The conceptual structure of transition to motherhood in the neonatal intensive care unit.

Aim: This paper is a report of a concept analysis of transition to motherhood for mothers with infants in a neonatal intensive care unit.

Background: Mothers with infants in a neonatal intensive care unit have more difficulty in their transition to motherhood compared with mothers of healthy infants. The concept of transition to motherhood in the neonatal intensive care unit is not well-understood in nursing, often being confused with mothers' psychological responses in the neonatal intensive care unit.

Methods: The concept analysis combined Rodgers' evolutionary method with Schwartz-Barcott & Kim's Hybrid method. Thirty-eight studies were reviewed and a purposive sample of 10 Korean mothers with infants in a neonatal intensive care unit was interviewed.

Findings: Three critical attributes of transition to motherhood in the neonatal intensive care unit were identified: (1) time-dependent process, (2) psycho-emotional swirling and (3) hovering around the edge of mothering. These are caused by the antecedents (1) unexpected outcome of pregnancy, (2) awareness of the situation and (3) mother-infant separation. The consequences were: (1) delayed motherhood and (2) developing a sense of meaning concerning family and life. Additionally, five influencing factors to be alleviated were identified: (1) negative meaning attribution, (2) uncertainty, (3) social prejudice, (4) lack of opportunities to make contact with the infant and (5) the neonatal intensive care unit environment.

Conclusions: This concept analysis should help nurses to understand the process of becoming a mother in a neonatal intensive care unit and plan appropriate interventions for mothers with special needs.