Heermann, J. A., Wilson, M. E., & Wilhelm, P. A. (2005).Pediatric Nursing, 31(3), 176-181
Nurses working in the NICU are exposed to the fears, joys, and triumphs of mothers who learn to deal with the high-tech world of intensive care. NICU nurses will be interested in this qualitative study, in which the authors explored and described how women became mothers, using a sample of 15 mothers whose premature infants were receiving care in a level III NICU. The researchers interviewed each of the mothers once for approximately 1 hour using broad, open-ended interview questions and used qualitative methods for analysis of data. Results showed that the mothers conceptualized their experiences as a developmental process. They first focused on the NICU environment, its technology, and chaos, and eventually were able to bring the baby into the forefront of their attention. Mothers viewed their relationship with their infants first as one of a stranger or outsider, and then later as a caregiver. Mothers moved from a more passive to active role in caregiving, and from a posture of silence to advocacy. As mothers gained confidence in parenting and became more comfortable in the NICU environment, with providers, and with their new role, they became partners with nurses in caregiving. This engaged parenting followed a specific sequential pattern and can be supported by several nursing interventions such as those found in developmentally focused care and supportive NICU environments (Als & Gilkerson, 1995). These can assist nurses in framing interventions that facilitate mothers' transition to a partnered relationship with nurses. Some mothers can be intimidated by nursing expertise, but nurses can find ways to capitalize on the strengths mothers bring to the NICU experience. Within a novice to expert framework, nurses can use guided participation to engage mothers in gaining confidence in caregiving. This study was limited to primarily Caucasian middle-class mothers, but it is the first to explore mothers' NICU experiences from a developmental perspective and offers many suggestions for individualized, developmentally focused interventions to foster maternal role attainment.
Comment by Judy Beal
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