Perception, Practice and Associated factors towards Family Centered Care among Health Care Professionals in Neonatal Intensive Care Unit at Public Hospitals in Addis Ababa, Ethiopia, 2024

Perception, Practice and Associated factors towards Family Centered Care among Health Care Professionals in Neonatal Intensive Care Unit at Public Hospitals in Addis Ababa, Ethiopia, 2024 | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Perception, Practice and Associated factors towards Family Centered Care among Health Care Professionals in Neonatal Intensive Care Unit at Public Hospitals in Addis Ababa, Ethiopia, 2024 meseret Wondemu, Abel teklit haile, Robel Gemechu haile, salhadin Mohammed Jemal, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9096501/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 7 You are reading this latest preprint version Abstract Background Family-Centered Care in Neonatal Intensive Care Units involves active family participation in the care of newborns and infants. Implementing family-centered care in neonatal intensive care units faces multiple challenges from the perspective of health care professionals. The neonatal intensive care environment can be stressful for parents, as health care professionals often prioritize the medical needs of newborns by addressing the emotional concerns and negative experiences of families. Objectives To assess the perception, practice and associated factors of family-centered care among health care professionals in the neonatal intensive care unit at Public Hospitals in Addis Ababa, Ethiopia, 2024. Method An institutional-based cross-sectional study was conducted in Neonatal Intensive Care Units (NICUs) of four randomly selected public hospitals using the lottery method. The study population included all health care professionals working in the NICU during the study period. The sample size was calculated using a single population proportion formula, and a total of 184 health care professionals were included using a survey sampling technique. Data was collected using the Family Centered Care Questionnaire-Revised (FCCQ-R). The collected data was coded and entered into SPSS version 27 for analysis. Descriptive statistics were used to summarize demographic characteristics and variable distributions, while bivariate and multivariable analyses were performed to identify associated factors. Result Out of the total 184 health care professionals, 57 (31%) had good perception and 67 (36.4%) had good practice of family-centered care. In multivariable logistic regression analysis, educational status of health care professionals (AOR = 0.237, 95% CI: 0.102–0.551) and negative staff attitude (AOR = 0.301, 95% CI: 0.127–0.712) were significantly associated with perception. Similarly, educational status (AOR = 0.359, 95% CI: 0.168–0.767) and negative staff attitude (AOR = 0.204, 95% CI: 0.086–0.482) were significantly associated with practice at p < 0.05. Conclusion and Recommendation: The practice of family-centered care among health care professionals was higher than their perception of family-centered care in the Neonatal Intensive Care Unit. Public hospitals should establish clear policies, guidelines, and accountability mechanisms to strengthen the implementation of family-centered care. In addition, health care providers should receive continuous education through both pre-service and in-service training. NICU Family Centered Care Health care professional Perception and Practice Background The birth of a child introduces significant changes within a family, requiring adjustment of roles and responsibilities.( 1 ). When a newborn develops complications and requires admission to a neonatal intensive care unit, parents often experience anxiety, uncertainty, and emotional distress. The unfamiliar environment, combined with limited involvement in the care of their newborn, can reduce parental confidence and increase feelings of helplessness( 2 , 7 ). Separation from the newborn and restricted participation in care further contribute to stress and negatively affect the parent–infant relationship ( 1 – 5 ). It is one of the important elements of the care of neonates which has a protective effect on parents( 6 ). Studies show that there is constant claim of parents in Brazilian neonatal unities to be part of their children care ( 8 ). The Patient-and- Family-Centered-Care Model (PFCCM) has been recommended as ideal for neonatal practice, since it fosters a truly collaborative relationship between family and health team( 10 ) Also, research conducted in Sweden and Norway shows influence of the NICU environment, with adequate and welcoming facilities for families necessary for successful family centered care implementation( 9 , 11 , 18 ). However, in Ethiopia most studies focus on parental satisfaction with family-centered care rather than the practices and perceptions of health care professionals; therefore, further research is needed. Therefore, the purpose of this study was to evaluate the perception, practice and its associated factor of family-centered care from the perspective of health care professionals in the neonatal intensive care unit. Ideally, families are an integral part of care in NICU: however, limited visitations to the NICU restrict them. The consequences are that family’s face isolation from their neonate, and they suffer separation anxiety, and post NICU depression ( 12 ) Moreover, the neonates cannot express their needs and experiences of the care provided to them in intensive care, their parents do so on their behalf, which justifies the need for parental involvement ( 13 ) Family-centered care (FCC) promotes partnership between health providers, patients, and families. In neonatal care, FCC improves parent satisfaction, reduces costs, and minimizes negative outcomes after hospitalization. ( 14 ) Staff attitudes towards FCC were explored by several authors describing the practices and perceptions of FCC by professionals in NICU ( 15 ) A gap exists between perception and practice, as many health professionals lack clarity on FCC actions, have limited skills to apply its principles, and struggle with effective communication with parents ( 16 )Such problems cause inconsistent practice of FCC even though health care professionals believe in the value of the philosophy. Therefore, staff should be encouraged to implement FCC with awareness; this improves the health status of infants and families with the care provided ( 17 ). Interaction and communication between healthcare professionals and parents remain major challenges in NICUs, contributing to gaps between the perception and practice of family-centered care (FCC). This study examines healthcare professionals’ perceptions, practices, and associated factors related to FCC across public hospitals in Addis Ababa. Its findings will guide the development of targeted educational interventions, enhance understanding of barriers and roles within FCC, and strengthen the overall quality of neonatal care. The results will also support policymakers, stakeholders, and hospitals in designing effective interventions, inform national guidelines, and provide baseline evidence for future research and implementation of FCC in Ethiopia. Studies also describe parental demand for involvement and highlight structural barriers in neonatal units( 19 ). Evidence from different countries reports variation in how parents, nurses, and physicians perceive neonatal intensive care practices ( 22 , 23 ). Family-centered care interventions improve parental satisfaction and reduce hospital readmission among premature infants ( 24 , 33 ). Pediatric intensive care literature also emphasizes family participation in care processes ( 25 ). Early separation between mother and newborn during hospitalization creates psychological stress and possible developmental risks, reinforcing the need for family involvement ( 26 , 32 ). Reviews of patient and family-centered care identify several components required for effective implementation in clinical settings( 27 , 28 ). Method Study Area & Study Period This institutional-based cross-sectional study was conducted in Addis Ababa, Ethiopia. Four public hospitals were selected by lottery: Saint Paul’s Hospital Millennium Medical College, Yekatit 12 Hospital Medical College, Zewditu Memorial Hospital, and Gandhi Memorial Hospital. Data collection took place from April 20 to May 20, 2024. The source population included all health care professionals working in the NICUs of public hospitals in Addis Ababa. The study population consisted of licensed NICU professionals working in the selected hospitals during the study period. Medical students and individuals with less than six months of NICU experience were excluded. The study applied a cross-sectional survey design to assess perception and practice of family-centered care among NICU staff. Four hospitals were selected based on NICU service level and staffing volume. All eligible professionals were included, resulting in a total sample of 184 participants. The dependent variable was perception and practice of family-centered care. Independent variables included socio-demographic characteristics such as age, residency, marital status, education level, and occupation. Organizational factors included workload, policies, health education, and length of stay. Professional factors included attitude toward family-centered care, knowledge of family-centered care, and work experience. Operational Definition Perception on FCC is belief, views and understanding of Health care professionals regarding Family centered care. (The total score is 45*5 = 225, after data collection and entry, the distribution of the data was analyzed, then depending on the distribution if participant score 109 and above it is good and if it is below 109 value it is poor) ( 35 ) Practice of FCC is an integrated Family centered care services delivered in a setting and manner that is responsive to their goals and values. (The total score is 225, after data collection and entry, the distribution of the data was analyzed, then depending on the distribution if participant score 103 and above it is good and if it is below 103 value it is poor) ( 35 ) Family Centered Care (FCC) is a way of providing services that assures the health and wellbeing of children and their families through respectful family/professional partnership. Neonatal Intensive Care Unit (NICU) is a hospital ward or department equipped and staffed to provide intensive care to seriously ill or premature newborn babies. Professional Family relationship is a consultative relationship in which the parents as colleagues seek consultants help to solve a particular problem. Data collection, technique, data management, and analysis The Family Centered Care Questionnaire-Revised (FCCQ-R), a previously published and validated instrument developed by Bruce and Ritchie, was used to assess health care professionals’ perceptions and practices of family-centered care( 35 ). The questionnaire includes nine domains: the family as the constant in the child’s life; collaboration between parents and health professionals; recognition of family individuality; sharing complete information; understanding the developmental needs of the child; encouragement of parent-to-parent support; provision of emotional and financial support; ensuring that the health care delivery system responds to