Unexpected: an interpretive description of parental traumas’ associated with preterm birth

BMC Pregnancy and Childbirth

Research

Thea Comeau¹  Gerri C Lasiuk²  Christine Newburn-Cook² 

[1] Department of Educational and Counselling Psychology, McGill University, 3700 McTavish Street, H3A 1Y2, Montréal, Québec, Canada;Faculty of Nursing, Level 3, Edmonton Clinic Health Academy, 11405-87 Avenue, University of Alberta, T6G 1C9, Edmonton Alberta, Canada;

关键词: Preterm Infant;    Preterm Birth;    Neonatal Intensive Care Unit;    Acute Stress Disorder;    Interpretive Description;   

DOI  :  10.1186/1471-2393-13-S1-S13

来源: Springer

【 摘 要 】

BackgroundPreterm birth (PTB) places a considerable emotional, psychological, and financial burden on parents, families, health care resources, and society as a whole. Efforts to estimate these costs have typically considered the direct medical costs of the initial hospital and outpatient follow-up care but have not considered non-financial costs associated with PTB such as adverse psychosocial and emotional effects, family disruption, strain on relationships, alterations in self-esteem, and deterioration in physical and mental health. The aim of this inquiry is to understand parents’ experience of PTB to inform the design of subsequent studies of the direct and indirect cost of PTB. The study highlights the traumatic nature of having a child born preterm and discusses implications for clinical care and further research.MethodThrough interviews and focus groups, this interpretive descriptive study explored parents’ experiences of PTB. The interviews were audiotaped, transcribed, and analyzed for themes. Analysis was ongoing throughout the study and in subsequent interviews, parents were asked to reflect and elaborate on the emerging themes as they were identified.ResultsPTB is a traumatic event that shattered parents’ taken-for-granted expectations of parenthood. For parents in our study, the trauma they experienced was not related to infant characteristics (e.g., gestational age, birth weight, Apgar scores, or length of stay in the NICU), but rather to prolonged uncertainty, lack of agency, disruptions in meaning systems, and alterations in parental role expectations. Our findings help to explain why things like breast feeding, kangaroo care, and family centered practices are so meaningful to parents in the NICU. As well as helping to (re)construct their role as parents, these activities afford parents a sense of agency, thereby moderating their own helplessness.ConclusionThese findings underscore the traumatic nature and resultant psychological distress related to PTB. Obstetrical and neonatal healthcare providers need to be educated about the symptoms of Acute Stress Disorder (ASD) and Posttraumatic Stress Disorder (PTSD) to better understand and support parents’ efforts to adapt and to make appropriate referrals if problems develop. Longitudinal economic studies must consider the psychosocial implications of PTB to in order to determine the total related costs.

【 授权许可】

CC BY   
© Lasiuk et al; licensee BioMed Central Ltd. 2013