ABSTRACT

Premature infants require intensive care in Neonatal Intensive Care Units (NICUs) to prevent life-threatening complications. However, the care process not only impacts the infants but also imposes significant emotional and psychosocial challenges on mothers. This study aims to identify and explore the needs of mothers during the hospitalization of their premature infants in the NICU. A qualitative case study design was employed. Three mothers of premature infants hospitalized in the NICU of Dr. Soediran Mangun Sumarso Hospital, Wonogiri, were purposively selected as participants. Data were collected through in-depth interviews and focus group discussions (FGD), then analyzed using a thematic approach. Seven main themes emerged concerning maternal needs: (1) emotional and spiritual needs, (2) limited access to the baby, (3) lack of practical care education, (4) the role of family support, (5) confusion in basic infant care, (6) the need for visual educational media, and (7) expectations for improved communication and hospital services. Conclusion: The needs of mothers during the NICU care of premature infants extend beyond technical aspects to encompass emotional, educational, and social support. Hospitals should develop more inclusive and family-responsive NICU care approaches to better address these needs.

Keywords: NICU, Premature Infants, Maternal Needs, Family Nursing, Qualitative Approach.

ABSTRAK

Bayi prematur memerlukan perawatan intensif di ruang NICU untuk menghindari komplikasi yang mengancam keselamatan jiwa. Namun, proses perawatan tersebut tidak hanya berdampak pada bayi, melainkan juga pada ibu yang secara emosional dan psikososial mengalami tantangan besar. Penelitian ini bertujuan untuk mengidentifikasi dan mengeksplorasi kebutuhan ibu selama proses perawatan bayi prematur di ruang NICU. Penelitian ini menggunakan pendekatan kualitatif dengan desain studi kasus. Tiga ibu yang memiliki bayi prematur dan dirawat di ruang NICU RSUD dr. Soediran Mangun Sumarso Wonogiri menjadi partisipan, dipilih menggunakan teknik purposive sampling. Data dikumpulkan melalui wawancara mendalam dan Focus Group Discussion (FGD), dianalisis menggunakan pendekatan tematik. Ditemukan tujuh tema utama terkait kebutuhan ibu: (1) kebutuhan emosional dan spiritual, (2) keterbatasan akses terhadap bayi, (3) kurangnya edukasi praktik perawatan, (4) peran dukungan keluarga, (5) kebingungan dalam perawatan dasar bayi prematur, (6) kebutuhan media edukasi visual, dan (7) harapan terhadap peningkatan komunikasi dan pelayanan rumah sakit. Kebutuhan ibu selama perawatan bayi prematur tidak hanya mencakup aspek teknis, tetapi juga mencakup kebutuhan emosional, edukatif, dan dukungan sosial. Rumah sakit perlu mengembangkan pendekatan pelayanan NICU yang lebih inklusif dan responsif terhadap kebutuhan keluarga pasien.

Kata Kunci: NICU, Bayi Prematur, Kebutuhan Ibu, Keperawatan Keluarga, Pendekatan Kualitatif.

Abbasi, F. et al. (2023) ‘The Effect of Premature Neonates Massage by Mothers on Maternal Anxiety and Self-Esteem: A Randomized Clinical Trial’, Evidence Based Care Journal, 13(3), pp. 43–49. doi: 10.22038/EBCJ.2023.67025.2794.

Alviyanti, N. P. and Nurlaila, N. (2024) ‘Gambaran Stres Pengasuhan Ibu Bayi Prematur Di Ruang Perawatan Intensif Neonatus’, Jurnal Keperawatan Karya Bhakti, 10(1), pp. 24–33. doi: 10.56186/jkkb.130.

Astuti, E. S. et al. (2019) ‘Mother’s independence model within caring for low birth weight babies at home after hospital care based on mother factors, family support, and social support’, Indian Journal of Public Health Research and Development, 10(10), pp. 1685–1690. doi: 10.5958/0976-5506.2019.03085.7.

Bua, J. et al. (2021) ‘Parental Stress, Depression, and Participation in Care Before and During the COVID-19 Pandemic: A Prospective Observational Study in an Italian Neonatal Intensive Care Unit’, Frontiers in Pediatrics, 9. doi: 10.3389/fped.2021.737089.

Byrne, E. M. et al. (2019) ‘Effects of Instruction on Parent Competency during Infant Handling in a Neonatal Intensive Care Unit’, Pediatric Physical Therapy, 31(1), pp. 43–49. doi: 10.1097/PEP.0000000000000557.

Castel, S. et al. (2016) ‘Effects of an intervention program on maternal and paternal parenting stress after preterm birth: A randomized trial’, Early Human Development, 103, pp. 17–25. doi: 10.1016/j.earlhumdev.2016.05.007.

Davis, D. (2020) ‘4 Saving the Babies’, pp. 121–144. doi: 10.18574/nyu/9781479812271.003.0006.

