Fleury Camila, Parpinelli Mary A, Makuch Maria Y
Campinas Center for Research in Reproductive Health (CEMICAMP), Campinas, São Paulo, Brazil.
BMC Pregnancy Childbirth. 2014 Sep 8;14:313. doi: 10.1186/1471-2393-14-313.
The mother-child interaction after delivery may be hampered when the newborn baby is hospitalized. The objective of the study was to understand perceptions and actions of healthcare professionals (HCPs), working in an intermediate neonatal intensive care unit (NICU), regarding mother-child relationship of hospitalized premature babies in the first weeks after delivery and the professionals' support for the development of this relationship within an NICU environment. The psychoanalytic concept of holding defined by Winnicott was used as the theoretical framework.
A qualitative study was conducted with 20 HCPs (physicians, medical residents, nurses, and nurse technicians) working at an intermediate NICU of a referral hospital in Brazil. Semi-structured interviews were conducted, recorded and transcribed verbatim; and thematic analysis was performed.
The HCPs referred to the difficulty that these mothers had to develop the mother-child relationship within this environment. If they observed that the mother had initial inhibitions to interact with her baby, they tried to facilitate this process, since they were aware of the importance of early bonding for the child's well-being. They attributed the mothers' difficulty to the fragile appearance of the premature baby, the limited contact often imposed by the routine of the unit and the lack of participation in the decisions regarding the care given to her baby. HCPs tried to help women bond with her child by giving support and encouragement. Most of the physicians reported that the nurses represented a link between physicians and the mothers of the hospitalized babies.
The HCPs reported attitudes and actions indicative of holding. A more in-depth understanding of the relationship between HCPs and mothers of premature babies at an NICU during the first days after delivery, and the needs of the mothers and her baby to be close to facilitate bonding should be part of the routine discussions of the NICU health team.
新生儿住院时，产后母婴互动可能会受到阻碍。本研究的目的是了解在中级新生儿重症监护病房（NICU）工作的医护人员（HCPs）对产后头几周住院早产儿母婴关系的看法和行动，以及专业人员在NICU环境中对这种关系发展的支持。采用了温尼科特定义的精神分析抱持概念作为理论框架。
对巴西一家转诊医院中级NICU工作的20名医护人员（医生、住院医生、护士和护士技术员）进行了定性研究。进行了半结构化访谈，录音并逐字转录；并进行了主题分析。
医护人员提到这些母亲在这种环境中建立母婴关系存在困难。如果他们观察到母亲最初与婴儿互动时有抑制情绪，他们会试图促进这一过程，因为他们意识到早期亲密关系对孩子幸福的重要性。他们将母亲的困难归因于早产儿脆弱的外表、病房常规操作经常限制的接触以及母亲在婴儿护理决策中缺乏参与。医护人员试图通过给予支持和鼓励来帮助女性与孩子建立亲密关系。大多数医生报告说，护士是医生与住院婴儿母亲之间的纽带。
医护人员报告了表明抱持的态度和行动。对产后头几天NICU中医护人员与早产儿母亲之间的关系，以及母亲和婴儿为促进亲密关系而亲近的需求进行更深入的了解，应成为NICU医疗团队日常讨论的一部分。
