Effects of an Experiential Learning Program on Maternal Knowledge and Behaviors in Promoting Preterm infant Development after Discharge
Main Article Content
Abstract
Purpose: To examine the effects of an experiential learning program on maternal knowledge and behaviors in promoting preterm infant development after discharge.
Design: A quasi-experimental study.
Methods: This study involved 40 mothers of preterm infants, with 20 participants assigned to the experimental group and 20 to the control group. The experimental group received an experiential learning program incorporating computer-assisted instruction (CAI) and developmental assessment activities based on the Developmental Assessment and Intervention Manual (DAIM) while the control group received standard care. A set of questionnaires included a general information questionnaire and validated the Maternal Knowledge and Behavior Assessment Questionnaires on Promoting Preterm Infant Development (CVI = .95 and .93; KR-20 = .71; Cronbach’s alpha = .83). Data were analyzed using independent and paired t-tests.
Main findings: After two weeks at home, both groups showed significant improvements in maternal knowledge. The experimental group had higher post-test knowledge scores than the control group ( = 18.10, SD = 1.29 vs.
= 17.00, SD = 1.56; p < .05, respectively). For maternal behaviors, the experimental group showed significantly greater improvement than the control group (
= 24.50, SD = 2.89 vs.
= 20.05, SD = 1.36; p < .001, respectively).
Conclusion and recommendations: An experiential learning program has been shown to enhance maternal knowledge and behaviors in promoting preterm infant development after hospital discharge. It is essential to encourage maternal involvement in this aspect of care before discharge. Additionally, accessible educational materials should be provided to ensure continuous maternal access to information on promoting development. Furthermore, a structured post-discharge follow-up system should be implemented to support and monitor maternal engagement in developmental care.
Article Details

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright Notice: Nursing Science Journal of Thailand has exclusive rights to publish and distribute the manuscript and all contents therein. Without the journal’s permission, the dissemination of the manuscript in another journal or online, and the reproduction of the manuscript for non-educational purpose are prohibited.

Disclaimer: The opinion expressed and figures provided in this journal, NSJT, are the sole responsibility of the authors. The editorial board bears no responsibility in this regard.
References
Song IG. Neurodevelopmental outcomes of preterm infants. Clin Exp Pediatr. 2023;66(7):281-7. doi: 10.3345/cep.2022.00822.
Morniroli D, Tiraferri V, Maiocco G, De Rose DU, Cresi F, Coscia A, et al. Beyond survival: the lasting effects of premature birth. Front Pediatr. 2023;11:1213243. doi: 10.3389/fped.2023.1213243.
Pettinger KJ, Copper C, Boyle E, Blower S, Hewitt C, Fraser L. Risk of developmental disorders in children born at 32 to 38 weeks' gestation: a meta-analysis. Pediatrics. 2023;152(6):e2023061878. doi: 10.1542/peds.2023-061878.
Lammertink F, Vinkers CH, Tataranno ML, Benders M. Premature birth and developmental programming: mechanisms of resilience and vulnerability. Front Psychiatry. 2021;11:531571. doi: 10.3389/fpsyt.2020.531571.
El-Metwally DE, Medina AE. The potential effects of NICU environment and multisensory stimulation in prematurity. Pediatr Res. 2020;88(2):161-2. doi: 10.1038/s41390-019-0738-4.
Leong M, Karr CJ, Shah SI, Brumberg HL. Before the first breath: why ambient air pollution and climate change should matter to neonatal-perinatal providers. J Perinatol. 2023;43(8):1059-66. doi: 10.1038/s41372-022-01479-2.
Allotey J, Zamora J, Cheong-See F, Kalidindi M, Arroyo-Manzano D, Asztalos E, et al. Cognitive, motor, behavioural and academic performances of children born preterm: a meta-analysis and systematic review involving 64,061 children. BJOG. 2018;125(1):16-25. doi: 10.1111/1471-0528.14832.
Rodrigues JCL, Gaspardo CM, Linhares MBM. Development of neonatal high-risk preterm infants in comparison to full-term counterparts. Appl Neuropsychol Child. 2022;11(4):840-9. doi: 10.1080/21622965.2021.1988601.
Bonacquisti A, Geller PA, Patterson CA. Maternal depression, anxiety, stress, and maternal-infant attachment in the neonatal intensive care unit. J Reprod Infant Psychol. 2020;38(3):297-310. doi: 10.1080/02646838.2019.1695041.
Girabent-Farrés M, Jimenez-Gónzalez A, Romero-Galisteo RP, Amor-Barbosa M, Bagur-Calafat C. Effects of early intervention on parenting stress after preterm birth: a meta-analysis. Child Care Health Dev. 2021;47(3):400-10. doi: 10.1111/cch.12853.