family needs; and provision of emotional support to staff. Data were collected using a structured questionnaire with family-centered care practice scales measured on a five-point Likert scale. The questionnaire was administered through face-to-face interviewer-administered interviews using the standardized FCCQ-R. Four data collectors and two supervisors conducted the data collection. The data collectors were Bachelor of Science neonatal nurses with more than one year of experience. The supervisors were Master of Science nurses. All data collectors received training on the study objectives and standardized data collection procedures before the start of data collection. A pretest was conducted on five percent of the sample at Ras Desta Damtew Hospital. Reliability was assessed using Cronbach’s alpha, which showed strong internal consistency. Completed questionnaires were reviewed daily for completeness and accuracy. Data was coded and entered into SPSS version 27 for analysis. Descriptive statistics were used to summarize participant characteristics using frequency, percentage, mean, and standard deviation. Logistic regression analysis was performed to identify factors associated with perception and practice of family-centered care. Variables with a p value less than 0.25 in bivariable analysis were included in the multivariable logistic regression model. Final associations were presented using adjusted odds ratios with 95 percent confidence intervals. Statistical significance was set at a p value less than 0.05. Result Socio demographic Characteristics A total of 184 health care professional participated in the study, among the participants, 123(66.8%) of the participants were females. The mean age of the participants was 29 years. Of the participants, 147(79.9%) were in the age group of 26–30 years. 50% of the participants were not married. Approximately 47.3% of the sample consisted of nurses.Table 1 . Table 1 Socio demographic characteristics of health care professionals in NICU at four randomly selected public hospitals of Addis Ababa Ethiopia, 2024 (n = 184) Variables Response Frequency Percentage Age 20–25 age 26–30 age 31–35 age 36–40 age 4 147 26 7 2.2% 79.9% 14.1% 3.8% Sex Male Female 61 123 33.2% 66.8% Marital status Married Unmarried 92 92 50% 50% Educational status Bachelor’s degree or below Master’s and above 86 98 46.7% 53.3% Professions Neonatologist and fellow Resident BSC nurse and neonatal nurse 16 81 87 8.7% 44% 47.3% Work experience in NICU 6month-1 year 1–3 years 3–4 years >4 years 6 108 28 42 3.3% 58.7% 15.2% 22.8% Perception and practice of Health care professional on Family Centered Care in NICU The mean score of Perception is (mean score = 109, SD = 36.5, 63.5%, 95%CI: 55.5, 70.8) and Practice is (means core = 103, SD = 33.95, 56.2%, 95%CI: 48.2, 64.2) to FCCQ-R Associated factors for practice and perception of Family Centered Care Health workers reported key barriers to FCC. Heavy workload and low staffing 149 of respondents. Lack of training 156. Limited education and information 160. Negative staff attitude toward families 61.Table 2 Table 2 Factor associated with practice and perception of health care professional in order to give FCC in NICU at four randomly selected public hospitals of Addis Ababa Ethiopia, 2024 (n = 184) Variables Yes (%) No (%) Health care professional workload and inadequate staff on FCC 149 (81%) 35 (19%) Lack of training on FCC 156 (84.8%) 28 (15.2%) Lack of education and information on FCC 160 (87%) 24 (13%) Lack of organizational policies on FCC 156 (84.8%) 28 (15.2%) Family stress and anxiety challenges full participation 145 (78.8%) 39 (21.2%) Culture and religion of the family challenge the participation 113 (61.4%) 71 (38.6%) Negative staff attitude towards family on FCC 61 (33.2%) 123 (66.8%) Reliability of the FCCQ-R Regarding the reliability study, the internal consistency measured with Cronbach’s alpha coefficient for Practice and Perception dimensions. For the current study the Cronbach alpha is greater than 0.70 thus the scale is reliable to measure the outcome. Practices and perception Mean scores on the practice and perceptions sub scales of FCC are presented in Table 5 . There are 9 different subscales, and they have different mean scores. Family constant (CP = 2.06, NP = 2.35), Parent and professionals Collaboration (CP = 2.2, NP = 2.32), sharing information with parents (CP = 2.39, NP = 2.32).Table 3 Table 3 ;Differences between practices and perception of FCC in NICU at four randomly selected public hospitals of Addis Ababa Ethiopia, 2024 (n = 184) Subscales Current Practice Necessary Perception Family is the constant 2.06 2.35 Parent and professional collaboration 2.2 2.32 Recognizing family individuality 2.1 2.24 Sharing information with parents 2.39 2.32 Developmental needs 2.3 2.3 Parent-to-parent support 2.29 2.48 Emotional and financial support for families 2.3 2.34 Design of healthcare system 2.3 2.37 Emotional support for staff 2.26 2.26 Factor associated with Perception of FCC The regression analysis showed key factors linked with poor perception of FCC. In the bivariate model, marital status, workload, profession, education level, NICU experience and lack of training showed association. In the multivariable model, residents had higher odds of poor perception than other professionals, AOR 2.516. Staff with master’s level and above had lower odds of poor perception than those with bachelor level and below. Lack of FCC training showed the strongest effect. Those who reported no training had 21 times higher odds of poor perception. Staff with positive attitudes toward family involvement had lower odds of poor perception than those with negative attitudes, AOR 0.301. Table 4 Table 4 Factor associated with perception of FCC in NICU at four randomly selected public hospitals of Addis Ababa Ethiopia, 2024 (n = 184) Variables Categories Perception of FCC COR (95%) p-value AOR (95%) p-value Poor Good Marital status Married 55 37 1 1 Unmarried 72 20 0.41(0.216,0.789) 0.007 1.717(0.807,3.651) 0.160 Profession Neonatologist fellow 12 4 0.357(0.107,1.194) 0.939(0.257.3.433) Resident 70 11 0.168(0.079,0.361) 0.001* 2.516(1.171,5.409) 0.018* BSC and neonatal nurse 45 42 1 1 Educational Status Bachelor’s and below 48 38 1 1 Master’s and above 79 19 3.29(1.706,6.351) 0.001 0.237(0.102,0.551) 0.01* Work experience in NICU 6month-1 year 3 3 0.33(0.063,1.751) 0.18 1.002(0.622,1.614) 0.99 1–3 year 81 27 0.556(0.094,3.285) 1.050(0.355,0.105) 3–4 year 18 10 0.680(0.122,3.778) 1.276(0.360,4.526) > 4 year 25 17 1 1 Workload and inadequate staff Yes 100 49 1.654(0.70,3.907) 0.003 0.622(0.205,1.887) 0.40 No 27 8 1 1 Lack of training Yes 101 55 7.08(1.619,30.95) 0.009* 21.38(3.402,134.4) 0.001* No 26 2 1 1 Negative staff attitude towards family on FCC Yes 46 15 0.629(0.315,1.250) 0.189* 0.301(0.127,0.712) 0.006* No 81 42 1 1 Factor associated with Practice of FCC Bivariate and multivariate logistic regression analysis has been done to identify factors associated with the practice of family centered care among health care professionals. In bivariate analyses, the practice of health care professionals was significantly associated with marital status, age, profession, educational status, work experience in NICU and lack of training. Then, multivariable logistic regression analysis was done using these variables, and the odds of having poor practice towards family centered care among resident professionals is 2.6 times higher than other health care professionals (AOR = 2.614, 95% CI = 1.343,5.091).The odds who poorly practice family centered care among health care professionals who reported that masters and above educational status is 65% less likely than those who has bachelors and below education (AOR = 0.359 95% CI; 0.168,0.767). The odds of having poor perception on FCC among NICU health care professionals who responded is lack of training was 4.1 times higher than their counterpart. (AOR 4.169 95% CI: 1.319, 13.18). The odds of having poor perception on FCC among NICU health care professionals who have positive attitude towards family on FCC is 80% less likely than having negative attitude (AOR = 0.204 95% CI: 0.86,0.482).Table 5 Table 5 Factor associated with practice of FCC in NICU at four randomly selected public hospitals of Addis Ababa Ethiopia, 2024 (n = 184) Variables Categories Practice of FCC COR (95%) p-value AOR (95%) p-value Poor Good Profession Neonatologist fellow 11 5 1.587(0.502,5.022) 1.211(0.339,4.331) Resident 67 14 2.289(1.082,4.842) 0.001* 2.614(1.343,5.091) 0.005* BSC and Neonatal Nurse 39 48 1 1 Age 20–25 2 2 0.250(0.017,3.770) 0.681(0.035,13.160) 26–30 91 56 0.396(0.84,1.866) 0.224 0.645(0.301,1.383) 0.260 31–35 18 8 0.833(0.145,4.781) 0.592(0.89,3.934) 36–40 6 1 1 1 Marital status Married 63 29 1 1 Unmarried 54 38 0.336(0.164,0.689) 0.169 0.897(0.424,1.900) 0.777 Educational status Bachelors and below 45 41 1 1 Masters and above 72 26 0.622(0.310,1.247) 0.003* 0.359(0.168,0.767) 0.008* Work experience in NICU 6month-1year 5 1 0.436(0.045,4.192) 0.244(0.018,3.298) 1–3 year 73 35 1.714(0.735,3.998) 0.246 1.188(0.751,1.878) 0.461 3–4 year 15 13 1.091(0.344,3.460) 1.389(0.374,5.158) .4 year 24 18 1 1 Lack of training Yes 95 61 2.0(0.71,5.56) 0.080* 4.169(1.319,13.18) 0.015* No 22 6 1 1 Negative staff attitude towards family FCC Yes 47 14 2.8(1.3,6.19) 0.009* 0.204(0.086,0.482) 0.001* No 70 53 1 1 Discussion The present study explored and described NICU health professionals’ perceptions of family-centered care concepts and the extent to which they practice these principles in neonatal intensive care units. The study showed that the practice of family-centered care among health care professionals was 36.4 percent, while perception of family-centered care was 31 percent. Health professionals with higher educational status showed a greater difference between perception and practice of family-centered care (AOR 0.359, 95 percent CI 0.168, 0.767). Professionals with a master’s degree or higher reported better perception and practice of family-centered care. Similar findings were reported in previous studies assessing health professionals’ perceptions and practices of family-centered care in neonatal and pediatric settings ( 35 , 36 ). Higher education improves understanding of the principles of family-centered care and strengthens professional confidence in implementing these practices. Another major finding shows that lack of training (AOR 4.16, 95 percent CI 1.319, 13.18) significantly affects the perception and practice of family-centered care among health professionals. Previous studies reported similar findings and identified training as an important factor influencing health professionals’ participation in family-centered care activities( 27 , 28 ). Training improves knowledge, communication skills, and awareness of the benefits of family involvement in neonatal care. The study also identified negative staff attitudes toward families (AOR 0.204, 95 percent CI 0.086, 0.482) as a barrier to family-centered care implementation. Similar findings were reported in studies examining health professionals’ perceptions and practices of family-centered care in neonatal intensive care settings ( 30 , 36 ). Negative attitudes influence collaboration between parents and health professionals and reduce effective communication. This situation limits partnership and shared decision making between