Yenidoğan Yoğun Bakım Ünitesinde Bebeği Olan Annelerin kaygı Düzeyi ve Maternal Bağlanma İlişkisinin İncelenmesi
Year 2025,
Volume: 9 Issue: 2, 21 - 33, 28.08.2025
Esra Özdemir
,
Meltem Mecdi Kaydırak
Abstract
Bu araştırma yenidoğan yoğun bakım ünitesinde (YYBÜ) bebeği olan kadınların kaygı düzeyi ve maternal bağlanma ilişkisinin incelenmek amacıyla yapıldı. Bir hastanenin YYBÜ’sinde Nisan 2022 – Eylül 2022 tarihleri arasında bebeği yatmakta olan 140 kadınla yapılan çalışma, tanımlayıcı ve ilişki arayıcı tasarımda planlandı. Veriler “Anne-Bebek Tanıtıcı Bilgi Formu”, “Görsel Kıyaslama Ölçeği”, “Anne-Bebek Bağlanma Ölçeği (ABBÖ)” ve “Beck Anksiyete Ölçeği (BAÖ)” kullanılarak yüz yüze görüşme tekniğiyle toplandı.Annelerin yaş ortalaması 28.48±5.66 olarak belirlendi. Annelerin ölçek toplam puan ortalaması şu şekildedir; ABBÖ= 14.85±2.13 ve BAÖ=7.21±6.33’tür. Bebeğin bakımına katılamayan annelerin daha yüksek ABBÖ puanına sahip oldukları belirlendi (p=0.045). Gebelikte düzenli kontrole giden annelerin daha düşük BAÖ puanına sahip oldukları belirlendi (p=0.005). Anne/babasından (p=0.021), eşinden (p=0.018) ve arkadaşından (p=0.040) destek gören katılımcıların daha düşük ABBÖ puanına sahip oldukları belirlendi(p<0.05). Eşinin ailesinden destek gören annelerin daha düşük anksiyeteye sahip oldukları belirlendi (p=0.044). ABBÖ ve BAÖ arasında anlamlı bir ilişki bulunmadı (r= -0.90; p= 0.290).Araştırma sonucunda bebeği yoğun bakım ünitesinde yatan annelerin anksiyete yaşadıkları ancak bebeklerine bağlanma düzeylerinin düşük olmadığı belirlendi. Annelerin anksiyete düzeyi ile bağlanma arasında anlamlı bir ilişki olmadığı sonucuna varıldı. Ancak annelerin bebeklerinin bakımına katılma durumu, aile ve sosyal destek varlığı, emzirmesi ve bilgi kaynağı kişi (hemşire/ebe), bebeği kaybetme korkusu gibi değişkenler anksiyete ve bağlanmayı etkileyen değişkenler olarak belirlendi.
Ethical Statement
Bu çalışma için etik kurul onayı Sosyal ve Beşeri Bilimler Araştırmaları Etik Kurulu'ndan alınmıştır (Tarih:
14.03 2022 ve Sayı No: :E-74555795-050.01.04-334568).
Supporting Institution
Bu çalışma için herhangi bir finansal destek alınmamıştır.
References
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1. Nacar, E.H. and Gökkaya, F. (2019). A Review on attachment and maternal bonding. Cyprus Turkish Journal of Psychiatry and Psychology. 1(1), 50-56. https://doi.org/10.35365/ctjpp.19.1.06
-
2. Balcı, M.E. (2022). Mother-infant attachment and related factors in mothers with premature babies in neonatal intensive care. Master's Thesis, Necmettin Erbakan University, Institute of Health Sciences. Department of Women's Health and Diseases. Konya.
-
3. Ainsworth, M.S. and Bowlby, J. (1991). An ethological approach to personality development. American Psychologist. 46(4), 333–341. https://doi.org/10.1037/0003- 066X.46.4.333
-
4. Kaynarpınar, D. (2019). The relationship between perceived social support snd psychological symptoms experienced by mothers whose babies are in the neonatal intensive care unit. Master's Thesis, Mersin University, Institute of Health Sciences. Department of Women's Health and Diseases. Mersin.
-
5. Çağlar, S., Ar, I., Yaşa, B. and Kurt, Ş. (2019). Family-centered care in the neonatal ıntensive care unit: mothers' views. STED/Journal of Continuous Medical Education. 28(2), 120-126.
