Adaptation to Motherhood for Rural Women With Newborn(s) in the Neonatal Intensive Care Unit Donna Tomasulo West, PhD, RN, FNP-BC Pamela Stewart Fahs, PhD, RN Geraldine R. Britton, PhD, RN, FNP Carolyn Pierce, PhD, RN
n Abstract The Roy adaptation model (Roy, 2009) serves as a framework for this qualitative descriptive study. Participants resided in rural areas of Upstate New York and had given birth within the last month to a baby who was admitted to the neonatal intensive care unit (NICU). Through semi-structured interviews, they expressed their needs, concerns, and experiences. The purpose was to gain an understanding of the experience of how women from rural areas adapt to motherhood when their newborn requires care in the NICU. In total, seven themes emerged. The meta-theme was trust, found to be an integral part of their adaptation to motherhood. The findings have implications for nursing, as they will help inform the best care at a crucial developmental time in the lives of this vulnerable group of women. This aligns with the goal of nursing, which is assisting to promote a state of integrated adaptation, which is health according to Roy (2009). Keywords: Roy adaptation model, qualitative study, trust, therapeutic relationship
Background The purpose of this qualitative descriptive research was to gain an understanding of the experience of adapting to motherhood for rural women when they have a newborn in the neonatal intensive care unit (NICU). Becoming a mother is generally considered a normative transition for many women in adulthood (Aber et al., 2013). Adaptation to the role of mother, while challenging, is not considered unusual. However, when a newbornâs condition warrants admission to the NICU, mothers often have limited opportunities for physical contact with them, thus interfering and delaying adaptation to the role of mother. Moreover, there are serious health concerns, often unanticipated, for their babies. Consequently, many mothers experience distress, which contributes to symptoms of anxiety and depression, potentially limiting their ability to care for their newborns and leading to less desirable outcomes (Rossman et al., 2015). Thus, when a non-normative transition to motherhood occurs, it is fraught with additional challenges to adaptation to motherhood.
Providers who treat newborns in the NICU are also engaged in a therapeutic relationship with the parents of their patients.
A newbornâs admission to the NICU has been described as a very stressful (Heinemann et al., 2013; Heydarpour et al., 2017) and even traumatic event for the parents (Aftyka et al., 2017). Regardless of the reason for admission to a NICU, it is an experience accompanied by many challenges to adaptation for a parent (Park & Chung, 2015; Rossman et al., 2015). Providers who treat newborns in the NICU are also engaged in a therapeutic relationship with the parents of their patients, assisting them in adapting to parenting their newborn who is in critical condition.
Donna Tomasulo West, PhD, RN, FNP-BC; Pamela Stewart Fahs, PhD, RN; Geraldine R. Britton PhD, RN, FNP; and Carolyn Pierce, PhD, RN Binghamton University, Decker College of Nursing and Health Sciences, Binghamton, New York 34
Journal of the New York State Nurses Association, Volume 48, Number 2
