| Sažetak | Cilj ovog istraživanja bio je dobiti uvid u doživljaje i iskustva majki prijevremeno rođene djece u prvoj godini njihova života. Ciljevi su opisati izvore stresa, izvore i oblike podrške, strategije suočavanja i potrebe za psihološkom podrškom kod majki prijevremeno rođene djece kronološke dobi do jedne godine. Metodologija koja se koristi u ovom istraživanju je kvalitativna metodologija, koja je izabrana za ovo istraživanje jer daje detaljan uvid u fenomenologiju individualnih iskustava. Sudionice su 18 majki prijevremeno rođene djece u dobi do godinu dana starosti koja su uključena u fizikalnu terapiju u Poliklinici Zlatni cekin u Slavonskom Brodu. Podaci su prikupljeni metodom dubinskog polustrukturiranog intervjua. Audio-snimke intervjua su transkribirane te je u obradi i interpretaciji podataka korištena interpretativna fenomenološka analiza. Dobiveno je pet nadređenih tema koje daju odgovore na istraživačka pitanja i zadovoljavaju cilj istraživanja. Nadređene teme su: Izvori stresa, Suočavanje sa stresom, Izvori podrške, Preporuke majki i Doživljene promjene nakon prijevremenog poroda. Majke izvještavaju o brojnim izvorima stresa tijekom trudnoće i poroda, boravka u bolnici, kod preuzimanja brige o djetetu i uključivanja u terapije te izvore stresa povezane sa organizacijom svakodnevnog života. Stres doživljavaju drugačijim i većim nego prije prijevremenog poroda a strategije koje koriste su suočavanje usmjereno na emocije, suočavanje usmjereno na problem, skretanje pozornosti i izbjegavanje te specifični načini suočavanja sa stresom roditeljstva i djetetovim mogućim teškoćama. Izvori podrške za majke su prije svega, partner i obitelj, koji pružaju i emocionalnu i praktičnu podršku, zatim se majke oslanjaju na podršku drugih majki prijevremeno rođene djece, podršku stručnjaka, koja je uglavnom informacijska i savjetodavna, te podršku traže i na internetu, u obliku informacija ili iskustava drugih roditelja. Majke iskazuju potrebu za psihološkom podrškom, no nisu je sklone tražiti, dijelom zbog straha od stigmatizacije, dijelom zbog fokusa na brigu o djetetu. Procjenjuju da je najveća potreba za psihološkom podrškom već u rodilištu, nakon poroda, a drugi krizni period je preuzimanje brige o djetetu kod kuće. Majke također predlažu i neka poboljšanja u pružanju usluga rane intervencije za djecu i roditelje. Majke izvještavaju da je prijevremeni porod utjecao na cijelu obitelj i na njih osobno te izvještavaju o doživljenim promjenama nakon prijevremenog poroda koje se odnose na promjene navika, drugačiji doživljaj majčinstva te osobne promjene među kojima mnoge navode osobni rast. Na temelju rezultata istraživanja osmišljene su preporuke za intervencije u sustavu zdravstva usmjerene prema roditeljima te je osmišljen plan psihološke podrške roditeljima prijevremeno rođene djece koja su uključena u rehabilitaciju u Poliklinici Zlatni cekin u Slavonskom Brodu. |
| Sažetak (engleski) | Introduction: Premature infants are babies born before the 37th week of gestation. Many studies link premature birth to the risk of adverse developmental outcomes. Premature birth of a child causes increased levels of parental stress. Interventions aimed at supporting parents in coping with parental stress that premature birth of the child brings, contribute to better recovery of children and better developmental outcomes. This study examines sources of stress and support and coping strategies for mothers of premature babies involved in early intervention, using qualitative methodology. The results of the research have their practical application in the guidelines for parent-oriented interventions in health systems and designing psychological support services for parents of premature infants from the earliest age.
Aim of the study: The aim of this research is to get a detailed insight into the experiences of parents and the stress that parents experience, how they cope with it, what kind of support they have and what kind of support they need.
