The study investigates the experiences of mothers with preterm newborns in a NICU. It identifies major themes such as emotional experiences, expectations, healthcare professionals' needs, health facility-related factors, and perceived incompetence in care.
In this study, mothers experienced negative emotions such as shock, worry, and anxiety when their babies were born early and admitted to the NICU. They expressed shock and worry when they saw their newborns in the NICU due to their small size and unstable medical condition. They were also worried when their babies died. This is consistent with the previous studies in Ethiopia and abroad, where mothers reported experiencing negative emotional feelings when their newborn needed admission to the NCU, as a result of the look at the different tubes and wires attached to the infants inside the incubators and the sound of the equipment [25–33].
In addition, mothers’ stated they were scared that the baby would be born prematurely and would not grow. This is supported by other findings in China, which found that mothers’ anxiety was related to their perception of their newborns’ serious condition and uncertainty about their survival [34]. In Rwanda, mothers were stressed by thinking that their babies would not survive [35]. Moreover, the finding is similar to a study conducted in Botswana that reported that it was difficult for the participants to believe that the tiny, frail, and vulnerable infant would survive, making investing in the new relationship even more challenging [36].
Another major finding was that good support from the healthcare team in the NICU, generally from nurses, is crucial to fulfilling the expectations of mothers. Some of the mothers appreciated the role of the healthcare team in discussing their infants’ situation, asking mothers to visit infants, and helping in the caring process. Furthermore, these mothers acknowledged their appreciation of the emotional, psychological, and spiritual support that was provided by the nurses. Some of the mothers expressed having bad experiences with NICU staff and said they expected the caring process to be better than it was. Some mothers reported receiving no emotional or psychological support, although they expressed their desire to be supported by the staff. In addition, mothers were waiting for the nurses or other healthcare teams to discuss their infants’ situation and to provide reassurance. This finding is consistent with the study conducted in Jordan [37].
This study indicates that some mothers mentioned that a lack of compassionate and respectful care and unsupportive health care providers and security guards had negative consequences for mothers, which meant the health care providers and security guards were not disciplined and lacked commitment and cooperation while they gave service in the NICU. Other studies also showed that health care providers were unsupportive, careless, and negligent [36, 37].
The study revealed that mothers faced numerous challenges during their hospital stay, including the unavailability of medicine and laboratory tests, as well as issues with facilities like inadequate bathroom space, inconvenient toilets, and a lack of rest areas for families. As a result, they had to purchase medicine from private pharmacies and lab tests from private clinics at a high cost, forcing them to rely on private pharmacies for their baby's care. Previous Research in Wolaita Sodo, Ethiopia, and Ghana has revealed a lack of adequate facilities and equipment for preterm newborn care in NICUs, including medicines, water, toilets, bathrooms, rest areas, and time for visiting neonates. This situation has put the economic potential of these communities at risk, and they are also concerned about the financial aspects of care [12, 16, 27, 28, 30, 37–39].
The study revealed that mothers often lack confidence and abilities in caring for preterm newborns, a finding consistent with previous research. It also found that emotional and professional support is crucial for increasing confidence and competence in this process, a finding consistent with a Chinese study [40].
Knowledge of and involvement in infant care is strongly related to caregiving confidence due to several factors: skill development through hands-on experience and education, empowerment from understanding preterm infants' needs, bonding and attachment through engaging in caregiving activities, communication with healthcare providers for better understanding, and emotional support from healthcare providers, family, and support groups. This holistic approach empowers mothers to navigate neonatal care challenges with resilience and self-assurance.
As strength, this purely qualitative study identified deep insight into the experience of mothers with preterm newborns in a neonatal intensive care unit. It was also noted that the anomalies, apart from the existing determinants of quantitative research, give direction for further research. As a limitation, this study couldn’t determine the cause-and-effect relationship of variables and cannot be generalized.
In conclusion, mothers whose preterm newborns were admitted to the NICU have faced emotional problems like anger, fear, guilt, crying, anxiety, sadness, frustration, dissatisfaction, happiness, disappointment, bad feelings, self-blaming, nervousness, disturbance, and lack of self-control. In addition, mothers suffered from a lack of spaces to take rest, a shortage of water for toilets and hygiene, the unavailability of some medicines, laboratory tests, and limited time to visit their neonates. It is essential for health care teams to provide education and support to help build their confidence in caring for their preterm infants. By recognizing and addressing these specific needs, healthcare professionals can contribute to positive outcomes for both the mother and the infant during their NICU stay. Based on the study findings, hospital management shall provide adequate waiting zones, space for the care of the neonates, avoid a shortage of medicines and laboratory reagents, and provide a standardized NICU setting in a way that HCPs and mothers can manage their hygiene and health education for both mothers and families to minimize the risk of emotional experiences for mothers.