Enhancing Maternal Self-efficacy in Caring for Preterm Infants with Ventilator through a Telehealth Program: A Randomized Controlled Trial

Authors

  • Kritsana Kongsaenkaew Master of Nursing Science Program in Pediatric Nursing, Mahidol University, Thailand.
  • Somsiri Rungamornarat Faculty of Nursing, Mahidol University, Thailand.
  • Sudaporn Payakkaraung Faculty of Nursing, Mahidol University, Thailand.

DOI:

https://doi.org/10.60099/prijnr.2024.264464

Keywords:

Maternal self-efficacy, Nursing, Preterm infants, Randomized controlled trial, Telehealth, Ventilator

Abstract

Telehealth is increasingly important in nursing, encouraging mothers of preterm infants with ventilators to have confidence in their infant care. This study investigated the impact of a telehealth program on maternal self-efficacy in caring for preterm infants with ventilators in the early postpartum period. We employed a randomized controlled trial using the block allocation method, enrolled 42 mothers of preterm infants receiving ventilators and randomly assigned 21 in the experiment group and 21 in the control group. The experimental group received asynchronous and synchronous telehealth programs for six days to enhance their self-efficacy. Data were obtained using the demographic data questionnaire and the maternal self-efficacy questionnaire. Data were analyzed using the Chi-square test, Fisher’s Exact test, Mann–Whitney U test, independent t-test, and paired t-test.

After completing the program, the experimental group had a significantly higher mean score of maternal perceived self-efficacy than the control group, and this was significantly higher than before the trial. A telehealth program is effective for mothers with preterm infants with ventilators. Nurses should allow the mothers to practice care activities with infants at least once before discharge and when they arrive home and provide health information via telehealth. These can enhance maternal self-efficacy in caring for premature infants with ventilators in the first week of life. However, further testing of the program in other settings is needed before widespread implementation.

References

Valipour S, Estebsari F, Nasiri M, Vasli P. Predictors of readiness for discharge in mothers of preterm infants: the role of stress, self–efficacy and perceived social support. Asian Pac J Reprod. 2022;11(6):269-75. doi:10.4103/2305-0500.356845. DOI: https://doi.org/10.4103/2305-0500.356845

Novak JL, Vittner D. Parent engagement in the NICU. J Neonatal Nurs. 2021;27(4):257-62. doi:10.1016/j.jnn.2020.11.007. DOI: https://doi.org/10.1016/j.jnn.2020.11.007

Sarapat P, Fongkaew W, Jintrawet U, Mesukko J, Ray L. Perceptions and practices of parents in caring for their hospitalized preterm infants. Pacific Rim Int J Nurs Res. 2017;21(3):220-33.

Apedani DB, Koduah A, Druye AA, Ebu NI. Experiences of mothers with preterm babies on support services in neonatal intensive care unit of a mission hospital in Ghana. Int J Africa Nurs Sci. 2021;15:100366. doi:10.1016/j.ijans.2021.100366. DOI: https://doi.org/10.1016/j.ijans.2021.100366

Spinelli M, Frigerio A, Montali L, Fasolo M, Spada MS, Mangili G. ‘I still have difficulties feeling like a mother’: the transition to motherhood of preterm infants mothers. Psychol Health. 2016;31(2):184-204. doi:10.1080/08870446.2015.1088015. DOI: https://doi.org/10.1080/08870446.2015.1088015

Namprom N, Picheansathian W, Jintrawet U, Chotibang J. The effect of maternal participation in preterm care and improved short-term growth and neurodevelopment outcomes. J Neonatal Nurs. 2018;24(4):196-202. doi:10.1016/j.jnn.2018.03.003. DOI: https://doi.org/10.1016/j.jnn.2018.03.003

Namprom N, Woragidpoonpol P, Altimier L, Jintrawet U, Chotibang J, Klunklin P. Maternal participation on preterm infants care reduces the cost of delivery of preterm neonatal healthcare services. J Neonatal Nurs. 2020;26(5):291- 6. doi:10.1016/j.jnn.2020.03.005. DOI: https://doi.org/10.1016/j.jnn.2020.03.005

Lv B, Gao XR, Sun J, Li TT, Liu ZY, Zhu LH, Latour JM. Family-centered care improves clinical outcomes of very-low-birth-weight infants: a quasi-experimental study. Front Pediatr. 2019 Apr 12;7:138. doi:10.3389/fped.2019.00138. DOI: https://doi.org/10.3389/fped.2019.00138

Pineda R, Bender J, Hall B, Shabosky L, Annecca A, Smith J. Parent participation in the neonatal intensive care unit: predictors and relationships to neurobehavior and developmental outcomes. Early Hum Dev. 2018 Feb;117:32-8. doi:10.1016/j.earlhumdev.2017.12.008. DOI: https://doi.org/10.1016/j.earlhumdev.2017.12.008

Reiter A, De Meulemeester J, Kenya-Mugisha N, Tagoola A, Kabajaasi O, Wiens MO, et al. Parental participation in the care of hospitalized neonates in low- and middle-income countries: a systematic review and meta-analysis. Front Pediatr. 2022; 10:987228. doi:10.3389/fped.2022.987228. DOI: https://doi.org/10.3389/fped.2022.987228

Schepp K. Psychometric assessment of the preferred participation scale for parents of hospitalized children. University of Washington, School of Nursing: WA; 1995.

