Iranian Journal of Neonatology

Iranian Journal of Neonatology

Effect of Fathers’ Involvement in the Care of Neonates with Congenital Anomalies on Paternal Bonding: A Quasi-Experimental Study

Document Type : Original Article

Authors
Somayeh Rahimi 1
Manijeh Nourian 2
Maryam Varzeshnejad 1
Maryam Mahdizadeh 1
Malihe Nasiri 3
1 Department of Pediatric Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2 2. Department of Biostatistics, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3 Department of Biostatistics, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
10.22038/ijn.2022.58115.2097
Abstract
Background: The birth of a neonate with a congenital anomaly who is admitted to the neonatal intensive care unit (NICU) is a threat to the formation of paternal bonding.  The present study aimed to assess the effect of fathers’ involvement in the care of neonates with congenital anomalies on father-neonate bonding in NICUs.
Methods: This quasi-experimental study with a control group was conducted on fathers of neonates with congenital anomalies admitted to the NICU of Mofid Hospital affiliated to Shahid Beheshti University of Medical Sciences in Tehran, Iran, from January 2019-September 2021. A total of 60 participants were selected via the convenience sampling method and randomly assigned to two groups of experimental and control. The Mother-to-Infant Bonding Scale was used to collect the needed data. The intervention lasted for four weeks. In the first week, fathers attended three sessions on how to provide care; thereafter, over the next three weeks, fathers became involved in the care of their newborns. The data were analyzed in SPSS software (version 21), and a p-value less than  0.05 was considered statistically significant.
Results: After the intervention, there was a statistically significant difference between the mean scores of paternal bonding in two groups of control (4.41±2.51) and experimental (2.21±2.37) (P=0.001), with a lower score indicating a stronger paternal bond. The mean paternal bonding scores decreased to 6.59±17.1 and 4.89±0.54 in the two groups of intervention and control, respectively. The obtained results pointed to a significant difference between the two groups in terms of alterations in bonding scores (P<0.001).
Conclusion: As evidenced by the results of the present study, the participation of fathers in the care of their neonates with congenital anomalies was associated with a greater improvement of father-neonate bonding. Therefore, nurses need to devote more assiduous attention to the involvement of fathers in the care of these neonates.
 
