The Effect of Implementation of the Programmed Empowerment Designed on Mothers' Self-Efficacy and Discharge Preparation of Neonate from Neonatal Intensive Care Unit: A Clinical Trial

Abstract

Abstract: Introduction: The transition from hospital to home in preterm infants is a critical period for parents, and many of them are discharged from the hospital in need of more care and follow up. Therefore, it is necessary to design a program and appropriate care interventions before neonate transition from hospital to home. Therefore, the aim of this study was to determine the effect of implementing a program on empowerment on mother's self-efficacy and Discharge Preparation of Neonate from neonatal intensive care units. Method: This study was a pre and post-test clinical trial. Sixty premature infants and their mothers were selected from the neonatal intensive care unit of Kermanshah by simple sampling method and assigned to control and test groups. Mothers in the control group received routine care and in the intervention group, in addition to routine care, the intervention by providing written instructional materials in a manual, an electronic image file (CD), in addition to face-to-face learning mothers (including hand washing education, nutrition, Sucking exercise , medication, massage therapy, bathing, developmental tasks, prevention of infection, symptoms and risk of neonatal resuscitation) was given in three sessions. . Regarding the level of prematurity or medical condition of the infant and according to the order of the physician, the first times of the care provided by the researcher in the presence of the mother, along with the instruction on how to do it, and the subsequent frequency of care, if the mother's skills in doing so , Was approved by a colleague of the researcher (working in the nicu unit), by the mother himself. And on the exercises, the mothers provided the necessary supervision and feedback. Questionnaires including demographic information of mother and infant, maternal self-efficacy questionnaire and maternal satisfaction were collected. The readiness of discharge in two steps (at admission and before discharge) by the researcher was checked through the checklist by the researcher. Also, by registering the mother's telephone number, 15 days after the discharge, the re hospitalization was followed up, then the data were analyzed by independent t-test and paired t-test. Results: In all dimensions, the level of self-efficacy of mothers, except for the importance dimension, in the empowerment group increased significantly compared to the control group (P <0.01). However, increasing the level of self-efficacy of mothers between the two groups in terms of importance, There was no significant difference (P=0.202).The change in the satisfaction level of mothers in the control and intervention group before discharge was significantly higher than the beginning of the study (P <0.001). Also, the satisfaction rate of the mothers in the intervention group was significantly higher than the control group (P <0.001). The total score of maternal discharge in the empowerment group (with a scorecard increase of 44.65) was significantly higher than the control group (33.41 points) (p <0.01). The rate of hospitalization in the empowerment group was significantly lower than the control group (P = 0.043). The mean duration of hospitalization in the empowerment group (14.79 days) was significantly higher than the control group (20.43 days) It was statistically shorter (p <0.01). Conclusion: Implementation of the designed empowerment plan for discharge, by increasing maternal self-efficacy and readiness for discharge, could reduce the duration of hospitalization and the rate of newborn's hospitalization and increase the satisfaction of mothers. With the active participation of mothers in taking care of their babies, in addition to reducing the number of neonatal complications and injuries, medical expenses are also reduced and they provide a bed for admission to needy infants.