ≤1500g and their parents. Following a baseline period additional Family Centred Care elements are introduced as potentially better practices, these elements focus on four areas: the NICU… Read more about this study

Who is it for?
Ages 1 minute to 14 daysHealthy volunteers can take part
Conditions the study is for
Family Centered Care
What is being tested?
Family Centred Care (FCC) interventions as potentially better practices (PBPs)
How many people
495 participants
Where
2 sitesGermany
Study dates
1 Oct 2020to 1 Jul 2026
Phase
Observational
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 1 minute to 14 days
  • All sexes
  • Healthy volunteers accepted
  • Child

Study population: The study population consists of inborn and outborn preterm infants of ≤32+0 weeks of gestational age (GA) and/or birthweight ≤1500g who are admitted to the Level 3 NICU and their parents

Who may be able to join

  • ≤32+0 weeks of gestational age (GA) and/or birthweight ≤1500g
  • biparental (or guardian) written informed consent

Who cannot join

  • severe congenital anomalies (e.g. cyanotic heart disease, severe lung hypoplasia, congenital diaphragmatic hernia)
  • decision not to provide full life support
  • decision for palliative care before study entry
  • parents with severe psychiatric disease

Trial locations and contacts

2 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Germany2 sites, 1 recruiting
  • Department of General Pediatrics and Neonatology, Justus- Liebig- University, Feulgenstrasse 12, D-35392 Giessen, Germany

    Giessen, Hesse, 35390

    Rahel Schuler, +4964198558821, rahel.schuler@paediat.med.uni-giessen.de

    Harald Ehrhardt, harald.ehrhardt@paediat.med.uni-giessen.de

    Recruiting
  • Mihatsch Walter

    Ulm, Baden-Wurttemberg, 89231

    Active, not recruiting

Other trials in Germany

About this study

Official title: Multidimensional Assessment of Infant, Parent and Staff Outcomes During a Family Centered Care Enhancement Project in a Tertiary Neonatal Intensive Care

This prospective single centre longitudinal cohort study enrols preterm infants ≤32+0 weeks of gestation and/or birthweight ≤1500g and their parents. Following a baseline period additional Family Centred Care elements are introduced as potentially better practices, these elements focus on four areas: the NICU (Neonatal Intensive Care Unit) environment, staff training, parental education and psychosocial support to the families. The effect of the implementation of additional Family Centred Care elements on infant, parent and staff outcomes are assessed. The parallel data collection enables to study the interrelation between these three important areas of research.

Read the detailed description

Background: The therapeutic advances and progress in the care for preterm infants have enabled the regular survival of more and more immature infants. However, the high burden of lifelong sequelae following premature delivery constitutes an ongoing challenge and psychomotor disorders and neurobehavioral difficulties persist into adulthood. Regardless of premature delivery, parental mental health and a healthy parent-child relationship were identified as essential prerogatives for normal infant development. Family centered care (FCC) supports preterm infants and their families by respecting the particular developmental, social and emotional needs in the NICU. Due to the large variations in concepts and goals of different FCC initiatives, scientific data on the benefits of FCC for the infant and family outcome are sparse and its effects on the clinical team need to be elaborated.

Methods: This prospective longitudinal single-center cohort study will enroll preterm infants with a gestational length of ≤32+0 weeks and/or a birth weight of ≤1500 g and their parents. After a baseline period, additional FCC elements will be introduced gradually every 6 months, covering staff training, parent education, psychosocial support for families, and last but not least, the neonatal intensive care unit environment. Recruitment will occur over a 5.5-year period, and outcomes will be tracked through periodic follow-up until 24 month of corrected age. Sample size calculation is based on corrected gestational age at discharge as the primary outcome. Secondary outcomes in infants include morbidities and treatment aspects of prematurity such as somatic growth, duration of ventilatory support, and psychomotor development. Parental outcomes relate to success of parenting education and skills, parent-family interaction, parental satisfaction, and mental health with particular emphasis on anxiety, depression, and stress. Staffing issues are addressed with special attention to the job satisfaction item. Quality improvement steps are monitored using the Plan-Do-Study-Act (PDSA) cycle method, and outcome measures address the child, parent, and medical team as they are inextricably linked. Parallel data collection allows for the interrelationship between these three important research areas to be examined.

