Clinical Studies
Creating Paths: Living With a Very-Low-Birth-Weight Infant

https://doi.org/10.1111/j.1552-6909.1995.tb02544.xGet rights and content

ABSTRACT

Objective:

To describe parents’ method of adaptation to the problems of caring for a very-low-birth-weight (VLBW) infant at home.

Design:

Exploratory, involving three interview sessions, 1 month, 3 months, and 5 months after hospital discharge of a VLBW infant.

Setting:

A newborn intensive-care unit in a tertiary-care center.

Participants:

Fourteen parents of VLBW (< 1,500 g) infants after hospital discharge.

Results:

A basic social process, Creating Paths, was identified. It is the continuous process experienced by parents living with a VLBW infant the first 5 months after hospital discharge. The process consists of three stages: gathering, emerging, and affirming.

Conclusions:

This grounded theory systematically tracks and describes the adaptation process of parents with VLBW infants during the first 5 months of living at home. The theory may be used to anticipate concerns and provide guidance and support to parents and their infants.

Section snippets

Conceptual Orientation

Roy’s adaptation model (1980) served as a conceptual orientation for this study. Roy proposed that adaptation is a process of ongoing interaction individuals experience with their environment to establish equilibrium. For example, the daily, constant interaction between parents and their VLBW infant changes as the infant grows and they adapt to each other.

Review of the Literature

This literature review presents three perspectives relevant to the purpose of this study. The study assumes that to understand the adaptation process and the factors influencing it, one must observe the interaction among premature infant development, the experience of parenting these infants, and follow-up care.

Design

The dearth of literature on the adaptation process of parents after hospital discharge led to the selection of grounded theory methodology (Glaser & Strauss, 1967). Grounded theory is an inductive method in which data are grounded in fact and theory is generated from data. The aim of grounded theory is to generate theories about social and psychologic phenomena.

Sample

Fourteen parents whose VLBW (< 1,500 g) infants had been discharged from the hospital were informants for this study. Additional criteria

Results

The grounded theory Creating Paths (see Figure 1) evolved from this study. Creating Paths tracks and describes the basic social process of parents as they adapt to living with their VLBW infant during the infant’s first 5 months after hospital discharge. This process consists of three stages: gathering, emerging, and affirming.

Discussion

Creating Paths evolved during the grounded theory discovery process, which described how parents live with a VLBW infant. Creating Paths is the process through which parents learn about, adapt, and provide care for their VLBW infant. This process begins during the infant’s first 5 months of life at home. After careful analysis, the grounded theory Creating Paths was chosen to represent the experiences of parents with VLBW infants.

In their journey down the created path, parents and the VLBW

Nursing Implications

The findings of this study add to what we know about parental behavior when living with a VLBW infant. Neonatal nurses need to recognize the adaptation process that parents of VLBW infants experience after the infant’s hospital discharge. This will allow nurses to identify behavior patterns that may place the infant and the parents at risk for disunity. For example, the nurse at the bedside observes parent–infant interactions while the infant is in the hospital. This provides valuable clues for

Conclusion

The grounded theory Creating Paths depicts the processes parents use to adapt to their VLBW infant. Creating Paths enhances understanding of these processes by providing descriptions of the behaviors during adaptation. Furthermore, this study establishes a beginning theoretical foundation for assessing the adaptation process of parents with VLBW infants during the first 5 months the infant lives at home. Research is needed to explore how parents of VLBW infants with chronic illnesses,

Acknowledgments

This research was supported by the American Nurses’ association mental health clinical traineeship #5T0MH15155.

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