Effect of Telenursing on Attachment and Stress in Mothers of Preterm Infants

Document Type: Original Article

Authors

1 School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran

2 Department of Psychiatric and Mental Health Nursing, Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran

3 Department of Neonatology, Isfahan University of Medical Science, Isfahan, Iran

4 Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: The necessity of professional nursing support to increase the role of families in neonatal care and their empowerment has been a subject of growing attention. The aim of this study was to determine the effect of telenursing on attachment and stress in the mothers of premature infants.
Methods: In this clinical trial, 50 mothers with premature infants who were admitted to neonatal intensive care unit (NICU) at Shahid Beheshti Hospital in Isfahan with a gestational age of more than 33 weeks were selected by convenience sampling method. They were randomly assigned to two groups of intervention (n=25) and control (n=25). The intervention group received an educational program designed through telephone and counseling center for the mothers of premature infants that started one week after the admission and continued one week after discharge. However, the control group only received the usual care provided in the NICU. One week after the admission of the infant, Maternal Postnatal Attachment (MPA) and Parent Stressor Scale: Neonatal Intensive Care Unit (PSS-NICU) questionnaires were completed. The PSS-NICU questionnaire and MPA questionnaire were completed at the time of discharge and one week after the discharge by the participants, respectively.
Results: The average increase in total attachment scores one week after discharge was significantly higher in the intervention group, compared to that of the control group (P<0.05). Moreover, the average decrease in the total stress score of the intervention group at the time of discharge in comparison to pre-intervention was significantly higher than that of the control group (P<0.05).
Conclusion: Considering the positive effects of telenursing on increasing attachment and mitigating the stress of mothers with premature infants, it is suggested to employ this supporting method to enhance the attachment and reduce the stress of mothers.

Keywords


1. World Health Organization. What is a preterm baby? Geneva: World Health Organization; 2017.

 2. Shviraga B. Uncomplicated antepartum, intrapartum, and postpartum care. Core curriculum for neonatal intensive care nursing-e-book. New York: Elsevier Health Sciences; 2014. P. 30.

3. Del Fabbro A, Cain K. Infant mental health and family mental health issues. Newborn Infant Nurs Rev. 2016; 16(4):281-4.

4. Busse M, Stromgren K, Thorngate L, Thomas KA. Parents’ responses to stress in the neonatal intensive care unit. Crit Care Nurse. 2013; 33(4):52-9.

5. Hall S, Cross J, Selix N, Patterson C, Segre L, ChuffoSiewert R, et al. Recommendations for enhancing psychosocial support of NICU parents through staff education and support. J Perinatol. 2015; 35(Suppl 1):S29-36.

6. Morey JA, Gregory K. Nurse-led education mitigates maternal stress and enhances knowledge in the NICU. MCN Am J Matern Child Nurs. 2012; 37(3):182-91.

7. Akbarbegloo M, Valizadeh L, Asadollahi M. Mothers and nurses viewpoint about importance and rate of nursing supports for parents with hospitalized premature newborn in natal intensive care unit. Iran J Crit Care Nurs. 2009; 2(2):71-4. [in Persian]

8. Kumar S, Snooks H. Telenursing. Berlin, Germany: Springer Science & Business Media; 2011.

9. Hannan J. APN telephone follow up to low-income first time mothers. J Clin Nurs. 2013; 22(1-2):262-70.

10. Willis V. Parenting preemies: a unique program for family support and education after NICU discharge. Adv Neonatal Care. 2008; 8(4):221-30.

11. Rhoads SJ, Green A, Mitchell A, Lynch CE. Neuroprotective core measure 2: partnering with families-exploratory study on web-camera viewing of hospitalized infants and the effect on parental stress, anxiety, and bonding. Newborn Infant Nurs Rev. 2015; 15(3):104-10.