families and health providers. Evidence from different countries reports variation in how parents, nurses, and physicians perceive neonatal intensive care practices (22.23). Family-centered care interventions improve parental satisfaction and reduce hospital readmission among premature infants ( 24 ). Pediatric intensive care literature also emphasizes the importance of family participation in care processes( 25 , 34 ). Early separation between mother and newborn during hospitalization increases psychological stress and creates possible developmental risks, which strengthens the need for parental involvement in neonatal care( 26 , 32 ). Reviews of patient and family-centered care also describe several components required for effective implementation in clinical settings( 27 , 28 ). Strength and Limitation of the study Strength of the study It is the first by its type of national level Limitation of the study Although the FCCQ-R was initially intended for nurses, our study involved a variety of Health care professionals working within the hospital in order to take different opinions into account. Since the practice of Family-centered care was assessed through a self-reported questionnaire, the results may differ from directly observed and measured data. Conclusion Assessing the level of Perception and Practice of FCC activities as perceived by the entire healthcare professionals is important to promote FCC. This research finding revealed that the practice of family-centered care among Health care professionals was higher than their perception of family-centered care in NICU. This suggests that while health professionals recognize the value of FCC principles, there are barriers or challenges that prevent them from fully implementing FCC in their clinical practice. Interestingly, the perception of FCC was not influenced by the profession, indicating that FCC should be pursued by every professional involved in NICU. Recommendation Based on the findings of the study, the following recommendations are proposed with a focus on key stakeholders: For Hospital Administrators and Policymakers: Better to encourage public hospitals to establish clear policies, guidelines, and accountability measures to promote the adoption and sustained practice of family-centered care in the NICU setting. Designating family-centered care champions and integrating it into hospital quality improvement processes would be better to include in the policy. Dedicated family-friendly spaces, educational materials, and adequate staffing levels. For NICU Healthcare Professionals: HCP would focus on continuous education, including both pre-service and in-service training. Encourage and empower healthcare professionals to actively engage families in the care of their infants, promoting open communication and shared decision-making. For Researchers Recommended to further investigate the practice and perception of family centered care on health care professional at NICU Abbreviations AOR: Adjusted Odds Ratio, CI: Confidence Interval, FCC: Family Centered Care, FCCQ-R: Family Centered Care Questionnaire Revised, HCP: Health Care Professional, NICU: Neonatal Intensive Care Unit, OR: Odds Ratio, SPSS: Statistical Package for the Social Sciences. Declarations Ethics approval and consent. Ethical clearance was obtained from the Institutional Review Board of Saint Paul’s Hospital Millennium Medical College (Ref. No: N/S/S/506869/16). An official letter was submitted to the Addis Ababa Public Health Research and Emergency Directorate and to the selected hospitals. Permission to conduct the study was obtained from the respective hospital administrations before data collection. Written informed consent was obtained from all participants after explanation of the purpose, procedures, potential risks, and benefits of the study. Participation was voluntary. No personal identifiers were collected, and confidentiality of the information was maintained throughout the study. Participants were informed of their right to withdraw at any time without any consequences. All methods were carried out in accordance with the Declaration of Helsinki. Consent for publication. Not relevant Availability of data and materials The corresponding author can provide the datasets used and analyzed in this study upon reasonable request. Competing interests The writers claim to have no conflicting agendas. Funding No grant from a public, private, or nonprofit organization was given for this research. Authors' contributions All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work. Acknowledgments The authors would like to thank the healthcare professionals working in the NICUs of Saint Paul’s Hospital Millennium Medical College, Yekatit 12 Hospital Medical College, Zewditu Memorial Hospital, and Gandhi Memorial Hospital for their participation and support. We also acknowledge the data collectors and supervisors for their dedication in ensuring accurate and complete data collection. Their contributions were essential to the success of this study. References Kenner C, Lott J. Comprehensive Neonatal Nursing Care eBook central. (2013). Fotiou C, Vlastarakos PV, Bakoula C, et al. Parental stress management using relaxation techniques in a neonatal intensive care unit: a randomised controlled trial. Intensive Crit Care Nurs. 2016;32:20–8. [PubMed] [Google Scholar]. Heidari H, Hasanpour M, Fooladi M. The experiences of parents with infants in neonatal intensive care unit. Iran J Nurs Midwifery Res. 2013;18(03):208–13. [PMC free article] [PubMed] [Google Scholar]. Ionio C, Colombo C, Brazzoduro V, et al. Mothers and fathers in NICU: the impact of preterm birth on parental distress. Eur J Psychol. 2016;12(04):604–21. [PMC free article] [PubMed] [Google Scholar]. Heidari H, Hasanpour M, Fooladi M. Stress management among parents of neonates hospitalized in NICU: a qualitative study. J Caring Sci. 2017;6(01):29–38. [PMC free article] [PubMed] [Google Scholar]. Roque ATF, Lasiuk GC, Radünz V, Hegadoren K. Scoping review of the mental health of parents of infants in the NICU. J Obstet Gynecol Neonatal Nurs. 2017;46(04):576–87. [PubMed] [Google Scholar]. Heidari H, Hasanpour M, Fooladi M. The Iranian parents of premature infants in NICU experience stigma of shame. Med Arh. 2012;66(01):35–40. [PubMed] [Google Scholar]. Silva TRG, Manzo BF, Fioreti. FCCF;Silva,PM.Cuidado centrado na familia na unidade de terapia intensive neonatal Rev.Rene 2016. Oude Maatman SM, Bohlin K, Lillieskold S et al. Factors infuluencing implementation of family-centered care in a neonatal intensive care unit.2020; 8:222. Toivonen M, Lehtonen L, Ahlqvist- Bjotkroth S, Axelin A. Key factors supporting implementation of a training program for neonatal family centered care. 2019;19(1):394. Benzies KM, Shah V, Aziz K, Lodha A, Misfeldt R. The health care system is making too much noise to provide family centered care in neonatal intensive care unit. 2019;50:44–53. Staniszewska S, Brett J, Psychol C et al. Developing a Model of Family-Centered Care for Neonatal Units journal of family nursing, 2012. Lauridsen EI, Higginbottom G. The roots and development of constructivist grounded theory, Nurse Researcher, 2015. Li X, et al. Assessing intercity multimodal choice behavior in a Touristy City: A factor analysis journal of Transport Georaphy. Elsevier; 2020. p. 102776. UNICEF. Investing in Survival: Enhancing the Neonatal Intensive Care Unit of Yekatit 12 Hospita. 2013. [Google Scholar]. Healthy Newborn Network. Survive and thrive: transforming care for every small and sicknewborn. https://www.healthynewbornnetwork.org/hnn-content/uploads/Survive-and-Thrive_Fin . Published 2019. [Context Link]. Harrison WN, Wasserman JR, Goodman DC. Regional variation in neonatal intensive care admissions and the relationship to bed supply. J Pediatr. 2018;192:73–e794. 10.1016/j.jpeds.2017.08.028 . [Context Link]. Raiskila S, Axelin A, Toome L, et al. Parents' presence and parent-infant closeness in 11 neonatal intensive care units in six European countries vary between and within the countries. Acta Paediatr. 2017;106(6):878–88. 10.1111/apa.13798 . [Context Link]. Abraham M et al. implementing patient- and family-centered care: Part I – understanding the challenges Pediatric. Nurse (2012). Shields L. What is Family Centered Care? Eur J Pers Cent Healthc. 2015;3:139–44. Dall’Oglio I, Di Furia M, Tiozzo E, Gawronski O, Biagioli V, Di Ciommo VM. Practices and perceptions of Family Centered Care among Healthcare Providers,2018. Latour JM, ‘Perceptions of parents, nurses, and physicians on neonatal intensive care practices Corresponding author Jos M., Latour RN et al. PhD Nurse Scientist Erasmus MC Sophia Children ’ s Hospital Department of Pediatrics, Room Sp-1539 P. O. Box 2060 Key Words’, Journal of Pediatircs, 2010, 157(2), pp. 215–220. Dall’Oglio I, Mascolo R, Tiozzo E, Portanova A, Fiori M, Gawronski O, Dotta A, Piga S, Offidani C, Alvaro R, Rocco G, Latour, Jos M. the current practice of family-centred care in Italian neonatal intensive care units: A multicentre descriptive study. Intensive Crit Care Nurs. 2019;50:36–43. https://doi.org/10.1016/j.iccn.2018.07.005 . Bastani F, Ali Abadi T, Haghani H. Effect of Family-centered Care on Improving Parental Satisfaction and Reducing Readmission among Premature Infants: A Randomized Controlled Trial. J Clin Diagn Res. (2015). Dixon M, Crawford D. Pediatric Intensive Care Nursing eBook Central. (2012). Császár-Nagy N, Bókkon I. Mother-newborn separation at birth in hospitals: A possible risk for neurodevelopmental disorders? accessed 2019,16.11. Gallo KP, Hill LC, Hoagwood KE. Olin SO A narrative synthesis of the components and evidence for patient and family centered care.clinical pediatrics 2016;55 (4): 333–346. Mikkelsen G, Frederiksen K. Family centered care of children in hospital a concept analysis. J Adv Nurs. 2011;67(5):1152–62. Choi M. Kim J.Associated factors in pediatric nurse parent partnership. Child Health Nurs Res. 2014;20.3.176. da Silva TRG, Manzo BF, Fiorete FCC, de Silva F. Family-centered care from the perspective of nurses in the Neonatal Intensive Care Unit. Rev da Rede Enferm do Nord. 2016;17:643. 10.15253/21756783.2016000500009CrossRef Full Text | Google Scholar. Oude Maatman SM, Bohlin K, Lillieskold S, Garbage HT. Uitewaal- Poslawky l, Kars MC, Factor influencing implementation of Family centered care in a. Neonatal Intensive Care Unit; 2020. Conde-Agudelo A, Díaz-Rossello JL. Kangaroo mother care to reduce morbidity and mortality in low birthweight infants. Cochrane Database Syst Rev. 2016. Marcenko MO, Smith LK. The impact of a Family-centered case management approach. Soc Work Health Care. 2011;22(1):56–73. Journal of Pediatric Nursing. Volume 43, Nov-Dec 2018, pages e18–125. Bruce B, Letourneau N, Ritchie J, Larocque S, Dennis C, Elliott MR. A Multisite Study of Health Professionals’ Perceptions and Practices of Family-Centered Care. J Fam Nurs. 2002;8:408–42. Coyne I, Murphy M, Costello T, O’Neill C, Donnellan C. A Survey of Nurses’ Practices and Perceptions of Family-Centered Care in Ireland. J Fam Nurs. 2013;19:469–88. