Abstract
Background: The population in the neonatal intensive care unit (NICU) is vulnerable
and dependent. The method by which they are cared for is of the utmost importance
as it contributes to the infant’s health status and outcome. The developed Adapted
Theory of Health Promotion (ATHP) model provides an opportunity to guide nurse
strategies through the nursing process in holistic caring and achieve evidence-based
practice in the NICU. The research aimed to validate the ATHP in NICUs. Furthermore,
it explored the practice readiness of the ATHP in the South African context and
attempted to yield recommendations for future practice in the NICU.
Methods: A three-phased, sequential, explanatory, mixed-method research design
was used in this study. For the quantitative phase, the Delphi technique was applied.
Respondents were recruited using purposive sampling with an inclusion criteria and
resulted in six respondents. The qualitative phase commenced by inviting the three
remaining respondents from phase one to take part in a focus group. Analysed data
from both phases were integrated and connected to create an overall view of the
validity of the ATHP, forming the third and final phase.
Results: Analysis revealed that the ATHP model is more desirable than feasible in
the experts’ opinion. Consensus was achieved on 68% of the model, and the average
rating at the end of round three was 100% positive for desirability, and 90% positive
for feasibility. The focus group allowed participants to elaborate and provide insight on
phase one, revealing the main themes of an “ideal” situation versus “reality”. These
themes coincided with the results from phase one.
Conclusion: The ATHP was validated by experts. The integration of both quantitative
and qualitative phases created the overall response from the participants. Concern
was raised about the model’s feasibility in the current South African NICU context.
Participants made recommendations for the practice readiness of the model, and
suggested introducing it at the postgraduate level or applying it as an orientation tool
for new staff to the NICU.
Keywords: Delphi technique, mixed-method study, model of care, neonatal nursing,
neonatal nursing model.