Perception of mothers admitted to NICU infants: influence of maternal, contextual variables, social support and coping

The neonatal intensive care unit (NICU), although it is a special care environment to ensure the survival of newborns, tends to raise in mothers and relatives ambiguous perceptions and feelings about hospitalization events and change the emotional health of those involved. These aspects can be influenced by the length of time the baby is hospitalized. This project was divided into two stages. In the first stage 1, it was intended to elaborate and adapt instruments that would enable the investigation of the perception and feelings that mothers of infants admitted to NICU have regarding this condition. The result was the elaboration of the instruments: Protocol for the evaluation of maternal perception on the condition of the baby hospitalized in NICU, with 24 items and the Protocol of feelings evaluation, with three multiple-choice items, to identify the frequency and justification of feelings emerged at the time of the news, during and after hospitalization. The Step 2 is composed of five studies, with the objective of evaluating maternal feelings and perceptions about hospitalization, maternal emotional health, perceived social support and coping strategies, relating them to length of stay. Data from all of them were obtained from a sample of 50 mothers of infants admitted to a NICU at Maternidade Santa Isabel, in the city of Bauru / SP, for at least three days. The Perceived Stress Scale, the State-Trait Anxiety Inventory, and the Beck Depression Inventory were used to assess maternal emotional health. For the evaluation of the coping was applied the Scale Modes of Confronting Problems and the social support was evaluated by the Scale of Social Support (EAS). In Study 1 the objective was to describe the emotional health of mothers of hospitalized babies, comparing it and relating it to the length of stay in NICU. The results pointed to 12% of mothers with clinical indicators for depression, 38% for high and moderate stress, 64% of mothers with clinical indicators for state anxiety and 54% for trait anxiety. Of these, 56% had two or more clinical indicators. There was a positive correlation between state anxiety and length of hospital stay in the NICU.In Study 2 the objective was to describe the network of social support perceived by baby mothers in NICU and to relate it to the length of hospital stay. It was observed that mothers perceive more the support of relatives, especially in the material, affective and informational dimensions. There was no correlation between the dimensions of social support assessed and the length of hospital stay. Study 3 aimed to describe the strategies of maternal coping, comparing them considering the time of hospitalization and number of clinical indicators. The results showed that the most frequent strategies were those focused on the problem. No correlations were observed with length of hospital stay and the strategies used. Depression was positively associated with strategies focused on emotion and negatively associated with strategies focused on the problem. Study 4 had as objectives to describe the feelings of the mothers at different moments of the hospitalization and to compare them considering absence and presence of clinical indicators. The results showed that mothers reported more negative feelings at the time of the hospitalization notice and less at the time of the visit. Most reported positive feelings regarding the expectation of hospital discharge. Mothers who reported negative feelings at the time of the news also showed more indicators during the visits, even reporting positive feelings. Study 5 aimed to describe the maternal perception about the infant's hospitalization in NICU and to correlate it with maternal emotional health. The results showed that maternal perception is divided between positive and negative in four of the five categories evaluated. Only the perception of social support was perceived as negative and was associated negatively with state anxiety. The data obtained suggest the importance of identifying how mothers perceive, feel and unfold the experience of the hospitalization of their babies for the implementation of interventions in the hospital space. (AU)