LIFE RESISTANCE AND PSYCHOLOGICAL ADAPTATION OF WOMEN RAISING A CHILD WITH HEALTH PROBLEMS

The article establishes the influence of psychoemotional stress on the psychological state of mothers who gave birth to a premature baby, in contrast to women who gave birth to a child with normal birth weight. The hypothesis of the study was that psychoemotional stress, due to premature birth in mothers, may be accompanied by a decrease in their resilience and a decrease in psychological adaptation. The individual psychological characteristics of the personality of women-mothers, the type and direction of emotional response, coping strategies, parental attitudes – indicators of the vitality and sociopsychological adaptation of women-mothers were investigated. As a result of the study, women raising a premature baby showed high emotional sensitivity and self-control, the predominance of self-accusatory reactions in emotional response to frustration, the use of non-adaptive coping strategies, which reduces vitality and reduces socio-psychological adaptation. The revealed psychological patterns can be used as targets of psychological correction in order to restore the psychological health of mothers and prevent deviations in the development of the child.

Perception of Stress and Styles of Coping with It in Parents Giving Kangaroo Mother Care to Their Children during Hospitalization in NICU

The experience of hospitalization of a newborn in the Neonatal Intensive Care Unit (NICU) may become distressing both for the baby and parent. The study aimed to assess the degree of parental stress and coping strategies in parents giving KMC to their babies hospitalized in NICU compared to the control group parents not giving KMC. The prospective observational study enrolled a cohort of 337 parents of premature babies hospitalized in NICU in 2016 in Eastern Poland. The Parental Stressor Scale: Neonatal Intensive Care Unit, Coping Inventory for Stressful Situations were used. The level of stress in parents giving KMC was defined as low or moderate. Analysis confirmed its greater presence in the group of parents initiating KMC late (2–3 weeks) compared to those starting this initiative in week 1 of a child’s life. An additional predictor of a higher level of stress in parents initiating KMC “late” was the hospital environment of a premature baby. Task oriented coping was the most common coping strategy in the study group. KMC and direct skin-to-skin contact of the parent with the baby was associated with a higher level of parental stress only initially and decreased with time and KMC frequency.

Efektivitas Kangaroo Mother Care Dalam Menstabilkan Suhu Tubuh Bayi Prematur : Literature Review

It is commonly known, premature babies are at risk of experiencing body temperature instability, so that a specialcare is needed. One of the ways to overcome this problem is by applying Kangaroo Mother Care method. This study aims to examine the effectiveness of the method in stabilizing premature baby’s body temperature. This study has conducted a literature review used database of PubMed with Kangaroo mother care, premature baby, and body temperature as the keywords. Garuda and Google Scholar were other searching spurces which have been used with ‘bayi prematur’, ‘perawatan metode kanguru’. And ‘suhu tubuh’. There were 5 articles in the research criteria and from 154 samples, it obtained paired t-test with p-value <0,01, (95% CI [-0.66338, -0.49246]). The results stated there is a sifnificant different pre and post treatment. Kangaroo mother care was proven more effectively in stabilizing premature baby’s body temperature than other treatment method. Mothers who have the baby with the condition stated above suggested applying this treatment. However, the further study is expected to be conducted considering this study did not analyze the articles used RCT (Randomized Control Trials) method. Keywords: Premature Baby; Kangaroo Mother Care; Body temperature. AbstrakBayi prematur beresiko mengalami ketidakstabilan suhu tubuh sehingga diperlukan perawatan yang khusus. Salah satu upaya untuk menjaga kestabilan suhu tubuh bayi prematur dengan menggunakan metode Kangaroo Mother Care. Penelitian ini bertujuan untuk mengetahui efektivitas Kangaroo Mother Care dalam menstabilkan suhu tubuh bayi prematur. Penelitian ini menggunakan penelusuran artikel (literature review) menggunakan databasePubMed dengan menggunakan kata kunci “Kangaroo mother care,” “Premature baby,” and “Body temperature.” Garba Rujukan Digital (Garuda) dan Google Scholar pencarian dilakukan dengan menggunakan kata kunci kata kunci ”Bayi prematur,” “perawatan metode kanguru,” dan ‘suhu tubuh.” Terdapat 5 artikel yang memenuhi kriteria penelitian. Dari total 154 sampel, didapatkan hasil paired t-test dengan p-value<0,01, (CI 95% [-0,66338, -0.49246]). Hasil penelitian ini menunjukkan bahwa terdapat perbedaan suhu tubuh sebelum dan sesudah dilakukan Kangaroo Mother Care. Kangaroo mother care lebih efektif dibandingkan dengan perawatan standar untuk menstabilkan suhu tubuh bayi prematur.Kata Kunci : Bayi Prematur; Kangaroo Mother Care; Suhu Tubuh

