Aims and objectives.To explore what fathers perceive to be facilitators or barriers to their involvement with their infants. Background. Fathers make unique and important contributions to the development of their infants. Fathers of infants in the neonatal intensive care unit often feel that they have a limited role to play in their infant's care, and surveys suggest that they are not typically involved in infant caregiving. Paradoxically, qualitative studies have found that fathers do want to be involved, and their lack of involvement is an important source of stress. Design. Qualitative descriptive. Methods. Eighteen fathers of infants, in the neonatal intensive care unit for at least one week, were interviewed and asked to describe what they perceived to be the barriers and facilitators to their involvement. Interviews were audio taped and transcribed, and the data was content analysed. Results. Three major categories of barriers/facilitators were identified: (1) infant factors (size and health status, twin birth and infant feedback), (2) interpersonal factors (the rewards of and attitudes and beliefs regarding fatherhood; family management; previous experiences) and (3) neonatal intensive care unit environmental factors (physical and social). These factors could often be a barrier or facilitator to involvement depending on the context. Conclusions. This study provides insights into what factors influence involvement, and how nursing staff can support involvement and best meet fathers' needs. Relevance to clinical practice. Nurses should explore the forms of involvement that a father desires, as well as the demands on their time, and determine what might be done to promote involvement. Fathers should be assisted to maximise the time that they do have with the infant. Nurses must provide clear and consistent information about whether and when caregiving is advisable, and they can explain and demonstrate how fathers can care for their infant.
The purpose of this study was to examine variations in endogenous oxytocin levels in pregnancy and postpartum state. We also explored the associations between delivery variables and oxytocin levels. A final sample of 272 mothers in their first trimester of pregnancy was included for the study. Blood samples were drawn during the first trimester and third trimester of pregnancy and at 8 weeks postpartum. Socio-demographic data were collected at each time point and medical files were consulted for delivery details. In most women, levels of circulating oxytocin increased from the first to third trimester of pregnancy followed by a decrease in the postpartum period. Oxytocin levels varied considerably between individuals, ranging from 50 pg/mL to over 2000 pg/mL. Parity was the main predictor of oxytocin levels in the third trimester of pregnancy and of oxytocin level changes from the first to the third trimester of pregnancy. Oxytocin levels in the third trimester of pregnancy predicted a self-reported negative labor experience and increased the chances of having an epidural. Intrapartum exogenous oxytocin was positively associated with levels of oxytocin during the postpartum period. Our exploratory results suggest that circulating oxytocin levels during the third trimester of pregnancy may predict the type of labor a woman will experience. More importantly, the quantity of intrapartum exogenous oxytocin administered during labor predicted plasma oxytocin levels 2 months postpartum, suggesting a possible long-term effect of this routine intervention, the consequences of which are largely unknown.
Nonspecific attention was as effective as an early skill-based intervention in reducing maternal anxiety and enhancing sensitive behavior in mothers of VLBW infants.
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