Abstract
Infants who survive prematurity have greater risk of neurodevelopmental impairments. Skin-to-skin during the neonatal period can improve infant outcomes. Greater understanding of Pasifika parents needs in implementing skin-to-skin could inform better implementation of skin-to-skin. This study explores Pasifika parents' experiences of skin-to-skin with their preterm infants in New Zealand-based neonatal units to inform culturally responsive care and service delivery. Pasifika parents of preterm infants born less than 33 weeks gestation were eligible to take part in interviews. Recruitment and data collection occurred in neonatal units across Auckland. Interpretive Phenomenological analysis informed by Talanoa and Tui Kakala research methods informed the interview format and data analysis. Five themes were identified: "overcoming fear and anxiety", "connection", "words matter", "actively managing racial bias", and "spirituality and religious beliefs facilitate resilience". Skin-to-skin promoted connection and strengthened all four pou of the Fonofale model. Communication styles of individual clinicians greatly influenced the Va (relational space) experienced by families, which subsequently affected their experience of skin-to-skin. Findings indicate the need for Pasifika cultural competence training in order to provide culturally safe care when supporting an intervention like skin-to-skin. Intentionally encouraging and facilitating Pasifika parents' spirituality within the neonatal intensive care unit could optimise skin-to-skin. Clinician communication has the potential to affect the initiation, uptake, and experience of skin-to-skin.