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KMID : 0922320010080010005
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Journal of Korean Academic Society of Home Care Nursing
2001 Volume.8 No. 1 p.5 ~ p.24
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Development of a Home-based Nursing Intervention Mothering Program for Low-Birth-Weight Infants
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Han Kyung-Ja
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Abstract
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The purpose of this study was to develop a parenting intervention program and determine the efficacy of the program with low-birth weight. infants and their mothers.
Nine dyads for the experimental group and twelve dyads for the control group discharged from the Neonatal Intensive Care Unit of a University Hospital in Seoul were recruited for the study. For the intervention group. programmed education and support which focused on the maternal sensitivity of the infant´s behavior, rearing environment, mother-infant interaction and infant care were given to each subject. Individual counseling and home visits were provided at discharge, one week after discharge, and one and three months of corrected age in every infant. structured questionaires were administered and feeding interactions were videotaped and coded by a blinded certified observer. A Quasi-experimental design was conducted for this study. Postpartum depression. maternal self esteem, infant, care burden, HOME. mother-infant interaction, and infant development were measured.
Results were in favor of the intervention versus the control group. On the Beck depression inventory, intervention mothers showed decreasing trends in depressive symptom vs control mothers although, there were statistically no significant differences between the two groups at each time. The mean score of experimental group was 11.55(mild depression state) at discharge and became 8.6(normal state) at 1 month of corrected age. On the other hand, the mean score of the control group was 13.92(mild depression state) at discharge and became 14.0. Maternal self esteem in both
groups improved over time. Infant care burden in both groups was also shown to increase over time.
There was a significant difference between the two groups in HOME(p=0340) at 3 months of corrected age. HOME scores of the experimental group and the control´s were 31.10 and 25.58, respectively. Mothers emotional and language responses were significantly high in the intervention group compared with the control group(p=.0155). Intervention group (53.33) showed a significantly high quality of mother- infant interaction compared with the in control group(42 .80) (p=.0340). Intervention group mothers appeared have a better quality of mother-infant interaction behaviors. on the other hand, there was no statistical difference in the infant part. between groups.
Intervention group infants had higher trends in a general developmental quotient although, there was no satistical difference between groups. The general developmental quotient of intervention infant was 102.56 and control´s was 91. 28. However, the developmental quotient. of the domain ‘individuality-sociality’ was higher in thy intervention group infants compared with the control´s(p=.0155).
The concerns identified by parents revealed two domains of an infants health management-knowledge and skills in caregiving of low birthweight-infants characteristics of low birthweight. infants, identifying a developmental milestone, coping with emergency situations and relaxation strategies of mothers from the infant care burden.
Interview data with the mothers of low-birth weight infants can be used to develop intervention program contents. Limited intervention time and frequency due to time and cost limitations of this study should be modified. The intervention should he continuously implemented when low-birth weight infants become three years old
An NNNS demonstration appeared to he a very effective intervention for tie mothers to improve the quality of mother-infant interactions. Therefore intervening in the mothers of low-birth weight infants as early after delivery as possible is desirable. This study has shown that home visit interventions are worthwhile for mothers only beyond the approach as an essential factor in ability of facilitating a growth fostering environment.
In conclusion, the intervention program of this study was very effective in enhancing the parenting tar the mothers of low-birth weight. infants, resulting in health promotion of low-birth weight infants. The home-visit outreach intervention program of this study will contribute to the health delivery system in this country where there is a lack of continuous follow-up programs for low-birth weight infants after discharge from NICU. if it is activated as part of the home visit programs in community health systems.
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KEYWORD
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Low-birth weight infant, Parenting intervention program, Mother-infant interaction, Infant development
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