ABSTRACT
AIM: The aim of this study was to investigate the nature and organization of maternal needs and priorities in a neonatal unit. BACKGROUND: The relationship between maternal needs and priorities appears to be an under studied area in neonatal nursing. METHODS: A quantitative survey was carried out based on 209 mothers with premature infants. Two self-assessment schedules were used: critical care maternal needs inventory (J. Leske, Heart and Lung 15, 27-42) and a ranking scale. The data were analysed with multivariate analysis. FINDINGS: Data analysis revealed clear priorities in maternal needs. In particular the need for accurate infant related information was a priority for 93% of the mothers. Good communication practices with professionals were also valued. The mothers displayed altruistic behaviour, and self-related needs took second place. It is proposed that maternal needs demonstrate a hierarchical organization. CONCLUSION: It is important for nurses to consider the individual needs of the mothers, simply because the satisfaction of these needs is essential for maternal well-being.
Subject(s)
Intensive Care Units, Neonatal/organization & administration , Mothers , Needs Assessment , Neonatal Nursing/methods , Professional-Family Relations , Communication , Factor Analysis, Statistical , Female , Humans , Infant, Newborn , Infant, Premature , Mothers/psychology , Multivariate Analysis , Social SupportABSTRACT
Birth has traditionally been recognized as a family-centred event where immediate exposure to the infant occurs and where the family begins, through direct contact, touch and voice, to form an attachment to the infant. In high-risk pregnancy and delivery, medical and technological advances distance the family from the birth event. This article describes some aspects of a research project with identified factors that facilitate and hinder family and mother attachment to the infant during periods of separation subsequent to premature delivery or other problems which require management in a neonatal intensive care unit (NICU). The project was exploratory. It involved observation of care, participation in care, individual unstructured interviews, focus group interviews and also use of Leske's (1986, 1991a,b) critical care family needs inventory, which was modified and responded to by family members (n = 109) in an attempt to quantify and validate their needs. Six constructs were derived from the inventory and then ranked by mothers (n = 100). The findings from this process were triangulated to observation and interview data in order to confirm factors that facilitate and hinder the process of attachment during family and mother-infant separation. The results of the study imply that when the family and mother are supported by an individualized approach to care and appropriate communication is used, attachment can be facilitated.
Subject(s)
Attitude to Health , Communication , Intensive Care, Neonatal/methods , Intensive Care, Neonatal/psychology , Mother-Child Relations , Mothers/psychology , Object Attachment , Anxiety, Separation/prevention & control , Anxiety, Separation/psychology , Female , Focus Groups , Health Promotion/methods , Health Promotion/standards , Humans , Infant, Newborn , Neonatal Nursing/methods , Nursing Methodology Research , Risk Factors , Social SupportABSTRACT
Attachment is defined as the formation of a relationship between a mother and her newborn infant. The concept of attachment has been inadequately defined and often confused with feelings associated with love, instinct, engrossment, and being connected to others. Prematurity and associated maternal-infant separation at birth can affect the attachment process. In this article, a research project, using Leninger's ethnonursing approach is described. Leninger's method was chosen to study the phenomenon of attachment in a neonatal intensive care unit (NICU). Ethnonursing has been found to be a suitable approach for the study of complex situations. Ethnonursing is based on an observation, participation in care, and reflection model. Qualitative data for this study were collected by observation, participation in care, and interviews of mothers (N = 25) in a tertiary NICU. Data were analyzed by comparison of narratives from field notes and transcripts. Findings from the analysis indicate the process of attachment was not automatic. Attachment should be considered as an individualized process. Two dichotomies associated with attachment were identified through the research. These were overt and covert attachment processes and may be dependent on the health status of the infant and the mother, environmental circumstances, and on the quality of care the infant receives.
