Fathering a premature baby

doi:10.21203/rs.3.rs-2988170/v1

Download PDF

Research Article

Fathering a premature baby

https://doi.org/10.21203/rs.3.rs-2988170/v1

This work is licensed under a CC BY 4.0 License

Version 1

posted

You are reading this latest preprint version

The hospitalization of premature infants is a difficult and anxiety-provoking experience for parents. Studies on the mother's experience are becoming increasingly numerous, while the father's experience remains little studied.

Objective: To explore the experiences of fathers of premature infants and the psychopathological and social consequences following the birth of their children.

A qualitative and quantitative study was carried out in the neonatology department of the Mohammed VI University Hospital in Marrakech among 80 men whose prematurely born child was still hospitalized in the neonatology department.

2 questionnaires were administered: the IES-R and the EPDS, and a semi-directive interview was also conducted.

Several aspects were highlighted, such as the difficult experience of premature birth and hospitalization, and the ambivalence of returning home. The importance of establishing a positive father-child relationship, social support and the versatility of the father's role. Premature birth has a less traumatic impact on fathers.

Promoting father/child contact and encouraging specific care could help men to take on their role as fathers, which is sometimes difficult to integrate.

experience

father

neonates

preterm

relationship

The hospitalization of a premature baby is a difficult and anxiety-provoking experience for parents. More and more studies are being carried out on the mother's experience, while that of the father remains little studied today.

IES-R (Impact of Event Scale-Revised) and EPDS (Edinburgh Postnatal Depression Scale) are both psychological assessment tools used to evaluate specific psychological conditions or experiences. IES-R is a questionnaire that measures the severity of a person's experiences related to a traumatic event. The questionnaire consists of 22 items and assesses symptoms such as intrusion, avoidance, and hyperarousal. It is commonly used to assess post-traumatic stress disorder (PTSD), but it can also be used for other traumatic experiences. EPDS is a questionnaire that is used to identify symptoms of depression in mothers during pregnancy and in the postnatal period. It consists of 10 items and assesses symptoms such as anxiety, loss of pleasure or interest, and feelings of guilt or worthlessness. It is widely used in clinical settings to help identify women who may be experiencing postpartum depression.

Objectives: There is currently limited research on the experiences of fathers of premature infants and the psychopathological and social consequences they may face following the birth of their children. However, studies suggest that fathers of premature infants may experience high levels of stress, anxiety, depression, feelings of isolation, and a lack of support during and after the hospitalization of their infant. Research also suggests that fathers may struggle with the transition to parenthood and may feel a sense of loss over the experience they expected to have with their child. Fathers may also experience challenges in their careers and relationships with their partners and may need additional support in coping with these stressors. Overall, it is important for healthcare providers to recognize the unique experiences of fathers of premature infants and to provide them with resources and support to promote their mental

A qualitative and quantitative study was carried out in the neonatology department at the Mohammed VI University Hospital in Marrakech among 80 men whose prematurely born child was still hospitalized in the neonatology department.

Edinburgh Postnatal Depression Scale (EPDS) and symptoms of acute stress reaction using Impact of Events Scale revised (IES-R). Determine correlation between EPDS and IES-R scores.

2 questionnaires were administered: IES-R and EPDS, a semi-directive interview was also conducted.

Ethical Approval

Statement:

The research has been approved by the ethics committee of the university [ ethical committee of medicine school MARRAKECH]. The committee has assessed the study and has confirmed that it follows all the necessary ethical considerations and regulations to ensure the safety, wellbeing, and confidentiality of all participants.

Consent Statement:

Before participating in this research, all parent will be provided with detailed information regarding the research and their involvement in it. Parent will be asked to provide their informed consent before participating.

The confidentiality of participants will be maintained throughout the research, and all data collected will be anonymized to protect the identity of participants.

By providing their informed consent, participants are confirming that they have read and understood the information provided and that they agree to participate in the study.

In a research study that involved 80 participants, it was found that a total of 8 fathers had an IES-R score above 36. This score is typically indicative of a high level of post-traumatic stress symptoms. Alongside this, the study also reported a mean EPDS score of 6.36. This tool measures symptoms of postnatal depression in both mothers and fathers. These findings suggest that a significant number of fathers may be experiencing symptoms of post-traumatic stress or depression, highlighting the importance of addressing mental health issues in both parents during the perinatal period. Future research could look at effective interventions to support fathers' mental health during this time.

-Hospitalization aroused anxiety and fear for the child's future in 56 fathers, and 20 fathers reported fear for the mother's physical and/or moral health.

-64 fathers had a good experience of separation from their baby, and 48 fathers found it difficult to see their wife separated from their child.

-Half the fathers had a positive view of the return home, while the other 40 had a more divided view, between the desire to see their child back in the family cocoon and the fear of not being able to manage delicate situations.

It is unclear how many fathers in total were surveyed or what the context of the separation and return home is. However, it appears that there is some variation in how fathers perceive and experience their separation from their baby and their wife's separation from their child. Some have a positive experience, while others find it difficult. Similarly, some have a positive view of the return home, while others have mixed feelings about it.

-60 fathers had a positive image of their child's physical appearance.

40 fathers explained that they felt uncomfortable with their child's fragility.

None of the fathers had seen a psychologist. All felt supported by the nursing team.

22 fathers acknowledged the presence of their family and 8 fathers had mentioned close friends.

-63 fathers seemed to find it difficult to assume their role as fathers in the hospital.

