A Qualitative Study on Mothers whose Babies in the Neonatal Intensive Care Unit/ Yenidoğan Yoğun Bakım Ünitesinde Bebeği Olan Anneler Üzerine Nitel Bir Araştırma

Öz

Bu araştırmada bebekleri Yeni Doğan Yoğun Bakım Ünitesi’nde (YDYBÜ) bulunan Doğu Anadolu Bölgesi’ndeki annelerin duygu ve düşüncelerini keşfetmeyi amaçladık. Bu araştırmada, betimleyici hermeneutik fenomenoloji paradigması kullanılmış ve Mart 2016'da Van ilinde (Doğu Anadolu/Türkiye) bulunan bir kamu ve bir özel hastanede on anne ile yarı yapılandırılmış görüşmeler yapılmıştır. Annelerin duygu ve düşüncelerine ilişkin “ilişkisel dayanıklılık kaynakları”, “yıkıcı ilişki kaynakları” ve “her iki ilişkisel kaynağın yarattığı etkiler” ana kategorilerini elde ettik. Anneler, bebeklerinin yeni doğan ünitesine yatırılmasıyla ilgili çoğunlukla hoş olmayan duygular hissederlerken; şükran veya iyimserlik duygusu gibi hoş duygular da açığa çıkmıştır. Doğu kültüründeki anneler bu tür zorlu bir sorunla karşılaştıklarında “direnç kaynakları” arasında “inanç” ve “çevresel destek” unsurlarını kullanabilmektedirler.

Anahtar Kelimeler

• Yenidoğan yoğun bakım ünitesi
• ilişkisel dayanıklılık kaynakları
• yıkıcı ilişkisel kaynaklar.

A Qualitative Study on Mothers whose Babies in the Neonatal Intensive Care Unit/ Yenidoğan Yoğun Bakım Ünitesinde Bebeği Olan Anneler Üzerine Nitel Bir Araştırma

Abstract

We aimed to explore the feelings and thoughts of eastern Anatolian mothers whose newborns are hospitalized in Neonatal Intensive Care Unit (NICU). This research employed a descriptive hermeneutical phenomenology paradigm and used semi-structured interviews with ten mothers, in one public and one private hospital located in the city of Van (Eastern Anatolia/Turkey) in March 2016. We found the main categories as “relational resilience sources”, “destructive relational sources” and “the effects of both relational sources” according to the feelings and thoughts of mothers. While mothers have mostly had unpleasant feelings about their baby’s hospitalization newborn unit, pleasant feelings also have been revealed such as a sense of gratitude or optimism. Mothers in eastern culture can trigger element of “faith” and “environmental support” among “resources of resilience” when they face this kind of challenging issue.

Keywords

• Newborn intensive care unit
• relational resilience sources
• destructive relational sources.

References

1. Aburn, G., Gott, M., & Hoare, K. (2016). What is resilience? An integrative review of the empirical literature. Journal of Advanced Nursing, 72(5), 980-1000. https://doi.org/10.1111/jan.12888
2. Ahn, Y.-M., & Kim, N.-H. (2007). Parental perception of neonates, parental stress and education for NICU parents. Asian Nursing Research, 1(3), 199-210. https://doi.org/10.1016/S1976-1317(08)60022-5 Bellido-González, M., Robles-Ortega, H., Castelar-Ríos, M. J., Díaz-López, M. Á, Gallo-Vallejo, J. L., Moreno-Galdó, M. F., & de los Santos-Roig, M. (2019). Psychological distress and resilience of mothers and fathers with respect to the neurobehavioral performance of small-for-gestational-age newborns. Health and Quality of Life Outcomes, 17(54), 1-13. https://doi.org/10.1186/s12955-019-1119-8
3. Creswell, J. W. (2018). Nitel araştırma yöntemleri beş yaklaşıma göre nitel araştırma ve araştırma deseni [Qualitative inquiry & research design choosing among five approaches] (M. Bütün, S. B. Demir, Trans. Eds.). Ankara: Siyasal Kitabevi. (Original work published 2013).
4. Cristóbal-Cañadas, D., Bonillo-Perales, A., Casado-Belmonte, M. Del P., Galera-Martínez R., & Parrón-Carreño, T. (2021). Mapping the field in stress, anxiety, and postpartum depression in mothers of preterm infants in Neonatal Intensive Care. Children, 8(9), 730-745. https://doi.org/10.3390/children8090730
5. Çakır Koçak Y, & Sevil Ü. (2015). Kadın doğum kliniklerinde yatan hastalara kültürlerarası yaklaşım. Türkiye Klinikleri Journal, 1(3), 52-61.
6. De Rouck, S., & Leys, M. (2009). Information needs of parents of children admitted to a neonatal intensive care unit: A review of the literature (1990-2008). Patient Education and Counseling, 76(2), 159-173. https://doi.org/10.1016/j.pec.2009.01.014
7. Dudek-Shriber, L. (2004). Parent stress in the neonatal intensive care unit and the influence of parent and infant characteristics. The American Journal of Occupational Therapy, 58(5), 509-520. https://doi.org/10.5014/ajot.58.5.509
8. Erdoğan, Ö., & Uçukoğlu, H. (2011). İlköğretim okulu öğrencilerinin anne-baba tutumu algıları ile atılganlık ve olumsuz değerlendirilmekten korkma düzeyleri arasındaki ilişkiler. Kastamonu Eğitim Dergisi, 19(1), 51-72.

