Poster #48 - Differences Between Focused versus Unfocused Maternal-Preterm Infant Engagement in the NICU

• In Event: Poster Session 06

Abstract

Purpose: The emergence of synchronous interactions between mothers and their premature infants in the NICU are influenced by the frequency and duration of dyadic interactions as well as the factors that may facilitate or hinder those interactions. The present study explored levels of maternal engagement during context-specific social interactions in the NICU, measured the frequency of maternal communicative interaction patterns during focused versus unfocused engagement, and identified issues that deterred or disrupted focused engagement. Methods: Using a coding scheme grounded in the Biobehavioral Model of Synchrony (Feldman, 2012; 2014), trained observers conducted systematic field observations in a Level-IV NICU. Observers recorded frequency and duration of maternal presence, proximity, unfocused versus focused engagement, frequency of maternal communicative behaviors (i.e., touch, vocalization, gaze), and the dyadic social contexts within which they occurred (i.e., nurturing, feeding, routine cares, education). Analyses included calculating mean duration and relative frequency of maternal behaviors in each social context and stratifying into levels of engagement. In addition, field notes describing alternate activities to focused engagement were synthesized into thematic categories using an iterative approach (Braun & Clarke, 2012). Results: Systematic observations occurred over a period of four months and totaled 52 hours spread across various time periods and days of the week. A total of 513 infants were present during field observations. Most infants (n = 353) did not have a familial caregiver present and an additional (n = 64) had obstructed view at the time of the observation. Thus, observational data was coded for 88 mother-infant dyads. Of those 88 dyads, findings indicated that mothers in the NICU most often engaged in nurturing social contexts with their infants using touch as their most frequent communicative behavior (see Table 1). Comparatively, vocal interactions were less frequently observed. Disruptions to focused engagement most often occurred during nurturing contexts. Qualitative analysis from descriptive notes revealed six thematic categories on alternate activities to focused interaction: Using cell phone; Talking with Healthcare staff; Talking to partner; Sitting quietly; Talking to another parent; and Observing other activity on unit (see Table 2). Focusing attention on a personal mobile device had the highest cumulative duration of time (307 minutes; M = 3.5) compared to other activities. However, talking with a member of the healthcare staff was the most frequently observed disruption (f = 90) to focusing attention on their infant and was observed in 67% of the relative proportion of mothers observed in unfocused engagement. Implications: Nurturing contexts appear to provide the optimal social contexts in the NICU for mothers to physically connect and bond with their infants. Nevertheless, a concern is the phenomenon of cell phone usage that was frequently observed during unfocused nurturing interactions and raises the question on how this behavior may impact maternal sensitivity and dyadic interaction quality. Future research studies should explore similarities and differences of mother-infant interaction patterns across different cultural contexts in the NICU.

Authors

• Christine Neugebauer, Texas Tech University
  Presenting Author

• Ann M Mastergeorge, Texas Tech University