Heo YJ, Oh WO. The effectiveness of a parent participation improvement program for parents on partnership, attachment infant growth in a neonatal intensive care unit: a randomized controlled trial. Int J Nurs Stud. 2019 Jul; 95:19-27. doi:10.1016/j.ijnurstu.2019.03.018. DOI: https://doi.org/10.1016/j.ijnurstu.2019.03.018

Liu TT, Lei MJ, Li YF, Liu YQ, Meng LN, Jin CD. Effects of parental involvement in infant care in neonatal intensive care units: a meta-analysis. Front Nurs. 2018;5:207-15. doi:10.1515/fon-2018-0028. DOI: https://doi.org/10.1515/fon-2018-0028

Treherne SC, Feeley N, Charbonneau L, Axelin A. Parents’ perspectives of closeness and separation with their preterm infants in the NICU. J Obstet Gynecol Neonatal Nurs. 2017 Sep-Oct;46(5):737-47. doi:10.1016/j.jogn.2017.07.005. DOI: https://doi.org/10.1016/j.jogn.2017.07.005

Helmer CS, Thornberg UB, Mörelius E. An early collaborative intervention focusing on parent-infant interaction in the neonatal period. A descriptive study of the developmental framework. Int J Environ Res Public Health. 2021;18(12): 6656. doi:10.3390/ijerph18126656. DOI: https://doi.org/10.3390/ijerph18126656

Raiskila S, Axelin A, Toome L, Caballero S, Tandberg BS, Montirosso R, et al. Parents’ presence and parent-infant closeness in 11 neonatal intensive care units in six European countries vary between and within the countries. Acta Paediatr. 2017 Jun;106(6):878-88. doi:10.1111/apa.13798. DOI: https://doi.org/10.1111/apa.13798

Bandura A. Self-efficacy: the exercise of control. New York, NY: WH Freeman; 1997.

Bahmanpour S, Farahani AS, Nourian M, Nasiri M, Nikfarid L, Derakhshan HB. The impact of telenursing on hope and perceived self-efficacy of the mothers of premature infants after discharge from the NICU. J Neonatal Nurs. 2023; 29(1):164-8. doi:10.1016/j.jnn.2022.05.001. DOI: https://doi.org/10.1016/j.jnn.2022.05.001

Chamgurdani FK, Barkin JL, Esmaeilpour K, et al. The effect of counseling with a skills training approach on maternal functioning: a randomized controlled clinical trial. BMC Womens Health. 2020;20(1):51. doi:10.1186/s12905-020-00914-w. DOI: https://doi.org/10.1186/s12905-020-00914-w

Liyana Amin NA, Tam WWS, Shorey S. Enhancing first-time parents’ self-efficacy: a systematic review and meta-analysis of universal parent education interventions’ efficacy. Int J Nurs Stud. 2018 Jun;82:149-62. doi:10.1016/j.ijnurstu.2018.03.021. DOI: https://doi.org/10.1016/j.ijnurstu.2018.03.021

Bembich S, Tripani A, Mastromarino S, Di Risio G, Castelpietra E, Risso FM. Parents experiencing NICU visit restrictions due to COVID-19 pandemic. Acta Paediatr. 2021 Mar;110(3):940-1. doi:10.1111/apa.15620. DOI: https://doi.org/10.1111/apa.15620

Bin-Nun A, Palmor-Haspal S, Mimouni FB, Kasirer Y, Hammerman C, Tuval-Moshiach R. Infant delivery and maternal stress during the COVID-19 pandemic: a comparison of the well-baby versus neonatal intensive care environments. J Perinatol. 2021 Nov;41(11):2614-20. doi:10.1038/s41372-021-01016-7. DOI: https://doi.org/10.1038/s41372-021-01016-7

Xue A, Oros V, Marca-Ghaemmaghami P, Scholkmann F, Righini-Grunder F, Natalucci G, et al. New parents experienced lower parenting self-efficacy during the COVID-19 pandemic lockdown. Children (Basel). 2021 Jan 24;8(2):79. doi:10.3390/children8020079. DOI: https://doi.org/10.3390/children8020079

Murray PD, Swanson JR. Visitation restrictions: is it right and how do we support families in the NICU during COVID-19? J Perinatol. 2020 Oct;40(10):1576-81. doi:10.1038/s41372-020-00781-1. DOI: https://doi.org/10.1038/s41372-020-00781-1

Ranu J, Sauers-Ford H, Hoffman K. Engaging and supporting families in the neonatal intensive care unit with telehealth platforms. Semin Perinatol. 2021 Aug;45(5):151426. doi:10.1016/j.semperi.2021.151426. DOI: https://doi.org/10.1016/j.semperi.2021.151426