9. Fegran, L., Helseth S., Fagermoen, M. S. (2008). A comparison of mothers’ and fathers’ experiences of the attachment process in a neonatal intensive care unit. Journal of Clinical Nursing, 17(6), 810-816. https://doi.org/10.1111/j.1365-2702.2007.02125.x
10. Fernández Medina, I. M., Granero-Molina, J., Fernández-Sola, C., Hernández-Padilla, J. M., Camacho Ávila, M., & López Rodríguez, M. D. M. (2018). Bonding in neonatal intensive care units: Experiences of extremely preterm infants’ mothers. Women and Birth, 31(4), 325-330. https://doi.org/10.1016/j.wombi.2017.11.008
11. Flacking, R., Ewald, U., Nyqvist, K. H., & Starrin, B. (2006). Trustful bonds: a key to ‘‘becoming a mother’’ and to reciprocal breastfeeding. Stories of mothers of very preterm infants at a neonatal unit. Social Science & Medicine, 62(1), 70-80. https://doi.org/10.1016/j.socscimed.2005.05.026
12. Garmezy, N., & Masten, A. S. (1986). Stress, competence, and resilience: Common frontiers for therapist and psychopathologist. Behavior Therapy, 17(5), 500-521. https://doi.org/10.1016/S0005-7894(86)80091-0
13. Grosik, C., Snyder, D., Cleary, G. M., Breckenridge, D. M., & Tidwell, B. (2013). Identification of internal and external stressors in parents of newborns in intensive care. The Permanente Journal, 17(3), 36-41. https://doi.org/10.7812/TPP/12-105
14. Guimarães, H. (2015). The importance of parents in the neonatal intensive care units. Journal of Pediatric and Neonatal Individualized Medicine, 4(2), 1-3.
15. Hane, A. A., Myers, M. M., Hofer, M. A., Ludwig, R. J., Halperin, M. S., Austin, J., … Welch, M. G. (2015). Family nurture intervention improves the quality of maternal caregiving in the neonatal intensive care unit: evidence from a randomized controlled trial. Journal of Developmental and Behavioral Pediatrics, 36(3), 188-196. https://doi.org/10.1097/DBP.0000000000000148
16. Hatunoğlu, Y., Hatunoğlu, A., & Avcı, M. A. (2014). Doğu ve Güneydoğu Anadolu’da kadın problemlerine genel bir bakış, özelde Ağrı Doğubeyazıt ve Muş Malazgirt yöresinde kadın dışlanmışlığının sosyolojik ve psikolojik boyutu üzerine değerlendirme. Akademik Sosyal Araştırmalar Dergisi, 2(2), 243-252. https://doi.org/10.16992/ASOS.146 Heerman, J. A., Wilson, M. E., & Wilhelm, P. A. (2005). Mothers in the NICU: outsider to partner. Pediatric Nursing, 31(3), 176-200.
17. Ho, S.-S., Holloway, A., & Stenhouse, R. (2019). Analytic methods’ considerations for the translation of sensitive qualitative data from Mandarin into English. International Journal of Qualitative Methods, 18, 1-6. https://doi.org/10.1177/1609406919868354
18. Ichijima, E. (2009). Nursing roles in parental support: A cross-cultural comparison between neonatal intensive care units in New Zealand and Japan [Unpublished thesis]. University of Canterbury.
19. Ionio, C., Mascheroni, E., Colombo, C., Castoldi, F., & Lista, G. (2019). Stress and feelings in mothers and fathers in NICU: identifying risk factors for early interventions. Primary Health Care Research & Development, 20(e81), 1-7. https://doi.org/10.1017/S1463423619000021
20. Johnson, A. N. (2016). Stress beyond the neonatal intensive care unit (NICU) discharge: Implications to outcome. Pediatrics and Neonatal Nursing, 3(1), 15-19. https://doi.org/10.17140/PNNOJ-3-120 Jurczak, A., Hop, I., Wieder-Huszla, S., Stanisławska, M., Branecka-Woźniak, D., & Grochans, E. (2015). The level of stress experienced by parents of infants hospitalized in a neonatal intensive care unit. Journal of Public Health, Nursing and Medical Rescue, 1, 32-38.
21. Küçükyıldız, D. (2017). Atma Türkülerde gelin-kaynana çatışması. Anasay, 1, 57-69.
22. Lam, J., Spence, K., & Halliday, R. (2007). Parents’ perception of nursing support in the neonatal intensive care unit (NICU). Neonatal, Paediatric and Child Health Nursing, 10(3), 19-25.
