Nursing support perceived by mothers of preterm infants in a neonatal intensive care unit in South Korea

What matters to families about the healthcare of preterm or low birth weight infants: A qualitative evidence synthesis

OBJECTIVE

We examined what matters to families about the healthcare provided to preterm or LBW infants in hospital and the community, to ensure that care meets the needs of infants and parents.

METHODS

We searched databases to identify eligible studies examining the views and expectations of families. Study quality was assessed using the CASP checklist for qualitative studies. The GRADE-CERQual approach was used to assess confidence in review findings. Studies were sampled and data analysed using thematic synthesis.

RESULTS

222 studies (227 papers) were eligible for inclusion. 54 studies (57 papers) were sampled based on data richness, methodological quality, and representation across settings. Eight analytical themes were identified. Confidence in results was moderate to high. What mattered was a positive outcome for the child; active involvement in care; being supported to cope at home after discharge; emotional support; the healthcare environment; information needs met; logistical support available; and positive relationships with staff.

CONCLUSION

Although parents and family members reported a variety of experiences in the care of their infant, we found high consistency in what matters to families.

PRACTICE IMPLICATIONS

This review identifies approaches to improve experiences of parents which are consistent with the Family Centred Care model of healthcare.

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.

The Development and Validation of a Perceived Nursing Support Scale for Mothers of Preterm Infants

PURPOSE

Many studies have maintained that nursing support is necessary and essential for mothers of preterm infants; however, the perceived nursing support for mothers of preterm infants has not been sufficiently measured. This study aimed to develop a perceived nursing support scale for mothers of preterm infants (PNSS-MP).

METHODS

The preliminary items of the PNSS-MP were developed through a literature review and in-depth interviews with mothers of preterm infants. Content validity and face validity were assessed by experts and mothers of preterm infants. A pilot study was conducted to confirm the feasibility and comprehension of the scale. To validate the PNSS-MP, 223 mothers of preterm infants were surveyed. Exploratory factor analyses were performed to confirm construct validity. Convergent and discriminant validity were analyzed using a multitrait-multimethod (MTMM) matrix. Reliability was tested by calculating Cronbach's alpha and performing split-half testing.

RESULTS

The PNSS-MP consisted of 27 items and was categorized into five factors, explaining 65.27% of the total variance. The factors were named: "baby care support" (7 items), "mental care support" (6 items), "maternal role support" (6 items), "introducing resources support" (4 items), and "information delivery support" (4 items). The overall reliability of the scale was .95.

CONCLUSION

The PNSS-MP adequately reflected the neonatal intensive care unit (NICU) in South Korea. Additionally, the PNSS-MP proved relatively valid and reliable; therefore, it can be used to measure nursing support in the NICU.

Differences in perceived parental stress between parents with very low birth weight infants and nurses in neonatal intensive care units, South Korea

PURPOSE

This descriptive study compared the perceived parental stress levels between parents with very low birth weight infants (VLBWIs) and nurses in the neonatal intensive care unit (NICU).

METHODS

In total, 83 parents of VLBWIs and 78 NICU nurses were enrolled. Data were collected with the Parental Stress Scale (PSS) and analyzed using the t-test and analysis of variance in SAS version 9.4.

RESULTS

The average PSS score was 3.31 among parents and 3.45 among nurses. The stress score was significantly higher among nurses with children (t=2.46, p=.016) and senior nurses (t=2.12, p=.037). There was a significant difference in the stress score according to parents' education (t=3.29, p=.002) and occupation (F=3.14, p=.049) in the sights and sounds subscale. Mothers had significantly higher stress scores than fathers in the parental role alterations subscale (t=2.32, p=.023). Parental stress scores were higher than those perceived by nurses in the infant's appearance and behaviors subscale for breathing patterns (t=2.95, p=.004), followed by jerky/restless behavior (t=2.70, p=.008).

CONCLUSION

Nurses should provide explanations to parents of VLBWIs in order to reduce parental stress about the appearances and behavior of VLBWIs. This is more important than aspect of the NICU environment and education about parental roles.