Dewi, D.T.K., Nguyen, C.T.T., Chen, S.R., Lee, G.T., Huda, M.H., & Kuo, S. Y. (2025) ‘Effectiveness of parenting interventions on self-efficacy, anxiety, stress, and depression among parents of preterm infants: A systematic review and meta-analysis of randomized control trials’, International Journal of Nursing Studies, 169, p. p.105128. doi: https://doi.org/10.1016/j.ijnurstu.2025.105128.

Discenza, D. (2020) ‘The Preemie Parent’s Survival Guide to the NICU’, Neonatology Today, 15(11), p. 102. doi: 10.51362/neonatology.today/2020111511102102.

Franck, L. S. et al. (2024) ‘Mobile-enhanced Family Integrated Care for preterm infants: A qualitative study of parents’ views’, PEC Innovation, 4. doi: 10.1016/j.pecinn.2024.100284.

Gautam, A. et al. (2024) ‘Financial Implications for Families of Newborns Admitted in a Tertiary Care Neonatal Unit in Northern India’, Journal of Neonatology, 38(1), pp. 118–123. doi: 10.1177/09732179231180976.

Ghadery-Sefat, A. et al. (2016) ‘Relationship Between Parent–infant Attachment and Parental Satisfaction With Supportive Nursing Care’, Iranian Journal of Nursing and Midwifery Research, 21(1), p. 71. doi: 10.4103/1735-9066.174756.

Ghetti, C. M. et al. (2021) ‘Longitudinal Study of Music Therapy’s Effectiveness for Premature Infants and Their Caregivers (LongSTEP): Feasibility Study With a Norwegian Cohort.’, Journal of music therapy, 58(2), pp. 201–240. doi: 10.1093/jmt/thaa023.

Ghetti, C. M. et al. (2023) ‘Effect of Music Therapy on Parent-Infant Bonding Among Infants Born Preterm: A Randomized Clinical Trial.’, JAMA network open, 6(5), p. e2315750. doi: 10.1001/jamanetworkopen.2023.15750.

Gondwe, K. W. et al. (2020) ‘Emotional distress in mothers of early-preterm infants, late-preterm infants, and full-term infants in Malawi.’, Nursing outlook, 68(1), pp. 94–103. doi: 10.1016/j.outlook.2019.05.013.

Gonya, J. et al. (2018) ‘Nursing Networks in the NICU and Their Association With Maternal Stress: A Pilot Study’, Journal of Nursing Management, 27(2), pp. 442–449. doi: 10.1111/jonm.12679.

Greene, M. M. et al. (2015) ‘Depression, anxiety, and perinatal-specific posttraumatic distress in mothers of very low birth weight infants in the neonatal intensive care unit’, Journal of Developmental and Behavioral Pediatrics, 36(5), pp. 362–370. doi: 10.1097/DBP.0000000000000174.

Hendy, A. et al. (2024) ‘The Stress Levels of Premature Infants’ Parents and Related Factors in NICU’, Sage Open Nursing, 10. doi: 10.1177/23779608241231172.

Ionio, C. et al. (2019) ‘Stress and feelings in mothers and fathers in NICU: identifying risk factors for early interventions.’, Primary health care research & development, 20, p. e81. doi: 10.1017/S1463423619000021.

Jang, Y. J. and Han, K. S. (2022) ‘Relationship Between Maternal Touch, Maternal Self-Confidence, Infant Length, and Feeding Volume in High-Risk Infants: Touch on the Mind’, Korean Journal of Stress Research, 30(2), pp. 118–128. doi: 10.17547/kjsr.2022.30.2.118.

Klawetter, S. et al. (2019) ‘An integrative review: maternal engagement in the neonatal intensive care unit and health outcomes for U.S.-born preterm infants and their parents’, AIMS Public Health, 6(2), pp. 160–183. doi: 10.3934/publichealth.2019.2.160.

Lestari, P. M. et al. (2025) ‘Factors Affecting Breastfeeding Practice Among Mothers With Hospitalized Neonates’, Indonesian Journal of Obstetrics & Gynecology Science, 8(1), p. 82. doi: 10.24198/obgynia.v8i1.707.

Li, S. et al. (2022) ‘Effectiveness of the PRECEDE-PROCEED model for improving the care knowledge, skill, and sense of competence in mothers of preterm infants’, Journal of International Medical Research, 50(7). doi: 10.1177/03000605221110699.

Mclean, M. A. et al. (2022) ‘Lower Maternal Chronic Physiological Stress and Better Child Behavior at 18 Months: Follow-Up of a Cluster Randomized Trial of Neonatal Intensive Care Unit Family Integrated Care’, Journal of Pediatrics, 243, pp. 107-115.e4. doi: 10.1016/j.jpeds.2021.12.055.

