Implementing NIDCAP training in a low-middle-income country: Comparing nurses and physicians' attitudes

Background: The Newborn Individualized Developmental Care and Assessment Program (NIDCAP) provides developmentally supportive environment for preterm infants and their families. Few studies evaluated staff perceptions about NIDCAP implementation and its effect on infant and parents and working conditions. Aims: To assess the perception and experience of NICU staff during the NIDCAP implementation. Study design: Cross-sectional anonymous online survey. Subjects: 57 NICU staff (29 nurses and 28 doctors) who were present at least one year prior to and during the implementation of NIDCAP training in a tertiary care center. Outcome measures: A standard questionnaire addressing attitude, perceived behavioral control, subjective norm, intention, behavior and NIDCAP impact related to NICU conditions was used after initiating developmental care activities and NIDCAP training in the unit from June 2014 to May 2018. Results: Forty-six doctors and nurses filled the questionnaire; they scored >= 3 out of 5 on all the questionnaire items. Nurses scored significantly higher than doctors (mean 4.00 +/- 036) versus (3.57 +/- 0.30) (p < 0.001) on the overall NIDCAP score. Specifically, nurses scores were significantly higher for attitude (p < 0.001), perceived behavioral control (p = 0.029); subjective norm (p = 0.011), intention (p = 0.024) and behavior (p < 0.001) questions. Conclusion: The implementation of NIDCAP in a low-middle income country was perceived as a positive experience for both nurses and doctors: It was thought to have improved infant care and wellbeing as well as the staff relationship with parents, however working conditions remained a challenge. More studies are needed to address areas of improvement for implementation.