Exploring the Potential of Music Therapy to Help Navigate Uncertainty in Neonatal Intensive Care: A Qualitative Study in England.

Many seriously ill infants admitted to neonatal intensive care units (NICU) have an uncertain future. The neonatal experience can be overwhelming and traumatic for parents and professionals caring for them. The infant may develop later psychosocial difficulties due to trauma. Services often fail to consider their cultural and religious accessibility for families. Music therapy (MT) is increasingly being considered for implementation on neonatal units to help address these challenges. However, the true acceptability of the therapy, particularly for parents with infants with uncertain futures, is unknown. Four focus groups (14 parent participants), 13 parent interviews, and 2 focus groups with 8 healthcare professionals (HCPs) were conducted to explore their lived experiences of uncertainty in the NICU and their perceptions of the use of MT in this environment. Parents experienced a prolonged period of liminality of identity as they faced multiple traumas and had minimal opportunities to connect with their infant. HCPs described the felt obligation to maintain a professional persona and an emotional disconnect to manage daily trauma. MT was considered to have the potential to support connection between baby-parent-professionals and the external world, as well as internal personal resources. Concerns about using MT included further disruption to family time in the NICU and potential disempowerment by professionalizing one of the few aspects of infant care to which parents could still contribute. Future neonatal MT approaches should ensure parents and HCPs are psychologically supported. Acknowledging family values and heritage is likely to increase feelings of acceptance and engagement.