23. Latour, J. M., Hazelzet, J. A., Duivenvoorden, H. J., & van Goudoever, J. B. (2010). Perceptions of parents, nurses, and physicians on neonatal intensive care practices. The Journal of Pediatrics, 157(2), 215-220. https://doi.org/10.1016/j.jpeds.2010.02.009
24. Lee, S. K., & O’Brien, K. (2014). Parents as primary caregivers in the neonatal intensive care unit. Cmaj, 186(11), 845-847. https://doi.org/10.1503/cmaj.130818
25. Magliyah, A. F., & Razzak, M. I. (2015). The parents' perception of nursing support in their neonatal intensive care unit (NICU) experience. International Journal of Advanced Computer Science and Applications, 6(2), 153-158. https://doi.org/10.14569/IJACSA.2015.060222
26. Magruder, L. (2021). African American Mothers’ experience in the neonatal intensive care unit [Unpublished doctoral thesis]. Walden University.
27. Margaret, B. E., Shetty S., Lewis, L. E., & Bhat, R. Y. (2014). Maternal anxiety and family support among mothers of neonates admitted in neonatal intensive care unit. Journal of Nursing and Health Science, 3(5), 40-43.
28. Merey, Z., & Şentepe Lokmanoğlu, A. (2019). Yenidoğan yoğun bakım ünitesinde bebeği yatan annelerin dini başa çıkma süreçleri. Bilimname, 37, 1117-1153. https://doi.org/10.28949/bilimname.534685 Moustakas, C. (1994). Phenomenological research methods. London, Thousand Oaks, New Delhi: Sage Publications.
29. Okito, O. A., Soghier, L., Fratantoni, K., Streisand, R., Tully, C., & Herrera, N. (2019). Parental resilience and psychological distress in the neonatal intensive care unit (Parent Study). Pediatrics, 144(2 Meeting Abstract), 703. https://doi.org/10.1542/peds.144.2_MeetingAbstract.703
30. Pişkin, G. (2008). Günümüzde Türkiye’de sinema filmleriyle televizyon dizilerinde kadınlar ve töre. Doğu Anadolu Bölgesi Araştırmaları, 6(2), 39-46.
31. Ramos, F. P., Enumo, S. R. F., & de Paula, K. M. P. (2017). Maternal coping with baby hospitalization at a neonatal intensive care unit. Paidéia (Ribeirão Preto), 27(67), 10-19. https://doi.org/10.1590/1982-43272767201702
32. Rossman, B., Greene, M. M., Kratovil, A. L., & Meier P. P. (2017). Resilience in mothers of very-low-birth-weight infants hospitalized in the NICU. Journal of Obstetric, Gynecologic & Neonatal Nursing, 46(3), 434-445. https://doi.org/10.1016/j.jogn.2016.11.016
33. Stake, R. E. (1995). The art case study research. Thousand Oaks, California: Sage Publications.
34. Taylor, Z. E., & Conger, R. D. (2017). Promoting strengths and resilience in single-mother families. Child Development, 88(2), 350-358. https://doi.org/10.1111/cdev.12741
35. Tropiano, L. M. C. C., Fiamenghi-Jr, G. A., & Blascovi-Assis, S. M. (2017). Mothers and premature infants’ emotional interactions in a neonatal infant care unit: Case studies. European Scientific Journal, 13(36), 85-92. https://doi.org/10.19044/esj.2017.v13n36p85
36. Valizadeh, L., Hosseini, M. B., Heydarpoor Damanabad, Z., Rahkar Farshi, M., Asgari Jafarabadi, M., & Ranjbar Kochaksaraie, F. (2016). Effect of NICU department orientation program on mother’s anxiety: A randomized clinical trial. Journal of Caring Sciences, 5(3), 205-214. https://doi.org/10.15171/jcs.2016.022
37. Vazguez, V., & Cong, X. (2014). Parenting the NICU infant: A meta-etnographic synthesis. International Journal of Nursing Sciences, 1(3), 281-290. https://doi.org/10.1016/j.ijnss.2014.06.001
38. Walsh, F. (2003). Family resilience: A framework for clinical practice. Family Process, 42(1), 1-18. https://doi.org/10.1111/j.1545-5300.2003.00001.x
39. Woodhart, L., Goldstone, J., & Hartz, D. (2018). The stories of women who are transferred due to threat of preterm birth. Women and Birth, 31(4), 307-312. https://doi.org/10.1016/j.wombi.2017.10.015 Yavuz, Ş. (2015). Ataerkil egemen erkeklik değerlerinin üretiminde kadınların rolü: Trabzon örneği. Fe Dergi, 7(1), 117-130.