Khoshnood Z, Nematollahi M, Monemi E. The effect of a virtual educational and supportive intervention on the mothers’ resilience with preterm infants: a quasi-experimental study. Middle East J Rehabil Health Stud. 2023;10(1):e129812. doi: 10.5812/mejrh-129812.
Li S, Liu S, Zhang X, Ren X, Chen Y. Effectiveness of the PRECEDE-PROCEED model for improving the care knowledge, skill, and sense of competence in mothers of preterm infants. J Int Med Res. 2022;50(7):3000605221110699. doi: 10.1177/03000605221110699.
Sohrabi M, Azizzadeh forouzi M, Mehdipour-Rabori R, Bagherian B, Nematollahi M. The effect of a training program on maternal role adaptation and self-esteem of mothers with preterm infants: a quasi-experimental study. BMC Women's Health. 2021;21(1):296. doi: 10.1186/s12905-021-01440-z.
Benzies K, Aziz K, Shah V, Faris P, Isaranuwatchai W, Scotland J, et al. Effectiveness of Alberta family integrated care on infant length of stay in level ii neonatal intensive care units: a cluster randomized controlled trial. BMC Pediatr. 2020;20(1):535. doi: 10.1186/s12887-020-02438-6.
Orton J, Doyle LW, Tripathi T, Boyd R, Anderson PJ, Spittle A. Early developmental intervention programmes provided post hospital discharge to prevent motor and cognitive impairment in preterm infants. Cochrane Database Syst Rev. 2024;2(2):CD005495. doi: 10.1002/14651858.CD005495.pub5.
Griffith T, Singh A, Naber M, Hummel P, Bartholomew C, Amin S, et al. Scoping review of interventions to support families with preterm infants post-NICU discharge. J Pediatr Nurs. 2022;67:e135-49. doi: 10.1016/j.pedn.2022.08.014.
Fueangfu A. Child developmental surveillance and screening. In: Sutcharitphong S, Rungpraiwan R, Hansakunachai T, Benjasuwantep B, Fueangfu A, Chutaphisit J, et al., editors. Textbook of child development and behaviour, Volume 4. Bangkok: P. A. Living; 2018. p.147-75. (in Thai).
Ministry of Public Health. Developmental Assessment for Intervention Manual (DAIM). Bangkok: War Veterans Organization Officer of Printing Mill; 2019. 76 p. (in Thai).
Kolb DA. Experiential learning: experience as the source of learning and development. Englewood Cliffs, NJ: Prentice Hall; 1984. 256 p.
Kolb DA. Experiential learning: experience as the source of learning and development. 2nd ed. New Jersey: FT Press; 2014. 416 p.
Kasemsiri J, Teerarungsikul N, Sananreangsak S. Effects of the developmental promoting program on mothers’ behavior to promote development of premature infants. Kuakarun Journal of Nursing. 2019;26(2):52-65. (in Thai).
Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale, NJ: Lawrence Erlbaum Associates; 1988. 567 p.
Namprom N, Picheansathian W, Jintrawet U, Chotibang J. The effect of maternal participation in preterm's 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.
Shorey S, Chong YS, Shi L, Chua JS, Mathews J, Lim SH, et al. Evaluating the effects of the supportive parenting app on infant developmental outcomes: longitudinal study. JMIR mHealth and uHealth. 2023;11(1):e43885. doi: 10.2196/43885.
Sugiarti S, Rustina Y, Efendi D. Increasing the knowledge and confidence of mothers in caring for low birth weight babies through education from the maternal and child health handbook. Jurnal Keperawatan Soedirman. 2020;15(2):11-23. doi: 10.20884/1.jks.2020.15.2.1160.
McCarty DB, Letzkus L, Attridge E, Dusing SC. Efficacy of therapist supported interventions from the neonatal intensive care unit to home: a meta-review of systematic reviews. Clin Perinatol. 2023;50(1):157-78. doi: 10.1016/j.clp.2022.10.004.
Öztürk Şahin Ö, Dinç S, Taşdelen Y, Aközlü Z. Concerns of mothers whose babies are transferred from NICU to adaptation room about post-discharge newborn care: a qualitative study. J Neonatal Nurs. 2024;30(3):221-6. doi: 10.1016/j.jnn.2023.09.003.
Sajadi H, Akhoundzadeh G, Hojjati H. The effect of empowerment program on participation of mothers with premature infants hospitalized in neonatal intensive care unit of Sayyed Shirazi Hospital in Gorgan, in 2018. Indian J Forensic Med Toxicol. 2020;14(2):1269-76. doi: 10.37506/ijfmt.v14i2.3082.
World Health Organization. Guidelines on physical activity, sedentary behaviour and sleep for children under 5 years of age [Internet]. Geneva: WHO; 2019 [cited 2022 Mar 15]. Available from: https://iris.who.int/bitstream/handle/10665/311664/9789241550536-eng.pdf?sequence=1.