An Observational Study on Early Dyadic Interactive Behaviors of Mothers With Early-Preterm, Late-Preterm, and Full-Term Infants in Malawi

Relationship Between Maternal Emotional Distress and Early Dyadic Interactions During Hospitalization of Preterm Infants in Malawi

OBJECTIVE

To examine the relationship between emotional distress and mother-preterm infant interactions among mothers who used skin-to-skin care and to explore their experiences of childbirth and continuous skin-to-skin care.

DESIGN

A sequential, explanatory, mixed-methods design.

SETTING

A neonatal nursery in a tertiary-level hospital in Malawi.

PARTICIPANTS

Forty-four mother-preterm infant dyads; we interviewed 15 of these mothers.

METHODS

We administered surveys to assess emotional distress (i.e., depression, anxiety, posttraumatic stress, and worry about infant health) and video-recorded mother-infant interactions. We used regression analysis to assess the relationship between indicators of emotional distress and mother-infant interactions and further examined whether skin-to-skin care was associated with maternal distress. We used in-depth interviews to collect qualitative data and used content analysis to identify common themes.

RESULTS

Symptoms of emotional distress were negatively associated with the frequency of infant negative behaviors and gestures, infant smiling, and mother looking and infant smiling when we controlled for the number of days administering continuous skin-to-skin care, gestational age, and severity of the infant's condition. Mothers reported that they felt stressed by providing continuous skin-to-skin care but appreciated its positive effects on the infant.

CONCLUSION

Emotional distress while providing continuous skin-to-skin care was associated with poorer mother-preterm infant interactions The mental distress that mothers undergo while delivering continuous skin-to-skin care to their infants can be draining. It is essential for nurses to offer the required psychological support to enhance maternal mental health and encourage positive infant behavior and development. Health care systems need to support this level of nursing care.

Experiences of Malawian Mothers During Their Infants' Hospitalization

BACKGROUND

Hospitalization of a newborn infant is stressful for all mothers. Hospitals in Malawi have limited nursing staff and support, so mothers are the primary care providers for their hospitalized infants. Few studies have explored the experience of these mothers as both care providers and mothers.

PURPOSE

The purpose of this study was to explore the experiences of mothers during the hospitalization of the infant. The goal was to increase knowledge of their primary concerns about the hospital stay.

METHODS

This was a descriptive qualitative study conducted at Queen Elizabeth Central Hospital in Malawi. Mothers were interviewed prior to their infant's discharge. We used the directed content analysis approach to analyze our data.

RESULTS

Twenty mothers of preterm or full-term infants were interviewed. The primary concerns were perinatal experiences, the infant's condition and care including breastfeeding, support from family members, and support and care from healthcare providers. Additionally, mothers of preterm infants were concerned about the burdens of kangaroo mother care.

IMPLICATION FOR PRACTICE

In hospitals that provide limited nursing support to mothers and their infants, it is important to identify a support system for the mother and provide mothers with information on infant care.

IMPLICATIONS FOR RESEARCH

Future research should identify specific supports and resources in the community and hospital settings that are associated with positive hospital experiences.