-
6. Akbaş, M., Akça, E., Şenoğlu, A. and Gökyıldız Sürücü, Ş. (2019). Investigation of anxiety and depression levels of parents whose babies are in the neonatal intensive care unit. STED/Journal of Continuous Medical Education. 28(2), 87-97. doi: 10.17942/sted.457029
-
7. Asatekin, H.Y. (2021). The effect of perceived social support on anxiety and worry levels of mothers whose babies are in the neonatal intensive care unit. Master's Thesis, Istanbul University-Cerrahpasa, Graduate Education Institute, Department of Women's Health and Diseases. Istanbul.
-
8. Keysan, M.E. (2021). The effect of family-centered care program on preterm babies and their mothers in the neonatal intensive care unit. Master's Thesis, Istanbul University-Cerrahpasa, Graduate Education Institute, Department of Women's Health and Diseases, Istanbul.
-
9. Wewers, M.E. and Lowe, N.K. (1990). A critical review of visual analog scales in the measurement of clinical phenomena. Research in Nursing and Health. 13(4), 227-236.
-
10. Taylor A., Atkins, R., Kumar, R., Adams, D.and Glover, V. (2005). A new mother-to-ınfant bonding scale: links with early maternal mood. Arch Womens Mental Health. (8), 45–51. doi: 10.1007/s00737-005-0074-z.
-
11. Karakulak, H. (2021). Adaptation of the mother-ınfant attachment scale to turkish society (Aydın Example). Master's Thesis, Cumhuriyet University Health Sciences Institute Midwifery Program. Department of Women's Health and Diseases. Sivas.
-
12. Ulusoy, M., Şahin, N. and Erkman, H. (1998). Turkish version of the beck anxiety ınventory: psychometric properties. Journal of Cogn Psychother: An Int Quarterly. 12, 28-35.
-
13. Beck, A.T., Epstein, N., Brown, G. and Steer, R. (1998). A. An ınventory or measuring clinical anxiety: psychometricproperties. Journal of Consult Clin Psychol. 56, 893-897.
-
14. Ölçer, Z., Bakır, N. and Oskay, Ü. (2016). Self-efficacy and social support perceptions of high-risk pregnant women. Anatolian Journal of Nursing and Health Sciences. 19(1), 25-33. https://doi.org/10.17049/ahsbd.27714
-
15. Taşar, M.A., Tapçı, A.E., Baydar, A., Dallar, Y.B. and Çakır, İ. (2016). Do postpartum depression and anxiety of mothers affect the weight gain of babies? Gulhane Medical Journal. 58(3), 233–237. doi: 10.5455/Gulhane.187775
-
16. TDHS (Turkey Demographic and Health Survey). (2018). Turkey Demographic and Health Survey, Ankara: Hacettepe University Institute of Population Studies. http://Www.Sck.Gov.Tr/Wpcontent/Uploads/2020/08/TNSA2018_Ana_Rapor.Pdf, [Visit Date: 10.04.2023].
-
17. Karabulutlu, Ö. and Yavuz, C. (2021). Evaluation of the frequency of depression and anxiety levels in high-risk pregnancies. Caucasian Journal of Science. 8(1), 51-69. https://doi.org/10.48138/cjo.940892
-
18. Desdicioğlu, R., Selvi, Y. and Eray, İ.K. (2021). Evaluation of the effect of breastfeeding education given during the antenatal period on breastfeeding knowledge level and breastfeeding self-efficacy scale. Ankara Medical Journal. 21(1), doi: 10.5505/amj.2021.49140
-
19. Mutlu, S. (2020). The effect of covid 19 pandemic on the number and type of births in the 3rd level pandemic hospital in our region. Journal Biotechnoland Strategic Healthres. 4(2), 115-120. https://doi.org/10.34084/bshr.728865
-
20. Engin, N. and Ayyıldız, T. (2021). Examination of mother-infant attachment according to perception of motherhood and some variables. Adnan Menderes University Faculty of Health Sciences Journal. 5(3), 583-596. https://doi.org/10.46237/amusbfd.947004
-
21. Özdemir, K., Başkaya, Y. and İdare, A. (2021). Evaluation of the relationship between maternal attachment levels of mothers and perceived social support. Journal of Gynecology-Obstetrics and Neonatology Medicine. 18(1), 638-642. https://doi.org/10.38136/jgon.715703
-
22. Satılmış, İ.G. and Aktaş, S. (2023). Two extreme situations in ınterventions applied during birth in the world: “too little-too late” and “too much-too early” applications. Ordu University Journal of Nursing Studies. 6(1), 205-216. https://doi.org/10.38108/ouhcd.1081787
-
23. Takahashi, K., Ganchimeg, T., Ota, E, Vogel, J.P., Souza, J.P., Laopaiboon, M., Castro, J.P., Jayaratne, K., Ortiz-Panozo, E., Lumbiganon, P. and Mori, R. (2017). Prevalence of early ınitiation of breastfeeding and determinants of delayed initiation of breastfeeding: secondary analysis of the who global survey. Scientific Reports. 7(1), 1-10, 7:44868. https://doi.org/10.1038/srep44868
-
24. İnce, T., Aktaş, G., Aktepe, N. and Aydın, A. (2017). Evaluation of mothers' breastfeeding self-efficacy and characteristics affecting breastfeeding success. Journal Of Dr. Behcet Uz Children's Hospital. 7(3), doi:10.5222/buchd.2017.183
-
25. Ataman, H., Akarsu, Ö. and Budak, M.İ. (2022). Determination of the relationship between marital adjustment and prenatal attachment in high-risk pregnancies in the third trimester. Turkish Journal of Family Medicine and Primary Care.16(4), 670-680. https://doi.org/10.21763/tjfmpc.1097177
-
26. Gülşen, Ç. and Merih, Y.D. (2018). What support do mothers expect from whom in the postpartum period. Journal of Women's Health Nursing. 4(1), 20-34.
