Schroeder, M., & Pridham, K. (2006). Journal of Obstetric, Gynecologic, and Neonatal Nursing, 35, 358-367.
This ambitious and theoretically grounded study explored the effects of guided participation on maternal competency development with their preterm hospitalized infants. Maternal relationship competencies measured specific behaviors within the broad categories of (a) being with the infant or committing to and investing herself in her baby and (b) knowing and relating to her baby. This study, which was part of a much larger randomized, longitudinal clinical trial, measured by survey and videotapes the relationship goals, expectations, and intentions and actual achievement of relationship competencies with convenience sample of 16 mothers of low-birth weight infants. Mothers were randomly assigned to either traditional standard care teaching (control) group or the experimental group, in which the guided participation intervention focused on development of parenting practice and relationship building rather than on transmission of knowledge around specific caregiving skills (Fenwick, Barclay, & Schmied, 1999). Although limited by a small and nongeneralizable sample, it is exciting to note that mothers in the guided participation group achieved greater relationship competency and had expectations and intentions that were more attuned and adaptive to their infants' needs. NICU nurses can easily refocus their role from teaching skill acquisition to more of a relational paradigm, in which the nurse guides the mother in developing her working model of parenting and caregiving roles. Guided participation processes facilitate the development of maternal relational competencies that allow the mother to more effectively attune and adapt to her infant's needs. This relational approach was further explored by Karl, Beal, O'Hare, and Rissmiller (2006) from the perspective of the role of nurse as "attacher." Future research is needed to further test this interesting and helpful theoretical approach to parenting.
Judy Beal
References