Coddington Heather Lynn
West Virginia University School of Nursing, Keyser, WV, USA.
UPMC Western Maryland Health System in Special Care Nursery, USA.
Int J Nurs Sci. 2022 Sep 20;9(4):529-532. doi: 10.1016/j.ijnss.2022.09.002. eCollection 2022 Oct.
Mothers with substance use disorder (SUD) experience a range of emotions such as feeling ostracized, diminished, and distressed while watching their baby experience withdrawal from substances. Being fully present in the now moment is to trust self to do what is best by moving beyond perceived boundaries to care for self and baby. The process of concept building arose from nursing practice encounters in a special care nursery (SCN) for babies who experienced withdrawal from substances.
Liehr and Smith's 10-phase concept building approach was used to guide the development of this concept. Concept building began with a practice story. The emerging concept was named, core qualities identified, and supported through a literature review. The middle range theory of uncertainty in illness was chosen to serve as theoretical support for the concept. A model was created to provide clarity on the relationships within the concept.
A mini-saga was gathered from a mother in the SCN whose newborn had experienced withdrawal from substances The minisaga follows: Due to the baby's discomfort and judging eyes of the staff, she was unable to mother her baby. As the baby recovered, she asked for help, comforted her baby, and gained confidence to move beyond perceived boundaries to become the mother she envisioned. Overcoming perceived boundaries to attend to self and baby is trusting oneself to do what is best in spite of feeling ostracized, diminished, and distressed while watching baby withdraw from substances.
This concept provides the perspective of mothers with SUD through intermodernism from experiences in nursing practice. The Uncertainty in Illness theory further allows practitioners to gain an understanding of the role uncertainty plays in this unique situation.
患有物质使用障碍（SUD）的母亲在看着自己的宝宝经历物质戒断时，会体验到一系列情绪，如感到被排斥、自卑和痛苦。全然活在当下就是相信自己能够超越既定界限，去做对自己和宝宝最有利的事情，从而照顾好自己和宝宝。概念构建的过程源于在一家为经历物质戒断婴儿设立的特殊护理病房（SCN）中的护理实践经历。
采用利尔和史密斯的10阶段概念构建方法来指导这一概念的发展。概念构建始于一个实践故事。确定了新出现的概念名称、核心特质，并通过文献综述进行支持。选择疾病不确定性的中程理论作为该概念的理论支持。创建了一个模型，以阐明该概念中各要素之间的关系。
从SCN的一位母亲那里收集到了一个小故事，她的新生儿经历了物质戒断。故事如下：由于宝宝的不适以及工作人员审视的目光，她无法照顾自己的宝宝。随着宝宝康复，她寻求帮助，安慰宝宝，并获得了超越既定界限的信心，成为了她所期望的母亲。克服既定界限去照顾自己和宝宝，就是相信自己在看着宝宝经历物质戒断时，尽管感到被排斥、自卑和痛苦，但仍能做出对自己和宝宝最有利的事情。
这个概念通过护理实践中的体验，从互现代主义的角度呈现了患有SUD的母亲的视角。疾病不确定性理论进一步使从业者能够理解不确定性在这种独特情况下所起的作用。
