The relationship between maternal age, communication and supportive relationships in the neonatal nursery for mothers of preterm infants

Nurses’ strategies to provide emotional and practical support to the mothers of preterm infants in the neonatal intensive care unit: A systematic review and meta-analysis

Aim:

To synthesize and integrate current international knowledge regarding nursing strategies for the provision of emotional and practical support to the mothers of preterm infants in the neonatal intensive care unit.

Methods:

A systematic review and meta-analysis was undertaken. Four English-language databases including EMBASE, PubMed (including MEDLINE), Scopus, and Web of Science were searched from January 2010 to October 2021. Original quantitative studies that were written in English and focused on nursing strategies for the provision of emotional and practical support to the mothers of preterm infants in the neonatal intensive care unit were included. Eligibility assessment, data extraction, and methodological quality appraisal were conducted independently by the review authors. A narrative synthesis of the review results and a meta-analysis were performed.

Results:

Twenty studies that were published from 2010 to 2021 were included in the review. Three categories concerning the review aims were identified: ‘nursing strategies related to mothers’ emotions and infant-mother attachment’, ‘nursing strategies related to mothers’ empowerment’, and ‘nursing strategies related to mothers’ participation in care process and support’. Eight interventional studies that reported mothers’ stress as the study outcome were entered into the meta-analysis. Interventions consisted of the educational programme, spiritual care, telenursing, parent support programme, skin-to-skin care, and guided family centred care. Significantly lower maternal stress was found in the intervention group compared with that of the control group (g: −1.06; 95% confidence interval: −1.64, −0.49; Z = 3.62, p < 0.001).

Conclusion:

This review identified and highlighted key nursing strategies used to provide emotional and practical support to the mothers of preterm infants in the neonatal intensive care unit. They included family centred care, skin-to-skin care, parent support and education programmes, interpersonal psychotherapy, spiritual care, newborn individualized developmental care and assessment programme, and telenursing.

How do health professionals decide whether an interpreter is needed for families in neonatal and pediatric units?

OBJECTIVE

To examine how health professionals decide whether family members require an interpreter.

METHODS

69 health professionals, doctors, nurses, and allied health, from neonatal and pediatric units participated. Interviews used a verbal protocol analysis, which elicited their thoughts about using interpreters, including how they decided if an interpreter was needed.

RESULTS

Five themes captured the decision-making process health professionals use. Of these, three themes described the goals and beliefs participants brought to their interactions with family members: Ensuring understanding, Addressing socioemotional needs, and Who decides. The theme Assessing understanding was prominent within the interaction, while the final theme was Contextual factors influencing decision making. No differences were found between mono and multilingual participants, and few differences between health professional groups.

CONCLUSION

Health professionals find it difficult to assess whether a family member needs an interpreter and there is no consistency in how they make this decision, with some using heuristics and others a more systematic approach. Health professionals have beliefs about the purpose of an interpreter that potentially limit the voice of family members.

PRACTICE IMPLICATIONS

Health professionals need training to assist them in decisions about whether an interpreter is needed, including a decision tool and knowledge about policies.

The Influence of Neonatal Nursery Design on Mothers' Interactions in the Nursery

This study examined the influence of neonatal nursery design on interactions between nurses and mothers of infants in the nursery.

DESIGN AND METHODS

We used a natural quasi-experimental design, using semi-structured interviews and a structured measure of mothers' and nurses' perceptions of nursing care, to compare mothers (n=26 and n=40) and nurses (n=22 and n=29) in an open-bay (OB) nursery and a single family room (SFR) nursery. Thematic analysis was used to generate key themes from the interviews.

RESULTS

Mothers and nurses in both nursery designs talked about Valuing interactions; the importance of interactions between mothers and nurses. Mothers and nurses described SFRs as providing a space, My/their room, which enhanced mothers' sense of control and connection with the infant. SFRs were also associated with Changing the norms of interactions with nurses and other mothers, which created challenges in the desired quantity and quality of interactions for mothers and nurses. Nurses in the SFR nursery also reported Enhanced interactions, including improved confidentiality and personalized communication. Mothers in the OB nursery reported more supportive mothering actions from nurses than mothers in the SFR nursery. Both mothers and nurses in the OB nursery also talked about Our nursery community, which captured the value of having other nurses and mothers in the rooms.

CONCLUSION

Mothers and nurses perceived that the SFR nursery enhanced privacy and maternal closeness for mothers compared to the OB nursery. However, the SFR nursery design presented challenges to some interactions of value to nurses and mothers.

Motherhood as the Vehicle for Change in Australian Adolescent Women of Preterm and Full-Term Infants

Preterm birth represents an interruption to the normal development of maternal identity and is considered a highly stressful event for adult mothers. However, no research has investigated whether or how preterm birth affects the adolescent mother’s transition to motherhood. The current study aimed to explicate the experience of being a mother for adolescent women who experienced a preterm or term birth in Australia. This Interpretative Phenomenological Analysis Study analyzed interviews with 14 primiparous, English-speaking adolescent mothers (15-19 years; 10 preterm and 4 full term) who participated in three interviews over a 12-month period. Findings suggested few differences in the experience of being a mother due to infant birth status. Instead, the experience of being a mother was fundamentally about transformations to the self. The young women constructed themselves differently as a result of being mothers. Changes included moving away from delinquent behaviors, development of internal resources, growth of a positive view of self, gaining meaning in their lives, and reconciling idealized and actual notions of self and other. This research adds to our understanding of how motherhood shapes the adolescent women’s lives, while also challenging our assumptions about the impact of preterm and full-term birth for adolescent mothers.

Trends in Family-Centered Care in Neonatal Intensive Care

Family-centered care in neonatal intensive care changed over the last decades. Initially, parents and infants were separated and parents were even being blamed for cau-sing infections in their infants. The importance, though, of the parents being the constant in the infant's life emerged and with that the importance of early bonding and attachment for the parents to take on their role and responsibi-lities as primary caregivers. Facilitation of family-centered care includes involving the parents in daily care activities, kangaroo care, developmental care, interaction and communication with the infant, as well as involving grandparents and siblings. Implementation of family-centered care requires appropriate policies, facilities and resources, education of all involved, and a positive attitude.

Negotiating Care in the Special Care Nursery: Parents' and Nurses' Perceptions of Nurse-Parent Communication

OBJECTIVE

Nursing staff are an important source of support for parents of a hospitalized preterm infant. This study aimed to describe parents' and nurses' perceptions of communicating with each other in the context of the special care nursery.

METHOD

A qualitative descriptive design was employed. Thirty two parents with a newborn admitted to one of two special care nurseries in Queensland, Australia participated, and 12 nurses participated in semi-structured interviews. Thematic analysis was used to analyze the interviews.

RESULTS

Nurses and parents focused on similar topics, but their perceptions differed. Provision of information and enabling parenting were central to effective communication, supported by an appropriate interpersonal style by nurses. Parents described difficulties accessing or engaging nurses. Managing enforcement of policies was a specific area of difficulty for both parents and nurses.

CONCLUSION

The findings indicated a tension between providing family-centered care that is individualized and based on family needs and roles, and adhering to systemic nursery policies.