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 26 Apr, 2026 Reviewers agreed at journal 17 Apr, 2026 Reviewers invited by journal 14 Apr, 2026 Editor assigned by journal 13 Apr, 2026 Editor invited by journal 19 Mar, 2026 Submission checks completed at journal 18 Mar, 2026 First submitted to journal 18 Mar, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9096501","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":626459067,"identity":"26ccee63-bf19-45a1-aa83-a96ad212e265","order_by":0,"name":"meseret Wondemu","email":"","orcid":"","institution":"Saint Paul's Hospital Millennium Medical College","correspondingAuthor":false,"prefix":"","firstName":"meseret","middleName":"","lastName":"Wondemu","suffix":""},{"id":626459068,"identity":"3ddf1d90-0c88-4689-904c-302ea700e211","order_by":1,"name":"Abel teklit haile","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABFElEQVRIie3PsUrDQBjA8U8CyXLa9aSQewLhQiA4lPgWzt8RSJa2FLoUHBoQ7OIbZPAVUgRXTw7q4guISzO5Zsxm7wpOcqluBe8/hHB8v3wXAJfrKPNPJAIgBEQ/ZxCaM7ntAQR8kIiaeIZwiPcEDxH4JsBBlOa4j1wFdyibLp0OvNOXdstHxcO1avSWNLwoLVvIRuqLZfPz27OMIs8n64+ca5LFibQQWpSaeKJWhGuiJusKDZHiyUbYpyFL8axI3CH/KqKqaPsJ9c3FlKg9klDzfTYcH9jylqPE/HVOFUkukWdRPRzPpH6x/kuw2kRNN7qZDlb38Xu3SBmrise2XaShjfyM7yf5b8dNrPzLtMvlcv2HdunPY5Cwht4XAAAAAElFTkSuQmCC","orcid":"","institution":"saint peter specialized hospital","correspondingAuthor":true,"prefix":"","firstName":"Abel","middleName":"teklit","lastName":"haile","suffix":""},{"id":626459069,"identity":"977dced8-1813-4f4f-a61a-7c87105696c1","order_by":2,"name":"Robel Gemechu haile","email":"","orcid":"","institution":"saint peter specialized hospital","correspondingAuthor":false,"prefix":"","firstName":"Robel","middleName":"Gemechu","lastName":"haile","suffix":""},{"id":626459070,"identity":"d55371a8-c234-43da-970b-007c1441985f","order_by":3,"name":"salhadin Mohammed Jemal","email":"","orcid":"","institution":"Wollo University","correspondingAuthor":false,"prefix":"","firstName":"salhadin","middleName":"Mohammed","lastName":"Jemal","suffix":""},{"id":626459071,"identity":"15579a89-071f-4733-b271-67c8ad34be85","order_by":4,"name":"rewina solomon kebede","email":"","orcid":"","institution":"Tikur Anbessa Hospital","correspondingAuthor":false,"prefix":"","firstName":"rewina","middleName":"solomon","lastName":"kebede","suffix":""}],"badges":[],"createdAt":"2026-03-11 16:10:42","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9096501/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9096501/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":107705956,"identity":"1e318649-56e2-4eec-8041-51c82a884aea","added_by":"auto","created_at":"2026-04-24 09:15:52","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":435051,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9096501/v1/8c0d92cf-1e00-42e9-9be4-8925fd38747c.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Perception, Practice and Associated factors towards Family Centered Care among Health Care Professionals in Neonatal Intensive Care Unit at Public Hospitals in Addis Ababa, Ethiopia, 2024","fulltext":[{"header":"Background","content":"\u003cp\u003eThe birth of a child introduces significant changes within a family, requiring adjustment of roles and responsibilities.(\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). When a newborn develops complications and requires admission to a neonatal intensive care unit, parents often experience anxiety, uncertainty, and emotional distress. The unfamiliar environment, combined with limited involvement in the care of their newborn, can reduce parental confidence and increase feelings of helplessness(\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). Separation from the newborn and restricted participation in care further contribute to stress and negatively affect the parent\u0026ndash;infant relationship (\u003cspan additionalcitationids=\"CR2 CR3 CR4\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIt is one of the important elements of the care of neonates which has a protective effect on parents(\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). Studies show that there is constant claim of parents in Brazilian neonatal unities to be part of their children care (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). The Patient-and- Family-Centered-Care Model (PFCCM) has been recommended as ideal for neonatal practice, since it fosters a truly collaborative relationship between family and health team(\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e) Also, research conducted in Sweden and Norway shows influence of the NICU environment, with adequate and welcoming facilities for families necessary for successful family centered care implementation(\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). However, in Ethiopia most studies focus on parental satisfaction with family-centered care rather than the practices and perceptions of health care professionals; therefore, further research is needed.\u003c/p\u003e \u003cp\u003eTherefore, the purpose of this study was to evaluate the perception, practice and its associated factor of family-centered care from the perspective of health care professionals in the neonatal intensive care unit.\u003c/p\u003e \u003cp\u003e Ideally, families are an integral part of care in NICU: however, limited visitations to the NICU restrict them. The consequences are that family\u0026rsquo;s face isolation from their neonate, and they suffer separation anxiety, and post NICU depression (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eMoreover, the neonates cannot express their needs and experiences of the care provided to them in intensive care, their parents do so on their behalf, which justifies the need for parental involvement (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eFamily-centered care (FCC) promotes partnership between health providers, patients, and families. In neonatal care, FCC improves parent satisfaction, reduces costs, and minimizes negative outcomes after hospitalization. (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e) Staff attitudes towards FCC were explored by several authors describing the practices and perceptions of FCC by professionals in NICU (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eA gap exists between perception and practice, as many health professionals lack clarity on FCC actions, have limited skills to apply its principles, and struggle with effective communication with parents (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e)Such problems cause inconsistent practice of FCC even though health care professionals believe in the value of the philosophy. Therefore, staff should be encouraged to implement FCC with awareness; this improves the health status of infants and families with the care provided (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eInteraction and communication between healthcare professionals and parents remain major challenges in NICUs, contributing to gaps between the perception and practice of family-centered care (FCC). This study examines healthcare professionals\u0026rsquo; perceptions, practices, and associated factors related to FCC across public hospitals in Addis Ababa. Its findings will guide the development of targeted educational interventions, enhance understanding of barriers and roles within FCC, and strengthen the overall quality of neonatal care. The results will also support policymakers, stakeholders, and hospitals in designing effective interventions, inform national guidelines, and provide baseline evidence for future research and implementation of FCC in Ethiopia. Studies also describe parental demand for involvement and highlight structural barriers in neonatal units(\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eEvidence from different countries reports variation in how parents, nurses, and physicians perceive neonatal intensive care practices (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). Family-centered care interventions improve parental satisfaction and reduce hospital readmission among premature infants (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e). Pediatric intensive care literature also emphasizes family participation in care processes (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e). Early separation between mother and newborn during hospitalization creates psychological stress and possible developmental risks, reinforcing the need for family involvement (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e). Reviews of patient and family-centered care identify several components required for effective implementation in clinical settings(\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e).\u003c/p\u003e"},{"header":"Method","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy Area \u0026amp; Study Period\u003c/h2\u003e \u003cp\u003eThis institutional-based cross-sectional study was conducted in Addis Ababa, Ethiopia. Four public hospitals were selected by lottery: Saint Paul\u0026rsquo;s Hospital Millennium Medical College, Yekatit 12 Hospital Medical College, Zewditu Memorial Hospital, and Gandhi Memorial Hospital. Data collection took place from April 20 to May 20, 2024. The source population included all health care professionals working in the NICUs of public hospitals in Addis Ababa. The study population consisted of licensed NICU professionals working in the selected hospitals during the study period. Medical students and individuals with less than six months of NICU experience were excluded.\u003c/p\u003e \u003cp\u003eThe study applied a cross-sectional survey design to assess perception and practice of family-centered care among NICU staff. Four hospitals were selected based on NICU service level and staffing volume. All eligible professionals were included, resulting in a total sample of 184 participants.\u003c/p\u003e \u003cp\u003eThe dependent variable was perception and practice of family-centered care. Independent variables included socio-demographic characteristics such as age, residency, marital status, education level, and occupation. Organizational factors included workload, policies, health education, and length of stay. Professional factors included attitude toward family-centered care, knowledge of family-centered care, and work experience.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eOperational Definition\u003c/h3\u003e\n\u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003ePerception on FCC is belief, views and understanding of Health care professionals regarding Family centered care. (The total score is 45*5\u0026thinsp;=\u0026thinsp;225, after data collection and entry, the distribution of the data was analyzed, then depending on the distribution if participant score 109 and above it is good and if it is below 109 value it is poor) (\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e)\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003ePractice of FCC is an integrated Family centered care services delivered in a setting and manner that is responsive to their goals and values. (The total score is 225, after data collection and entry, the distribution of the data was analyzed, then depending on the distribution if participant score 103 and above it is good and if it is below 103 value it is poor) (\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e)\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eFamily Centered Care (FCC) is a way of providing services that assures the health and wellbeing of children and their families through respectful family/professional partnership.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eNeonatal Intensive Care Unit (NICU) is a hospital ward or department equipped and staffed to provide intensive care to seriously ill or premature newborn babies.