Webcam use in German neonatological intensive care units: an interview study on parental expectations and experiences

Background: To bridge the physical distance between parents and children during a neonatal intensive care unit (NICU) stay, webcams are used in few German NICUs. They allow parents to view their infant even when they cannot be present on the ward. The aim of the study was to explore the factors for and against webcam use that parents with or without webcam use encountered. Methods: Guideline-based, semi-structured qualitative interviews were conducted in the period from September 2019 to August 2020. Interview transcripts were analysed using a category-based content analysis. The categories were generated in a combined deductive-inductive procedure. Results: We interviewed 33 mothers and seven fathers. Parents with webcam experience emphasised positive aspects concerning their webcam use. Factors that increased webcam acceptance included feeling certain about the child's well-being and an increased sense of proximity. Only a few critical voices emerged from parents who had webcam experience, e.g. regarding privacy concerns. Parents who had no experience with webcam use showed ambivalence. On the one hand, they expressed a positive attitude towards the webcam system and acknowledged that webcam use could result in feelings of control. On the other hand, reservations emerged concerning an increase of mental stress or a negative influence on parental visitation behaviour. Conclusion: In addition to the parents' positive experiences with webcam use, results show a need within parents who lacked webcam experience. Despite some criticism, it was evident that webcam use was primarily seen as an opportunity to counteract the negative consequences of separation in the postnatal phase.