-
27. Küçükkaya, B. (2022). The effects of early half swaddling and kangaroo care practices on breastfeeding, mother-infant bonding, maternal sleep quality and postpartum depression in preterm infants. PhD Thesis, Trakya University, Institute of Health Sciences. Department of Women's Health and Diseases. Edirne.
-
28. Kabasakal, A. and Kitiş, Y. (2022). The effects of kangaroo care on mother-infant bonding and breastfeeding process in premature infants. Journal of Health Academy Kastamonu (SAK). 7(2), 260 - 274. https://doi.org/10.25279/sak.723534
-
29. Keklikçi, Y., Dorum, B.A. and Vatansever, A. (2020). Stress levels and coping methods of families with babies in the neonatal ıntensive care unit. Van Medical Journal. 27(2), 160-165. doi: 10.5505/Vtd.2020
-
30. Soysal, Ç. (2021). The effect of antenatal follow-up number on pregnancy outcomes. Gynecology-Obstetrics and Neonatology Medical Journal. 18(4), 1089-1094. https://doi.org/10.38136/jgon.1028739
-
31. Kaynak, S. (2022). The effect of video conferencing between preterm infants and their mothers on physiological parameters of infants and mother-infant bonding. PhD Thesis. Ege University. Institute of Health Sciences. Department of Women's Health and Diseases. Izmir.
-
32. Özşahin, Z., Akça, E., and Gökbulut, N. (2020). The relationship between postpartum depression level and maternal bonding. İnönü University Health Services Vocational School Journal. 8(3), 715-724. https://doi.org/10.33715/inonusaglik.757249
-
33. Çimen, K. and Varol, H. (2021). Maternal attachment level and affecting factors. Sakarya University Journal of Holistic Health. 4(3), 126-135. https://doi.org/10.54803/sauhsd.977480
Investigating The Relationship Between Anxiety Level and Maternal Attachment in Mothers With a Baby in The Neonatal Newborn Care Unit
Year 2025,
Volume: 9 Issue: 2, 21 - 33, 28.08.2025
Esra Özdemir
,
Meltem Mecdi Kaydırak
Abstract
The study was conducted to investigate the relationship between anxiety level and maternal attachment in women whose babies were in the neonatal intensive care unit (NICU). The study, conducted with 140 women whose babies were admitted to the hospital's NICU between April 2022 and September 2022, was planned in a descriptive and correlational design. Data were collected by face-to-face interview using the "Mother-Infant Description Questionnaire", the "Visual Analog Scale (VAS)", the "Mother-Infant Attachment Scale (MIAS)" and the "Beck Anxiety Inventory (BAI)". The mean age of the mothers was 28.48±5.66 years. The average total scores of the mothers were as follows: MICS= 14.85±2.13 and BAS= 7.21±6.33. It was found that the mothers who could not participate in the care of the baby had higher MICS scores (p= 0.045). It was found that mothers who attended regular check-ups during pregnancy had lower BAI scores (p= 0.005). Participants who received support from their mothers/fathers (p=0.021), husband (p=0.018) and friends (p=0.040) had lower BAI scores (p<0.05). Mothers who received support from their husbands' families had less anxiety (p=0.044). No statistical correlation was found between the MIAS and the BAI (r: -0.90; p: 0.290).
As a result of the study, it was found that although mothers whose babies were hospitalized in the NICU had anxiety, their attachment to their babies was not low. It was found that there was no significant relationship between mothers' anxiety levels and attachment. However, variables such as mothers' involvement in caring for their babies, the presence of family and social support, breastfeeding and the person from whom the information was obtained (nurse/midwife), and fear of losing the baby were identified as variables influencing anxiety and attachment.
