Mothers' different styles of involvement in preterm infant pain care.
OBJECTIVE
To describe and understand how mothers utilize the opportunity to actively participate in their preterm infants' pain care using facilitated tucking by parents (FTP).


METHODS
Descriptive and exploratory study with postintervention interview.


METHODS
Finnish level III Neonatal Intensive Care Unit (NICU).


METHODS
Twenty-three mothers who had preterm infants born at gestational ages of 32 to 34 weeks.


METHODS
The parents (N=45) of 29 preterm infants were taught to use FTP. In addition, all nurses in the NICU (N=76) received the same education to support the parents' use of FTP. After 2 to 4 weeks of FTP use, the mothers (n=23) were interviewed using the Clinical Interview for Parents of High-Risk Infants with additional questions related to the infants' pain care. The interviews were analyzed inductively with cross-case analysis and deductively with a previously developed coding scheme.


RESULTS
Facilitated tucking by parents was perceived positively and was used by all participating mothers. Three different styles of involvement in preterm infants' pain care with FTP were identified. They formed a continuum from external to random and finally to internalized involvement. In external involvement, the pain care with FTP was triggered by outside factors such as nurses, whereas in random and internalized involvement the motivation emerged from a parent. Mothers with external involvement thought that any person could apply the FTP. In random involvement, mothers were mainly absent during painful procedures, although they saw themselves as the best caregivers. In internalized involvement, the responsibility for infant pain care was shared within the family. Mothers' NICU-related stress and maternal attachment were associated with this variation.


CONCLUSIONS
This study showed that mothers' are willing to actively participate in their preterm infants' pain care. However, the participation is unique according to mother and her experiences before and during NICU admission. Nurses need to consider these differences in mothers when involving them in preterm infants' pain care.
Axelin
Anna
A
Finnish Post-Graduate School in Nursing Science, Department of Nursing Science, University of Turku, Turku, Finland. anna.axelin@utu.fi
Lehtonen
Liisa
L
Pelander
Tiina
T
Salanterä
Sanna
S
D000328:Adult; D005260:Female; D005387:Finland; D006801:Humans; D018730:Infant Behavior; D007224:Infant Care / Q000379:methods*; D007231:Infant, Newborn; D007234:Infant, Premature; D015931:Intensive Care, Neonatal; D008425:Maternal Behavior / Q000523:psychology*; D009034:Mother-Child Relations; D009035:Mothers / Q000193:education* / Q000523:psychology; D010146:Pain / Q000451:nursing* / Q000517:prevention & control; D010147:Pain Measurement; D012867:Skin; D014110:Touch; D055815:Young Adult