 
Keywords
Congenital anomaly
Fathers
Neonatal intensive care unit
Neonates
Paternal bonding
  1. Figueroa L, Garces A, Hambidge KM, McClure EM, Moore J, Goldenberg R, Krebs NF, et al. Prevalence of clinically-evident congenital anomalies in the Western highlands of Guatemala. Reprod Health. 2020;17(2):1-6.
  2. news-room/fact-sheets/detail/congenital-anomalies 2016 [Available from: https://www.who.int/news-room/fact-sheets/detail/congenital-anomalies.
  3. Sitkin NA, Ozgediz D, Donkor P, Farmer DL. Congenital anomalies in low and middle-income countries: the unborn child of global surgery. World J 2015;39(1):36–40.
  4. Daliri S, Sayehmiri K, Asadollahi Kh, Rezaei N, Saroukhani D, Karimi A, et al. Prevalence of Congenital Anomalies in Iran: A Systematic Review and Meta-analysis. Iran J Neonatol. 2018;9(2):21-32.
  5. Jabraeili M, Arshadi M, Namdar H, Ghojazadeh M, Jafarpour Z, Najafi F, et al. Correlation of perceived nursing support with stress and self-confidence among the mothers of infants with congenital gastrointestinal anomalies. Nurs Midwifery Stud. 2018;7(4):163-167.
  6. Golfenshtein N, Hanlon AL, Deatrick JA, Medoff-Cooper B. Parenting stress in parents of infants with congenital heart disease and parents of healthy infants: the first year of life. Compr. Child Adolesc Nurs. 2017;40(4):294-314.
  7. Borghini A, Despars J, Habersaat S, Turpin H, Monnier M, Ansermet F, et al. Attachment in infants with cleft lip and/or palate: marginal security and its changes over time. Infant Ment Health J. 2018;39(2):242–53.
  8. Boztepe H, Ay A, Kerimoğlu Yıldız G, Çınar S. Does the visibility of a congenital anomaly affect maternal–infant attachment levels?. J Spec Pediatr Nurs. 2016;21(4):200-11.
  9. Cummings L. Fathers' Experiences with Their Premature Infants or Unhealthy Neonates. The University of Missouri, St. Louis A Dissertation Submitted to The Graduate School at the University of Missouri– St. Louis in partial fulfillment of the requirements for the degree. Doctor of Philosophy in Nursing December 2019.
  10. Walmsley R, Jones T. Are fathers supported by neonatal teams?: An exploration of the literature. J Neonatal Nurs. 2016;22(6):292-6.
  11. van IJzendoorn M. The strange situation procedure: the role of the attachment patterns. Am J Appl Psychol. 1993,3(3):47-56.
  12. Ettenberger M, Bieleninik Ł, Epstein S, Elefant C. Defining attachment and bonding: overlaps, differences and implications for music therapy clinical practice and research in the Neonatal Intensive Care Unit (NICU). Int J Environ Res Public Health. 2021;18(4):1-10.
  13. Kim AR, Kim SY, Yun JE. Attachment and relationship-based interventions for families during neonatal intensive care hospitalization: a study protocol for a systematic review and meta-analysis. Syst Rev. 2020;9(1):1-7.
  14. Cho E S, Kim S J, Kwon M S, Cho H, Kim E H, Jun E M, Lee S, et al. The effects of kangaroo care in the neonatal intensive care unit on the physiological functions of preterm infants, maternal-infant attachment, and maternal stress. J Pediatr Nurs. 2016;31(4): 430–438.
  15. Verklan MT, Walden M. Core Curriculum for neonatal intensive care nursing-e-book: Elsevier Health Sciences. 2014.
  16. Schaber R, Kopp M, Zähringer A, Mack JT, Kress V, Garthus-Niegel S. Paternal Leave and Father-Infant Bonding: Findings From the Population-Based Cohort Study DREAM. Front Psychol. 2021;12:1-13.
  17. Taing R, Galescu O, Noble L, Hand IL. Factors Influencing Paternal Attachment Among Preterm Infants in an Urban Neonatal Intensive Care Unit. Cureus. 2020;12(6):1-6.
  18. Hall RA, De Waard IE, Tooten A, Hoffenkamp HN, Vingerhoets AJ, van Bakel HJ, et al. From the father's point of view: how father's representations of the infant impact on father-infant interaction and infant development. Early Hum Dev. 2014;90(12):877-83.
  19. Arshadi Bostanabad M, Valizadeh S, Rezanezhad J Jabbari T. Paternal – Newborn Bonding and its related factors. Nurs Midwifery J. 2014;12(8):
    777-783.
  20. Morovati F. The Impact of Involvement of Father's with Preterm Newborns on their Paternal-Infant Bonding and Self-Efficacy: A non-randomized clinical trial. Master Thesis in Neonatal Intensive Care, Tehran University of Medical Sciences. 1396.
  21. Soares RL, Christoffel MM, Rodrigues ED, Machado ME, Cunha AL. Being a father of a premature newborn at neonatal intensive care unit: from parenthood to fatherhood. Escola Anna Nery. 2015;19(3):409-16.
