Volume 30, Issue 2 (Spring 2022)                   Avicenna J Nurs Midwifery Care 2022, 30(2): 107-115 | Back to browse issues page


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Derakhshani R, Salmani N, Tavangar H. Effect of Multi-Sensory Stimulation of Neonates on Stress Level of Mothers with Premature Neonate Hospitalized in Neonatal Intensive Care Unit. Avicenna J Nurs Midwifery Care 2022; 30 (2) :107-115
URL: http://nmj.umsha.ac.ir/article-1-2424-en.html
1- School of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
2- School of Meybod Nursing, Shahid Sadoughi University of Medical Sciences, Yazd, Iran , n.salmani@ssu.ac.ir
3- Department of Nursing, Research Center for Nursing and Midwifery Care, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Background and Objective
Multisensory stimulation (MSS) is a newly developed intervention in infant care that stimulates two or more human faculties (visual, auditory, tactile, and balance) and provides a good opportunity for mother-infant interaction. This intervention begins with the baby’s auditory stimulation when the mother talks to the baby for at least 30 seconds. The baby is massaged by the mother after the initial verbal communication.  It is worth mentioning that very few studies have examined the effects of this method on mothers. In one study, it has been shown that the use of MSS on depression of mothers with premature infants reduced maternal depression.
Regarding the results of studies conducted on the effect of this intervention on the emotional and mental state of mothers with premature infants hospitalized in the ICU and given the importance of parenting in mothers with premature infants, this study aimed to determine the effect of multisensory stimulation of neonates (by mothers) on the stress level of mothers with premature infants admitted to neonatal intensive care unit (NICU).
Materials and Methods
This semi-experimental study was conducted on 80 mothers with neonates admitted to the NICU of Shahid Sadoughi Hospital, Yazd, Iran. The mothers were selected from among those who met the inclusion criteria using a non-random sampling method. The selected mothers were among those who were residing in the NICU, had no history of registered and/or treated mental illnesses (e.g., postpartum depression or psychosis), and has no history of neonatal hospitalization in the ICU. However, mothers with non-Persian language dialects and those with more than one infant admitted to the NICU were excluded from the study.
Inclusion criteria for neonates were premature single babies in the age range of 28-36 weeks, hospitalization for a maximum of three days after admission, and stable hemodynamic status (decided by the physician). However, neonates with anomalies that prevented the mother from contacting and/or touching the baby (e.g., neural tube defects), congenital skin diseases (e.g., epidermolysis bullosa), abdominal wall defects (e.g., omphalocele, gastroschisis, and intracranial hemorrhage), and those with machine-assisted ventilation were excluded from the study. After completing the questionnaires, information about MSS and how to practice it was given to mothers in the experimental group during a theoretical session. The MSS training was provided practically.
The MSS intervention was performed for three days, twice a day for 15 min. Data collection tools in this study included the mother-infant demographic characteristics form and parental stress questionnaire used by Miles et al. The collected data were analyzed using SPSS software (version 18) through Chi-square and independent t-tests. A p-value less than 0.05 (P<0.05) was considered significant.
Results
In the pre-intervention stage, no statistically significant difference was observed between the two groups in terms of the mean level of stress. In the post-intervention stage, the independent t-test showed statistically significant differences between the experimental and control groups in terms of the mean level of stress caused by scenes and sounds, the baby’s appearance and behavior, the relationship with the baby, and parental role, and the overall stress.
Conclusion
This study aimed to determine the effect of multisensory stimulation on the level of stress in mothers with premature infants admitted to the NICU. The results showed a significant decrease in the level of stress in mothers who stimulated their premature infants with sensory stimuli in the areas of scenes and sounds, infant’s appearance and behavior, relationship with infant and parental role, and overall stress compared to mothers in the control group. However, there was no significant difference between the two study groups in the level of stress related to the area of communication and personnel’s behavior post-intervention.
These results were in line with the findings of several studies indicating that mother-infant interaction, through infant massaging, can reduce maternal stress and educate mothers on how to communicate with their infant, as an effective intervention that can improve mother’s mood and self-efficacy by reducing the stress caused by changes in parenting. When mothers take an active role in infants’ care and their performance is supported and approved by nurses, they will feel a sense of inner satisfaction. In fact, mothers who used multisensory stimulation had a positive experience since they learned how to communicate with their infants. Moreover, this technique allows mothers to learn how to interact with and stimulate their baby, recognize the baby’s characteristics, and create a multi-sensory stimulus that allows the mother to react appropriately to her baby’s behaviors, resulting in a positive social interaction between mother and baby. These consequences are in contrast with the stress-induced outcome that reduces the mother’s response to the baby’s behaviors.
The results showed a significant decrease in the level of stress in mothers who stimulated their premature infants with sensory stimuli compared to mothers in the control group in the areas of scenes and sounds, infant’s appearance and behavior, relationship with the infant and parental role, and overall stress. However, no significant difference was observed between the two study groups in terms of the level of stress related to the area of communication and personnel’s behavior post-intervention.
Type of Study: Original Research | Subject: Nursing
Received: 2022/02/10 | Accepted: 2022/05/3 | Published: 2022/05/31

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