Parenting Expectations, NICU Experiences, and Maternal Psychological Outcomes: An Exploratory Mixed-Methods Study.

IF 1.6 4区医学 Q2 NURSING

Advances in Neonatal Care Pub Date : 2024-04-01 Epub Date: 2024-01-12 DOI:10.1097/ANC.0000000000001139

Sarah M Rodrigues, Sanghyuk S Shin, Melissa D Pinto, Dawn T Bounds, Jennifer Terry, Candace W Burton

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引用次数: 0

Abstract

Background: Infant neonatal intensive care unit (NICU) hospitalization increases maternal risk for psychological distress. However, no universal screening standards exist and predicting maternal risk remains challenging. Reconceptualizing maternal distress in relation to differences between parenting expectations and NICU experiences may illuminate commonalities across a range of experiences.

Purpose: This study explored parenting expectation-experience differences (EEDs) among NICU mothers and assessed correlations between EED scores and psychological outcomes 1 to 5 years post-NICU hospitalization.

Methods: A 3-phase explanatory sequential mixed-methods design was used. Pearson's correlation coefficients were used to measure relationships between EED scores and maternal psychological outcomes. Reflexive thematic analysis of one-on-one, semi-structured interviews contextualized EED scores.

Results: Most participants (92.9%) reported negative EED scores, indicating NICU experiences fell short of parenting expectations. Significant inverse correlations were found between EED scores and maternal outcomes, including depression ( r = -0.25, P < .01), anxiety ( r = -0.25, P < .01) and posttraumatic stress disorder symptoms ( r = -0.41, P < .001), and perceived parenting self-efficacy ( r = -0.28, P < .01). Major qualitative themes included unexpected versus prepared, lost parenting experiences, and surviving and thriving. Data synthesis contextualized EED scores and revealed key differences in meaning ascribed to unmet parenting expectations.

Implications for practice and research: Preparing mothers for infant NICU hospitalization and creating a NICU parenting environment, which better supports mothers and their engagement in parenting tasks, may help to reduce differences between parenting expectations and NICU experiences. Further research is needed to elucidate the impacts of parenting EEDs in this population.

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育儿期望、新生儿重症监护室经历和产妇心理结果：一项探索性混合方法研究。

背景：新生儿重症监护室（NICU）住院会增加产妇出现心理困扰的风险。然而，目前还没有通用的筛查标准，预测产妇风险仍具有挑战性。目的：本研究探讨了新生儿重症监护室（NICU）母亲的养育期望-经验差异（EED），并评估了EED评分与NICU住院后1至5年的心理结果之间的相关性：采用三阶段解释性顺序混合方法设计。采用皮尔逊相关系数来测量 EED 评分与产妇心理结果之间的关系。对一对一的半结构式访谈进行了反思性主题分析，将 EED 分数与背景情况相结合：大多数参与者（92.9%）的 EED 分数为负，表明新生儿重症监护室的经历没有达到育儿期望。研究发现，EED 分数与产妇的结果之间存在显著的反相关关系，包括抑郁（r = -0.25，P < .01）、焦虑（r = -0.25，P < .01）和创伤后应激障碍症状（r = -0.41，P < .001），以及感知到的养育自我效能（r = -0.28，P < .01）。主要的定性主题包括意料之外与有备而来、失去的育儿经验以及生存与发展。数据综合将 EED 分数与背景联系起来，并揭示了未实现的育儿期望在意义上的关键差异：实践与研究的启示：让母亲为新生儿重症监护病房的婴儿住院做好准备，创造新生儿重症监护病房的育儿环境，更好地支持母亲和她们参与育儿任务，可能有助于减少育儿期望和新生儿重症监护病房经历之间的差异。还需要进一步的研究，以阐明育儿EED对这一人群的影响。

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来源期刊

Advances in Neonatal Care NURSING-

CiteScore

2.60

自引率

5.90%

发文量

101

期刊介绍： Advances in Neonatal Care takes a unique and dynamic approach to the original research and clinical practice articles it publishes. Addressing the practice challenges faced every day—caring for the 40,000-plus low-birth-weight infants in Level II and Level III NICUs each year—the journal promotes evidence-based care and improved outcomes for the tiniest patients and their families. Peer-reviewed editorial includes unique and detailed visual and teaching aids, such as Family Teaching Toolbox, Research to Practice, Cultivating Clinical Expertise, and Online Features. Each issue offers Continuing Education (CE) articles in both print and online formats.