1 Department of Public Health - Department of Science in Nursing, Department of Public Health, Health, Aarhus University2 Department of Clinical Medicine - Department of Paediatrics, Department of Clinical Medicine, Health, Aarhus University3 Børneafdeling A, Aarhus Universitets Hospital4 Department of Clinical Medicine - Department of Paediatrics, Department of Clinical Medicine, Health, Aarhus University
Background: The knowledge of parents’ of preterm infants' self-esteem is limited. The nursing of the preterm infants is based on the principles of family centered care. The dyad between the mother and the infant was the primary focus in earlier investigations. Current research shows that involvement of the father increases the fatherhood and thereby the bonding to the child. The parents’ self-esteem seems to be affected negatively by the premature birth. Objective: To gain further knowledge and a deeper understanding of the parents’ experience of their self-esteem during the admission to the hospital and after discharge. Method and data: A qualitative interview research was utilized, in which data is created using semistructured interviews and afterwards analyzed by inspiration of the French philosopher Paul Ricoeur. The parents (six mothers and five fathers) were enrolled successively in two phases: 1) Three weeks from birth and 2) eight months after discharge. Results: The findings of the research are based on a theoretical frame concerning self-esteem from a psychological point of view. The data from the first phase three weeks after birth show that, individual, relational and structural aspects influence the parents’ experience of their self-esteem after the premature birth. Individual aspects include fathers' description of feeling as being split between taking care of the mother and taking care of the newborn infant admitted to the newborn intensive care. The mothers' experience difficulties remembering what happened during the first day after giving birth. The relational aspects affect the relationship between the mother and father, the relationship towards their infant and the parents’ experience of their self-esteem. Furthermore, the support from the nurses and the parents’ network has a positive effect on the self-esteem. The structural aspects refer to how the parents experience the high-tech environment of the newborn intensive care. The parents describe how the infants’ needs, the medical state and development have an effect on how they evaluate themselves as a parent in the nursing context. The interviews of the second phase at eight months after discharge show that the premature birth and the unexpected early link to the infant consolidate the foundation of parenthood and established the bonding process. The transfer to home has affected and improved their self-esteem through active responsibility. Retrospectively, it became obvious for the parents that the hospital structure and environment became a limitation to take responsibility for the parenthood. Conclusion: The findings indicate that division of attention (the fathers) and amnesia of early experience (the mothers) characterize the parents experienced self-esteem within the first twenty-four hours after the premature birth. Barriers, such medical high tech equipment, the professional attitudes and lack of knowledge within the newborn nursery environment limit the parents' possibility to take responsibility for the infant are experienced as frustrating. Later on, when the parents have established a sense of their parenthood, their self-esteem is affected by their relationship to one another, the relation to their infant and their closest social support network.