ArticleMaternal Responsiveness in Mothers of Preterm Infants☆
Section snippets
Design
A nonexperimental, longitudinal, correlation design was used to examine data. Data were collected from mothers whose infants were enrolled in a study of preterm infant feeding. All data were collected for this study between August 2002 and August 2003 at three collection points. The study was approved the university's institutional review board, and all participants gave informed, written consent by a registered nurse.
Setting
Infants of participating mothers were hospitalized in a level three nursery at a university medical center. Data collection occurred in a quiet room located in the school of nursing.
Sample
The sample consisted of 23 mothers of preterm infants; mothers were eligible for the study if their infants had participated in a larger feeding study.30 Additional inclusion criteria were the ability to read and comprehend English and being 18 years old or older. Participating mothers' ages ranged from 18 to 42 years. There were 15 African-American and 5 white mothers; 3 mothers indicated they were of more than one race. Most mothers had incomes less than $20,000, with 10 indicating an income
Measures
Data were collected from mothers by questionnaire. Mothers completed questionnaires at three intervals—6 weeks postpartum, 2 weeks after the infant's discharge to home from the neonatal intensive care unit, and 3 months postpartum. Data were collected using the following instruments: Edinburgh Postnatal Depression Scale31; Postpartum Support Questionnaire20; Everyday Stressors Index32; Rosenberg Self-Esteem (RSE) Scale25; Subjective Well-Being Scale28; Maternal Attitude Questionnaire29; and the
Procedures
Mothers were enrolled in this study at the same time their infants were enrolled in the feeding study. Mothers completed questionnaires at three intervals: 2 weeks postpartum, 2 weeks after the infant's discharge from the neonatal intensive care unit, and 3 months postpartum. Questionnaires were read to mothers who requested assistance.
Analysis
Data were analyzed using descriptive statistics. Pearson r was used to examine the relationship among variables. Three data points, along with the longitudinal analyzes, are presented in the result.
Results
Only 15 of the mothers completed questionnaires at all three data collection points. Results on the variables of interest at each data collection interval are shown in Table 1; there were no significant differences across time. That is, scores for depression, social support, stressors, self-esteem, maternal well-being, attitude, and responsiveness did not differ significantly from one time to the next. Although the changes were not significant, scores for well-being, self-esteem, and maternal
Discussion
Although mothers of both term and preterm infants experience the process of maternal role attainment, the process is different for mothers of preterm infants. Rubin36, 37 and Mercer38, 39 suggest that preterm birth disrupts the normal transition to maternal role attainment. This disruption may be seen in the increased incidence of postpartum depression in mothers of preterm infants.40 Although factors such as adequate social support, positive attitude, self esteem, and minimal stressors may
Conclusion
Neonatal intensive care unit nurses have the ability to observe mother-infant interaction on a daily basis. They are very likely to notice the difference between a mother who is responsive and one who is not responsive to her infant. Infants whose mothers “pick-up on” their infants' cues, whether they be cues for feeding, fatigue, or readiness for interaction may develop more normal patterns of behavior, which ultimately increases their likelihood of survival and quality of life.
The literature
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Supported in part by a grant from the National Institute of Nursing Research, National Institutes of Health, 3R01 NR005182. This work was completed while the author was an Assistant Professor at Virginia Commonwealth University with support and direction from Dr. Rita Pickler and Dr. Shannon Humenick.