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eProfessional Family relationship is a consultative relationship in which the parents as colleagues seek consultants help to solve a particular problem.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e\n\u003ch3\u003eData collection, technique, data management, and analysis\u003c/h3\u003e\n\u003cp\u003eThe Family Centered Care Questionnaire-Revised (FCCQ-R), a previously published and validated instrument developed by Bruce and Ritchie, was used to assess health care professionals\u0026rsquo; perceptions and practices of family-centered care(\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e). The questionnaire includes nine domains: the family as the constant in the child\u0026rsquo;s life; collaboration between parents and health professionals; recognition of family individuality; sharing complete information; understanding the developmental needs of the child; encouragement of parent-to-parent support; provision of emotional and financial support; ensuring that the health care delivery system responds to family needs; and provision of emotional support to staff.\u003c/p\u003e \u003cp\u003eData were collected using a structured questionnaire with family-centered care practice scales measured on a five-point Likert scale. The questionnaire was administered through face-to-face interviewer-administered interviews using the standardized FCCQ-R. Four data collectors and two supervisors conducted the data collection. The data collectors were Bachelor of Science neonatal nurses with more than one year of experience. The supervisors were Master of Science nurses. All data collectors received training on the study objectives and standardized data collection procedures before the start of data collection.\u003c/p\u003e \u003cp\u003eA pretest was conducted on five percent of the sample at Ras Desta Damtew Hospital. Reliability was assessed using Cronbach\u0026rsquo;s alpha, which showed strong internal consistency.\u003c/p\u003e \u003cp\u003eCompleted questionnaires were reviewed daily for completeness and accuracy. Data was coded and entered into SPSS version 27 for analysis. Descriptive statistics were used to summarize participant characteristics using frequency, percentage, mean, and standard deviation. Logistic regression analysis was performed to identify factors associated with perception and practice of family-centered care. Variables with a p value less than 0.25 in bivariable analysis were included in the multivariable logistic regression model. Final associations were presented using adjusted odds ratios with 95 percent confidence intervals. Statistical significance was set at a p value less than 0.05.\u003c/p\u003e"},{"header":"Result","content":"\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eSocio demographic Characteristics\u003c/h2\u003e \u003cp\u003eA total of 184 health care professional participated in the study, among the participants, 123(66.8%) of the participants were females. The mean age of the participants was 29 years. Of the participants, 147(79.9%) were in the age group of 26\u0026ndash;30 years. 50% of the participants were not married. Approximately 47.3% of the sample consisted of nurses.Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSocio demographic characteristics of health care professionals in NICU at four randomly selected public hospitals of Addis Ababa Ethiopia, 2024 (n\u0026thinsp;=\u0026thinsp;184)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eResponse\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercentage\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20\u0026ndash;25 age\u003c/p\u003e \u003cp\u003e26\u0026ndash;30 age\u003c/p\u003e \u003cp\u003e31\u0026ndash;35 age\u003c/p\u003e \u003cp\u003e36\u0026ndash;40 age\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4\u003c/p\u003e \u003cp\u003e147\u003c/p\u003e \u003cp\u003e26\u003c/p\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.2%\u003c/p\u003e \u003cp\u003e79.9%\u003c/p\u003e \u003cp\u003e14.1%\u003c/p\u003e \u003cp\u003e3.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e61\u003c/p\u003e \u003cp\u003e123\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e33.2%\u003c/p\u003e \u003cp\u003e66.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarital status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003cp\u003eUnmarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e92\u003c/p\u003e \u003cp\u003e92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e50%\u003c/p\u003e \u003cp\u003e50%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEducational status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBachelor\u0026rsquo;s degree or below\u003c/p\u003e \u003cp\u003eMaster\u0026rsquo;s and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e86\u003c/p\u003e \u003cp\u003e98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e46.7%\u003c/p\u003e \u003cp\u003e53.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProfessions\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNeonatologist and\u003c/p\u003e \u003cp\u003efellow\u003c/p\u003e \u003cp\u003eResident\u003c/p\u003e \u003cp\u003eBSC nurse and neonatal nurse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16\u003c/p\u003e \u003cp\u003e81\u003c/p\u003e \u003cp\u003e87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8.7%\u003c/p\u003e \u003cp\u003e44%\u003c/p\u003e \u003cp\u003e47.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWork experience in NICU\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6month-1 year\u003c/p\u003e \u003cp\u003e1\u0026ndash;3 years\u003c/p\u003e \u003cp\u003e3\u0026ndash;4 years\u003c/p\u003e \u003cp\u003e\u0026gt;4 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003cp\u003e108\u003c/p\u003e \u003cp\u003e28\u003c/p\u003e \u003cp\u003e42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.3%\u003c/p\u003e \u003cp\u003e58.7%\u003c/p\u003e \u003cp\u003e15.2%\u003c/p\u003e \u003cp\u003e22.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003ePerception and practice of Health care professional on Family Centered Care in NICU\u003c/h2\u003e \u003cp\u003eThe mean score of Perception is (mean score\u0026thinsp;=\u0026thinsp;109, SD\u0026thinsp;=\u0026thinsp;36.5, 63.5%, 95%CI: 55.5, 70.8) and Practice is (means core\u0026thinsp;=\u0026thinsp;103, SD\u0026thinsp;=\u0026thinsp;33.95, 56.2%, 95%CI: 48.2, 64.2) to FCCQ-R\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eAssociated factors for practice and perception of Family Centered Care\u003c/h3\u003e\n\u003cp\u003eHealth workers reported key barriers to FCC. Heavy workload and low staffing 149 of respondents. Lack of training 156. Limited education and information 160. Negative staff attitude toward families 61.Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eFactor associated with practice and perception of health care professional in order to give FCC in NICU at four randomly selected public hospitals of Addis Ababa Ethiopia, 2024 (n\u0026thinsp;=\u0026thinsp;184)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Taba\" border=\"1\"\u003e \u003ccolgroup cols=\"1\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHealth care professional workload and inadequate staff on FCC\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e149\u003c/p\u003e \u003cp\u003e(81%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35\u003c/p\u003e \u003cp\u003e(19%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLack of training on FCC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e156\u003c/p\u003e \u003cp\u003e(84.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28\u003c/p\u003e \u003cp\u003e(15.2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLack of education and information on FCC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e160\u003c/p\u003e \u003cp\u003e(87%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24\u003c/p\u003e \u003cp\u003e(13%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLack of organizational policies on FCC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e156\u003c/p\u003e \u003cp\u003e(84.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28\u003c/p\u003e \u003cp\u003e(15.2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFamily stress and anxiety challenges full participation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e145\u003c/p\u003e \u003cp\u003e(78.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e39\u003c/p\u003e \u003cp\u003e(21.2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCulture and religion of the family challenge the participation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e113\u003c/p\u003e \u003cp\u003e(61.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e71\u003c/p\u003e \u003cp\u003e(38.6%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNegative staff attitude towards family on FCC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61\u003c/p\u003e \u003cp\u003e(33.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e123\u003c/p\u003e \u003cp\u003e(66.8%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e\n\u003ch3\u003eReliability of the FCCQ-R\u003c/h3\u003e\n\u003cp\u003eRegarding the reliability study, the internal consistency measured with Cronbach\u0026rsquo;s alpha coefficient for Practice and Perception dimensions. For the current study the Cronbach alpha is greater than 0.70 thus the scale is reliable to measure the outcome.\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003ePractices and perception\u003c/h2\u003e \u003cp\u003eMean scores on the practice and perceptions sub scales of FCC are presented in Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e. There are 9 different subscales, and they have different mean scores. Family constant (CP\u0026thinsp;=\u0026thinsp;2.06, NP\u0026thinsp;=\u0026thinsp;2.35), Parent and professionals Collaboration (CP\u0026thinsp;=\u0026thinsp;2.2, NP\u0026thinsp;=\u0026thinsp;2.32), sharing information with parents (CP\u0026thinsp;=\u0026thinsp;2.39, NP\u0026thinsp;=\u0026thinsp;2.32).Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e;Differences between practices and perception of FCC in NICU at four randomly selected public hospitals of Addis Ababa Ethiopia, 2024 (n\u0026thinsp;=\u0026thinsp;184)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSubscales\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCurrent Practice\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNecessary Perception\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFamily is the constant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.35\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eParent and professional collaboration\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.32\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRecognizing family individuality\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.24\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSharing information with parents\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.32\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDevelopmental needs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eParent-to-parent support\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.48\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmotional and financial support for families\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.34\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDesign of healthcare system\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.37\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmotional support for staff\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.26\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eFactor associated with Perception of FCC\u003c/h2\u003e \u003cp\u003eThe regression analysis showed key factors linked with poor perception of FCC. In the bivariate model, marital status, workload, profession, education level, NICU experience and lack of training showed association. In the multivariable model, residents had higher odds of poor perception than other professionals, AOR 2.516. Staff with master\u0026rsquo;s level and above had lower odds of poor perception than those with bachelor level and below. Lack of FCC training showed the strongest effect. Those who reported no training had 21 times higher odds of poor perception. Staff with positive attitudes toward family involvement had lower odds of poor perception than those with negative attitudes, AOR 0.301. Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eFactor associated with perception of FCC in NICU at four randomly selected public hospitals of Addis Ababa Ethiopia, 2024 \u003cem\u003e(n\u0026thinsp;=\u0026thinsp;184)\u003c/em\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCategories\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003ePerception of FCC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCOR\u003c/p\u003e \u003cp\u003e(95%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAOR (95%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePoor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMarital status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUnmarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.41(0.216,0.789)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.007\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.717(0.807,3.651)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.160\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eProfession\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNeonatologist fellow\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.357(0.107,1.194)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.939(0.257.3.433)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eResident\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.168(0.079,0.361)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.001*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2.516(1.171,5.409)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.018*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBSC and neonatal nurse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eEducational Status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBachelor\u0026rsquo;s and below\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMaster\u0026rsquo;s and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.29(1.706,6.351)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.237(0.102,0.551)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.01*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eWork experience in NICU\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6month-1 year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.33(0.063,1.751)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.002(0.622,1.614)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.99\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u0026ndash;3 year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.556(0.094,3.285)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.050(0.355,0.105)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3\u0026ndash;4 year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.680(0.122,3.778)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.276(0.360,4.526)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;4 year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eWorkload and inadequate staff\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.654(0.70,3.907)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.622(0.205,1.887)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.40\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eLack of training\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e101\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7.08(1.619,30.95)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.009*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e21.38(3.402,134.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.001*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eNegative staff attitude towards family on FCC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.629(0.315,1.250)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.189*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.301(0.127,0.712)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.006*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eFactor associated with Practice of FCC\u003c/h2\u003e \u003cp\u003eBivariate and multivariate logistic regression analysis has been done to identify factors associated with the practice of family centered care among health care professionals. In bivariate analyses, the practice of health care professionals was significantly associated with marital status, age, profession, educational status, work experience in NICU and lack of training. Then, multivariable logistic regression analysis was done using these variables, and the odds of having poor practice towards family centered care among resident professionals is 2.6 times higher than other health care professionals (AOR\u0026thinsp;=\u0026thinsp;2.614, 95% CI\u0026thinsp;=\u0026thinsp;1.343,5.091).The odds who poorly practice family centered care among health care professionals who reported that masters and above educational status is 65% less likely than those who has bachelors and below education (AOR\u0026thinsp;=\u0026thinsp;0.359 95% CI; 0.168,0.767). The odds of having poor perception on FCC among NICU health care professionals who responded is lack of training was 4.1 times higher than their counterpart. (AOR 4.169 95% CI: 1.319, 13.18). The odds of having poor perception on FCC among NICU health care professionals who have positive attitude towards family on FCC is 80% less likely than having negative attitude (AOR\u0026thinsp;=\u0026thinsp;0.204 95% CI: 0.86,0.482).Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eFactor associated with practice of FCC in NICU at four randomly selected public hospitals of Addis Ababa Ethiopia, 2024 (n\u0026thinsp;=\u0026thinsp;184)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"9\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCategories\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e \u003cp\u003ePractice of FCC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCOR\u003c/p\u003e \u003cp\u003e(95%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAOR (95%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003ePoor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eProfession\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNeonatologist fellow\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.587(0.502,5.022)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.211(0.339,4.331)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eResident\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.289(1.082,4.842)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.001*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2.614(1.343,5.091)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.005*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBSC and\u003c/p\u003e \u003cp\u003eNeonatal\u003c/p\u003e \u003cp\u003eNurse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20\u0026ndash;25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.250(0.017,3.770)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.681(0.035,13.160)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e26\u0026ndash;30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.396(0.84,1.866)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.224\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.645(0.301,1.383)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.260\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e31\u0026ndash;35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.833(0.145,4.781)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.592(0.89,3.934)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e36\u0026ndash;40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMarital status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUnmarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.336(0.164,0.689)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.169\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.897(0.424,1.900)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.777\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eEducational status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBachelors and below\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMasters and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.622(0.310,1.247)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.003*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.359(0.168,0.767)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.008*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eWork experience in NICU\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6month-1year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.436(0.045,4.192)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.244(0.018,3.298)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u0026ndash;3 year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.714(0.735,3.998)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.246\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.188(0.751,1.878)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.461\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3\u0026ndash;4 year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.091(0.344,3.460)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.389(0.374,5.158)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.4 year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eLack of training\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.0(0.71,5.56)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.080*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e4.169(1.319,13.18)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.015*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eNegative staff attitude towards family FCC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.8(1.3,6.19)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.009*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.204(0.086,0.482)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.001*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe present study explored and described NICU health professionals\u0026rsquo; perceptions of family-centered care concepts and the extent to which they practice these principles in neonatal intensive care units. The study showed that the practice of family-centered care among health care professionals was 36.4 percent, while perception of family-centered care was 31 percent.