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Fathers’ experiences of supporting their partners during their preterm infant’s stay in the neonatal intensive care unit: a multi-method study

Journal of Perinatology volume 42, pages 714–722 (2022)Cite this article

Subjects

Abstract

Objective

To explore how the fathers experience their role as a support for their partner and the relationship with them during their preterm infant’s stay in the NICU.

Study design

Multi-method longitudinal study involving ethnographic observation, semi-structured interviews, self-report questionnaires, and clinical information. Twenty fathers of preterm infants hospitalized in a level-III-NICU were included. Data were analyzed using thematic continent analysis.

Results

Three main themes were identified: support for mother (subthemes: putting mother’s and infant’s needs first; hiding worries and negative emotions; counteracting the sense of guilt; fear that the mother would reject the child), mother’s care for the infant (subthemes: observing mother engaged in caregiving; mother has “something extra”), and couple relationship (subthemes: collaboration; bond).

Conclusion

Fathers supporting their partners during the stay in the NICU experience emotional distress and the need for being supported that often are hidden. This demands a great deal of emotional and physical energy.

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References

  1. Treyvaud K, Spittle A, Anderson PJ, O’Brien K. A multilayered approach is needed in the NICU to support parents after the preterm birth of their infant. Early Hum Dev. 2019;139:104838 https://doi.org/10.1016/j.earlhumdev.2019.104838

    Article  PubMed  Google Scholar 

  2. Whittingham K, Boyd RN, Sanders MR, Colditz P. Parenting and prematurity: understanding parent experience and preferences for support. J Child Fam Stud. 2013;23:1050–61. https://doi.org/10.1007/s10826-013-9762-x.

    Article  Google Scholar 

  3. Amorim M, Alves E, Kelly-Irving M, Silva S. Needs of parents of very preterm infants in Neonatal Intensive Care Units: a mixed methods study. Intensive Crit Care Nurs. 2019;54:88–95. https://doi.org/10.1016/j.iccn.2019.05.003

    Article  PubMed  Google Scholar 

  4. Haddad S, Dennis C-L, Shah PS, Stremler R. Sleep in parents of preterm infants: a systematic review. Midwifery. 2019;73:35–48. https://doi.org/10.1016/j.midw.2019.01.009

    Article  PubMed  Google Scholar 

  5. Stefana A, Lavelli M. I genitori dei bambini prematuri una prospettiva psicodinamica [parents of premature babies: a psychodynamic perspective]. Med Bambino. 2016;35:327–32.

    Google Scholar 

  6. Paulson JF, Bazemore SD, Goodman JH, Leiferman JA. The course and interrelationship of maternal and paternal perinatal depression. Arch Women’s Ment Health. 2016;19:655–63. https://doi.org/10.1007/s00737-016-0598-4

    Article  Google Scholar 

  7. Di Blasio P, Caravita SCS, Camisasca E, Milani L. Parenting stress and posttraumatic stress symptoms after childbirth. a longitudinal study. J Dev Psychol. 2011;3:71–91.

    Google Scholar 

  8. Forcada-Guex M, Borghini A, Pierrehumbert B, Ansermet F, Muller-Nix C. Prematurity, maternal posttraumatic stress and consequences on the mother-infant relationship. Early Hum Dev. 2011;87:21–26. https://doi.org/10.1016/j.earlhumdev.2010.09.006

    Article  PubMed  Google Scholar 

  9. Stefana A, Lavelli M, Rossi G, Beebe B. Interactive sequences between fathers and preterm infants in the neonatal intensive care unit. Early Hum Dev. 2020;140:104888. https://doi.org/10.1016/j.earlhumdev.2019.104888

    Article  Google Scholar 

  10. Lavelli M, Stefana A, Lee, SH, Beebe B. Preterm infant contingent communication in the NICU with mothers vs. fathers. Dev Psychol (accepted for publication).

  11. Korja R, Latva R, Lehtonen L. The effects of preterm birth on mother-infant interaction and attachment during the infant’s first two years. Acta Obstet Gynecol Scand. 2012;91:164–73. https://doi.org/10.1111/j.1600-0412.2011.01304.x

    Article  PubMed  Google Scholar 

  12. Treyvaud K. Parent and family outcomes following very preterm or very low birth weight birth: a review. Semin Fetal Neonatal Med. 2014;19:131–5. https://doi.org/10.1016/j.siny.2013.10.008

    Article  PubMed  Google Scholar 

  13. Cena L, Biban P, Janos J, Lavelli M, Langfus J, Tsai A, et al. The collateral impact of COVID-19 emergency on neonatal intensive care units and family-centered care: challenges and opportunities. Front Psychol. 2021;12:630594 https://doi.org/10.3389/fpsyg.2021.630594