WHO Global Observatory for eHealth. Telemedicine: opportunities and developments in member states: report on the second global survey on eHealth. Geneva: World Health Organization; 2010. Available from: https://iris.who.int/bitstream/handle/10665/44497/9789241564144_eng.pdf?sequence=1&isAllowed=y

Westwood AR. Telehealth and maternity. Br J Midwifery. 2021;29(6):352-5. doi:10.12968/bjom.2021.29.6.352. DOI: https://doi.org/10.12968/bjom.2021.29.6.352

Sadek BN, Abdalla ZA, Haleem SAA, Ali EA. Effect of electronic-based instructions guide on supporting mothers of preterm infants regarding safe breastfeeding during Covid-19 pandemic. Egypt J Health Care. 2021; 12(2): 1979-97. doi:10.21608/ejhc.2021.316043. DOI: https://doi.org/10.21608/ejhc.2021.316043

Ozawa M, Sakaki H, Meng X. Family presence restrictions and telemedicine use in neonatal intensive care units during the coronavirus disease pandemic. Children (Basel). 2021 Jul 12;8(7):590. doi:10.3390/children8070590. DOI: https://doi.org/10.3390/children8070590

Nourani A, Ayatollahi H, Mirnia K. A Smart phone application for the mothers of premature infants. IRBM. 2019;40(5): 263-9. doi:10.1016/j.irbm.2019.04.006. DOI: https://doi.org/10.1016/j.irbm.2019.04.006

Owen N. Feasibility and acceptability of using telehealth for early intervention parent counselling. Adv Ment Health. 2020;18(1):39-49. doi:10.1080/18387357.2019.1679026. DOI: https://doi.org/10.1080/18387357.2019.1679026

Mobbs C, Spittle A, Johnston L. PreEMPT (Preterm infant Early Intervention for Movement and Participation Trial): Feasibility outcomes of a randomised controlled trial. Early Hum Dev. 2022 Mar;166:105551. doi:10.1016/j.earlhumdev.2022.105551. DOI: https://doi.org/10.1016/j.earlhumdev.2022.105551

Outhwaite LA. App-based support for parental self-efficacy in the first 1,000 days: a randomized control trial. Front Psychol. 2023 Jan 12;13:998170. doi:10.3389/fpsyg.2022.998170. DOI: https://doi.org/10.3389/fpsyg.2022.998170

Cohen, J. Statistical power analysis for the behavioral sciences, 2nd ed. Hillsdale, NJ: Lawrence Erlbaum Associates, Publishers; 1988. Available from: https://www.utstat.toronto.edu/~brunner/oldclass/378f16/readings/CohenPower.pdf

Damrongrak P, Prasopkittikun T, Tilokskulchai F, Ngerncham S. Effects of family-centered care on self-efficacy in participatory involvement in newborn care and satisfaction towards nursing service of mothers in Nur Sci J Thail J Nurs Sci. 2012;30(2):70-9. Available from: https://www.tci-thaijo.org/index.php/ns/article/view/10294 (in Thai)

Askary Kachoosangy R, Shafaroodi N, Heidarzadeh M, Qorbani M, Bordbbr A, Hejazi Shirmard M, et al. Increasing mothers’ confidence and ability by creating opportunities for parent empowerment (COPE): a randomized, controlled trial. Iran J Child Neurol. 2020 Winter;14(1):77-83. PMID: 32021631.

George K, Rowe J, Barnes M, Kearney L. The parenting premmies support program: designing and developing a mobile health intervention for mothers of preterm infants. Cogent Soc Sci. 2021;7(1):1865617. doi:10.1080/23311886.2020.1865617. DOI: https://doi.org/10.1080/23311886.2020.1865617

Fang Y, Boelens M, Windhorst DA, Raat H, van Grieken A. Factors associated with parenting self-efficacy: a systematic review. J Adv Nurs. 2021 Jun;77(6):2641-61. doi:10.1111/jan.14767. DOI: https://doi.org/10.1111/jan.14767

Labrie NHM, van Veenendaal NR, Ludolph RA, Ket JCF, van der Schoor SRD, van Kempen AAMW. Effects of parent-provider communication during infant hospitalization in the NICU on parents: a systematic review with meta-synthesis and narrative synthesis. Patient Educ Couns. 2021 Jul;104(7): 1526-52. doi:10.1016/j.pec.2021.04.023. DOI: https://doi.org/10.1016/j.pec.2021.04.023

Heidary S, Heidari H, Choopani R, Sedehi M. The effect of the supportive care program based on Bandura’s self-efficacy on stress and participation of the mothers of the neonates admitted to neonatal intensive care unit. J Edu Health Promot. 2023;12:265. doi:10.4103/jehp.jehp_899_22. DOI: https://doi.org/10.4103/jehp.jehp_899_22

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Published

2023-11-27

How to Cite

1.
Kongsaenkaew K, Rungamornarat S, Payakkaraung S. Enhancing Maternal Self-efficacy in Caring for Preterm Infants with Ventilator through a Telehealth Program: A Randomized Controlled Trial. PRIJNR [Internet]. 2023 Nov. 27 [cited 2024 Oct. 6];28(1):88-102. Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/264464