Struggling to get connected : the process of maternal attachment to the preterm infant in the neonatal intensive care unit

Abstract

Hospitalization of preterm infants in the NICU is crisis for mothers in developing an attachment process. The purpose of this grounded theory study was to explore how mothers in Thailand develop maternal attachment to infants born preterm, and requiring NICU hospitalization. Fifteen Thai mothers whose preterm infants had birth weights less than 1,500g, without congenital anomalies, and experienced mechanical ventilation were interviewed and audiotaped. Four mother-preterm infant dyads interaction were observed and videotaped. The audiotape and videotape were transcribed for analysis. Textual data were analyzed through the constant comparative method developed by Strauss and Corbin. Findings indicate the basic social process of maternal attachment was "Struggling to Get Connected" through the crisis circumstance of preterm birth, composed of 4 phases of establishing the connections, disrupting of the connection, resuming to get connected, and becoming connected. The movement of actions/interactions of maternal attachment to the preterm infants in these phases depended on having concern for the baby, adjusting emotionally to the crisis, supporting connections, life experience, and health care system facilitating. Discussion included the cultural context. Understanding this process was valued in clinical practice and nursing education. Future direction of qualitative and quantitative investigation was recommended.