McCarty Dana B, Ferrari Renée M, Golden Shelley, Zvara Bharathi J, Wilson Wylin D, Shanahan Meghan E
Division of Physical Therapy, Department of Health Sciences, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
Children (Basel). 2024 Nov 16;11(11):1390. doi: 10.3390/children11111390.
BACKGROUND/OBJECTIVES: The experience of parenting in a highly medicalized, unnatural environment can result in impaired mother-infant bonding, but increased maternal presence at the infant's bedside has been associated with improved infant and maternal outcomes. The primary objective of this study was to explore barriers and facilitators during the NICU Experience in regard to maternal presence in an NICU.
We interviewed 12 mothers (7 Black, 5 white) of low socioeconomic status (SES) whose preterm infants (average birth gestational age of 27 weeks) were currently hospitalized in an NICU. We engaged the NICU Family Advisory Board in all steps of the research process.
Barriers and facilitators to maternal presence spanned all levels of the Socioecological Model; however, barriers were mostly at the societal, community, and institutional levels, while facilitators varied based on interpersonal and individual-level factors. Assets that mothers accessed to facilitate visits, such as free housing and shuttle services, were not available to all mothers based on individual circumstances (e.g., caregiving responsibilities). While a few mothers identified negative interactions with health care practitioners, these encounters were not attributed to racism or described as barriers to visitation.
Hospitals can support families with infants in an NICU by providing free or inexpensive short-term sibling support, alleviating the burden of parking costs, and communicating early and frequently about available institutional resources during the hospital stay.
背景/目的：在高度医疗化、非自然的环境中育儿的经历可能会导致母婴联结受损，但母亲在婴儿床边陪伴时间的增加与改善婴儿和母亲的结局相关。本研究的主要目的是探讨新生儿重症监护病房（NICU）体验期间母亲陪伴存在的障碍和促进因素。
我们采访了12位社会经济地位较低（SES）的母亲（7位黑人，5位白人），她们的早产儿（平均出生孕周为27周）目前正在一家NICU住院。我们让NICU家庭咨询委员会参与了研究过程的所有步骤。
母亲陪伴存在的障碍和促进因素跨越了社会生态模型的所有层面；然而，障碍大多存在于社会、社区和机构层面，而促进因素则因人际和个人层面的因素而异。母亲们用来便利探视的资源，如免费住房和班车服务，并非所有母亲都能根据个人情况获得（例如，照顾责任）。虽然有几位母亲提到了与医护人员的负面互动，但这些遭遇并未被归因于种族主义或被描述为探视障碍。
医院可以通过提供免费或廉价的短期兄弟姐妹支持、减轻停车费用负担以及在住院期间尽早且频繁地沟通可用的机构资源，来支持NICU中有婴儿的家庭。
