Document Type : original article
Authors
1 Neonatal Intensive Care Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences
2 Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
3 Pediatric and infantDepartment,Nursing and Midwifery Faculty, Isfahan University of medical sciences, IRAN
Abstract
Background: Separation of the mother from her preterm hospitalized infant and the restrictions imposed by the Covid-19 pandemic can influence psychological dimensions such as the mothers’ attachment to the preterm infants.
Methods: This cross-sectional correlational study was conducted during the Covid-19 pandemic and before the nationwide vaccination in a 4-month period from December 2020 to March 2021 on 190 mothers whose preterm infants were admitted to the neonatal intensive care unit (NICU) of the selected hospitals in Isfahan, Iran. All mothers with the inclusion criteria had the chance of participating in the study. After obtaining their consent, they completed Brockington's Postpartum Bonding Questionnaire, Corona Disease Anxiety Scale (CDAS), the multidimensional scale of perceived social support (mspss), and a researcher-made form concerning the Maternal-Neonatal Demographic Characteristics.
Results: The Covid-19 anxiety (12.21±10.31), perceived social support (66.55±12.81) and maternal attachment (43.81±6.82) were estimated to be at the levels of mild, high, and medium respectively. As shown by the results of the Pearson correlation coefficient, a significant relationship was observed between the Covid-19 anxiety and maternal attachment (P <0.001). No significant relationship was observed between the perceived social support and maternal attachment at the significance level of 0.05 (p <0.05). Moreover, based on the results of the final multiple regression model, the Covid-19 anxiety, income level of the mother and her job were significant predictors of maternal attachment (P <0.001).
Conclusion: Based on the results of the study, increased anxiety of the Covid-19 could reduce the level of maternal-neonatal attachment. The factors of Covid-19 anxiety, income level and job of mothers were significant predictors of maternal attachment.
Keywords
- Wang L, Gao YH, Lou LL, Zhang GJ. The clinical dynamics of 18 cases of COVID-19 outside of Wuhan, China. Eur Respir J. 2020; 55(4).
- Zaigham M, Andersson O. Maternal and perinatal outcomes with COVID-19: A systematic review of 108 pregnancies. Acta Obst Gynecol Scand. 2020; 99:823–9.
- Davenport MH, Meyer S, Meah VL, Strynadka MC, Khurana R. Moms Are Not OK: COVID-19 and Maternal Mental Health. Front Glob Women’s Heal. 2020; 20:1–6.
- Nanjundaswamy MH, Shiva L, Desai G, Ganjekar S, Kishore T, Ram U, et al. COVID-19-related anxiety and concerns expressed by pregnant and postpartum women—a survey among obstetricians. Arch Womens Ment Health. 2020; 23(6):787–90.
- Mayopoulos GA, Ein-Dor T, Dishy GA, Nandru R, Chan SJ, Hanley LE, et al. COVID-19 is associated with traumatic childbirth and subsequent mother-infant bonding problems. J Affect Disord. 2021; 282:122–5.
- Bastani F, Rahmatnejad L, Jahdi F, Haghani H. Breastfeeding Self Efficacy and Perceived Stress in Primiparous Mothers. IJN. 2008; 21(54):9–24.
- Pichler-Stachl E, Pichler G, Baik N, Urlesberger B, Alexander A, Urlesberger P, et al. Maternal stress after preterm birth: Impact of length of antepartum hospital stay. Women and Birth. 2016; 29:e105–9.
- Sankaranarayanan K, Mondkar J A, Search articles by “J A Mondkar,” Mondkar J, Chauhan M, B M Mascarenhas, et al. Oil massage in neonates: an open randomized controlled study of coconut versus mineral oil. Indian Pediatr. 2005; 42(9):877–84.
- Lowdermilk DL, Perry SE, Cashion MC. Lowdermilk’s Maternity Nursing. 8th ed. Mosby; 2013.
- Juan J, Gil MM, Rong Z, Zhang Y, Yang H, Poon LC. Effect of coronavirus disease 2019 (COVID-19) on maternal, perinatal and neonatal outcome: systematic review. Ultrasound Obs Gynecol. 2020; 56:15–27.
- Alipour A, Ghadami A, Alipour Z, Abdollahzadeh H. Preliminary Validation of the Corona Disease Anxiety Scale (CDAS) in the Iranian Sample. Q J Heal Psychol. 2020; 8(4):163–75.
- Eyni S, Ebadi M, Hashemi Z. Research paper corona anxiety in nurses: The predictive role of perceived social support and sense of coherence. Iran J Psychiatry Clin Psychol. 2020; 26(3):320–31.