  22. Feeley N, Waitzer E, Sherrard K, Boisvert L, Zelkowitz P. Fathers’ perceptions of the barriers and facilitators to their involvement with their newborn hospitalized in the neonatal intensive care unit. J Clin Nurs. 2013;22(3-4):521-30.
  23. Shahkolahi Z, Abdeyazdan Z, Mehrabi T, Hajiheidari M. Supporting fathers of premature infants hospitalized in Neonatal Intensive Care Unit (NICU). Intensive Crit Care Nurs. 2014;7(1):31–40.
  24. Valizadeh S, Mirlashari J, Navab E, Higman W, Ghorbani F, Dowling D, et al. Fathers: The Lost Ring in the Chain of Family-Centered Care. A Phenomenological Study in Neonatal Intensive Care Units of Iran. Adv Neonatal Care. 2018;18(1): E3-E11.
  25. Pineda R, Bender J, Hall B, Shabosky L, Annecca A, Smith J, et al. Parent participation in the neonatal intensive care unit: Predictors and relationships to neurobehavior and developmental outcomes. Early Hum Dev. 2018;117:32-8.
  26. Gómez-Cantarino S, García-Valdivieso I, Moncunill-Martínez E, Yáñez-Araque B, Ugarte Gurrutxaga MI. Developing a Family-Centered Care Model in the Neonatal Intensive Care Unit (NICU): A New Vision to Manage Healthcare. Int J Environ Res Public Health. 2020;17(19):1-22.
  27. Mianaei SJ, Karahroudy FA, Rassouli M, Tafreshi MZ. The effect of Creating Opportunities for Parent Empowerment program on maternal stress, anxiety, and participation in NICU wards in Iran. Iran J Nurs Midwifery Res. 2014;19(1):9-100.
  28. Taylor A, Atkins R, Kumar R, Adams D, Glover V. A new Mother-to-Infant Bonding Scale: links withearly maternal mood. Arch Womens Ment Health. 2005;8(1):45–51.
  29. Brandao S, Figueiredo B. Fathers’ emotional involvement with the neonate: impact of the umbilical cord-cutting experience. J Adv Nurs. 2012;68(12):2730-9.
  30. Ohashi Y, Sakanashi K, Tanaka T, Kitamura T. Mother-to-infant bonding disorder, but not depression, 5 days after delivery is a risk factor for neonate emotional abuse: A study in Japanese mothers of 1-month olds. Open Fam Stud J. 2016;8(1):27-36.
  31. Kitamura T, Takegata M, Haruna M, Yoshida K, Yamashita H, Murakami M, et al. The Mother-Infant Bonding Scale: factor structure and psychosocial correlates of parental bonding disorders in Japan. J Child Fam Stud. 2015;24(2):393-401.
  32. Figueiredo B, Costa R, Pacheco A, Pais A. Mother-to‐infant and father‐to‐infant initial emotional involvement. Early Child Dev Care. 2007;177(5):
    521–32.
  33. Garnica-Torres Z, Gouveia Jr A, da Silva Pedroso J. Attachment between father and premature baby in kangaroo care in a neonatal unit of a public hospital. J Neonatal Nurs .2021;27(5):334-40.
  34. Taing R, Galescu O, Noble L, Hand IL. Factors Influencing Paternal Attachment Among Preterm Infants in an Urban Neonatal Intensive Care Unit. Cureus. 2020;12(6):1-6.
  35. Shorey S, Ang L. Experiences, needs, and perceptions of paternal involvement during the first year after their infants’ birth: A meta-synthesis. PloS one. 2019;14(1):1-21.
  36. Schaber R, Kopp M, Zähringer A, Mack JT, Kress V, Garthus-Niegel S, et al. Paternal Leave and Father-Infant Bonding: Findings From the Population-Based Cohort Study dream. Front Psychol. 2021:1-12.
  37. Chen E-M, Gau M-L, Liu C-Y, Lee T-Y. Effects of father-neonate skin-to-skin contact on attachment: a randomized controlled trial. Nursing research and practice. 2017;2017(5):1-8.
  38. Hearn G, Clarkson G, Day M. The Role of the NICU in Father Involvement, Beliefs, and Confidence: A Follow-up Qualitative Study. Advances in Neonatal Care. Adv Neonatal Care. 2020;20(1):80-89 .
  39. Cong X, Ludington-Hoe SM, Hussain N, Cusson RM, Walsh S, Vazquez V, et al. Parental oxytocin responses during skin-to-skin contact in pre-term infants. Early Hum Dev. 2015;91(7):401-6.
  40. Fisher D, Khashu M, Adama EA, Feeley N, Garfield CF, Ireland J, et al. Fathers in neonatal units: Improving infant health by supporting the baby-father bond and mother-father coparenting. J Neonatal Nurs. 2018;24(6):1-7.
  41. Scatliffe N, Casavant S, Vittner D, Cong X. Oxytocin and early parent-infant interactions: A systematic review. Int J Nurs Sci. 2019;6(4):445-53.
  42. Clarkson G, Gilmer MJ. Factors affecting time NICU nurses spend with fathers: Results from a larger study. Adv Neonatal Care. 2019;19(5): E16-25.
  43. Mäkelä H, Axelin A, Feeley N, Niela-Vilén H. Clinging to closeness: the parental view on developing a close bond with their infants in a NICU. Midwifery. 2018;62:183-88.

 

 

Iranian Journal of Neonatology
Volume 13, Issue 1
Winter 2022
Pages 46-54