Method: Qualitative research methodology is applied- Semi-structured in-depth interviews are conducted with 21 mothers of premature infants. The infants ranged from 1 month of age to 11 months of age. Mothers were recruited during child’s rehabilitation in Polyclinic Zlatni cekin in Slavonski Brod. Mothers were interviewed by the researcher. Interviews were recorded on dictaphone and later transcribed. Interviews with 18 mothers were included in analysis on basis of data saturation and the interpretative phenomenological analysis is applied on data.
Results: Data analysis resulted in five main themes: Sources of stress, Coping, Sources of support, Mothers recommendations and Experienced change after a premature birth of the infant. Mothers report many sources of stress during pregnancy and child birth, staying at the hospital, taking responsibility and care of the infant at home, involving the child in early intervention treatments and the stress of organizing their everyday lives. Mothers describe that the stress they are experiencing during and after premature birth of the child is different and more intense then the stress they were experiencing before the childbirth. Coping strategies mothers are using are emotion-oriented coping, problem-oriented coping, avoidance and distraction. Mothers are also reporting some specific coping mechanisms to cope with their parental stress and child’s developmental and health difficulties, such as accepting the situation, finding motivation in child’s progress, confidence in their parental skills, positive expectations for the future and avoiding negative or stressful information online. Sources of support for the mothers are firstly their partners and other family members. Support from partners and family is instrumental and emotional. Mothers are reporting about using support from other mothers of premature infants and also from health professionals. Support form professionals is mainly information support and educational. Mothers are using sources of online support for the information and sharing experiences with other mothers of premature infants. Mothers are reporting that they did need psychological support, but they rarely sought one. Reason for that is the fear of stigmatization and their focus on care for the infant. Mothers report that they needed psychological support the most right after the premature childbirth, during their stay at the hospital. Another point in time when mothers need psychological support is during transition from hospital care to home care for the child that was previously cared for by the medical professionals. Mothers report that the premature birth had an impact on their families but also reported experiencing changes themselves, such as changes in habits and everyday activities, experiencing motherhood differently and personal changes, many of them reporting about personal growth. Mothers also gave constructive recommendations for advancement of early intervention programs and psychological support for mothers of premature infants. The results are compared to existing literature and research on premature birth, early intervention and parental stress, coping and support for the parents. Guidelines for parent-oriented interventions in health systems are created: • Education of medical professionals in communication and interpersonal skills and giving emphatic informational and emotional support to the parents of premature infants • Informational and emotional support for the parents after the premature birth, during their stay in the hospital, which consists of timely information of child’s health status in a way that is empathetic and understandable for the parents, and of supporting parents coping with stress. • Preparing parents for their first encounter with the premature infant and medical equipment, explaining the role of the equipment. • Preparing parent for taking responsibility for caring for the infant at home after discharge form the hospital. Parents should be trained in taking care of the premature infant and participate in taking care of the infant in hospital. • Written information for the parents about available treatments for the child and the parent and instructions how to get it. • Better availability of different health treatments and diagnostics for the premature infants in smaller communities. • Group support for parents of premature infants. • Easily accessible psychological support for the parents of premature infants, preferably in the same institution in witch child is being treated.
Conclusion: The aim of the study was to get a detailed insight into the experiences of parents and the stress that parents experience, how they cope with it, what kind of support they have and what kind of support they need, and data analysis reached that aim. Using interpretative phenomenological analysis on data collected from interviews with 18 mothers of premature infants resulted in five main themes: Sources of stress, Coping, Sources of support, Mothers recommendations and Experienced change after the premature childbirth. Each of the main themes are consisted of subthemes. Mothers report various sources of stress just before and after premature birth, during their stay a t the hospital, during the transition from hospital care to home care of the child and during early intervention. Coping strategies that mothers use are emotion focused coping, problem focused coping, avoidance and distractions. Mothers use specific strategies to cope with child’s health and developmental difficulties and parental stress associated with them. Mothers report that the premature birth had an impact on their families but also reported experiencing changes themselves, such as changes in habits and everyday activities, experiencing motherhood differently and personal changes, many of them reporting about personal growth. Mothers also gave constructive recommendations for advancement of early intervention programs and psychological support for mothers of premature infants. The results of the research have their practical application in the guidelines for parent-oriented interventions in health systems and designing psychological support services for parents of premature infants from the earliest age. |