- Ezazi Bojnourdi E, Ghadampour S, Moradi Shakib A, Ghazbanzadeh R. Predicting Corona Anxiety based on Cognitive Emotion Regulation Strategies, Health Hardiness and Death Anxiety in Diabetic Patients. Iran J Psychiatr Nurs. 2020; 8(2):34–44.
- Zimet GD, Dahlem NW, Zimet SG, Farley GK. The Multidimensional Scale of Perceived Social Support. J Pers Assess. 1988; 52(1):30–41.
- Karami J, Moradi A, Hatamian P. The Effect of Resilience, Self-Efficacy, and Social Support on Job Satisfaction among the Employed, Middle-Aged and Elderly. Iran J Ageing. 2017; 12(3):300–11.
- Tabatabaeichehr M, Mortazavi H, Sharifiyan E, Mehraban Z. Comparative Study of Received Social Support and Perceived Social Support from the Viewpoint of the Elderly People. J North Khorasan Univ Med Sci. 2019; 11(2):98–106.
- Khoramirad A, Ansari Shahidi M, Rezaii Jamaloi H, Sadeghimoghaddam P. The Effect of Mindfulness-Based Developmental Care on Maternal Stress and Bonding with Premature Infants Hospitalized in NICU. Qom Univ Med Sci J. 2020; 14(1):61–73.
- Aflakseir A, Jamali S. Relationship between Mother-Child Bonding with Postpartum Depression among a Group of Mothers in Shiraz-Iran. Prev Care Nurs Midwifery J. 2014; 3(2):61–9.
- Bonacquisti A, Geller PA, Patterson CA. Maternal depression, anxiety, stress, and maternal-infant attachment in the neonatal intensive care unit. J Reprod Infant Psychol. 2020; 38(3):297–310.
- Mounts KO. Screening for Maternal Depression in the Neonatal ICU. Clin Perinatol. 2009; 36(1):137–52.
- Hara MWO. Postpartum Depression: What We Know. J Clin Psychol. 2010; 65(12):430–41.
- Moses-Kolko E, Roth EK. Antepartum and postpartum depression: Healthy mom, healthy baby. Antepartum postpartum Depress Heal mom, Heal baby. 2004; 59(3):181–91.
- Ponti L, Smorti M, Ghinassi S, Tani F. The relationship between romantic and prenatal maternal attachment : The moderating role of social support. Int J Psychol. 2021; 56(1):143–50.
- Keskin F, Yagmur Y. The Factors Affecting Maternal Attachment in Eastern Turkey. Int J Caring Sci. 2020; 13(2):858–67.
- Delavari M, Mirghafourvand M, Mohammad-Alizadeh-Charandabi S. The relationship of maternal–fetal attachment and depression with social support in pregnant women referring to health centers of Tabriz–Iran, 2016. J Matern Neonatal Med. 2018; 31(18):2450–6.
- Cinar N, Köse D, Altinkaynak S. The relationship between maternal attachment, perceived social support and breast-feeding sufficiency. J Coll Physicians Surg Pakistan. 2015; 25(4):271–5.
- Lefkowitz DS, Baxt C, Evans JR. Prevalence and correlates of posttraumatic stress and postpartum depression in parents of infants in the neonatal intensive care unit (NICU). J Clin Psychol Med Settings. 2010; 17(3):230–7.
- Dudek-Shriber L. Parent stress in the Neonatal Intensive Care Unit and the influence of parent and infant characteristics. Am J Occup Ther. 2004; 58(5):509–20.
- Jamshidimanesh M, Astaraki L, Behboodi Moghadam Z, Taghizadeh Z, Haghani H. Maternal-Fetal Attachment and its Associated Factors. J Hayat. 2013; 18(5):33–45.
- Khabaz M, Nematollahi M, Mahdipoor R, Sabzevari S. The relationship between maternal attachment and self-esteem in mothers of hospitalized preterm infants in neonatal intensive care units. Nurs Midwifery J. 2020; 18(5):398–408.
- Daglar G, Nur N. Level of Mother-Baby Bonding and Influencing Factors during Pregnancy and Postpartum Period. Psychiatr Danub. 2018; 30(4):433–40.
- Valizadeh S, Arshadi Bostanabad M, Babapour Kheiroddin J, Shameli R. Comparison of kindergarten and non-kindergarten students to parent’s attachments in Tabriz. Iran J Psychiatr Nurs. 2013; 1(1):10–8.
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