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Introduction: NICU hospitalization creates a highly technical and emotionally demanding environment for families. Parental health literacy is pivotal for informed participation in care, discharge readiness, and safe continuity at home, yet evidence remains fragmented regarding predictors, effective interventions, and associated outcomes. Objective: To identify predictors and interventions that enhance parental health literacy in NICUs and the associated outcomes for families and the health system. Methods: Integrative review (Whittemore & Knafl) reported per PRISMA 2020. Searches (September 2025) in CINAHL and MEDLINE (EBSCO), plus grey literature. PCC/PIO: P—parents/caregivers of NICU infants; I—predictors and/or educational/communicational/organizational interventions; O—health literacy and parental outcomes (self-efficacy, participation, anxiety/discharge readiness) and organizational outcomes (service use/readmissions). Timeframe 2020–2025; PT/EN/ES; full text. Dual independent screening and standardized data extraction. Convergent integrated synthesis framed by Donabedian’s model. No formal methodological quality assessment was conducted. Non-empirical documents informed context only. Results: Eight primary studies were included (3 qualitative, 4 observational, 1 quasi-experimental) across multiple countries. Predictors of higher literacy: education, language proficiency, and prior health-system navigation; barriers: parental stress/anxiety and overly complex materials. Effective interventions combined plain-language resources, teach-back, structured parental involvement from admission, and phased discharge plans with follow-up. Outcomes showed improved literacy and self-efficacy, better participation in care, and enhanced discharge readiness; evidence for fewer unplanned contacts post-discharge is promising but limited. Conclusions: Parental health literacy is a critical mediator between organizational structures and NICU outcomes. This review shows that in the NICU, despite digital advances, human connection – listening, welcoming, and the relationship between professionals and parents – is irreplaceable and should guide the use of technology in neonatal care. We recommend systematic communication protocols (e.g., teach-back, NURSE), plain-language materials, and structured discharge planning with follow-up. Future work should include pragmatic trials and cross-cultural validation of instruments in European Portuguese.

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Parental Health Literacy in the NICU: Predictors, Interventions, and Outcomes in Family-Centred Care in the Technological Era− Integrative Review

  • 会议论文

  • 发表日期：

    2026年

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  • Catarina Albardeiro,
  • Ana Malveira,
  • Margarida Goes,
  • Ana Dias

摘要

Introduction: NICU hospitalization creates a highly technical and emotionally demanding environment for families. Parental health literacy is pivotal for informed participation in care, discharge readiness, and safe continuity at home, yet evidence remains fragmented regarding predictors, effective interventions, and associated outcomes. Objective: To identify predictors and interventions that enhance parental health literacy in NICUs and the associated outcomes for families and the health system. Methods: Integrative review (Whittemore & Knafl) reported per PRISMA 2020. Searches (September 2025) in CINAHL and MEDLINE (EBSCO), plus grey literature. PCC/PIO: P—parents/caregivers of NICU infants; I—predictors and/or educational/communicational/organizational interventions; O—health literacy and parental outcomes (self-efficacy, participation, anxiety/discharge readiness) and organizational outcomes (service use/readmissions). Timeframe 2020–2025; PT/EN/ES; full text. Dual independent screening and standardized data extraction. Convergent integrated synthesis framed by Donabedian’s model. No formal methodological quality assessment was conducted. Non-empirical documents informed context only. Results: Eight primary studies were included (3 qualitative, 4 observational, 1 quasi-experimental) across multiple countries. Predictors of higher literacy: education, language proficiency, and prior health-system navigation; barriers: parental stress/anxiety and overly complex materials. Effective interventions combined plain-language resources, teach-back, structured parental involvement from admission, and phased discharge plans with follow-up. Outcomes showed improved literacy and self-efficacy, better participation in care, and enhanced discharge readiness; evidence for fewer unplanned contacts post-discharge is promising but limited. Conclusions: Parental health literacy is a critical mediator between organizational structures and NICU outcomes. This review shows that in the NICU, despite digital advances, human connection – listening, welcoming, and the relationship between professionals and parents – is irreplaceable and should guide the use of technology in neonatal care. We recommend systematic communication protocols (e.g., teach-back, NURSE), plain-language materials, and structured discharge planning with follow-up. Future work should include pragmatic trials and cross-cultural validation of instruments in European Portuguese.