| dc.description.abstract | Abstract Teaching the postpartum mother who has an infant in the Neonatal Intensive Care Unit (NICU) about infant feeding may be delayed if the nurse does not determine readiness to learn (RTL) and confidence to feed (CTF) and/or makes assumptions about a lack of readiness based on the inherent stress of the situation. The purpose of this research was 1) to investigate the timing of maternal perceptions of RTL and CTF; 2) to compare maternal perceptions of RTL and CTF with postpartum nurse perceptions of the same, and 3) to investigate variables which may influence maternal perceptions of RTL and CTF. Research questions included: 1.When do new mothers perceive that they are ready to learn about infant feeding? 2. When do the nurses assigned to these mothers perceive that the mothers are ready to learn about infant feeding? 3. Are there differences in perception of timing of readiness to learn in the nurse-patient dyad? 4. How confident are new mothers about their ability to feed their infants? 5. How confident are the nurses assigned to these mothers about the mothers' ability to feed their infants? 6. Are there differences in the perception of confidence to feed in the nurse-patient dyad? 7. What is the relationship of level of state anxiety to mother's perception of readiness to learn? 8. What is the relationship of level of parenting experience to mother's perception of readiness to learn? 9. What is the relationship of level of maternal education to mother's perception of readiness to learn? 10. What is the relationship between maternal confidence in her ability to manage infant feeding and mother's readiness to learn? Participants included a convenience sample of 25 maternal-nurse dyads in the antepartum and postpartum units of a regional medical center (five dyads were used for the pilot phase and 20 were used for formal data collection). Using a two-phased, descriptive, quantitative design, mothers were measured on their perception of RTL timing, CTF level, and state anxiety. Nurses assigned to these mothers were also measured on their perceptions of the mothers' RTL and CTF. Primary and secondary statistical analyses were performed, looking at the impact of factors such as anxiety, previous parenting experience, and educational level on maternal RTL and CTF, using independent samples t-tests, Mann-Whitney, Chi Square, and Pearson correlation as appropriate, based on variable type and level of data distribution normality. Results of the pilot phase indicated that the newly-created RTL question and an existing CTF question had face validity and that the study protocol was deemed feasible by the nurses. Results of the formal data collection phase revealed that all mothers chose a RTL timing of "0", meaning that they were RTL now. Further results indicated that there was a statistically significant difference in values of nurses' perceptions of maternal readiness timing when compared across RN education level (Mean Rank 13.55 associate, 7.55 bachelor; p =.023). Pearson correlation revealed a statistically significant negative correlation between RN RTL and Maternal CTF (r = -.475; p =.034). The mean difference in RTL within the maternal-nurse dyad was 3.3 hours (95% CI [1.3/5.2]); that is, nurses' perception of their mothers' readiness to learn was, on average, 3.3 hours later than the mothers' own perception of their readiness. Statistically significant differences in nurses' perception of CTF were found when compared by maternal race type (Mean Rank 12.63 Caucasian, 7.31 African-American; p = .047) and level of maternal education (Mean Rank 8.58 high school, 14.07 college; p = .046). RN CTF was significantly correlated to RN Age (r = .497; p = .026) and RN Years as a nurse (r = .479; p = .033). The perception of confidence among maternal and nurse participants was significantly correlated using Pearson correlation (r = .483; p =.031). Anxiety level was significantly negatively correlated with maternal CTF (r = -.500; p =.025), nurse experience as an R.N. (r = -.657; p =.002), nurse experience as an obstetrical (OB) R.N. (r = -.614; p =.004) and RN age (r = -.738; p <.001). Conclusions derived from the results indicated that, despite having some level of state anxiety and having an infant in the NICU, mothers were RTL now and were moderately to very confident to feed their infants. Older, more experienced nurses appeared to be a factor in this maternal confidence. Nurse perceptions appeared to be influenced by maternal characteristics and type of nursing degree. Implications of these findings include an alignment between maternal and nurse perceptions, the need to continue to perform a thorough psychological and physical assessment of the mother, and the importance of promoting teaching and learning for a mother experiencing NICU stress. | |
