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Hospitalized preterm infants are separated from parents in many countries, including Thailand, neonatal care has promoted parental involvement in caring for their infants to support breastfeeding and parent-infant bonding. This descriptive qualitative approach aimed to gain a better understanding of Thai parental involvement in caring for hospitalized preterm infants. Purposive sampling was used to select 22 parents, two grandmothers, and three nurses at a sick newborn unit of a regional hospital in Eastern Thailand. Data were collected through in-depth interviews, participant observation and clinical document reviews, from September 2014 to October 2015. The data were analyzed by using a thematic analysis.
The findings revealed parents’ perceptions and caregiving practices regarding their involvement in caring for hospitalized preterm infants that could be categorized into five categories, 1) uncertainty about their child’s condition, 2) desire to be close to their preterm babies, 3) lack of confidence in providing care for their preterm babies, 4) overcoming difficulties in breastfeeding, and 5) socio-cultural factors influencing parental involvement. Parental involvement in caring for hospitalized preterm infants is crucial to the quality of infant care. The findings of this study could assist in evidence for developing a nursing intervention program to enhance and support parental involvement in caring for preterm infants.
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2. Supapannachart S. Public health news. Thairath. 2013 March 11[cited 2016 August 26]. Available from https:// www.thairath.co.th/content/331737
3. Kenner C, Ellerbee S. Nursing care for high risk newborn. In Lowdermilk DL, Perry SE, Cashion K, Alden KR, editors. Maternity & Women’s Health Care. St.Louis: Mosby Elsevier; 2012. p. 894-930.
4. Smith GC, Gutovich J, Smyser C, Pineda R, Newnham C, Tjoeng TH, et al. Neonatal intensive care unit stress is associated with brain development in preterm infants. Ann Neurol. 2011; 70(4): 541-9.
5. Wachman EM, Lahav A. The effects of noise on preterm infants in the NICU. Arch Dis Child Fetal Neonatal Ed. 2011; 96(4): F305-9.
6. Fraser D. Health problems of newborns. In Hockenberry MJ, Wilson D. (Eds.), Wong’s essentials of pediatric nursing (9th ed) (pp.228-307). St.Louis: Mosby Elsevier; 2013.
7. Ionio C, Colombo C, Brazzoduro V, Mascheroni E, Confalonieri E, Castoldi F, et al. Mothers and fathers in NICU: The impact of preterm birth on parental distress. Eur J Psychol. 2016; 12(4): 604-21.
8. Shelton SL, Meaney-Delman DM, Hunter M, Lee SY. Depressive symptoms and the relationship of stress, sleep, and well-being among NICU mothers. J Nurs Educ Pract. 2014; 4(8), 70-9.
9. Malakouti J, Jabraeeli M, Valizadeh S, Babapour J. Mothers’ experience of having a preterm infant in the neonatal intensive care unit, a phenomenological study. Iran J Crit Care Nurse. 2013; 5(4): 172-81.
10. Flacking R, Lehtonen L, Thomson G, Axelin A, Ahlqvist S, Moran VH, et al. Closeness and separation in neonatal intensive care. Acta Paediatr. 2012; 101(10): 1032-7.
11. Bastani F, Abadi TA, Haghani H. Effect of family-centered care on improving parental satisfaction and reducing readmission among premature infants: A Randomized Controlled Trial. J Clin Diagn Res. 2015; 9(1): SC04-8.
12. Russell G, Sawyer A, Rabe H, Abbott J, Gyte G, Duley L, et al. Parents’ views on care of their very premature babies in neonatal intensive care units: A qualitative study. BMC Pediatr. 2014; 14:230.
13. Blomqvist YT, Nyqvist KH. Swedish mothers’ experience of continuous kangaroo mother care. J Clin Nurs. 2011; 20(9-10): 1472-80.
14. Bjork M, Thelin A, Peterson I, Hammarlund K. A journey filled with emotions-mothers’ experiences of breastfeeding their preterm infant in a Swedish neonatal ward. Breastfeed Rev. 2012; 20(1): 25-31.
15. Skene C, Franck L, Curtis P, Gerrish K. Parental involvement in neonatal comfort care. J Obstet Gynecol Neonatal Nurs. 2012; 41(6): 786-97.
16. Bracht M, O’Leary L, Lee SK, O’Brien K. Implementing family-integrated care in the NICU: A parent education and support program. Adv Neonatal Care. 2013; 13(2): 115-26.
17. Melnyk BM, Feinstein NF, Alpert-Gillis L, Fairbanks E, Crean HF, Sinkin RA, et al. Reducing premature infants’ length of stay and improving parents’ mental health outcomes with the Creating Opportunities for Parent Empowerment (COPE) neonatal intensive care unit program: A randomized, controlled trial. Pediatrics. 2006; 118(5): e1414-27.
18. Holditch-Davis D, White-Traut RC, Levy JA, O’Shea TM, Geraldo V, David RJ. Maternally administered interventions for preterm infants in the NICU: Effects on maternal psychological distress and mother-infant relationship. Infant Behav Dev. 2014; 37(4): 695-710.
19. Gathwala G, Singh B, Singh J. Effect of kangaroo mother care on physical growth, breastfeeding and its acceptability. Trop Doct. 2010; 40(4): 199-202.