Mulder, M. B. et al. (2020) ‘The unborn fetus: The unrecognized victim of trauma during pregnancy.’, Journal of pediatric surgery, 55(5), pp. 938–943. doi: 10.1016/j.jpedsurg.2020.01.047.

Murphy, M., Shah, V. and Benzies, K. (2021) ‘Effectiveness of alberta family-integrated care on neonatal outcomes: A cluster randomized controlled trial’, Journal of Clinical Medicine, 10(24). doi: 10.3390/jcm10245871.

Negarandeh, R. et al. (2020) ‘Health Care Staff Support for Mothers in NICU: A Focused Ethnography Study’. doi: 10.21203/rs.3.rs-49592/v3.

O’Brien, K. et al. (2018) ‘Effectiveness of Family Integrated Care in neonatal intensive care units on infant and parent outcomes: a multicentre, multinational, cluster-randomised controlled trial’, The Lancet Child and Adolescent Health, 2(4), pp. 245–254. doi: 10.1016/s2352-4642(18)30039-7.

Palazzi, A. et al. (2021) ‘Music therapy enhances preterm infant’s signs of engagement and sustains maternal singing in the NICU’, Infant Behavior and Development, 64, p. 101596. doi: https://doi.org/10.1016/j.infbeh.2021.101596.

Pavlyshyn, H., Sarapuk, I. and Saturska, U. (2022) ‘Maternal Stress Experience in the Neonatal Intensive Care Unit After Preterm Delivery’, American Journal of Perinatology, 41(09), pp. 1155–1162. doi: 10.1055/s-0042-1747942.

Pourmovahed, Z. and Aryaeenezhad, A. (2021) ‘Comparison of Maternal-Infant Attachment Behaviors and Social Support in Mothers of Healthy Newborn and Premature Newborn Hospitalized in Neonatal Intensive Care Units’, Journal of Health and Care, 22(4), pp. 348–357. doi: 10.52547/jhc.22.4.348.

Shaw, R. J. et al. (2013) ‘Prevention of traumatic stress in mothers with preterm infants: a randomized controlled trial.’, Pediatrics, 132(4), pp. e886-94. doi: 10.1542/peds.2013-1331.

Singh, A. K. et al. (2024) ‘Assessing the Impact of Different Levels of Parental Involvement in the NICU on Neonatal Outcomes and Parental Mental Health’, Journal of Pharmacy and Bioallied Sciences, 16(Suppl 3), pp. S2836–S2838. doi: 10.4103/jpbs.jpbs_350_24.

Siva, N. et al. (2023) ‘Involvement of mothers in high-risk neonatal care: A capacity building program for neonatal nurses’, Journal of Neonatal Nursing, 29(1), pp. 91–96. doi: 10.1016/j.jnn.2022.03.001.

Siva, N. et al. (2024) ‘Interventional Strategies to Mitigate Maternal Stress and Enhance Coping Skills During Neonatal Admission Into Intensive Care Units in Low- and Middle-Income Countries: A Scoping Review’, Nursing Open, 11(11). doi: 10.1002/nop2.70071.

Thanh, B. Y. L. et al. (2019) ‘Mode of delivery and pregnancy outcomes in preterm birth: a secondary analysis of the WHO Global and Multi-country Surveys.’, Scientific reports, 9(1), p. 15556. doi: 10.1038/s41598-019-52015-w.

Turk Dudukcu, F. and Tas Arslan, F. (2022) ‘Effects of health promotion program on maternal attachment, parenting self-efficacy, infant development: a randomised controlled trial’, Journal of Obstetrics and Gynaecology, 42(7), pp. 2818–2825. doi: 10.1080/01443615.2022.2109949.

Ünal, N., Küçükdağ, M. and Şengun, Z. (2023) ‘Evaluatıon of Stress Levels in Both Parents of Newborns Hospıtalızed in the Neonatal Intensıve Care Unit’, Mathews Journal of Pediatrics, 8(1). doi: 10.30654/mjp.10029.

Valizadeh, L. et al. (2016) ‘Effect of NICU Department Orientation Program on Mother’s Anxiety: A Randomized Clinical Trial’, Journal of Caring Sciences, 5(3), pp. 205–214. doi: 10.15171/jcs.2016.022.

Wigley, I. L. C. M. et al. (2021) ‘The Role of Maternal Touch in the Association Between SLC6A4 Methylation and Stress Response in Very Preterm Infants’, Developmental Psychobiology, 63(S1). doi: 10.1002/dev.22218.

Yang, R. et al. (2022) ‘Experiences of mothers of NICU preterm infants in milk management out of the hospital: a qualitative study’, International Breastfeeding Journal, 17(1), p. 95. doi: 10.1186/s13006-022-00540-2.

Zohrehvand, T. et al. (2024) ‘Investigation of Prognosis and Related Factors of Premature Neonates’, Acta Medica Iranica. doi: 10.18502/acta.v62i1.16885.