The effect on maternal attachment and self-efficacy of the nursing care provided to mothers of infants with cleft lip and palate

Çınar, S., The Effect on Maternal Attachment and Self-Efficacy of the Nursing Care Provided to Mothers of Infants with Cleft Lip and Palate, Hacettepe University Institute of Health Sciences, Department of Pediatric Nursing, Nursing Program Dissertation, Ankara, 2019. This study, designed as a pretest-posttest quasi-experimental type study with a control group, investigates the effect on maternal attachment and self- efficacy of the nursing care provided to the mothers of infants with cleft lip and palate anomalies who have undergone cleft repair surgery. Included in the study were 32 mothers who met the inclusion criteria and whose infants with cleft lip and palate anomalies had undergone cleft lip repair surgery in the Department of Plastic, Reconstructive and Aesthetic Surgery of Hacettepe University Faculty of Medicine. The study involved two groups: an intervention group (n=16) and a control group (n=16). Infants with cleft lip and palate in both the intervention and control groups were matched in terms of gender, weight percentile values and type of cleft (unilateral cleft lip and palate, bilateral cleft lip and palate). Data was collected between April 1 and August 8, 2019 using the Data Collection Form, the Care Requirements Identification Form for Infants with Cleft Lip and Palate, the Maternal Attachment Scale, the Parental Self-Efficacy Scale, and the Tracking Form for the Infant's Height, Weight and Head Circumference. The mothers in the intervention group (n = 16) were subjected to nine-week follow-up after the cleft repair surgery, and were provided training in care requirements in accordance with the nursing care principles and, using the North American Nursing Diagnosis Association's Nursing Diagnosis System and Nursing Interventions Classification. No additional procedures were applied to the mothers in the control group other than the standard nursing care in the hospital. In the analysis of descriptive data, numbers and percentages were used for discrete data, while continuous data was presented as mean±standard deviation. A t-test was used to determine the difference between independent groups; Pearson's Chi-square test and Fisher's exact test were used to determine the relationship between two independent categorical variables; and Cochran's Q test was used to determine the relationship between more than two dependent categorical variables. The mean age of the mothers was 28.5 ± 5.0 and the mean age of the babies was 4.7 ± 1.7 months. Prior to the application of the study procedures, no statistically significant difference was noted between the intervention group and control group in terms of pretest maternal attachment and parental self-efficacy scores (p>0.05). However, the scores of the mothers in the intervention group increased as the visits progressed, and by the end of the 9th week, the difference between the mothers in the intervention group and control group in terms of posttest maternal attachment and parental self-efficacy was found to be statistically significant (p<0.05). Among the nursing diagnoses identified in the mothers and infants of the intervention group, a statistically significant decrease was identified between the visits (p<0.05) in the adequacy of parenting, inability to cope with family, lack of knowledge, disruption/risk of disruption of the mother and infant attachment, risk of underfeeding, risk of infection and risk of aspiration factors. Based on these results, it is suggested that to reduce the problems experienced by the mothers of infants with cleft lip and palate who have undergone cleft lip and palate repair surgery, and to increase the level of maternal attachment and parental self- efficacy, nursing care should be provided in the relevant factors through the monitoring of activities in the home.