A qualitative study: Mothers of late preterm infants relate their experiences of community-based care.
OBJECTIVE
In Alberta, the high occurrence of late preterm infants and early hospital discharge of mother-infant dyads has implications for postpartum care in the community. Shortened hospital stay and complexities surrounding the care of biologically and developmentally immature late preterm infants heighten anxiety and fears. Our descriptive phenomenological study explores mothers' experience of caring for their late preterm infants in the community.


METHODS
Eleven mothers were interviewed using a semi-structured interview guide. Interview transcripts were analysed using an interpretive thematic approach.


RESULTS
The mothers' hospital experience informed their perspective that being a late preterm infant was not a "big deal," and they tended to treat their infant as normal. "Feeding was really problem," especially the variability in feeding effectiveness, which was not anticipated. Failing to recognize late preterm infants' feeding distress exemplified lack of knowledge of feeding cues and tendencies to either rationalize or minimize feeding concerns. Public health nurses represent a source of informational support for managing neonatal morbidities associated with being late preterm; however, maternal experiences with public health nurses varied. Some nurses used a directive style that overwhelmed certain mothers. Seeing multiple public health nurses and care providers was not always effective, given inconsistent and contradictory guidance to care. These new and changing situations increased maternal anxiety and stress and influenced maternal confidence in care. Fathers, family, and friends were important sources of emotional support.


CONCLUSIONS
After discharge, mothers report their lack of preparation to meet the special needs of their late preterm infants. Current approaches to community-based care can threaten maternal confidence in care. New models and pathways of care for late preterm infants and their families need to be responsive to the spectrum of feeding issues encountered, limit duplication of services, and ensure consistent and effective care that parents will accept.
Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada.|Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.|O'Brien Institute of Public Health, University of Calgary, Calgary, Alberta, Canada.|Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada.
Shahirose S
http://orcid.org/0000-0003-0323-8009
SS
Premji
School of Nursing and Midwifery, Mount Royal University, Calgary, Alberta, Canada.
Genevieve
G
Currie
Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada.|O'Brien Institute of Public Health, University of Calgary, Calgary, Alberta, Canada.
Sandra
S
Reilly
O'Brien Institute of Public Health, University of Calgary, Calgary, Alberta, Canada.|School of Nursing and Midwifery, Mount Royal University, Calgary, Alberta, Canada.
Aliyah
A
Dosani
Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada.
Lynnette May
LM
Oliver
Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.|Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada.|Department of Paediatrics, Division of Neonatology, Alberta Health Services, Calgary, Alberta, Canada.
Abhay K
AK
Lodha
Prenatal and Postpartum Services, Public Health Calgary Zone, Alberta Health Services, Calgary, Alberta, Canada.
Marilyn
M
Young
D000328:Adult; D000416:Alberta; D019058:Community Networks; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D008425:Maternal Behavior / Q000523:psychology*; D000068097:Maternal Health; D009035:Mothers / Q000523:psychology*; D011181:Postnatal Care / Q000379:methods / Q000523:psychology*; D036301:Qualitative Research