Impact of a Research Study a Decade Later: The Use of Pictures in a Neonatal Intensive Care Unit as a Mode of Nursing Intervention to Enhance Maternal-Infant Bonding

By Huckabay, Loucine M. D. Rn, Cpnp, PhD, Faan | Scholarly Inquiry for Nursing Practice, January 1, 1999 | Go to article overview

Impact of a Research Study a Decade Later: The Use of Pictures in a Neonatal Intensive Care Unit as a Mode of Nursing Intervention to Enhance Maternal-Infant Bonding


Huckabay, Loucine M. D. Rn, Cpnp, PhD, Faan, Scholarly Inquiry for Nursing Practice


Approximately 12 years ago a preliminary study (Huckabay, 1987) was published on the use of giving mothers the picture of their premature babies as a mode of nursing intervention to enhance maternal-infant bonding. There is a mandate (Polit & Hungler, 1999) which stipulates that nurses need to be informed consumers of nursing research, be aware of the range of effective interventions that have been published, and use them in improving their nursing care. As reports of successful nursing interventions are published, a question is raised as to the impact of such studies on the actual care of patients or on furthering the knowledge base. To answer this question, an extensive computer search of the literature was done and neonatal intensive care unit (NICU) specialists of six major hospitals in southern California were interviewed to determine if they provide mothers the pictures of their premature babies as part of their nursing intervention to facilitate maternal-infant bonding. Findings based upon the NICU specialist interviews and the computer search of the literature are presented in the following order: (1) Current practices regarding use of pictures in six major hospitals, (2) Update of the incidence of premature births and the challenges they present, (3) Update of the importance of bonding theory and controversial issues surrounding its implementation, (4) A cross-cultural bonding study resulting from the use of the tool developed by Huckabay (1987) study, (5) Studies that have extended the use of pictures as a mode of nursing intervention in other situations, (6) Conclusion.

CURRENT PRACTICES REGARDING USE OF PICTURES IN NICU SETTINGS IN SIX MAJOR HOSPITALS

Even though the literature reveals few studies that may have resulted from the 1987 Huckabay study, it does not mean that those who read the article do not implement the recommendations. It was recommended that hospitals' NICU nursing staff provide the parents of premature babies who are separated from their infants with a photograph of their babies to encourage bonding behaviors between parent (mother) and the premature infant. When the NICUs of six major hospitals in southern California were contacted by telephone to find out if they give premature babies' pictures to the parents to encourage bonding behavior between parent and infant, 5 out of 6 hospitals indicated that they do. The sixth hospital gave two reasons for not giving the photograph of the premature baby to his or her parent: (1) its Polaroid camera was broken, and (2) most mothers visit their babies on a daily basis, therefore, it does not feel that it is necessary to give pictures. When asked if they had a written policy about giving pictures to mothers of premature babies, none indicated that they had any written policy statement; they said they just did it. The third question concerned the length of time the NICUs had been practicing giving the pictures of premature babies to their mothers/parents. The responses ranged from 5 years to over 10 years. Of course, no one can make a causal inference regarding the year of my study and the timing of photograph usage, but it is interesting to note that such changes in the practice of giving pictures of premature babies to parents have occurred since the study was published.

UPDATE ON THE INCIDENCE OF PREMATURE BIRTHS AND THE CHALLENGES THEY PRESENT

Each year approximately 1 in 10 births in the U.S. are preterm deliveries. A large percentage of these preterm infants are born to parents of low socioeconomic status (Van Der Pool, 1998). Premature infants often present challenges to their primary care providers. They are at high risk for multiple problems, pulmonary and neurological sequellae, developmental delays, and vision and hearing disturbances (Bernstein, Heinlee, & Sasidharen, 1998). In addition to physical limitations, preterm infants are threatened by psychosocial disruptions due to prolonged periods of separation from their mothers because of hospitalization. …

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