\u003c/p\u003e \u003cp\u003eHealth professionals with higher educational status showed a greater difference between perception and practice of family-centered care (AOR 0.359, 95 percent CI 0.168, 0.767). Professionals with a master\u0026rsquo;s degree or higher reported better perception and practice of family-centered care. Similar findings were reported in previous studies assessing health professionals\u0026rsquo; perceptions and practices of family-centered care in neonatal and pediatric settings (\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e). Higher education improves understanding of the principles of family-centered care and strengthens professional confidence in implementing these practices.\u003c/p\u003e \u003cp\u003eAnother major finding shows that lack of training (AOR 4.16, 95 percent CI 1.319, 13.18) significantly affects the perception and practice of family-centered care among health professionals. Previous studies reported similar findings and identified training as an important factor influencing health professionals\u0026rsquo; participation in family-centered care activities(\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e). Training improves knowledge, communication skills, and awareness of the benefits of family involvement in neonatal care.\u003c/p\u003e \u003cp\u003eThe study also identified negative staff attitudes toward families (AOR 0.204, 95 percent CI 0.086, 0.482) as a barrier to family-centered care implementation. Similar findings were reported in studies examining health professionals\u0026rsquo; perceptions and practices of family-centered care in neonatal intensive care settings (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e). Negative attitudes influence collaboration between parents and health professionals and reduce effective communication. This situation limits partnership and shared decision making between families and health providers.\u003c/p\u003e \u003cp\u003eEvidence from different countries reports variation in how parents, nurses, and physicians perceive neonatal intensive care practices (22.23). Family-centered care interventions improve parental satisfaction and reduce hospital readmission among premature infants (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). Pediatric intensive care literature also emphasizes the importance of family participation in care processes(\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e). Early separation between mother and newborn during hospitalization increases psychological stress and creates possible developmental risks, which strengthens the need for parental involvement in neonatal care(\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e). Reviews of patient and family-centered care also describe several components required for effective implementation in clinical settings(\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e).\u003c/p\u003e "},{"header":"Strength and Limitation of the study","content":"\u003cp\u003e\u003cstrong\u003eStrength of the study\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003eIt is the first by its type of national level\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cstrong\u003eLimitation of the study\u003c/strong\u003e\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003eAlthough the FCCQ-R was initially intended for nurses, our study involved a variety of Health care professionals working within the hospital in order to take different opinions into account.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eSince the practice of Family-centered care was assessed through a self-reported questionnaire, the results may differ from directly observed and measured data.\u003c/li\u003e\n\u003c/ul\u003e"},{"header":"Conclusion","content":"\u003cp\u003eAssessing the level of Perception and Practice of FCC activities as perceived by the entire healthcare professionals is important to promote FCC. This research finding revealed that the practice of family-centered care among Health care professionals was higher than their perception of family-centered care in NICU. This suggests that while health professionals recognize the value of FCC principles, there are barriers or challenges that prevent them from fully implementing FCC in their clinical practice. Interestingly, the perception of FCC was not influenced by the profession, indicating that FCC should be pursued by every professional involved in NICU.\u003c/p\u003e"},{"header":"Recommendation","content":"\u003cp\u003eBased on the findings of the study, the following recommendations are proposed with a focus on key stakeholders:\u003c/p\u003e\n\u003cp\u003eFor Hospital Administrators and Policymakers:\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003eBetter to encourage public hospitals to establish clear policies, guidelines, and accountability measures to promote the adoption and sustained practice of family-centered care in the NICU setting.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eDesignating family-centered care champions and integrating it into hospital quality improvement processes would be better to include in the policy.\u003c/li\u003e\n \u003cli\u003eDedicated family-friendly spaces, educational materials, and adequate staffing levels.\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eFor NICU Healthcare Professionals:\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003eHCP would focus on continuous education, including both pre-service and in-service training.\u003c/li\u003e\n \u003cli\u003eEncourage and empower healthcare professionals to actively engage families in the care of their infants, promoting open communication and shared decision-making.\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u0026nbsp;For Researchers\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003eRecommended to further investigate the practice and perception of family centered care on health care professional at NICU\u003c/li\u003e\n\u003c/ul\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eAOR: Adjusted Odds Ratio, CI: Confidence Interval, FCC: Family Centered Care, FCCQ-R: Family Centered Care Questionnaire Revised, HCP: Health Care Professional, NICU: Neonatal Intensive Care Unit, OR: Odds Ratio, SPSS: Statistical Package for the Social Sciences.\u003c/p\u003e\n"},{"header":"Declarations","content":"\u003cp\u003eEthics approval and consent.\u003c/p\u003e\n\u003cp\u003eEthical clearance was obtained from the Institutional Review Board of Saint Paul\u0026rsquo;s Hospital Millennium Medical College (Ref. No: N/S/S/506869/16). An official letter was submitted to the Addis Ababa Public Health Research and Emergency Directorate and to the selected hospitals. Permission to conduct the study was obtained from the respective hospital administrations before data collection. Written informed consent was obtained from all participants after explanation of the purpose, procedures, potential risks, and benefits of the study. Participation was voluntary. No personal identifiers were collected, and confidentiality of the information was maintained throughout the study. Participants were informed of their right to withdraw at any time without any consequences.\u0026nbsp;All methods were carried out in accordance with the Declaration of Helsinki.\u003c/p\u003e\n\u003cp\u003eConsent for publication.\u003c/p\u003e\n\u003cp\u003eNot relevant\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAvailability of data and materials\u003c/p\u003e\n\u003cp\u003eThe corresponding author can provide the datasets used and analyzed in this study upon reasonable request.\u003c/p\u003e\n\u003cp\u003eCompeting interests\u003c/p\u003e\n\u003cp\u003eThe writers claim to have no conflicting agendas.\u003c/p\u003e\n\u003cp\u003eFunding\u003c/p\u003e\n\u003cp\u003eNo grant from a public, private, or nonprofit organization was given for this research.\u003c/p\u003e\n\u003cp\u003eAuthors\u0026apos; contributions\u003c/p\u003e\n\u003cp\u003eAll authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eAcknowledgments\u003c/p\u003e\n\u003cp\u003eThe authors would like to thank the healthcare professionals working in the NICUs of Saint Paul\u0026rsquo;s Hospital Millennium Medical College, Yekatit 12 Hospital Medical College, Zewditu Memorial Hospital, and Gandhi Memorial Hospital for their participation and support. We also acknowledge the data collectors and supervisors for their dedication in ensuring accurate and complete data collection. Their contributions were essential to the success of this study.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eKenner C, Lott J. Comprehensive Neonatal Nursing Care eBook central. (2013).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFotiou C, Vlastarakos PV, Bakoula C, et al. Parental stress management using relaxation techniques in a neonatal intensive care unit: a randomised controlled trial. Intensive Crit Care Nurs. 2016;32:20\u0026ndash;8. [PubMed] [Google Scholar].\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHeidari H, Hasanpour M, Fooladi M. The experiences of parents with infants in neonatal intensive care unit. Iran J Nurs Midwifery Res. 2013;18(03):208\u0026ndash;13. [PMC free article] [PubMed] [Google Scholar].\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eIonio C, Colombo C, Brazzoduro V, et al. Mothers and fathers in NICU: the impact of preterm birth on parental distress. Eur J Psychol. 2016;12(04):604\u0026ndash;21. [PMC free article] [PubMed] [Google Scholar].\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHeidari H, Hasanpour M, Fooladi M. Stress management among parents of neonates hospitalized in NICU: a qualitative study. J Caring Sci. 2017;6(01):29\u0026ndash;38. [PMC free article] [PubMed] [Google Scholar].\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRoque ATF, Lasiuk GC, Rad\u0026uuml;nz V, Hegadoren K. Scoping review of the mental health of parents of infants in the NICU. J Obstet Gynecol Neonatal Nurs. 2017;46(04):576\u0026ndash;87. [PubMed] [Google Scholar].\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHeidari H, Hasanpour M, Fooladi M. The Iranian parents of premature infants in NICU experience stigma of shame. Med Arh. 2012;66(01):35\u0026ndash;40. [PubMed] [Google Scholar].\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSilva TRG, Manzo BF, Fioreti. FCCF;Silva,PM.Cuidado centrado na familia na unidade de terapia intensive neonatal Rev.Rene 2016.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOude Maatman SM, Bohlin K, Lillieskold S et al. Factors infuluencing implementation of family-centered care in a neonatal intensive care unit.2020; 8:222.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eToivonen M, Lehtonen L, Ahlqvist- Bjotkroth S, Axelin A. Key factors supporting implementation of a training program for neonatal family centered care. 2019;19(1):394.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBenzies KM, Shah V, Aziz K, Lodha A, Misfeldt R. The health care system is making too much noise to provide family centered care in neonatal intensive care unit. 2019;50:44\u0026ndash;53.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eStaniszewska S, Brett J, Psychol C et al. Developing a Model of Family-Centered Care for Neonatal Units journal of family nursing, 2012.