Parent Perspectives of Co-Occupations in Neonatal Intensive Care: A Thematic Review of Barriers and Supports

Co-occupations within the neonatal intensive care unit (NICU), which include parenting activities, such as bathing, feeding, diapering, comfort care, and bonding for attachment, are consequential for optimal infant development. This thematic systematic review examines supports and barriers for facilitating co-occupations between parents and infants in the neonatal setting. A search of four databases (MEDLINE, CINAHL, PsycINFO, and PubMed) resulted in 20 studies that met inclusion criteria for data extraction. Family-centered NICU design, good communication between parents and NICU staff, increased physical contact, parent involvement in caregiving, psychological wellness, parent education, peer support, and established parental roles are identified as supports to co-occupational engagement. Identified barriers include physical separation, loss of parental role, restrictions of the NICU environment, medical technology, role strain, psychological burden, lack of knowledge, and poor communication. Findings suggest that neonatal occupational therapy practitioners can facilitate parent-infant co-occupations by addressing barriers and augmenting existing supports.