    Article  PubMed  PubMed Central  Google Scholar 

  14. O’Brien K, Robson K, Bracht M, Cruz M, Lui K, Alvaro R, et al. Effectiveness of Family Integrated Care in neonatal intensive care units on infant and parent outcomes: a multicentre, multinational, cluster-randomised controlled trial. Lancet Child Adolesc Health. 2018;2:245–54. https://doi.org/10.1016/S2352-4642(18)30039-7

    Article  PubMed  Google Scholar 

  15. Montirosso R, Del Prete A, Bellu R, Tronick E, Borgatti R. Level of NICU Quality of developmental care and neurobehavioral performance in very preterm infants. Pediatrics. 2012;129:e1129–e1137. https://doi.org/10.1542/peds.2011-0813

    Article  PubMed  PubMed Central  Google Scholar 

  16. Lundqvist P, Weis J, Sivberg B. Parents’ journey caring for a preterm infant until discharge from hospital‐based neonatal home care—a challenging process to cope with. J Clin Nurs. 2019;28:2966–78. https://doi.org/10.1111/jocn.14891

    Article  PubMed  Google Scholar 

  17. Stefana A, Lavelli M. What is hindering research on psychological aspects of fathers of premature infants? Minerva Pediatr. 2018;70:204–6. https://doi.org/10.23736/S0026-4946.16.04618-1

    Article  PubMed  Google Scholar 

  18. Provenzi L, Santoro E. The lived experience of fathers of preterm infants in the Neonatal Intensive Care Unit: a systematic review of qualitative studies. J Clin Nurs. 2015;24:1784–94. https://doi.org/10.1111/jocn.12828

    Article  PubMed  Google Scholar 

  19. Huhtala M, Korja R, Lehtonen L, Haataja L, Lapinleimu H, Rautava P. Associations between parental psychological well-being and socio-emotional development in 5-year-old preterm children. Early Hum Dev. 2014;90:119–24. https://doi.org/10.1016/j.earlhumdev.2013.12.009

    Article  PubMed  Google Scholar 

  20. McMahon GE, Spencer-Smith MM, Pace CC, Spittle AJ, Stedall P, Richardson K, et al. Influence of fathers’ early parenting on the development of children born very preterm and full term. J Pediatr. 2019;205:195–201. https://doi.org/10.1016/j.jpeds.2018.09.073

    Article  PubMed  Google Scholar 

  21. Hagen IH, Iversen VC, Svindseth MF. Differences and similarities between mothers and fathers of premature children: a qualitative study of parents’ coping experiences in a neonatal intensive care unit. BMC Pediatr. 2016;16:92 https://doi.org/10.1186/s12887-016-0631-9

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Sawyer A, Rabe H, Abbott J, Gyte G, Duley L, Ayers S. Parents’ experiences and satisfaction with care during the birth of their very preterm baby: a qualitative study. BJOG. 2013;120:637–43. https://doi.org/10.1111/1471-0528.12104

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Iafrate R, Bertoni A, Margola D, Cigoli V, Acitelli LK. The link between perceptual congruence and couple relationship satisfaction in dyadic coping. Eur Psychol. 2012;17:73–82. https://doi.org/10.1027/1016-9040/a000069

    Article  Google Scholar 

  24. Cigoli V, Scabini E. Family identity. Routledge, 2017. https://doi.org/10.4324/9781410617712.

  25. Dykes F, Flacking R. Ethnographic research in maternal and child health. Routledge, 2015. https://doi.org/10.4324/9781315762319.

  26. Stefana A, Lavelli M. Parental engagement and early interactions with preterm infants during the stay in the neonatal intensive care unit: protocol of a mixed-method and longitudinal study. BMJ Open. 2017;7:e013824. https://doi.org/10.1136/bmjopen-2016-013824

    Article  PubMed  PubMed Central  Google Scholar 

  27. Welch MG, Hofer MA, Brunelli SA, Stark RI, Andrews HF, Austin J, et al. Family nurture intervention (FNI): methods and treatment protocol of a randomized controlled trial in the NICU. BMC Pediatr. 2012;12:14. https://doi.org/10.1186/1471-2431-12-14

    Article  PubMed  PubMed Central  Google Scholar 

  28. Flückiger C, Del Re AC, Wampold BE, Horvath AO. The alliance in adult psychotherapy: a meta-analytic synthesis. Psychotherapy. 2018;55:316–40. https://doi.org/10.1037/pst0000172