Ethical Statement
Ethical approval for this study was obtained from the Social and Human Sciences Research Ethics Committee (Date: 14 March 2022; Approval No: E-74555795-050.01.04-334568).
Supporting Institution
This article has not received any financial/in-kind support.
References
-
1. Nacar, E.H. and Gökkaya, F. (2019). A Review on attachment and maternal bonding. Cyprus Turkish Journal of Psychiatry and Psychology. 1(1), 50-56. https://doi.org/10.35365/ctjpp.19.1.06
-
2. Balcı, M.E. (2022). Mother-infant attachment and related factors in mothers with premature babies in neonatal intensive care. Master's Thesis, Necmettin Erbakan University, Institute of Health Sciences. Department of Women's Health and Diseases. Konya.
-
3. Ainsworth, M.S. and Bowlby, J. (1991). An ethological approach to personality development. American Psychologist. 46(4), 333–341. https://doi.org/10.1037/0003- 066X.46.4.333
-
4. Kaynarpınar, D. (2019). The relationship between perceived social support snd psychological symptoms experienced by mothers whose babies are in the neonatal intensive care unit. Master's Thesis, Mersin University, Institute of Health Sciences. Department of Women's Health and Diseases. Mersin.
-
5. Çağlar, S., Ar, I., Yaşa, B. and Kurt, Ş. (2019). Family-centered care in the neonatal ıntensive care unit: mothers' views. STED/Journal of Continuous Medical Education. 28(2), 120-126.
-
6. Akbaş, M., Akça, E., Şenoğlu, A. and Gökyıldız Sürücü, Ş. (2019). Investigation of anxiety and depression levels of parents whose babies are in the neonatal intensive care unit. STED/Journal of Continuous Medical Education. 28(2), 87-97. doi: 10.17942/sted.457029
-
7. Asatekin, H.Y. (2021). The effect of perceived social support on anxiety and worry levels of mothers whose babies are in the neonatal intensive care unit. Master's Thesis, Istanbul University-Cerrahpasa, Graduate Education Institute, Department of Women's Health and Diseases. Istanbul.
-
8. Keysan, M.E. (2021). The effect of family-centered care program on preterm babies and their mothers in the neonatal intensive care unit. Master's Thesis, Istanbul University-Cerrahpasa, Graduate Education Institute, Department of Women's Health and Diseases, Istanbul.
-
9. Wewers, M.E. and Lowe, N.K. (1990). A critical review of visual analog scales in the measurement of clinical phenomena. Research in Nursing and Health. 13(4), 227-236.
-
10. Taylor A., Atkins, R., Kumar, R., Adams, D.and Glover, V. (2005). A new mother-to-ınfant bonding scale: links with early maternal mood. Arch Womens Mental Health. (8), 45–51. doi: 10.1007/s00737-005-0074-z.
-
11. Karakulak, H. (2021). Adaptation of the mother-ınfant attachment scale to turkish society (Aydın Example). Master's Thesis, Cumhuriyet University Health Sciences Institute Midwifery Program. Department of Women's Health and Diseases. Sivas.
-
12. Ulusoy, M., Şahin, N. and Erkman, H. (1998). Turkish version of the beck anxiety ınventory: psychometric properties. Journal of Cogn Psychother: An Int Quarterly. 12, 28-35.
-
13. Beck, A.T., Epstein, N., Brown, G. and Steer, R. (1998). A. An ınventory or measuring clinical anxiety: psychometricproperties. Journal of Consult Clin Psychol. 56, 893-897.
-
14. Ölçer, Z., Bakır, N. and Oskay, Ü. (2016). Self-efficacy and social support perceptions of high-risk pregnant women. Anatolian Journal of Nursing and Health Sciences. 19(1), 25-33. https://doi.org/10.17049/ahsbd.27714
-
15. Taşar, M.A., Tapçı, A.E., Baydar, A., Dallar, Y.B. and Çakır, İ. (2016). Do postpartum depression and anxiety of mothers affect the weight gain of babies? Gulhane Medical Journal. 58(3), 233–237. doi: 10.5455/Gulhane.187775
-
16. TDHS (Turkey Demographic and Health Survey). (2018). Turkey Demographic and Health Survey, Ankara: Hacettepe University Institute of Population Studies. http://Www.Sck.Gov.Tr/Wpcontent/Uploads/2020/08/TNSA2018_Ana_Rapor.Pdf, [Visit Date: 10.04.2023].
