Neonatal intensive care units (NICUs) provide essential treatment and care for sick or preterm infants. Admission to NICU may, however, cause parent-infant separation and expose infants to environments that could harm their development. There is a need for initiatives that promote parent-infant closeness and integrate parents into neonatal care, known as family-centered care.

This thesis included two family-centered care interventions: the Close Collaboration with Parents intervention and the Couplet Care Model. The studies aimed to evaluate the effects of these interventions on family-centered care practices and infant outcomes. Implementation fidelity of the the Close Collaboration with Parents intervention and its effects on family-centered care practices were also evaluated. A comparison study in Japan and Finland aimed to understand how different discharge practices contributed to the differences in the length of stay.

The family-centered care practices, including staff-parent communication and emotional support for parents, improved after the implementation of the Close Collaboration with Parents intervention in six Estonian NICUs. Better implementation fidelity was associated with better improvement in family-centered care practices. The Finnish register study showed that the intervention also promoted growth, shortened the length of stay, and reduced the likelihood of unscheduled outpatient visits after discharge in preterm infants. The comparison study between Japan and Finland showed that the promotion of the parents’ readiness for discharge contributed to shorter hospital stays of preterm infants in Finland. After the introduction of the Couplet Care Model, the first parent-infant skin-to-skin was performed earlier and the duration of the parents’ NICU presence was extended.

The improvement in the staff-parent communication, NICU architecture and care system are the key components of family-centered care to improve infant outcomes.