    Article  PubMed  Google Scholar 

  29. Stefana A, Padovani EM, Biban P, Lavelli M. Fathers’ experiences with their preterm babies admitted to neonatal intensive care unit: a multi-method study. J Adv Nurs. 2018;74:1090–8. https://doi.org/10.1111/jan.13527

    Article  PubMed  Google Scholar 

  30. Fava GA. Assessing depressive symptoms across cultures: Italian validation of the CES-D self-rating scale. J Clin Psychol. 1983;39:249–51. https://doi.org/10.1002/1097-4679(198303)39:2%3C249::aid-jclp2270390218%3E3.0.co;2-y

    Article  CAS  PubMed  Google Scholar 

  31. Gentili P, Contreras L, Cassaniti M, D’Arista F. La Dyadic Adjustment Scale. Una misura dell’adattamento di coppia. Minerva Psichiatr. 2002;43:107–16.

    Google Scholar 

  32. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3:77–101. https://doi.org/10.1191/1478088706qp063oa

    Article  Google Scholar 

  33. Carter N, Bryant-Lukosius D, DiCenso A, Blythe J, Neville AJ. The use of triangulation in qualitative research. Oncol Nurs Forum. 2014;41:545–7. https://doi.org/10.1188/14.onf.545-547

    Article  PubMed  Google Scholar 

  34. Pierrehumbert B. Parental post-traumatic reactions after premature birth: implications for sleeping and eating problems in the infant. Arch Dis Child—Fetal Neonatal Ed. 2003;88:400F–404. https://doi.org/10.1136/fn.88.5.f400

    Article  Google Scholar 

  35. Hallström I, Runesson I, Elander G. Observed parental needs during their child’s hospitalization. J Pediatr Nurs. 2002;17:140–8. https://doi.org/10.1053/jpdn.2002.123020

    Article  PubMed  Google Scholar 

  36. John WS, Cameron C, McVeigh C. Meeting the challenge of new fatherhood during the early weeks. J Obstet Gynecol Neonatal Nurs. 2005;34:180–9. https://doi.org/10.1177/0884217505274699

    Article  Google Scholar 

  37. Lindberg B, Axelsson K, Öhrling K. The birth of premature infants: experiences from the fathers’ perspective. J Neonatal Nurs. 2007;13:142–9. https://doi.org/10.1016/j.jnn.2007.05.004

    Article  Google Scholar 

  38. Noergaard B, Ammentorp J, Fenger-Gron J, Kofoed P-E, Johannessen H, Thibeau S. Fathers’ needs and masculinity dilemmas in a neonatal intensive care unit in denmark. Adv Neonatal Care. 2017;17:E13–E22. https://doi.org/10.1097/ANC.0000000000000395

    Article  PubMed  PubMed Central  Google Scholar 

  39. Hugill K, Letherby G, Reid T, Lavender T. Experiences of fathers shortly after the birth of their preterm infants. JOGNN. 2013;42:655–63. https://doi.org/10.1111/1552-6909.12256

    Article  PubMed  Google Scholar 

  40. Ireland J, Minesh Khashu, Cescutti-Butler L, van Teijlingen E, Hewitt-Taylor J. Experiences of fathers with babies admitted to neonatal care units: a review of the literature. J Neonatal Nurs. 2016;22:171–6. https://doi.org/10.1016/j.jnn.2016.01.006

    Article  Google Scholar 

  41. Arnold L, Sawyer A, Rabe H, Abbott J, Gyte G, Duley L, et al. Parents’ first moments with their very preterm babies: a qualitative study. BMJ Open. 2013;3:e002487 https://doi.org/10.1136/bmjopen-2012-002487

    Article  PubMed  PubMed Central  Google Scholar 

  42. Garel M, Dardennes M, Blondel B. Mothers’ psychological distress 1 year after very preterm childbirth. Results epipage qualitative study Child Care Health Dev. 2007;33:137–43. https://doi.org/10.1111/j.1365-2214.2006.00663.x

    Article  CAS  PubMed  Google Scholar 

  43. Koliouli F, Gaudron CZ, Raynaud J-P. Life experiences of French premature fathers: a qualitative study. J Neonatal Nurs. 2016;22:244–9. https://doi.org/10.1016/j.jnn.2016.04.003

    Article  Google Scholar 

  44. Heidari H, Hasanpour M, Fooladi M. The Iranian parents of premature infants in NICU experience stigma of shame. Med Arch. 2012;66:35. https://doi.org/10.5455/medarh.2012.66.35-40

    Article  Google Scholar 

  45. Pector EA, Smith-Levitin M. Mourning and psychological issues in multiple birth loss. Semin Neonatol. 2002;7:247–56. https://doi.org/10.1053/siny.2002.0112

