Experience of Mothers Having Preterm Newborns in Neonatal Care Units

Abstract

Background: Preterm births are vulnerable to morbidities and require hospitalization in the neonatal care unit (NCU). The situation is stressful for mothers influencing their attachment and care to the newborns. Therefore, this study was conducted to explore the experience of mothers having preterm newborns in NCU.
 Methods: The qualitative study was conducted among purposively selected 13 mothers of NCU admitted preterm infants at Tribhuvan University, Teaching Hospital. Data was collected using in-depth interview. Colaizzi content analysis method was used for data analysis.
 Results: Among 13 mothers, 8 were primipara, 25-30 years, homemakers; 6 had Bachelor or above education; 11 had ANC visit > 4 times. Ten infants were very preterm (< 32 weeks gestational age), 11 have very low birth weight (< 1500 gram), 9 born by caesarian section and stayed NICU for 7-14 days. Study identified 5 themes and 18 subthemes: loss of control (fear and anxiety, distress towards pain and suffering, guilt feeling, hopelessness); sense of difference (newborn’s appearance, needs and problems, breastfeeding and parental roles); care of newborn (trust to nurses, confidence and emotional attachment with care involvement,), support for coping (support from family, nurses and other mothers); and difficulties faced (distance to NCU, inadequate guidance and information, and lack of supportive environment)
 Conclusion: The hospitalization of preterm newborns in NCUs was usually stressful situation for mothers. Their positive experience and coping was related with provided guidance support and involvement in newborn care. Therefore, nurses working in NCU should consider these care components in their practice.

Experience of Mothers towards Hospitalization of Preterm Infants in Neonatal Intensive Care Units

“…Their worry increased knowing the deterioration in the condition of their PTIs. 7,8,11,17 Consistent with studies of South Africa and China, mothers also expressed worry about the death of the other PTIs in the unit. 10,11 Mothers in present and previous studies experienced separation and inadequate attachment with their PTIs.…”

“…When there was time to care for their PTIs after transfer from NICU, parents identified new anxiety concerning assuming primary responsibility for caring for their infants. 8,10,17,19,21 The mothers in this study experienced challenges in the breastfeeding role.…”

“…10,11 Mothers in present and previous studies experienced separation and inadequate attachment with their PTIs. 7,8,18,19 They also shared about limited visiting time and lack of opportunity to be close and hold their PTIs. Evidence of systematic review and other studies also indicated an inadequate conducive environment for mother-infant attachment.…”

“…23,24 Mothers' of present and previous studies experienced care involvement like providing KMC, breastfeeding as a positive, pleasant, means of attachment, and understanding their infants. 8,[12][13][14]25,26 Furthermore, the mothers reported that their involvement in PTI care like touching and interaction with their PTIs, feeding, changing nappies was useful to develop mother-infant attachment, emotional comfort, and caring ability before discharge. 8,12,14,15,27 Like previous findings, mothers were satisfied with the affectionate care by nurses to their PTIs.…”

“…Mothers of NICU admitted PTIs experience more emotional distress related to the condition and progress of the PTIs as well as separation, and inadequate and altered maternal role. [6][7][8][9] Because of early and prolonged separation, and special care needs of the infant, these mothers lose their selfconfidence and feel incompetency in playing their maternal roles. 10,11 Previous studies showed mothers' appreciation for nurses' competent and compassionate PTI care.…”