The Edinburgh Postnatal Depression Scale (EPDS) is a questionnaire with 10 items rated on a four-point scale that evaluates depression during pregnancy and postpartum. The score ranges from 0 to 30, with higher scores revealing greater depression severity. A score between ≥ 11 and ≥ 13 is considered optimal for screening and detecting depressive symptoms. The Impact of Event Scale-Revised (IES-R) is a 22-item questionnaire that has three subscales measuring subjective distress from traumatic events. For this study, women were asked about their recent birth experience when responding to the questionnaire. A score ≥ 33 identifies moderate Post-Traumatic Stress Symptoms (PTSS), while a score ≥ 24 indicates mild PTSS.

This study attests to a painful experience: hospitalization was described as a difficult stage generating stress and anxiety [1–2]. The approach to the return home was marked by a certain ambivalence [1–3]. Contrary to Carel's work [4], the fathers reported being satisfied with their child's physical appearance, but the majority seemed to have difficulty investing their role as fathers in the hospital. This result is not in line with Fegran's data [5]. It therefore seems important for healthcare professionals to integrate fathers into the care process. Premature birth seemed to have a positive impact on the couple by bringing the conjugal partners closer together, in line with previous work [6–7], and a less traumatic impact on fathers: 2 fathers reported IES-R scores above the threshold score [8].

Hospitalization can be a challenging and stressful experience, not just for the patients, but also for their loved ones. In this case, the fathers of the hospitalized children expressed apprehension and unease about their offspring's future well-being. This anxiety could have been caused by various factors, such as the severity of the child's illness, the duration of hospitalization, the quality of healthcare provided, or the family's financial resources. Additionally, some of the fathers were worried about the mother's physical and moral health, which may have been a result of the stress and strain of caring for a sick child or the fear of contracting an infectious disease. This shows the important role that fathers play in the healthcare of their families and the emotional stress that comes with it. Helping fathers to cope with these fears and concerns can improve their relationship with their families and enhance their overall well-being.

In terms of coping strategies, fathers defined relationships with friends, family and the medical team as an important source of support [9].

Promoting father/child contact and encouraging specific care can have a positive impact on men's ability to take on their role as fathers. Many men struggle with being actively involved in their children's lives, particularly in the early stages of fatherhood.

By encouraging and promoting father/child contact, fathers are given the opportunity to establish a strong bond with their children and become more comfortable in their role as caregivers. This can also help to dispel the myth that child-rearing is the sole responsibility of women, and foster a more equal distribution of responsibilities within families.

Additionally, specific care such as diaper changing, feeding, bathing, and playing with children can provide fathers with practical ways to connect with their children and feel more confident in their ability to provide childcare. This can also help to break down traditional gender roles and further promote a more equitable distribution of household and childcare responsibilities.

In conclusion, by promoting father/child contact and encouraging specific care, we can support men in becoming more engaged and involved fathers, which is crucial for the healthy development and well-being of children, as well as for gender equality and family wellbeing.

Author contribution: FATIHA BENNAOUI, LALAOUI ABDESSAMAD, NADIA EL IDRISSI SLITINE and FADL MRABIH RABOU MAOULAININE

Conflict of interest: NO

-Ethics approval and consent to participate: The study has been conducted in accordance to relevant guidelines and regulations. Informed consent was obtained from all the participants The research has been approved by the ethics committee of the university [ ethical committee of medicine school MARRAKECH]."

-Consent for publication: Not applicable

-Availability of data and materials: The datasets used and analysed during the current study available from the corresponding author on reasonable request
-Funding: None

-Acknowledgements: all participants

- Ferrari L. Place de la psychanalyste dans l'accompagnement de l'enfant prématuré et de sa famille, 2000.
- Fraser D, Cooper M. Myles Textbook for Midwives. Edinburgh: Elsevier; 2009.
- Garel M, Blondel B, EPIPAGE group. Parents' experience of the neonatal stay of a very premature baby. Results of a qualitative study in the EPIPAGE survey. Journées Parisiennes de Pédiatrie. Paris: Flammarion Médecines-sciences; 2003. 187 – 92.
- Carel A. Le nouveau-né à risques et ses parents. Etude psychodynamique. Le devenir de la prématurité. Paris: Puf; 1977, 125 – 64.
- Fegran L, Helseth S, Fagermoen MS. A comparison of mothers' and fathers' experiences of the attachment process in a neonatal intensive care unit. J Clin Nurs. 2008;17(Suppl 6):810–6.
- Arockiasamy V, Holsti L, Albersheim S. Fathers' experiences in the neonatal intensive care unit: a search for control. Pediatrics. 2008;121(Suppl 2):215–22.
- Percival P, McCourt C. Becoming a parent. In: Page LA, editor. The new art of midwifery: science and listening put into practice. France: Elsevier; 2004. pp. 187–225.
- Pierrehumbert B, Nicole A, Muller-Nix C, Forcada-Guex M, Ansermet F. Parental post-traumatic reactions after premature birth: Implications for sleeping and eating problems in the infant. Arch Dis Child Fetal Neonatal Ed. 2003;88:400–4.
- Miles MS, Carlson J, Funk SG. Sources of support reported by mothers and fathers of infants hospitalized in a neonatal intensive care unit. Neonatal Netw. 1996;15:45–52.

No competing interests reported.

Download PDF

Version 1

posted

You are reading this latest preprint version

Fathering a premature baby

Status:

Version 1

Abstract

INTRODUCTION

MATERIALS AND METHODS

RESULTS

DISCUSSION

CONCLUSION

Declarations

References

Additional Declarations

Status:

Version 1