Mother's level of confidence in caring for her late preterm infant: A mixed methods study.

AIM AND OBJECTIVES: To examine what it means to be a mother of a late preterm infant including a mother's level of confidence in caring for her late preterm infant over time and the effect of maternal depression of this experience. BACKGROUND: Little is known about mothers' experiences of caring for their late preterm infants in the community, including their level of confidence and parenting stress within the context of a supported care environment by public health nurses. DESIGN: A mixed methods study, sequential explanatory quantitative and qualitative study. METHODS: A convenience sample of mothers with LPIs (n = 71) completed questionnaires on maternal confidence (3-4 weeks and 6-8 weeks), parenting stress (6-8 weeks), social support (6-8 weeks) and postpartum depression (6-8 weeks). A purposive sample of mothers (n = 11) underwent in-depth, semi-structured interviews. RESULTS: Maternal confidence decreased from 3-4 weeks-6-8 weeks after delivery, and similar results were found for mothers who reported depressive symptoms. Narratives of the mothers suggested the decrease in maternal confidence over time was influenced by the demanding characteristics of the late preterm infant, the prospect of their rehospitalisation and the mother's reported interactions with public health nurses. Depression had an effect on maternal confidence; that is, the depressed mothers demonstrated less confidence about their caretaking role than the nondepressed mothers at 6-8 weeks. Mothers did not discuss mental health issues, which may reflect the protective effects of social support on emotional instability or an inability to recognise postpartum depression. CONCLUSION: The confidence of mothers with LPIs decreased over the first 2 months following delivery and being home with their infants. Assisting mothers to meet their personal needs and the needs of their infant should promote maternal skills, which will likely increase maternal confidence related to the care of their late preterm infant. RELEVANCE FOR CLINICAL PRACTICE: Characteristics of LPIs contributed more to parenting stress score than parent characteristics; mothers however attempted to normalise the late preterm infant in order to minimise the parenting stress. Evidence-informed brief interventions tailored based on late preterm infant and parent characteristics may improve maternal confidence over time. Healthcare professional should provide education and anticipatory guidance prior to discharge, consistent care in hospital and postdischarge as this may impact maternal level of confidence. Future research needs to examine standards of care for discharge of LPIs and adherence to these standards.