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Session 6C NNA: Developmental Care

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6.10 NEONATAL NURSES' ATTITUDES TOWARDS EXTREMELY LOW GESTATION INFANTS

K. Gallagher, N. Marlow, D. Porock, A. Edgley. University of Nottingham, Nottingham, UK

Background: As more infants receive intensive care at extremely low gestations, the attitudes that neonatal nurses hold towards extreme prematurity will have a significant impact upon the nursing care that they provide to infants and families.

Aim: This study investigated the factors that may be impacting upon the attitudes of neonatal nurses towards extremely preterm birth.

Methods: Neonatal nurses from bands 5 to 8 working within the Trent Perinatal Network were recruited into a Q study. Nurses completed a Q Sort and follow-up interview. The Q Sort comprised 53 statements developed from literature surrounding extremely preterm birth. The semi-structured interview discussed participants’ attitudes towards the Q statements. Q Sort and thematic analysis were used to analyze the data.

Results: 14 out of 48 nurses have currently undertaken the Q study. Emerging themes indicate nurses believe: disability has a profound impact upon infant and family quality of life and should be a factor in decision making; the impact of disability should be made explicit to parents; primary decision making surrounding treatment withdrawal should be undertaken by healthcare professionals; the care of borderline infants can sometimes conflict with their perception of their nursing role.

Conclusions: Current analysis of the interview data has identified common factors that nurses feel influence their care of extremely preterm infants. In order for nurses to provide optimum care, a more open and inclusive approach is needed when dealing with decisions about disability and care withdrawal.

6.11 “THE PROMISE OF CATCH-UP”: MATERNAL EXPECTATIONS REGARDING THE NOTION OF “CATCH-UP” IN THE DEVELOPMENT OF PREMATURELY BORN INFANTS

S. V. Manns. University of the West of England, Bristol, UK, Centre for Child and Adolescent Health, Bristol, UK

This presentation explores the phenomenon of catch-up, a term used in relation to the development of prematurely born children. It discusses how catch-up influences the mothering of children born prematurely at or before 32 weeks of gestational age.

It will provide a definitional drift of catch-up highlighting how the term has drifted from the original specific meaning. It outlines a doctoral study into catch-up in which a thematic analysis associated with the term was developed from Internet discussion boards and e-mail groups that support families with children born prematurely; these themes were tested in interviews with 17 mothers whose children were aged 3, 5 or 7 years living in five primary care trusts in south-west England.

The central analytical theme interprets catch-up as hope, either supporting the mothers’ hopes for their children or as a myth that can lead to the promotion of false hopes. This paradox of hope is discussed, referencing Gabriel Marcel, and considers catch-up as a trial with characteristics of captivity, duration, endurance and fluidity.

The presentation concludes by exploring catch-up in relation to amor fati and the associated idea of ressentiment, as described by Nietzsche, and considers whether amor fati can offer a different way of thinking for mothers and health professionals involved in the care of these children. This way of thinking challenges the more analytical approach currently characterising the life of children in the 21st century in western society and prematurely born children in particular.

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