How do mothers cope with the hospitalization of their babies at a Neonatal Intensive Care Unit?

Fabiana Pinheiro Ramos, Professor, Universidade Federal do Espírito Santo, Vitória, ES. Brazil

 Sônia Regina Fiorim Enumo, Professor, Pontifícia Universidade Católica de Campinas, Campinas, SP, Brazil

Kely Maria Pereira de Paula, Professor, Universidade Federal do Espírito Santo, Vitória, ES, Brazil

Three Psychology researchers from Universidade Federal do Espírito Santo investigated how 25 mothers cope with the hospitalization of their babies at a Neonatal Intensive Care Unit (NICU) of a public hospital in the Metropolitan Region of Vitória, ES, from the moment they receive the news until after the discharge (RAMOS, 2012; RAMOS; ENUMO; PAULA, 2017). In a study published in the Journal Paideia (vol. 27, no. 67, 2017), the authors used an integrative method with data from interviews, questionnaires and scales to analyze the coping process from a novel perspective. They tried to capture in real time and longitudinally how these mothers coped with this stressful situation throughout the first months during and after their children’s hospitalization, due to their premature and low-weight birth. They applied a motivational and developmental approach that is original in research in the area, especially in Brazil, to analyze the coping process at three moments: at birth, during the hospitalization and after the discharge. Thus, they were able to describe how the ways of coping with these stressors changed over time and how the mothers tried to regulate their behaviors, emotions and thoughts when they felt threatened or challenged in their basic psychological needs of relatedness, competence and autonomy, according to the Motivational Coping Theory (RAMOS; ENUMO; PAULA, 2015; SKINNER; ZIMMER-GEMBECK, 2007, 2016). These data supported a brief intervention proposal in group during the hospitalization.

We highlight the care the health team should take when conveying the news of the baby’s hospitalization, as well as the mother’s first visit to the NICU. These are moments of great emotional impact, when the mothers react with sadness and fear. Nevertheless, the longer the infants are hospitalized, the more the mothers were able to cope with the situation adaptively. Some mothers are more vulnerable to stress though, who also demand more psychosocial attention, such as mothers with more than one child and with a paid job, due to the burden of tasks and concerns.

Against our expectations, these mothers showed more adaptive responses, with emotional regulation, mainly mediated by religious beliefs, even for the two mothers whose babies died. After the discharge, problem-solving strategies were predominant and support-seeking increased. The health professionals should identify these emotional, cognitive, behavioral and motivational self-regulation actions in conditions of psychological stress, like in the case of a baby’s NICU hospitalization. The ways of coping with stress are fundamental to overcome the adversities and construct a healthy development trajectory.

The research was funded by the Brazilian Scientific and Technological Development Council (CNPq) (Proc. 485564/2006-8, 481483/2009-8; doctoral grant for the first author Proc. 142308/2009-9; research productivity grant level 1B for the second author).

References

RAMOS, F. P. Uma proposta de análise do coping no contexto de grupo de mães de bebês prematuros e com baixo peso na Unidade de Terapia Intensiva Neonatal. Tese (Doutorado), Universidade Federal do Espírito Santo, Vitória, ES, 2012. Available from: http://portais4.ufes.br/posgrad/teses/tese_3518_Tese%20Fabiana%20Pinheiro%20Ramos%20vers%E3o%20final%2016%2006%202013.pdf

RAMOS, F. P., ENUMO, S. R. F. and PAULA, K. M. P. Teoria Motivacional do Coping: uma proposta desenvolvimentista de análise do enfrentamento do estresse. Estud. psicol. (Campinas) [online]. 2015, vol.32, n.2, pp.269-279. [viewed 9 November 2017]. ISSN 0103-166X. DOI: 10.1590/0103-166X2015000200011. Available from: http://ref.scielo.org/dhgtsg

RAMOS, F. P., ENUMO, S. R. F. and PAULA, K. M. P. Maternal Coping with Baby Hospitalization at a Neonatal Intensive Care Unit.Paidéia (Ribeirão Preto) [online]. 2017, vol.27, n.67, pp.10-19. [viewed 9 November 2017]. ISSN 0103-166X. DOI: 10.1590/1982-43272767201702. Available from: http://ref.scielo.org/vkzhbj

SKINNER, E. A., ZIMMER-GEMBECK, M. J. The development of coping. Annual Review of Psychology, 2007, v. 58, p. 119-144. [viewed 13 October 2017]. ISSN: 0066-4308  DOI: 10.1146/annurev.psych.58.110405.085705. Avaliable from: http://www.annualreviews.org/doi/abs/10.1146/annurev.psych.58.110405.085705

SKINNER, E. A.; ZIMMER-GEMBECK, M. J. The development of coping – Stress, neurophysiology, social relationships and resilience during childhood and adolescence. Switzerland: Springer International Publishing, 2016.

To read the articles, access

Paidéia (Ribeirão Preto) vol.27 no.67 Ribeirão Preto May/Aug. 2017

External link

Paidéia – www.scielo.br/paideia