    Article  PubMed  Google Scholar 

  46. Sajaniemi N, Mäkelä J, Salokorpi T, von Wendt L, Hämäläinen T, Hakamies-Blomqvist L. Cognitive performance and attachment patterns at four years of age in extremely low birth weight infants after early intervention. Eur Child Adolesc Psychiatry. 2001;10:122–9. https://doi.org/10.1007/s007870170035

    Article  CAS  PubMed  Google Scholar 

  47. Albuquerque S, Pereira M, Narciso I. Couple’s relationship after the death of a child: a systematic review. J Child Fam Stud. 2016;25:30–53. https://doi.org/10.1007/s10826-015-0219-2

    Article  Google Scholar 

  48. Cena L, Lazzaroni S, Stefana A. The psychological effects of stillbirth on parents: a qualitative evidence synthesis of psychoanalytic literature. Z Psychosom Med Psychother. 2021;67:329–50. https://doi.org/10.13109/zptm.2021.67.3.329

    Article  PubMed  Google Scholar 

  49. Arockiasamy V, Holsti L, Albersheim S. Fathers’ experiences in the neonatal intensive care unit: a search for control. Pediatrics. 2008;121:e215–e222. https://doi.org/10.1542/peds.2007-1005

    Article  PubMed  Google Scholar 

  50. Candelori C, Trumello C, Babore A, Keren M, Romanelli R. The experience of premature birth for fathers: the application of the Clinical Interview for Parents of High-Risk Infants (CLIP) to an Italian sample. Front Psychol. 2015;6:1444. https://doi.org/10.3389/fpsyg.2015.01444

    Article  PubMed  PubMed Central  Google Scholar 

  51. Stefana A, Lavelli M. Fathers of preterm infants: a resource to invest on [I padri dei bambini nati pretermine: una risorsa su cui investire]. Psicologia Clin dello Svilupp. 2016;20:165–88. https://doi.org/10.1449/84129

    Article  Google Scholar 

  52. Baldoni F, Giannotti M. Perinatal distress in fathers: toward a gender-based screening of paternal perinatal depressive and affective disorders. Front Psychol. 2020;11:1892. https://doi.org/10.3389/fpsyg.2020.01892

    Article  PubMed  PubMed Central  Google Scholar 

  53. Cena L, Rota M, Calza S, Massardi B, Trainini A, Stefana A. Estimating the impact of the COVID-19 pandemic on perinatal health care services in Italy. Front Public Health. 2021;9:701638. https://doi.org/10.3389/fpubh.2021.701638.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Stefana A, Youngstrom EA, Hopwood CJ, Dakanalis A. The COVID-19 pandemic brings a second wave of social isolation and disrupted services. Eur Arch Psychiatry Clin Neurosci. 2020;270:785–6. https://doi.org/10.1007/s00406-020-01137-8

    Article  PubMed  PubMed Central  Google Scholar 

  55. Stefana A. Mourning the death of a foreign child. Indian J Pediatr. 2017;84:245. https://doi.org/10.1007/s12098-016-2264-2

    Article  PubMed  Google Scholar 

  56. Scheiner AP, Sexton ME. Prediction of developmental outcome using a perinatal risk inventory. Pediatrics 1991;88:1135–43.

    Article  CAS  Google Scholar 

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Funding

The first author received doctoral scholarships for this work from the University of Verona.

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Authors and Affiliations

  1. Independent Researcher, Brescia, Italy

    Alberto Stefana

  2. Neonatal and Pediatric Intensive Care Unit, Department of Pediatrics, University Hospital of Verona, Verona, Italy

    Paolo Biban & Ezio Maria Padovani

  3. Department of Human Sciences, University of Verona, Verona, Italy

    Manuela Lavelli

Authors
  1. Alberto Stefana
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  2. Paolo Biban
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  3. Ezio Maria Padovani
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  4. Manuela Lavelli
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Contributions

Conceptualization: AS; methodology: AS; qualitative analysis: AS; quantitative analysis: ML; writing—original draft preparation: AS; writing—review and editing: AS, ML, PB, EMP. All authors approved the final version of the article.

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Correspondence to Alberto Stefana.

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Fathers’ experiences of supporting their partners during their preterm infant’s stay in the neonatal intensive care unit: a multi-method study

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Stefana, A., Biban, P., Padovani, E.M. et al. Fathers’ experiences of supporting their partners during their preterm infant’s stay in the neonatal intensive care unit: a multi-method study. J Perinatol 42, 714–722 (2022). https://doi.org/10.1038/s41372-021-01195-3

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