Mothers’ experiences of neonatal intensive care: A systematic review and implications for clinical practice

Table 1 Characteristics of included studies

Ref.	Design/data collection/data analysis	Population studied (P)/exposure (E)	Sample selection	Outcomes
Malakouti et al[10], Iran	Descriptive qualitative study; Individual semi-structured interviews; Phenomenological method (Colaizzi’s)	P: 20 mothers (19-37 yr) with average socioeconomic status in a NICU. No data on infants provided	-	Four main themes: (1) Sense of alienation; (2) Lack of control; (3) Care; and (4) Deprivation
Lindberg and Öhrling[18], Northern Sweden	Descriptive qualitative study; Narrative interviews; Content analysis	P: 6 mothers (25-35 yr); infants GA 28-34 w.E: The infants were cared for at the NICU for at least 1 wk	Purpose sample	The content analysis resulted in five categories: (1) Being a mother without being prepared; (2) Being in a situation filled with anxiety; (3) Struggling to feel close to the infant; (4) Effects on family life; (5) Being able to handle the situation
Lee et al[19], Taiwan	Qualitative research, ground theory; In-depth interviews and participant observations; Comparison analysis	P: 26 mothers (22-36 yr); infants GA 25-34 w, BW 530-1490 gE: The infants remained in NICU for periods of 32-120 d	-	The paradigm model comprising: (1) Casual conditions; (2) Context; (3) Intervening conditions; (4) Action/interaction strategies; and (5) Consequences
Obeidat and Callister[20], Jordan	Descriptive qualitative study; Individual open-ended interviews; Phenomenological method (Colaizzi’s)	P: 20 Muslim mothers (25-42 yr); Infants born before GA 28-34 w.E: The infants were hospitalized in NICU for at least 1 wk	-	Four main themes: (1) Feeling emotional instability; (2) Living with challenges in observance; (3) Finding strength through spiritual beliefs; and (4) Trying to normalize life
Khoza and Ntswane-Lebang[21], Africa	Descriptive qualitative study; Individual in-depth interviews; Tesch’s method of analyzing qualitative data	P: 13 mothers (15-31 yr) for at least 1 wk. No data on infants provided	-	Five major categories: (1) Emotions; (2) Subjective suffering; (3) Support; (4) desperate wishes; and (5) Expressed needs
Fernández Medina et al[22], London	Interpretive qualitative research; In-depth, semi-structured interviews; Gadamer's hermeneutic phenomenology	P: 16 mothers (> 18 yr); infants mean GA 25.9 w.E: The infants were hospitalized in NICU for at least 30 d	Convenience sampling	Two main themes: (1) Negative emotional impact; and (2) Learning to be a mother

BW: Birth weight; GA: Gestational age; NICU: Neonatal intensive care units.

Table 2 Thematic analysis

Ref.	The negative emotional impact on mother			Support			Barriers to parenting	Establishing loving relationships with their baby
	Shock and unpreparedness	Fear and anxiety	Guilt	Support from religious or spiritual beliefs	Support from family members	Support from health professionals
Lindberg and Öhrling[18], Northern Sweden	√							√
Khoza and Ntswane-Lebang[21], Africa	√	√		√	√
Lee et al[19], Taiwan	√			√	√	√	√	√
Malakouti et al[10], Iran		√	√			√	√
Obeidat and Callister[20], Jordan		√	√	√				√
Fernández Medina et al[22], London		√	√					√