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLauridsen EI, Higginbottom G. The roots and development of constructivist grounded theory, Nurse Researcher, 2015.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLi X, et al. Assessing intercity multimodal choice behavior in a Touristy City: A factor analysis journal of Transport Georaphy. Elsevier; 2020. p. 102776.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eUNICEF. Investing in Survival: Enhancing the Neonatal Intensive Care Unit of Yekatit 12 Hospita. 2013. [Google Scholar].\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHealthy Newborn Network. Survive and thrive: transforming care for every small and sicknewborn. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.healthynewbornnetwork.org/hnn-content/uploads/Survive-and-Thrive_Fin\u003c/span\u003e\u003cspan address=\"https://www.healthynewbornnetwork.org/hnn-content/uploads/Survive-and-Thrive_Fin\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Published 2019. [Context Link].\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHarrison WN, Wasserman JR, Goodman DC. Regional variation in neonatal intensive care admissions and the relationship to bed supply. J Pediatr. 2018;192:73\u0026ndash;e794. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.jpeds.2017.08.028\u003c/span\u003e\u003cspan address=\"10.1016/j.jpeds.2017.08.028\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. [Context Link].\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRaiskila S, Axelin A, Toome L, et al. Parents' presence and parent-infant closeness in 11 neonatal intensive care units in six European countries vary between and within the countries. Acta Paediatr. 2017;106(6):878\u0026ndash;88. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1111/apa.13798\u003c/span\u003e\u003cspan address=\"10.1111/apa.13798\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. [Context Link].\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAbraham M et al. implementing patient- and family-centered care: Part I \u0026ndash; understanding the challenges Pediatric. Nurse (2012).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eShields L. What is Family Centered Care? Eur J Pers Cent Healthc. 2015;3:139\u0026ndash;44.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDall\u0026rsquo;Oglio I, Di Furia M, Tiozzo E, Gawronski O, Biagioli V, Di Ciommo VM. Practices and perceptions of Family Centered Care among Healthcare Providers,2018.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLatour JM, \u0026lsquo;Perceptions of parents, nurses, and physicians on neonatal intensive care practices Corresponding author Jos M., Latour RN et al. PhD Nurse Scientist Erasmus MC Sophia Children \u0026rsquo; s Hospital Department of Pediatrics, Room Sp-1539 P. O. Box 2060 Key Words\u0026rsquo;, Journal of Pediatircs, 2010, 157(2), pp. 215\u0026ndash;220.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDall\u0026rsquo;Oglio I, Mascolo R, Tiozzo E, Portanova A, Fiori M, Gawronski O, Dotta A, Piga S, Offidani C, Alvaro R, Rocco G, Latour, Jos M. the current practice of family-centred care in Italian neonatal intensive care units: A multicentre descriptive study. Intensive Crit Care Nurs. 2019;50:36\u0026ndash;43. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.iccn.2018.07.005\u003c/span\u003e\u003cspan address=\"10.1016/j.iccn.2018.07.005\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBastani F, Ali Abadi T, Haghani H. Effect of Family-centered Care on Improving Parental Satisfaction and Reducing Readmission among Premature Infants: A Randomized Controlled Trial. J Clin Diagn Res. (2015).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDixon M, Crawford D. Pediatric Intensive Care Nursing eBook Central. (2012).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCs\u0026aacute;sz\u0026aacute;r-Nagy N, B\u0026oacute;kkon I. Mother-newborn separation at birth in hospitals: A possible risk for neurodevelopmental disorders? accessed 2019,16.11.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGallo KP, Hill LC, Hoagwood KE. Olin SO A narrative synthesis of the components and evidence for patient and family centered care.clinical pediatrics 2016;55 (4): 333\u0026ndash;346.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMikkelsen G, Frederiksen K. Family centered care of children in hospital a concept analysis. J Adv Nurs. 2011;67(5):1152\u0026ndash;62.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChoi M. Kim J.Associated factors in pediatric nurse parent partnership. Child Health Nurs Res. 2014;20.3.176.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eda Silva TRG, Manzo BF, Fiorete FCC, de Silva F. Family-centered care from the perspective of nurses in the Neonatal Intensive Care Unit. Rev da Rede Enferm do Nord. 2016;17:643. 10.15253/21756783.2016000500009CrossRef Full Text | Google Scholar.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOude Maatman SM, Bohlin K, Lillieskold S, Garbage HT. Uitewaal- Poslawky l, Kars MC, Factor influencing implementation of Family centered care in a. Neonatal Intensive Care Unit; 2020.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eConde-Agudelo A, D\u0026iacute;az-Rossello JL. Kangaroo mother care to reduce morbidity and mortality in low birthweight infants. Cochrane Database Syst Rev. 2016.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMarcenko MO, Smith LK. The impact of a Family-centered case management approach. Soc Work Health Care. 2011;22(1):56\u0026ndash;73.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJournal of Pediatric Nursing. Volume 43, Nov-Dec 2018, pages e18\u0026ndash;125.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBruce B, Letourneau N, Ritchie J, Larocque S, Dennis C, Elliott MR. A Multisite Study of Health Professionals\u0026rsquo; Perceptions and Practices of Family-Centered Care. J Fam Nurs. 2002;8:408\u0026ndash;42.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCoyne I, Murphy M, Costello T, O\u0026rsquo;Neill C, Donnellan C. A Survey of Nurses\u0026rsquo; Practices and Perceptions of Family-Centered Care in Ireland. J Fam Nurs. 2013;19:469\u0026ndash;88.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-health-services-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bhsr","sideBox":"Learn more about [BMC Health Services Research](http://bmchealthservres.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/BHSR/default.aspx","title":"BMC Health Services Research","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"NICU, Family Centered Care, Health care professional Perception and Practice","lastPublishedDoi":"10.21203/rs.3.rs-9096501/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9096501/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFamily-Centered Care in Neonatal Intensive Care Units involves active family participation in the care of newborns and infants. Implementing family-centered care in neonatal intensive care units faces multiple challenges from the perspective of health care professionals. The neonatal intensive care environment can be stressful for parents, as health care professionals often prioritize the medical needs of newborns by addressing the emotional concerns and negative experiences of families.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eObjectives\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTo assess the perception, practice and associated factors of family-centered care among health care professionals in the neonatal intensive care unit at Public Hospitals in Addis Ababa, Ethiopia, 2024.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethod\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAn institutional-based cross-sectional study was conducted in Neonatal Intensive Care Units (NICUs) of four randomly selected public hospitals using the lottery method. The study population included all health care professionals working in the NICU during the study period. The sample size was calculated using a single population proportion formula, and a total of 184 health care professionals were included using a survey sampling technique. Data was collected using the Family Centered Care Questionnaire-Revised (FCCQ-R). The collected data was coded and entered into SPSS version 27 for analysis. Descriptive statistics were used to summarize demographic characteristics and variable distributions, while bivariate and multivariable analyses were performed to identify associated factors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResult\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOut of the total 184 health care professionals, 57 (31%) had good perception and 67 (36.4%) had good practice of family-centered care. In multivariable logistic regression analysis, educational status of health care professionals (AOR = 0.237, 95% CI: 0.102–0.551) and negative staff attitude (AOR = 0.301, 95% CI: 0.127–0.712) were significantly associated with perception. Similarly, educational status (AOR = 0.359, 95% CI: 0.168–0.767) and negative staff attitude (AOR = 0.204, 95% CI: 0.086–0.482) were significantly associated with practice at p \u0026lt; 0.05.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion and Recommendation:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe practice of family-centered care among health care professionals was higher than their perception of family-centered care in the Neonatal Intensive Care Unit. Public hospitals should establish clear policies, guidelines, and accountability mechanisms to strengthen the implementation of family-centered care. In addition, health care providers should receive continuous education through both pre-service and in-service training.\u003c/p\u003e","manuscriptTitle":"Perception, Practice and Associated factors towards Family Centered Care among Health Care Professionals in Neonatal Intensive Care Unit at Public Hospitals in Addis Ababa, Ethiopia, 2024","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-22 11:45:58","doi":"10.21203/rs.3.rs-9096501/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-04-26T18:42:50+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"263405476583147842687594032313233327254","date":"2026-04-17T06:17:48+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-04-14T16:59:04+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-04-13T08:23:56+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-03-19T05:14:02+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-03-19T01:35:56+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Health Services Research","date":"2026-03-18T16:21:42+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-health-services-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bhsr","sideBox":"Learn more about [BMC Health Services Research](http://bmchealthservres.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/BHSR/default.aspx","title":"BMC Health Services Research","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"e55d4a05-1859-4646-9b58-7588a9af54a2","owner":[],"postedDate":"April 22nd, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-04-22T11:45:59+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-22 11:45:58","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9096501","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9096501","identity":"rs-9096501","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}