Discussion: It is scientifically impossible to allocate improvements in outcome measures to individual enhancement steps of FCC that constitutes a continuous change in NICU culture and attitudes covering diverse areas of change. Therefore, our trial is designed to allocate childhood, parental and staff outcome measures during the stepwise changes introduced by a FCC intervention program. But even if no positive outcome measures can be confirmed, the successful execution of our standardized statistical process control method approach is suited to guide quality improvement in future studies in neonatology and beyond.

Being tested
Family Centred Care (FCC) interventions as potentially better practices (PBPs)

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Family Centred Care (FCC) interventions as potentially better practices (PBPs)Behavioural

    After the previous period, additional Family Centred Care (FCC) elements will be introduced gradually every 6 months, covering staff training, parent education, psychosocial support for families, and last but not least, the neonatal intensive care unit environment.

    The focus group consisting of nurses and healthcare professionals will meet regularly and will decide on new FCC interventions as potentially better practices (PBPs). New additional PBPs will be disseminated into the greater team through workshops, hands-on teaching, displays, etc. Potential PBPs for our department enclose:

    Parent participation on rounds Parent skill self-assessment Parent-to-parent support Regular staff education Improvement of psychosocial support Improvement of neonatal unit surroundings to promote parent-infant-closeness

Study groups in NCT05286983
Study groupRoleWhat they receive
K0 - baseline cohort45 preterm infants and their parents (average number of patient admissions per 6 months during the last 5 years)
K1 - 1st intervention cohortAll preterm infants and their parents enrolled during the first 6 months period after completion of the baseline cohort and who are treated according to prespecified Family Centred Care interventions implemented as Potentially Better Practices.
Receives: Behavioral: Family Centred Care (FCC) interventions as potentially better practices (PBPs)
K2 - 2nd intervention cohortAll preterm infants and their parents enrolled during the 6 months period after the previous 6 months period who are treated according to prespecified Family Centred Care interventions implemented as Potentially Better Practices.
Receives: Behavioral: Family Centred Care (FCC) interventions as potentially better practices (PBPs)
K3 - 3rd intervention cohortAll preterm infants and their parents enrolled during the 6 months period after the previous 6 months period who are treated according to prespecified Family Centred Care interventions implemented as Potentially Better Practices.
Receives: Behavioral: Family Centred Care (FCC) interventions as potentially better practices (PBPs)
K4 - 4th intervention cohortAll preterm infants and their parents enrolled during the 6 months period after the previous 6 months period who are treated according to prespecified Family Centred Care interventions implemented as Potentially Better Practices.
Receives: Behavioral: Family Centred Care (FCC) interventions as potentially better practices (PBPs)
K5 - 5th intervention cohortAll preterm infants and their parents enrolled during the 6 months period after the previous 6 months period who are treated according to prespecified Family Centred Care interventions implemented as Potentially Better Practices.
Receives: Behavioral: Family Centred Care (FCC) interventions as potentially better practices (PBPs)
K6 - 6th intervention cohortAll preterm infants and their parents enrolled during the 6 months period after the previous 6 months period who are treated according to prespecified Family Centred Care interventions implemented as Potentially Better Practices.
Receives: Behavioral: Family Centred Care (FCC) interventions as potentially better practices (PBPs)
K7 - 7th intervention cohortAll preterm infants and their parents enrolled during the 6 months period after the previous 6 months period who are treated according to prespecified Family Centred Care interventions implemented as Potentially Better Practices.
Receives: Behavioral: Family Centred Care (FCC) interventions as potentially better practices (PBPs)
K8 - 8th intervention cohortAll preterm infants and their parents enrolled during the 6 months period after the previous 6 months period who are treated according to prespecified Family Centred Care interventions implemented as Potentially Better Practices.
Receives: Behavioral: Family Centred Care (FCC) interventions as potentially better practices (PBPs)
K9 - 9th intervention cohortAll preterm infants and their parents enrolled during the 6 months period after the previous 6 months period who are treated according to prespecified Family Centred Care interventions implemented as Potentially Better Practices.
Receives: Behavioral: Family Centred Care (FCC) interventions as potentially better practices (PBPs)
K10 - 10th intervention cohortAll preterm infants and their parents enrolled during the 6 months period after the previous 6 months period who are treated according to prespecified Family Centred Care interventions implemented as Potentially Better Practices.
Receives: Behavioral: Family Centred Care (FCC) interventions as potentially better practices (PBPs)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Length of hospital stay

