Mothers' Challenges after Infants' Discharge from Neonatal Intensive Care Unit: A Qualitative Study

Document Type: Original Article

Authors

1 Nursing and midwifery care research center, faculty of nursing and midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.

2 Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.

3 Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Abstract

ABSTRACT
Background: Mothers with premature infants face certain challenges such as uncertainty on how to deal with their infant's condition and care for it after discharge from neonatal intensive care unit (NICU).
Methods: A qualitative design was used to explain mothers' challenges after their infant's discharge from NICUs in Isfahan, Iran, 2015. Purposive sampling was adopted to interview the mothers who could provide us information about the challenges after their infant's discharge. Data collection was performed by interviewing mothers. Data saturation was reached after conducting 23 in-depth, semi-structured interviews. All the data was analyzed by qualitative content analysis.
Results: Four themes and nine categories were identified. The themes were incompetence in breastfeeding, dependence on hospital and nurses, feeding tube as a reason for stress, and constantly worried mothers.
Conclusion: Mothers have difficulty in meeting their infants' basic needs after discharge. Supporting these mothers can enable them promote their infant's health.

Keywords


References
1. Hockenbery MJ, Wilson D. Wong's nursing care of infants and children. 2011, 9th Edition, Elsevier Mosby, Missouri.
2. Leifer G. Maternity Nursing: an introductory text, 10 Th Edition, Saunders, 2008.
3. Mok E, Loung SF. Nurses as providers of support for mothers of premature infant. Journal of Clinical
Nursing 2006, 15(6):726-34.
4. Malusky S, Donze A. Neutral head positioning in premature infants for interventricular haemorrhage prevention: an evidence-based review. Neonatal Netw 2011; 30(6): 381-96.
5. Keshavars M, Eskandari N, Jahdi F, Ashaieri H, Hoseini F, Kalani M. The effect of holy Quran recitation on physiological responses of premature infant. Koomesh journal of semnan university of medical science 2010; 3(35):169-178.
6. Alaei Karahroudi F, Jafari Mianaei S, Rasouli M, Zayeri F (2013). Evaluating the effectiveness ofParent Empowerment (COPE) program on participation of mothers of preterm infants hospitalized in NICUs of hospitals affiliated to Isfahan University of Medical Sciences and Health Services, 2009-2010. Journal of Nursing & Midwifery Faculty, Shahid Beheshti University of Medical Sciences2013; 23 (81):33-40.
7. Megan M, Spencer S, Alicia JS, Lex WD, Katherine JL, Lucy L, and et al. Long-term benefits of home-based preventive care for preterm infants: a randomized trial. Journal of Pediatrics2012; 103:1094-1101.
8. Akbarbegloo M, Valizadeh L, Asadollahi M. Mothers and nurses’ viewpoint on importance and amount of nursing supports for parents with hospitalized premature infants in neonatal intensive care unit. Iranian Journal of Critical Care Nursing2009; 2(2); 71-74.
9. Aliabadi T, Bastani F, Haghani H. Effect of mothers’ participation in preterm infants care in NICU on readmission rates. Journal of Faculty of Nursing and Midwifery Tehran University of Medical Sciences2011; 17(2): 71-7.
10. Wheeler B. Health promotion of the newborn and family. In: Hockenbery MJ, Wilson D (editors). Wong's Essentials pediatric nursing: Canada: Mosby, 2009.
11. Nicolaou M, Rosewell R, Marlow N, Glazebrook C. Mothers' experiences of interacting with their premature infants. Journal of Reproductive and Infant Psychology2009; 27(2): 182-94.
12. Brinchmann BS, Forde R, Nortvedt P. What matters to the parents? a qualitative study of parents' experiences with life-and-death decisions concerning their premature infants. Nursing Ethics 2002; 9(4): 388-404.
13. McGrath JM. Strategies to support the transition to home. J Pediatric Neonatal Nurse 2012; 26(1):8-9.
14. Griffin JB, Pickler RH. Hospital-to-home transition of mothers of preterm infants. MCN Am J Maternal Child Nursing 2011; 36(4):252-7.
15. Green B. Personal constructs psychology and content analysis. Personal Construct Theory &Practice 2004; 1: 82-91.
16. Griffin T, Abraham M. Transition to home from the newborn intensive care unit: Applying the principles of family-centered care to the discharge process. The Journal of perinatal & neonatal nursing 2006;
20(3):243-249.
17. Smith V, Young S, Pursley D, McCormick M, Zupancic J. Are families prepared for discharge from the NICU & quest? Journal of Perinatology 2009; 29(9):623-9.
18. Sneath N. Discharge teaching in the NICU: are parents prepared? An integrative review of parents' perceptions. Neonatal Network. The Journal of Neonatal Nursing 2009; 28(4):237-46.
19. Valizadeh S, Penjvini S. Mothers' experiences of breastfeeding premature infants after discharge from NICU; a qualitative study. Indian journal of applied research2014; 4(1):374-378.
20. Flacking R, ewald U, nygvist K H, strrin B. trustful bonds: A key to becoming a mother and to reciprocal breast feeding. Stories of mothers of very preterm infants at a neonatal unit. Social science & medicine2006; 62:70-80.
21. Ross ES, Browne JV. Developmental progression of feeding skills: an approach to supporting feeding in preterm infants. Seminars in fetal & Neonatal 2002; 7:469–475.
22. Nyqvist KH, Engvall G. Parents as their infant's primary caregivers in a neonatal intensive care unit. Journal Pediatric Nursing 2009; 24(2):153-163.
23. Raffray M, Osorio S, Ochoa SC, Semenic S. Barriers and facilitators to preparing families with premature infants for discharge home from the neonatal unit. Perceptions of health care providers. Investigation & Education Enfermeria2014; 32(3): 379-392.
24. Arockiasamy V, Holsti L, Albersheim S. Fathers’ experiences in the neonatal intensive care unit: a search for control. Pediatrics Journal 2008; 121(2): 215-222.
25. Verma RP, Sridhar S, Spitzer AR. Continuing care of NICU graduates. Clinical Pediatric 2003; 42(4):299-315. 26. Lopez GL, Anderson KH, Feutchinger J. Transition of premature infants from hospital to home life. Neonatal Network2012; 31(4):207-14.
27. Valizadeh L, Namnabati M, Zamanzadeh V, Badiee Z. Factors affecting infant's transition from neonatal intensive care unit to home: A qualitative study. Iran Journal Nurse Midwifery Research 2013; 18(1): 71–78.