Information needs for Inclusion in a Post-Discharge Guideline Booklet for Mothers with Prematurely born Babies in a Low-Resource Setting in South Africa

Background: Prematurity brings along a high risk of early and late mortality and morbidity that demands specialized care within the NICU. Mothers of premature babies often feel powerless and helpless once the premature baby is discharged from the neonatal intensive care unit (NICU). These experiences might interfere with their transitions into parenthood as they might question their ability to care for their baby. As nurses become greatly concerned regarding the continuity of care at home, the purpose of this study was to explore and describe the information that mothers of prematurely born babies need upon discharge for inclusion in a guideline booklet. Methods: A qualitative explorative design was used to conduct interviews with mothers of prematurely born babies in a NICU of a tertiary hospital in Gauteng Province, South Africa. Purposive sampling was used to select mothers whose prematurely born babies were preparing for discharge from NICU and mothers whose babies were discharged and at home and were brought to the hospital for their six weeks follow-up after discharge. Unstructured individual interviews were conducted. Results: The following seven themes were identified, namely feeding of a prematurely born baby, positioning of the baby, infection control and hygiene, care for a sick baby or baby with special needs, immunisation and clinic visits, normal development and growth, and information guidelines. Conclusion: The findings of this study were used to include essential information in a guideline booklet for mothers with prematurely born babies upon discharge from the NICU.

The Impact of a Preterm Baby Arrival in a Family: A Descriptive Cross-Sectional Pilot Study

Background: The rate of premature births is increasing every day, with an estimated 15 million premature babies born worldwide each year. When a child is born prematurely, he or she is transferred to a Neonatal Intensive Care Unit (NICU), requiring special care on an ongoing basis. The admission of the newborn to these units can negatively affect the family routine as it generates changes and requires adaptation to new roles. Objectives: The objective of the present study was to understand the effect of the arrival of a premature baby on the family, based on the parents’ perception. Methods: A cross-sectional descriptive observational study conducted by means of a self-administered online ad-hoc questionnaire which collected information related to the situation of the relatives of premature infants in the region of Extremadura (Spain). The questionnaire consisted of a total of 35 questions, divided into three sections: ‘family environment’, ‘stay in hospital’ and ‘return home’. Results: Among the 53 responses obtained from fathers and mothers, 44 were from mothers. 53.6% of the respondents felt a delay in the acquisition of their parental role and 86.8% were afraid for their baby. During hospital stay, most of the parents had to modify their routines (94.3%), 69.8% suffered from sleep disturbances, 84.9% changed their eating habits and 88.5% referred to loss of time for themselves. Once at home, the time it took to recover their family normality ranged from 4 to 11 months, while 84.9% of respondents neglected their personal appearance and more than half had to give up or reduce their working hours. Conclusion: The arrival of a premature baby has a strong impact on the parents’ family environment, altering their daily routines and occupations both in hospital and at home. If preterm care programmes take into account these possible occupational imbalances, it will not only meet the needs of the parents but also provide family-centred care.