    Length of hospital stay measured by corrected gestational age at discharge

    Measured: 5.5years

Secondary outcomes (29)
  1. Key neonatal morbidities

    Number of Participants with Bronchopulmonary Dysplasia (BPD), Number of Participants with Intraventricular Hemorrhage (IVH) Grade III-IV, Number of Participants with Periventricular Leucomalacia (PVL), Number of Participants with Necrotizing Enterocolitis (NEC) stage 2 or stage 3, Number of Participants with Retinopathia of Prematurity (ROP) stage 3 or greater or treatment

    Measured: 5.5years

  2. Weight gain

    weight gain (g/kg/d) from admission to 36+0/40+0 weeks (corrected age)

    Measured: 5.5years

  3. Weight Z-Score

    Z- Scores for weight at 36+0, 40+0, 3, 12 and 24 months (corrected age)

    Measured: 5.5years

  4. Weight

    Weight in Gram at 36+0, 40+0, 3, 12 and 24 months (corrected age)

    Measured: 5.5years

  5. Length Z-Score

    Z- Scores for length at 36+0, 40+0, 3, 12 and 24 months (corrected age)

    Measured: 5.5years

  6. Length

    Length in cm at 36+0, 40+0, 3, 12 and 24 months (corrected age)

    Measured: 5.5years

  7. Head Circumference Z-Score

    Z- Scores for head circumference at 36+0, 40+0, 3, 12 and 24 months (corrected age)

    Measured: 5.5years

  8. Head Circumference

    Head circumference in cm at 36+0, 40+0, 3, 12 and 24 months (corrected age)

    Measured: 5.5years

  9. Full enteral feeds

    Day of Life (DOL) of achievement of full enteral feeds defined as 150ml/kg/d for 3 consecutive days

    Measured: 5.5 years

  10. Length of tube feeding

    corrected gestational age at removal of nasogastric tube

    Measured: 5.5 years

  11. First Breastmilk Feed

    DOL (Day of Life) with first breast milk feed

    Measured: 5.5years

  12. Breastmilk Nutrition

    Breastmilk proportion within Day of Life (DOL) 1-14

    Measured: 5.5years

  13. Fully Breastfed

    DOL when infant is fed only with breast milk

    Measured: 5.5years

  14. Breastfeeding at Discharge

    Breast milk proportion at discharge

    Measured: 5.5years

  15. Mechanical ventilation

    Gestational age (GA) at end of respiratory support: Continuous Positive Airway Pressure (CPAP)/ Highflow Nasal Cannula (HFNC)/ oxygen supplementation

    Measured: 5.5years

  16. End of parenteral nutrition (PN)

    DOL of end of PN

    Measured: 5.5years

  17. Family room

    cGA at move-in with mother or father into a family room

    Measured: 5.5years

  18. Neurodevelopment at 12 months corrected age

    Neurodevelopment measured with Neuropsychological Developmental Screening, Score 0-15, higher scores indicating better neurodevelopment

