To Analyze the effect of person-environment-occupation intervention model on stress and breast-feeding efficacy on mothers of preterm neonates: A randomized controlled study

Abstract

Background: Mothers of infants admitted to the neonatal intensive care unit (NICU) are believed to experience high levels of distress, which affects breastfeeding ability in nursing mothers. The Person-Environment-Occupation (PEO) model based on environmental behavior approach was used as a tool to enhance coping behavior in mothers of preterm infants. Mothers were assessed for their stress levels and breastfeeding abilities and for environmental barriers and coping skills. Objectives: The objectives of this study were to assess the effect of PEO model as a tool in the intervention of postpartum mothers of preterm infants and on parental stress levels and breastfeeding efficacy. Study Design: A randomized, intervention-controlled study design was chosen for the research. Methods: A total of 52 postpartum mothers of preterm infants of gestational age 28 weeks to 36 weeks from NICU were included using a convenient sampling method using a lottery method for random allocation into two groups. The control group was given counseling regarding breastfeeding, handling, and positioning of infants, and the experimental group received intervention considering their individual environmental barriers and then implementing appropriate solutions with client agreement. The baseline scores were obtained on the Edinburgh Postnatal Depression Scale (EPDS), Parental Stress Scale: NICU (PSS:NICU), Breastfeeding Self-Efficacy Scale (BFSES) and followup was taken after 15 day. Results: The experimental group showed a significant reduction in PSS score at 95% confidence interval [CI]: 143.86-158.57 to 95% CI: 124.88-144.95, whereas the control group showed a PSS score at 95% CI: 135.16-151.19 to 95% CI: 127.45-144.62, with P = 1.23. On EPDS, the experimental group showed a score at 95% CI: 15.99-20.22 to 95% CI: 13.16-16.19 and the control group showed a minimal reduction at 95% CI: 14.18-18.81 to 95% CI: 13.75-17.64, with P = 0.65. No infant was able to receive breastfeed preintervention; however, some of them had shown the ability to attach while feeding. This has given the confidence of breastfeeding ability to mothers. Postintervention, the experimental group showed a significant difference in breastfeeding efficacy, with P = 0.0003. Conclusions: PEO intervention model can be recommended for improving mothers' breastfeeding capabilities in preterm neonates.