Maternal Characteristics Associated with Social Support in At-Risk Mothers of Premature Infants: A Research Critique

 Support is an important factor in managing a lifestyle change or event. For new mothers, support can be as invaluable resource as they transition into their new role of parent to the newborn. In addition, the newborn will reap the benefit of the mother who has support and is resilient and capable of utilizing the resources made available to her. In this qualitative study, White- Traut, Rankin, Fabiyi, Liu, Cheung, and Norr examined the perceived social support of new mothers of premature infants as it could possibly affect the child’s developmental patterns (2017).

Social support from women in disadvantaged areas who have premature newborns is a niche of research that has not been studied extensively. Due to the lack of information on this particular subject, this study, among future research may help shape evidence-based practice within the medical field; allowing nurses and other health care professionals target at-risk populations and supplying them with the necessary resources to contribute their health in a holistic manner (White-Traut, et al., 2017).

 According to White-Traut, et al., this study’s purpose was to reveal how well new mothers perceived their social support based on their social-environmental data (2017). Through the consideration of prior research endeavors, social support with new mothers of premature infants admitted to the Neonatal Intensive Care Unit did not yield many results. White-Traut, et al., consider this a worthy topic of research in order to best serve this population within the community (2017). 

Although the location of this study focused on two urban community hospitals between 2008-2011, the population of 194 participants yielded only two ethnic groups. Half of the participants were Black and the other half of participants were Hispanic. Due to the location of the study, these two ethnic groups also represented a minority population within the two hospital areas; therefore, contributing information to the research community on this population and topic (White-Traut, et al., 2017).

In choosing the target population, an array of factors was considered by the researchers in order to focus on a population of individuals that could be considered at-risk for limited resources and social support. The study’s independent variables of the study included the maternal factors in which the participants were chosen to participate. Some of the criteria included demographic information, age, race, language preference, living situation, disadvantaged neighborhood residency, etc. (White-Traut et al., 2017). The dependent variable included the social support that was evaluated through the Personal Resources Questionnaire 2000. As the participants selected moved forward in the research endeavor, they were given this questionnaire to gage their perceived social support. According to Weinert, this survey provides fifteen positively worded items on a seven-point Likert scale (2003). As it were, the purpose and consistency of the study provided insightful results and produced significant data.

The study’s design was a cross-sectional evaluation from a randomized controlled trial of the 194 mother/baby couplets who qualified to participate in the study. For those who qualified to participate by providing demographic information, their infant must have had to have been labeled as preterm (between 29 and 34 weeks of gestation) who was admitted to the Neonatal Intensive Care Unit (White-Traut, et al., 2017). Infants admitted into the NICU for observation and medical intervention create stress for the mother as well as the infant. Consequently, creating an interest and motivation from the researchers to further evaluate the support in which the mothers feel they have as they face the challenge of their infant being placed in a high-acuity area of the hospital.

When conducting research studies, ethical considerations and data security are of the utmost importance. White-Traut, et al., acquired the demographic information of the participants and geocoded their addresses along with calculating the Index of Neighborhood Disadvantage Score (INDS) (2017). In taking this precaution with the participant data, there was no breech in confidential information such as a physical address. The Index of Neighborhood Disadvantage Score utilized by Ross & Mirowsky was also able to provide the calculation for whether the participant lives in a disadvantaged neighborhood (2001). Of the 198 original participants included in the study, only 194 completed the interview and questionnaire, providing all necessary information for the study (White-Traut, et al., 2017).

Through the utilization of the Personal Resource Questionnaire 2000, individuals were given the opportunity to state their opinions regarding their perceived social support. As the research was evaluated, the results confirmed that younger, Hispanic, multiparous women with a history of mental health issues perceive to have less social support. The Personal Resources Questionnaire 2000 scores were generally lower for Hispanic participants in comparison to Black participants. Other evaluative tools such as t tests were used in order to define variance and control within the study (White-Traut, et al., 2017).

There could be several reasons for why the Hispanic participants had the least optimistic questionnaire answers. Over two thirds of the Hispanic population chose Spanish as their preferred language (CITE). Both culture and language barrier are two hindrances in the perception of social support found in this research. In a previous study, Viruell-Fuentes & Schulz found that women who were less acculturated were more likely to indicate their perceived social support lower than other participants (2009). The study conducted by Viruell-Fuentes & Schulz as well as the study by White-Traut, et al., suggests that the Hispanic women represented in these studies are not fluently participating in acculturation and may not be perceptive to the utilization of resources provided due to the lack of understanding due to the language barrier present (2009;2017).

