Preparing for Home: a before-and-after study to investigate the effects of a neonatal discharge package aimed at increasing parental knowledge, understanding and confidence in caring for their preterm infant before and after discharge from hospital

The Effect of Supportive-Educational Interventions on Stress and Adaptation to Maternal Role: A Quasi-Experimental Study

BACKGROUND

Preterm delivery is a stressful event and stress can affect adaptation to maternal role. The purpose of this study is to determine the effect of supportive-educational interventions on stress and adaptation to the maternal role among women with premature infants hospitalized in the neonatal intensive care unit.

METHODS

This quasi-experimental study was conducted on 60 women with premature infants hospitalized in the neonatal intensive care unit. A control group (n = 30) was initially selected from eligible female participants. Sampling was stopped for three weeks and then the intervention group was sampled. The entire sampling process was carried out from December 2018 to June 2019. The control group received usual care at the hospital and the intervention group (n = 30) received three sessions of supportive-educational intervention in addition to routine care. Data were collected through the perceived stress and the maternal role adaptation questionnaires completed by both groups at the time of infant discharge, and also at the follow-up period (one month after discharge).

RESULTS

The results showed that maternal stress score changed considerably over time and a significant difference between the two groups was observed (P < 0.05). Additionally, adaptation to the maternal role changed substantially over time and the difference between the two groups was statistically significant (P < 0.05).

CONCLUSION

The supportive-educational program reduced the stress of mothers with premature infants hospitalized in the neonatal intensive care unit and increased their adaptation to the maternal role.

How can educational support for parents in the care of children with life-limiting illnesses be successful? An empirically-founded and theory-based concept development / Wie kann edukative Begleitung von Eltern in der Versorgung lebenslimitierend erkrankter Kinder gelingen? Eine empirischfundierte und theoriegeleitete Konzeptentwicklung

Background and objectives

Parents of children with life-limiting diseases are central informal care providers. They fill out their role as co-producers of the health care system in different ways, as empirically reconstructed parent type's show. In this article, the heterogeneous social practice of physiotherapeutic care provision is reflected from the perspective of self-regulation theory. The aim is to identify starting points for how parental self-efficacy can be positively influenced by educational support.

Method

The types of parents reconstructed by means of the Documentary Method according to Ralf Bohnsack serve as a starting point for the theoretical consideration. First, the theory of self-regulation and findings from research on increasing parental self-efficacy are presented. In the following, we will discuss how parents of children with life-limiting illnesses regulate themselves or develop self-efficacy when taking over care. Finally, it is shown which findings result from the theoretical consideration for an educational concept development.

Results

This theory-guided consideration of empirically generated parent types shows that their self-perception and situation perception, motivation and level of participation, self-regulation processes and trained self-efficacy vary significantly. There is evidence that parent-oriented information, observation of peers in groups and the possibility of positive experiences have a positive influence on self-efficacy.

Conclusion

These elements should be taken up in the development of educational intervention concepts for this target group and systematically tested for their effects.

Perspectives of Low Socioeconomic Status Mothers of Premature Infants

BACKGROUND AND OBJECTIVES

Transitioning premature infants from the NICU to home is a high-risk period with potential for compromised care. Parental stress is high, and families of low socioeconomic status may face additional challenges. Home visiting programs have been used to help this transition, with mixed success. We sought to understand the experiences of at-risk families during this transition to inform interventions.

METHODS

Mothers of infants born at <35 weeks' gestation, meeting low socioeconomic status criteria, were interviewed by telephone 30 days after discharge to assess caregiver experiences of discharge and perceptions of home visitors (HVs). We generated salient themes by using grounded theory and the constant comparative method. Interviews were conducted until thematic saturation was achieved.

RESULTS

Twenty-seven mothers completed interviews. Eighty-five percent were black, and 81% had Medicaid insurance. Concern about infants' health and fragility was the primary theme identified, with mothers reporting substantial stress going from a highly monitored NICU to an unmonitored home. Issues with trust and informational consistency were mentioned frequently and could threaten mothers' willingness to engage with providers. Strong family networks and determination compensated for limited economic resources, although many felt isolated. Mothers appreciated HVs' ability to address infant health but preferred nurses over lay health workers.

CONCLUSIONS

Low-income mothers experience significant anxiety about the transition from the NICU to home. Families value HVs who are trustworthy and have relevant medical knowledge about prematurity. Interventions to improve transition would benefit by incorporating parental input and facilitating trust and consistency in communication.