Premji Shahirose S, Currie Genevieve, Reilly Sandra, Dosani Aliyah, Oliver Lynnette May, Lodha Abhay K, Young Marilyn
Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada.
Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
PLoS One. 2017 Mar 23;12(3):e0174419. doi: 10.1371/journal.pone.0174419. eCollection 2017.
In Alberta, the high occurrence of late preterm infants and early hospital discharge of mother-infant dyads has implications for postpartum care in the community. Shortened hospital stay and complexities surrounding the care of biologically and developmentally immature late preterm infants heighten anxiety and fears. Our descriptive phenomenological study explores mothers' experience of caring for their late preterm infants in the community.
Eleven mothers were interviewed using a semi-structured interview guide. Interview transcripts were analysed using an interpretive thematic approach.
The mothers' hospital experience informed their perspective that being a late preterm infant was not a "big deal," and they tended to treat their infant as normal. "Feeding was really problem," especially the variability in feeding effectiveness, which was not anticipated. Failing to recognize late preterm infants' feeding distress exemplified lack of knowledge of feeding cues and tendencies to either rationalize or minimize feeding concerns. Public health nurses represent a source of informational support for managing neonatal morbidities associated with being late preterm; however, maternal experiences with public health nurses varied. Some nurses used a directive style that overwhelmed certain mothers. Seeing multiple public health nurses and care providers was not always effective, given inconsistent and contradictory guidance to care. These new and changing situations increased maternal anxiety and stress and influenced maternal confidence in care. Fathers, family, and friends were important sources of emotional support.
After discharge, mothers report their lack of preparation to meet the special needs of their late preterm infants. Current approaches to community-based care can threaten maternal confidence in care. New models and pathways of care for late preterm infants and their families need to be responsive to the spectrum of feeding issues encountered, limit duplication of services, and ensure consistent and effective care that parents will accept.
在艾伯塔省，晚期早产儿的高发生率以及母婴二元组的早期出院对社区产后护理产生了影响。住院时间缩短以及生物学和发育上不成熟的晚期早产儿护理的复杂性加剧了焦虑和恐惧。我们的描述性现象学研究探讨了母亲在社区中照顾晚期早产儿的经历。
使用半结构化访谈指南对11位母亲进行了访谈。访谈记录采用解释性主题分析法进行分析。
母亲们在医院的经历使她们形成了一种观点，即作为晚期早产儿并不是什么“大不了的事”，她们倾向于将自己的婴儿视为正常婴儿。“喂养真的是个问题”，尤其是喂养效果的差异，这是未曾预料到的。未能认识到晚期早产儿的喂养困扰体现了对喂养线索的缺乏了解以及将喂养问题合理化或最小化的倾向。公共卫生护士是管理与晚期早产相关的新生儿疾病的信息支持来源；然而，母亲们与公共卫生护士的经历各不相同。一些护士采用的指导方式让某些母亲不堪重负。由于护理指导不一致且相互矛盾，看多个公共卫生护士和护理提供者并不总是有效。这些新的和不断变化的情况增加了母亲的焦虑和压力，并影响了母亲对护理的信心。父亲、家人和朋友是重要的情感支持来源。
出院后，母亲们表示自己没有做好满足晚期早产儿特殊需求的准备。当前基于社区的护理方法可能会威胁到母亲对护理的信心。针对晚期早产儿及其家庭的新护理模式和途径需要应对所遇到的一系列喂养问题，减少服务重复，并确保父母能够接受的一致且有效的护理。
