WONG, Lecery Sophia C.

BSN 2-I Journal Reflection

Mothers’ Different Styles of Involvement in Preterm Infant Pain Care

There are different Three styles of involvement in preterm infants’ pain care with Facilitated
Tucking by Parents were identified. The external to random and finally to internalized
involvement. In external involvement, the pain care with Facilitated Tucking by Parents was
triggered by outside factors such as nurses, Nurses have a unique opportunity to help mothers
experience meaningful motherhood in NICU settings. In the presence of infants’ pain, staff
should be sensitive to parents’ wishes. Some parents want to participate as much as possible,
some need encouragement, and some might wish to withdraw during painful procedures or pain
In addition, staff could improve their approach by giving parents more information on means of
detecting and alleviating pain. whereas in random and internalized involvement the motivation
emerged from a parent, many parents wants to more involved in their preterm infants’ pain care.
They have given reasons why they want to be the main care provider , including staffs lack of
sensitivity regarding infant pain, the parental protective role, and the fact that participation in
pain care alleviates their own stress levels mothers with external involvement thought that any
person could apply the Facilitated Tucking by Parents. In random involvement, mothers were
mainly absent during painful procedures, although they saw themselves as the best caregivers. In
internalized involvement, the responsibility for infant pain care was shared within the family.
Mothers’ NICU-related stress and maternal attachment were associated with this variation. The
mother’s readiness for participation in her preterm infant’s pain care is inseparable from other
elements of motherhood in the NICU environment. During pregnancy, maternal attachment to
the fetus increases simultaneously with fetal development. Ideally, the mother’s physical,
biological, cognitive, and emotional changes during pregnancy enable her to create an
emotionally secure and safe environment for her baby. In Facilitated Tucking in By Parents a
parent holds the infant in a side-lying, fetal-type position, offering support and skin-to-skin
contact with her or his hands during a stressful or painful situation. It alleviates preterm infants’
pain, is safe in terms of short term adverse effects. The maternal attachment of these mothers
toward their infants was strong. Pregnancy had become real to these mothers during the first
trimester. These mothers were certain that their infants recognized them. Mothers had positive
feelings toward their babies immediately after birth and at the time of discharge. Fathers also
had a clear place in these mothers’ stories and were seen as important persons for the children.
One mother said that “I feel it is important that I’m able to comfort my child with my closeness.
The closeness strengthens my motherhood. Unlike when I have to be separated from my child,
I’m able to really be with my child in these situations. It really helps, I feel”. As verbalized by
the mother. Involving the mother in pain care is just the first important step. The second phase
could be to teach her to recognize infant cues in these situations. After facilitating interaction by
giving the mother the tools to understand the infant, the final step may be to support synchronize
in mother/infant interaction during stressful situations.

Importance to Nursing Research: This journal article may enhance the skills of the nurses,
especially the staffs in the NICU. I think that further research may be suggested. Just like
parental ways of applying FTP and what other position can be used other than , parent holds the
infant in the side-lying, flexed fetal-type position. The next step could be to develop tools for
identifying different involvement styles and specific interventions for mothers. In addition,
future research should pay attention to the fathers’ role in preterm infants’ pain care. It will be
very helpful if both parents will involve in the pain care of the pre-term infant.

Importance to Nursing Practice: Others’ involvement in pain care with FTP relects the
development of maternal attachment and may give nurses an idea of how to support mothers.
Nurses have an excellent opportunity to synchronize the mother’s behavior with the infant, as
active support by NICU staff may help the mother to become closer and more connected to her
infant than she might have been with a healthy infant in a home environment. The use of FTP
with nurses’ support may also work as an intervention that increases maternal attachment. This
was seen with the mother who was able to move in our typology toward comprehensive
involvement in pain care with FTP.

Importance to Nursing Education: Knowing this Facilitated Tucking by Parent will help the
nurses to know how infant cope in this type of situation and also the nurse will have sufficient
knowledge in giving support to the mother and the infant. It is helpful in the nursing education
because not all mother can be present in the care of the pre-term infant, the nurses can be the
care provider and all of the data that has been tackled about in this journal can be applicable in
the area. It is important that the student nurses who are will have clinical duties in the Nursery
knows about pre-term infants and the interventions that can be done to help alleviate the pain
that the pre-term are experiencing.

REFERENCE:
Axelin, A., Lehtonen, L., Pelander, T., & Salanterä, S. (2020). Mothers' Different Styles of
Involvement in Preterm Infant Pain Care. Retrieved 17 May 2020, from.
https://www.ncbi.nlm.nih.gov/pubmed/20629928