    Measured: 7.5years

  19. Neurodevelopmental outcome at 24 months corrected age

    Neurodevelopmental outcome measured with Bayley Scales of Infant Development, German Version, 3rd Edition (mean 100; Standard Deviation 15, higher Scores indicating better neurodevelopment)

    Measured: 7.5years

  20. Motor Developmental outcome at 24 months corrected age

    Gross Motor Function Classification System (GMFCS), Grade I-V, higher Grade indicating worse motor outcome

    Measured: 7.5years

  21. Parental Anxiety

    Parental Anxiety, measured with the German version of the Hospital and Anxiety and Depression Scale (HADS-D) within the first 10 days after birth, after 4 weeks, at discharge, at 3, 12 and 24 months (corrected age of the preterm infant), Score 0-21; higher scores indicating more anxiety

    Measured: 5.5years

  22. Parental Depression

    Parental Depression measured with the German version of the Hospital and Anxiety and Depression Scale (HADS-D) within the first 10 days after birth, after 4 weeks, at discharge, at 3, 12 and 24 months (corrected age of the preterm infant), Score 0-21, higher scores indicating more depression

    Measured: 5.5years

  23. Parental Stress

    Parental Stress measured with the Parenting Stress Index (PSI), German Version (Eltern-Belastungs-Inventar, EBI) within the first 10 days after birth, after 4 weeks, at discharge, at 3, 12 and 24 months (corrected age of the preterm infant); Score 0-100, higher score indicating more stress

    Measured: 5.5years

  24. Parental Satisfaction

    Measured with a newly designed Questionnaire focussing on Neonatal Intensive Care Surroundings, Visiting Hours, Medical Care and communication

    Measured: 5.5years

  25. Parental Skills

    Self assessed with a Questionnaire

    Measured: 5.5years

  26. Parental Visiting Hours

    Time spent with the infant. Measured seperately for mothers and fathers throughout hospital stay

    Measured: 5.5years

  27. Degree of Family Centred Care

    Self Assessment Questionnaire (Institute for Family Centred Care) by staff members

    Measured: 5.5years

  28. Staff satisfaction

    Self assessment (Copenhagen Psychosocial Questionnaire, COPSQ) by staff members

    Measured: 5.5years

  29. Kangarooing time

    Time spent kangarooing with the infant. Measured separately for mothers and fathers throughout the NICU stay

    Measured: 5.5yrs

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted18 Mar 2022
  2. Study start1 Oct 2020
  3. Primary completion1 Jul 2026 (estimated)
  4. Study completion1 Jul 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
495 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05286983
Sponsor's protocol ID
153/20
Status last verified
Mar 2025
First submitted
23 Feb 2022
Last updated
30 Mar 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Schuler R, Ehrhardt H, Mihatsch WA. Safety and Parental Satisfaction With Early Discharge of Preterm Infants on Nasogastric Tube Feeding and Outpatient Clinic Follow-Up. Front Pediatr. 2020 Aug 25;8:505. doi: 10.3389/fped.2020.00505. eCollection 2020.

    PubMed 32984217
  • Schuler R, Woitschitzky L, Eiben C, Beck J, Jagers A, Windhorst A, Kampschulte B, Petzinger J, Waitz M, Kilsdonk MOR, Neubauer BA, Zimmer KP, Ehrhardt H, Brosig B, Mihatsch WA. Multidimensional assessment of infant, parent and staff outcomes during a family centered care enhancement project in a tertiary neonatal intensive care unit: study protocol of a longitudinal cohort study. BMC Pediatr. 2023 Jul 7;23(1):344. doi: 10.1186/s12887-023-04165-0.

    PubMed 37420180

Questions about this trial

What is this clinical trial studying?

An observational study of Family Centered Care, run by University of Giessen at 2 sites in Germany.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 30 Mar 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in Germany. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Rahel Schuler, Dr. (+4964198558821, rahel.schuler@paediat.med.uni-giessen.de), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Length of hospital stay (time frame: 5.5years). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05286983, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 30 Mar 2025.

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