20. Gregson S, Blacker J. Kangaroo care in preterm or low birth weight babies in a postnatal ward. BJM. 2011; 19(9): 568-77.
21. Sannino P, Gianni ML, De Bon G, Fontana C, Picciolini O, Plevani L, et al. Support to mothers of premature babies using NIDCAP method: A non-randomized controlled trial. Early Hum Dev. 2016; 95:15-20.
22. Als H, McAnulty GB. The Newborn Individualized Developmental Care and Assessment Program (NIDCAP) with Kangaroo Mother Care (KMC): Comprehensive Care for Preterm Infants. Curr Womens Health Rev. 2011; 7(3): 288-01.
23. Pholanun P, Kantawang S, Klunklin P. Maternal participation in caring for preterm infants in neonatal intensive care unit and related factors. Nursing Journal. 2013; 40(1): 89-101. [in Thai].
24. Supaporn J, Klunklin P, Urharmnuay M. Maternal participation in caring for neonates with jaundice receiving phototherapy and related factors. Nursing Journal. 2013; 40(1): 115-26. [in Thai].
25. Tepmalapunsiri P, Chaimongkol N, & Pongjaturawit Y. Relationships between parent participation to care for sick newborn and quality of nursing care as perceive by the parent. Journal of Faculty of Nursing Burapha University. 2011; 19(1), 91-101. [in Thai].
26. Pronlerttaveekul S, Prasopkittikun T, Sangperm P. Factors associated with mothers’ participation in care for hospitalized newborns. J Nurs Sci. 2013; 31(1): 59-69. [in Thai].
27. Bunmachu D, Theunnadee SK. Effects of promotion program on perceived self-efficacy preterm caring behaviors of mothers and health status of preterm babies. Journal of Nursing and Health Care. 2015; 33(4): 150-8. [in Thai].
28. Sawattrakool N. Effects of perceived self-efficacy promotion program on maternal stress and role attainment among mothers of hospitalized preterm infants. [Unpublished master’s thesis]. Khon Kaen, Thailand: Khon Kaen University; 2011. [in Thai].
29. Suknithi J, Thampanichawat W, Wichiencharoen K, Lerthamatewe W. Impact of oral stimulation program on nursing mothers’ knowledge of oral stimulation and prematurely born infants’ sucking ability. TJNC. 2012; 27(1): 78-91. [in Thai].
30. Phanthufak M, Phumonsakuk S, Chareonpol O. The effect of a maternal role promoting program on maternal-infant attachment, maternal role satisfaction, competency in infant behavioral learning and infant growth. Rama Nurs J. 2009; 15(2): 149-161. [in Thai].
31. Sangsawang R, Punthmatharith B, Prateepchaikul L. Effect of kangaroo care on father-preterm infant bonding. TJNC. 2010; 25(2): 100-10. [in Thai].
32. Pathom-aree N. Maternal participation in caring for newborns in a neonatal intensive care unit. [Unpublished master’s thesis]. Chiang Mai, Thailand: Chiang Mai University; 2008. [in Thai].
33. Rungamornrat S, Karnjanawanich W, Muangyoo U. Maternal participation in caring for a premature infant with respirator. J Nurs Sci. 2012; 30(4): 49-60. [in Thai].
34. Coyne IT. Parent participation: a concept analysis. J Adv Nurs. 1996; 23(4): 733-40.
35. Chang Lee S-N, Long A, Boore J. Taiwanese women’s experiences of becoming a mother to a very-low-birth-weight preterm infant: A grounded theory study. Int J Nurs Stud. 2009; 46(3): 326-36.
36. Lambert VA, Lambert CE. Editorail: Qualitative descriptive research: An acceptable design. Pacific Rim Int J Nurs Res. 2012; 16(4):255-6.
37. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006; 3(2): 77-101.
38. Lincoln SY, Guba EG. Naturalistic inquiry. Newbury Park: Sage Publications; 1985.
39. Klaus MH, Kennell JH, Fanaroff JM. Care of the parents. In Fanaroff AA, Fanaroff, JM, editors. Klaus & Fanaroff’s Care of the high-risk neonate. (6th ed). Philadelphia: Elsevier Saunders; 2013. p. 201-24.
40. Pongjaturawit Y. Parent participation in the care of hospitalized young children. [Dissertation]. Chiang Mai, Thailand: Chiang Mai University; 2005.
41. Luecha P, Umehara K. Thai medicinal plants for promoting lactation in breastfeeding women. In Zibadi S, Watson RR, Preedy VR, editors. Handbook of dietary and nutritional aspects of human breast milk. Wageningen: Wageningen Academic Publishers; 2013. p. 645-54.
42. Lee TY, Lee TT, Kuo SC. The experiences of mothers in breastfeeding their very low birth weight infants. J Adv Nurs. 2009; 65(12): 2523-31.
43. Ministry of Public Health. Health strategic plan: 5 Flagship projects (B.E.2557) [Internet]. 2014. [cited 2016 October 25]. Available from https://www.anamai.moph. go.th/ download/ download.pdf
44. Ministry of Labour. Employee right. 2009 [cited 2016 October 27]. Available from https://www.mol.go.th/employee/rihgt_ labor%20low