Letter to the Editors
The letter aims to draw attention to a recent article published in the Belitung Nursing Journal that sheds light on mothers’ narratives of having hospitalised preterm newborns. I read the article “Quality of life among mothers of preterm newborns in a Malaysian neonatal intensive care unit” by Ong et al. (2022) with a sense of deja vu. This study highlights a vital dimension for newborn mothers and the importance of nursing support throughout newborn hospitalisation. As a mother of a 23-weeker newborn daughter back in 2018, I still vividly remember having had to visit my daughter for the first time in less than twenty-four after the emergency caesarian. The role change was unprecedented, but it was a relatively breathtaking journey, particularly on the expectation of healthcare professionals on the mothers.
Ong et al. (2022) proposed that more attention is needed to planning strategies to reduce maternal stress. I agree with Ong et al. (2022) that there is a need for a special nursing intervention program to be implemented immediately. I believe engaging mothers in neonatal caregiving and focusing on the maternal needs for information, communication, and support, when and where appropriate, is fundamental. While there are several nursing interventions that nurses can do that help reduce the stress of mothers of newborns in the NICU, I wish to focus on the appropriateness of education, with early education and emotional support given to mothers in developing maternal-focused services. In a study by Morey and Gregory (2012), nurse-led patient education is an effective intervention strategy to reduce maternal stress in the NICU. After the intervention, mothers were significantly more knowledgeable about who would take care of their babies, their bodies, their physical needs, and the equipment used in the NICU. A study by Shimizu and Mori (2018) found that maternal perceptions of family-centred support for hospitalised preterm infants promoted better collaboration between mothers and nurses to obtain parent-crafting skills in the perinatal units in Japan. This is relevant in practice since transparent visual information materials might promote better maternal understanding of their infants and improve mother-nurse collaboration. Mothers feel empowered and better able to care for their infants autonomously at home. Such needs are critical for two reasons: first, mothers like to have correct information on their hospitalised infants’ status and expect healthcare professionals to inform them about the desired changes in their baby’s physical status (Boxwell et al., 2019); and secondly, giving information causes the feeling of control and power from the mothers’ side about their condition so that they participate more in the care given to their newborns. In other words, providing clear, consistent information is the key to parental education and understanding.
There is also a striking need to recognise the readiness and competence of the nurses themselves. Abuidhail et al. (2017) made a critical observation whereby there was a significant mean difference between perceived and received nursing support. These findings demonstrated that parents desired more nursing support than they received, particularly in supportive communication and the giving of information. They also recognised that considerable nursing support was required to help parents cope with this stressful condition and lessen their emotional burden. Nurses must also be able to provide competent care and psychological support to the mothers to help them manage. The provision of appropriate and adequate care, as well as consistent support for the mothers, can be emotionally challenging for the nurses themselves. This was reflected in a recent systematic review whereby healthcare professionals had mixed views of parental involvement, making them feel unconfident and unprepared. Thus, organisational, environmental, and policy changes, as well as psychological support, were strategies identified to enhance healthcare professionals’ sense of coherence and, consequently, their ability to cope (Chan & Shorey, 2021). Meanwhile, a study by Benzies et al. (2019) recommended several exciting improvements to health systems. This includes enhanced staffing models, improved professional development prospects, provision of tools to deliver consistent information, valued parental capacity to participate in care, strengthened continuity of care, and a tailored family-friendly environment.
Indeed, every nursing support matters, particularly when the study highlighted where mothers subconsciously disregarded their well-being, particularly their physical health. Thus, some light motivation and encouragement from the nurses about the mother’s well-being help in many ways and are appreciated by mothers. Lau et al. (2022) argued that maternal stress in NICU is well acknowledged. However, there is currently no well-defined support on how to assist mothers during their infants’ hospitalisation best. In a nutshell, a better quality of life among mothers with NICU infants is paramount and essentially something that must be strived for. This study by Ong et al. (2022) indeed calls for more attention to realising the need to capture the quality of life for mothers with hospitalised preterm newborns and the dire need for focused-nursing interventions to lessen maternal stress. While it is crucial to highlight that every nursing support is important, there is also a need to develop a sustainable and effective integrated nursing program as one approach to increasing mothers’ overall quality of life.