Neonatal Unit Culture in Mothers’ Participatory Care of Hospitalized Infants:A Focused Ethnographic Study

Abstract

Abstract: Introduction: One of the aspects of family-based care is parental involvement in the care of the baby, which has been increasingly emphasized. Active involvement of parents in the care of the infant improves the parents' ability to facilitate the development of their infants during and after the hospitalization, and reduces the duration of hospitalization of the infant in the neonatal intensive care unit. Reducing economic costs and reducing the probability of acquiring hospital infections from the benefits of family-based care. Given that the staff of the neonatal unit and mothers are the main members of the collaborative care, so describing their experiences in caring participation is a very important topic. The ethnographic study defines the experiences of individuals in a particular cultural context, and the main consequence of it is the way in which people believe in what they do. Since the main focus of this study is on the participation phenomenon in a specific section, such as neonates, in this study, an ethnographic approach was used. Method: This study is a focused ethnographic study. The information was analyzed using two methods of observation and interview (formal and informal) and reviewing the documents in the ward. Participants to this study were doctors, educational supervisor, head nurses, nurses, nurse assistance and mothers of infants admitted to the neonatal ward. purposeful sampling was used for interview with participants. 250 hours of descriptive, focused and selective observation, 44 formal interviews and 64 informal interviews were conducted for collecting data. To explore the cultural components of participatory care, Roper and Shapira's 5-step (2000) framework was used. Ethnographic writing was done using a narrative, semi-narrative and interpretive method. The Lincoln and Goba methods were used for scientific accuracy and data validity. Finding: The findings of this study were presented in two sections. The first part relates to the findings of the descriptive section, which describes the environment of the neonatal unit, actors, and activities related to each of them. In this section, the semi-narrative method was used. The second section deals with the explanation of the cultural patterns of the neonatal unit, that these patterns is repeated in the neonate unit. From the findings of this study, there are five cultural patterns of Providing information to the mother selectively, Conditional support, Trust toward care partner is gradual and fragile, authoritarian communication overcomes compassionate communication, and the mother's participation in the promotion of activities instead empowerment. In the second section, semi- narrative and interpretive methods were used. Discussion: In this study, the behavioral patterns of the neonate unit were identified as part of the participatory care phenomenon. These patterns by nursing profession planners can be used in the fields of education, clinical nursing, modify of policy and management, modify and enhance the culture of the participation of mothers in the care of the infant