-
17. Karabulutlu, Ö. and Yavuz, C. (2021). Evaluation of the frequency of depression and anxiety levels in high-risk pregnancies. Caucasian Journal of Science. 8(1), 51-69. https://doi.org/10.48138/cjo.940892
-
18. Desdicioğlu, R., Selvi, Y. and Eray, İ.K. (2021). Evaluation of the effect of breastfeeding education given during the antenatal period on breastfeeding knowledge level and breastfeeding self-efficacy scale. Ankara Medical Journal. 21(1), doi: 10.5505/amj.2021.49140
-
19. Mutlu, S. (2020). The effect of covid 19 pandemic on the number and type of births in the 3rd level pandemic hospital in our region. Journal Biotechnoland Strategic Healthres. 4(2), 115-120. https://doi.org/10.34084/bshr.728865
-
20. Engin, N. and Ayyıldız, T. (2021). Examination of mother-infant attachment according to perception of motherhood and some variables. Adnan Menderes University Faculty of Health Sciences Journal. 5(3), 583-596. https://doi.org/10.46237/amusbfd.947004
-
21. Özdemir, K., Başkaya, Y. and İdare, A. (2021). Evaluation of the relationship between maternal attachment levels of mothers and perceived social support. Journal of Gynecology-Obstetrics and Neonatology Medicine. 18(1), 638-642. https://doi.org/10.38136/jgon.715703
-
22. Satılmış, İ.G. and Aktaş, S. (2023). Two extreme situations in ınterventions applied during birth in the world: “too little-too late” and “too much-too early” applications. Ordu University Journal of Nursing Studies. 6(1), 205-216. https://doi.org/10.38108/ouhcd.1081787
-
23. Takahashi, K., Ganchimeg, T., Ota, E, Vogel, J.P., Souza, J.P., Laopaiboon, M., Castro, J.P., Jayaratne, K., Ortiz-Panozo, E., Lumbiganon, P. and Mori, R. (2017). Prevalence of early ınitiation of breastfeeding and determinants of delayed initiation of breastfeeding: secondary analysis of the who global survey. Scientific Reports. 7(1), 1-10, 7:44868. https://doi.org/10.1038/srep44868
-
24. İnce, T., Aktaş, G., Aktepe, N. and Aydın, A. (2017). Evaluation of mothers' breastfeeding self-efficacy and characteristics affecting breastfeeding success. Journal Of Dr. Behcet Uz Children's Hospital. 7(3), doi:10.5222/buchd.2017.183
-
25. Ataman, H., Akarsu, Ö. and Budak, M.İ. (2022). Determination of the relationship between marital adjustment and prenatal attachment in high-risk pregnancies in the third trimester. Turkish Journal of Family Medicine and Primary Care.16(4), 670-680. https://doi.org/10.21763/tjfmpc.1097177
-
26. Gülşen, Ç. and Merih, Y.D. (2018). What support do mothers expect from whom in the postpartum period. Journal of Women's Health Nursing. 4(1), 20-34.
-
27. Küçükkaya, B. (2022). The effects of early half swaddling and kangaroo care practices on breastfeeding, mother-infant bonding, maternal sleep quality and postpartum depression in preterm infants. PhD Thesis, Trakya University, Institute of Health Sciences. Department of Women's Health and Diseases. Edirne.
-
28. Kabasakal, A. and Kitiş, Y. (2022). The effects of kangaroo care on mother-infant bonding and breastfeeding process in premature infants. Journal of Health Academy Kastamonu (SAK). 7(2), 260 - 274. https://doi.org/10.25279/sak.723534
-
29. Keklikçi, Y., Dorum, B.A. and Vatansever, A. (2020). Stress levels and coping methods of families with babies in the neonatal ıntensive care unit. Van Medical Journal. 27(2), 160-165. doi: 10.5505/Vtd.2020
-
30. Soysal, Ç. (2021). The effect of antenatal follow-up number on pregnancy outcomes. Gynecology-Obstetrics and Neonatology Medical Journal. 18(4), 1089-1094. https://doi.org/10.38136/jgon.1028739
-
31. Kaynak, S. (2022). The effect of video conferencing between preterm infants and their mothers on physiological parameters of infants and mother-infant bonding. PhD Thesis. Ege University. Institute of Health Sciences. Department of Women's Health and Diseases. Izmir.
-
32. Özşahin, Z., Akça, E., and Gökbulut, N. (2020). The relationship between postpartum depression level and maternal bonding. İnönü University Health Services Vocational School Journal. 8(3), 715-724. https://doi.org/10.33715/inonusaglik.757249
-
33. Çimen, K. and Varol, H. (2021). Maternal attachment level and affecting factors. Sakarya University Journal of Holistic Health. 4(3), 126-135. https://doi.org/10.54803/sauhsd.977480