Gaining confidence and perspective: a phenomenological study of mothers' lived experiences caring for infants at home after neonatal unit discharge.

AIM: This paper is a report of a descriptive study of mothers' experiences in caring for preterm or term infants following discharge from a neonatal unit, including how they manage infant pain/discomfort.

BACKGROUND: Few studies have focused on the transition that parents experience after infants are discharged home and little is known about parents' caregiving experiences when their infant has pain/discomfort. Greater knowledge about these issues will help healthcare professionals to better support parents.

METHOD: Nine mothers were interviewed in 2007-2008 about their caregiving experiences in the months following neonatal unit discharge. Interviews were conducted using a descriptive phenomenological approach and analysed using Giorgi's framework.

FINDINGS: Six themes formed mothers' experiences: apprehension, confidence, responsibility, awareness, normalcy and perspective. Mothers had apprehension about their infants' fragile health, losing support of the neonatal team, and performing medical procedures. They developed confidence as infant health improved. Responsibility for performing infant medical care often dominated mothers' experiences. Awareness of infant needs was described as a learning process utilizing external resources, trial-and-error, and an internal intuitive sense; particularly in identifying and dealing with infant pain/discomfort. During the transition to prior social environments, concerns about normalcy arose. Over time, mothers' gained a philosophical perspective and saw their experiences in a positive light.

CONCLUSION: The apprehension-confidence continuum model provides a framework for nursing assessment of mothers' needs following their infants' discharge from a neonatal unit. Factors such as infant health, medical procedures, and family or health professional support may influence the degree of apprehension or confidence.