Inversely, according to Callister & Birkhead, the acculturation hypothesis suggests that the more acculturation is present in foreign-born individuals, the less likely they are to reap such benefits as support due to cultural variances (2002). This rationale could suggest that through cultural immersion, the woman will lose the ability to perform rituals or carry her primary culture through a time of life that presents challenges and lifestyle change. Through the observation of women who give birth outside of the United States report having a positive birth experience, it may be inferred that the acculturation hypothesis may not be applicable in all circumstances. It can be suggested that there are caveats to this hypothesis that could use further evaluation.

In a study researching postpartum Hispanic women at risk for postpartum depression, it was suggested that social support was a key factor in whether the women experienced this common postpartum occurrence (Kim & Dee, 2017). Postpartum depression affects women across every culture. The Hispanic culture is more engaged and focused on community and the family unit. Evidence from this study affirmed that there was a strong correlation suggesting social support, spirituality, and self-care ability plays a role in the prevention of postpartum depression (Kim & Dee, 2017). Throughout the postpartum period, depression may result due to hormonal changes and certainly the presence or perceived social support.

The nurse’s role within the pregnant woman through the various stages of pregnancy and most importantly postpartum is to fulfill a supportive role. Along for the education of self-care competency, the nurse must also act as a resource for at-risk women (Kim & Dee, 2017). By being competent and alert of different cultures, the nurse will assess for not only physical conditions surrounding the postpartum period, but can also assess the woman’s ability to care for herself and her newborn as they are discharged from the hospital and transition to their new lifestyle. 

It can be suggested that women who are perceived to have more social support have a better birth process and immediate postpartum experience. The premature infants admitted to the NICU in the White-Traut, et al., study also suggests that these infants will have a greater newborn experience as a result of the care provided by their mother upon discharge (2017). Therefore, it is reasonable for nurses who work within NICU areas to pay attention to the social cues and dynamics of the mother. The utilization and encouragement of resources can provide the social support needed throughout this lifestyle change. Nurses have the unique role of providing both physical care as well as mental support to both their patients and families (Kim & Dee, 2017).

In conclusion, social support is imperative to the well-being of both the mother and newborn. The study found that there is a correlation between at-risk mothers of premature infants and perceived social support. More specifically, younger, multiparous Hispanic women with a history of mental health issues reported that they felt less social support than the Black participant population of the study (White-Traut, et al., 2017). This was a significant finding due to the cultural dynamics that were formerly believed to have more perceived support during their postpartum period. I learned through the chosen study and secondary study that support is important across ethnic groups. It is important to pay attention to ethnic groups that might be overlooked or perceived to not require support due to their community-focused culture. I was surprised by the study by White-Traut, et al., as it was clear that those who were not acculturated, participated in their own culture’s customary techniques, which ultimately resulted in less perceived social support than those who actively participate in the culture of the country that they reside in (2017).

References

• Callister, L. C., & Birkhead, A. (2002). Acculturation and perinatal outcomes in Mexican immigrant childbearing women: An integrative review. Journal of Perinatal and Neonatal Nursing, 16(3),22–38.
• Kim, Y., & Dee, V. (2017). Self-care for health in rural Hispanic women at risk for postpartum depression. Maternal and Child Health Journal, 21(1), 77-84. doi:http://dx.doi.org/10.1007/s10995-016-2096-8
• Ross E. C. & Mirowsky, J. Journal of Health and Social Behavior Vol. 42, No. 3 (Sep., 2001), pp. 258-276
• Viruell-Fuentes, E. A., & Schulz, A. J. (2009). Toward a dynamic conceptualization of social ties and context: Implications for understanding immigrant and Latino health. American Journal of Public Health, 99(12), 2167–2175.
• Weinert, C. (2003). Measuring social support: PRQ2000. In O. L. Strickland & C. Dilorio (Eds.), Measurement of Nursing Outcomes (Vol. 3, 2nd ed., pp. 161–172). New York, NY: Springer.