Intrauterine Intussusception Presenting as Fetal Ascites and Meconium Peritonitis

Intussusception is a well-known cause of intestinal obstruction in children. Its occurrence in fetus as an intrauterine incidence is extremely rare and poses a diagnostic difficulty. Intrauterine intussusception may result in intestinal atresia once the gangrenous segment resorbed. However, a very late occurrence of intussusception just prior to delivery may present as meconium peritonitis. We are reporting a case of premature baby who was born at 35 weeks gestation via emergency caesarean for breech in labour. Routine scan 4 days prior to the delivery showed evidence of fetal ascites. She was born with good Apgar Score and weighed 2.5kg. Subsequently she developed respiratory distress syndrome requiring mechanical ventilation. She passed minimal meconium once after birth then developed progressive abdominal distension and vomiting. Abdominal radiograph on day 4 of life revealed gross pneumoperitoneum and bedside percutaneous drain was inserted to ease the ventilation. Upon exploratory laparotomy, a single ileal perforation was seen 20cm from ileocecal junction with an intussusceptum was seen in the distal bowel. Gross meconium contamination and bowel edema did not favour the option of primary anastomosis, thus stoma was created. Reversal of stoma was performed a month later and she recovered well. Fetus with a complicated intrauterine intussusception may present with fetal ascites and their postnatal clinical and radiological findings need to be carefully assessed for evidence of meconium peritonitis; in which a timely surgical intervention is required to prevent the sequelae of prolonged intraabdominal sepsis in this premature baby.International Journal of Human and Health Sciences Supplementary Issue-2: 2021 Page: S18

Case Of NAIT Causing Severe Thrombocytopenia due to Anti-HLA Class I

Neonatal alloimmune thrombocytopenia (NAIT) is the leading cause of thrombocytopenia in otherwise healthy new-born. (1,2) Maternal antibodies raised against paternally inherited alloantigen carried on fetal platelet causing NAIT. Maternal IgG antibodies passed through to the fetal via the placenta, attack and cause the destruction of the fetal platelet. (3) We present a case of NAIT without any complications in a premature baby (35 weeks) with VACREL association, G6PD deficiency, left calcified cephalohaematoma, cardiomegaly and hypospadias with severe thrombocytopenia (platelet counts is 23 109/L) at day two of life and received twice platelet transfusion. Platelet count initially 123 109/L at birth but significantly drop and persistently less than 50 109/L until day 10 of life before it normalized. Maternal serum antibody screening was negative, but platelet immunology test detected maternal platelet-reactive antibody Anti-HLA Class I and correlates with incompatible parental crossmatch indicating that parent had “platelet-antigen incompatibility”. The goal of obstetric management is to identify pregnancies at risk and prevent intracranial haemorrhage. (4) There is no evidence to support routine screening for pregnancies as per current practice. (2, 5) The latest treatments include maternal administration of intravenous immunoglobulin to suppress maternal antibody production and or to reduce placental transfer of antibodies; with or without steroids during antepartum period besides planning of mode, timing and method of delivery. (2, 5, 6, 7) This is a rare and unique case of NAIT secondary to Anti-HLA Class I antibody and hence clinician should be au fait with the diagnosis and management as it is infrequent among Malaysian.International Journal of Human and Health Sciences Supplementary Issue-2: 2021 Page: S21

Maternal Stressful Experience in Giving Birth to Premature Baby in Neonatal Intensive Care Unit Ward

AIM: This study aimed to determine the stressor of mothers whose baby was treated in Neonatal Intensive Care Unit (NICU) ward and identify the demography parameter which affected the stressor. METHODS: This cross-sectional study was done in four hospitals in Makassar City. Stressor was evaluated using Parental Scale Stressor (PSS): NICU. Samples were taken consecutively for 30 babies treated in NICU ward for more than 24 h. RESULTS: On the average, the mothers’ stressors were the situation and view of NICU (2.87), appearance and behavior of the baby (2.78), the role of parents (2.74), and communication relationship between the parents and nurse (2.80). Meanwhile, demography factors (maternal age, age of pregnancy, parity, and experience) did not affect the maternal stress statistically. CONCLUSION: Premature babies who are treated in NICU ward can be the source of maternal stress, thus provision of education to the mothers can decrease the stress.