12. Gray JE, Safran C, Davis RB, Pompilio-Weitzner G, Stewart JE, Zaccagnini L, et al. Baby CareLink: using the internet and telemedicine to improve care for high-risk infants. Pediatrics. 2000; 106(6):1318-24.

 13. Kadivar M, Seyedfatemi N, Mokhlesabadi Farahani T, Mehran A, Pridham KF. Effectiveness of an internetbased education on maternal satisfaction in NICUs. Patient Educ Couns. 2017; 100(5):943-9. 14. Condon JT, Corkindale CJ. The assessment of parentto-infant attachment: development of a self-report questionnaire instrument. J Reprod Infant Psychol. 1998; 16(1):57-76.

15. Ghadery-Sefat A, Abdeyazdan Z, Badiee Z, ZarghamBoroujeni A. Relationship between parent–infant attachment and parental satisfaction with supportive nursing care. Iran J Nurs Midwifery Res. 2016; 21(1):71.

16. Miles MS, Funk SG, Carlson J. Parental Stressor Scale: neonatal intensive care unit. Nurs Res. 1993; 42(3):148-52.

17. Abdeyazdan Z, Shahkolahi Z, Mehrabi T, Hajiheidari M. A family support intervention to reduce stress among parents of preterm infants in neonatal intensive care unit. Iran J Nurs Midwifery Res. 2014; 19(4):349-53.

 18. Ericson J, Eriksson M, Hellström-Westas L, Hagberg L, Hoddinott P, Flacking R. The effectiveness of proactive telephone support provided to breastfeeding mothers of preterm infants: study protocol for a randomized controlled trial. BMC Pediatr. 2013; 13(1):73.

19. Bikmoradi A, Masmouei B, Ghomeisi M, Roshanaei G. Impact of Tele-nursing on adherence to treatment plan in discharged patients after coronary artery bypass graft surgery: a quasi-experimental study in Iran. Int J Med Inform. 2016; 86:43-8.

20. Fakharzadeh L, Shahbazian H, Salehinia H, Yaghoobi M, Haghighizadeh M, Karandish M. Effect of telenursing on glycosylated hemoglobin (HbA1c) and anthropometric indexes in type 2 diabetic patients. Modern Care J. 2013; 10(2):101-7.

21. Tan K, Lai NM. Telemedicine for the support of parents of high-risk newborn infants. Cochrane Database Syst Rev. 2012; 6:CD006818.

 22. Karbandi S, Momenizadeh A, Heidarzadeh M, Mazlom SR, Hassanzadeh MH. Effects of maternal empowerment program on the length of hospitalization and readmission rate of premature infants. J Babol Univ Med Sci. 2015; 17(10):28-33. [in Persian]

23. Dashti E, Rassouli M, Khanali Mojen L, Puorhoseingholi A, Shirinabady Farahani A. Correlation between discharge preparation and rehospitalization of premature newborns. J Health Promot Manag. 2014; 3(4):37-45.

24. Penny K, Friedman S, Halstead G. Psychiatric support for mothers in the neonatal intensive care unit. J Perinatol. 2015; 35(6):451-7.

 25. Lyons-Ruth K. Dissociation and the parent–infant dialogue: a longitudinal perspective from attachment research. Attachment. 2015; 9(3):253-76.

26. Pichler-Stachl E, Pichler G, Baik N, Urlesberger B, Alexander A, Urlesberger P, et al. Maternal stress after preterm birth: Impact of length of antepartum hospital stay. Women Birth. 2016; 29(6):e105-9.

 27. Namnabati M, Taleghani F, Sadeghnia A. Homebased care needs of preterm infants discharged early from the neonatal intensive care unit: a descriptive qualitative study. Iran J Neonatol. 2017; 8(4):74-82.

28. Iranmanesh S, Hosseini SS, Rayyani M, Razban F, Pooraboli B. Effect of nursing support on perceived stress among parents of preterm infants in southeast of Iran. Asian J Nurs Educ Res. 2014; 4(1):81.