The lived experience of Hong Kong Chinese mothers of extremely low birth weight preschool children : a phenomenological study

Abstract

The birth of a child conveys expectations, new challenges and responsibilities, and the start of a new phase of life for the infant and mother. Yet, the birth of a premature infant is represented in previous reports as a traumatic, stressful and insecure time-dependent process to the mothers. Although studies pertaining to the western culture have reflected a long standing interest on the impact and stress on the families perceived by the parents of very low birth weight children, little attention has been given to the mothers' lived experience in caring for an extremely low birth weight (ELBW) child during the preschool years in the Chinese culture. This hermeneutic-phenomenological inquiry was conducted to uncover the mothers' experience of living with ELBW preschool children. The purpose of this study was to describe and interpret the mother's experience so as to provide health care professionals with an increased understanding and insight about this experience. Twelve mothers were recruited for in-depth interviews that were audiotaped and transcribed verbatim. Supplementary information from field notes was also used to enhance understanding of the mothers' experience. The process of analysis was guided by the methodological process of a nursing inquiry adopted from Ray (1991), together with the phenomenological hermeneutic ideas from van Manen (1990). The process of data analysis was cyclic and summarized into three core phases. The first phase aimed for a naive understanding of the text. The second phase was the structural analysis composed of descriptive reflection and interpretive reflection to elucidate the experience of mothers. In the third phase, the text was considered as a whole again to obtain a critical understanding of the experience. From the mothers' narrations, seven metathemes emerged through deep reflection. The first four metathemes reveal the fundamental existential nature of the experience of extremely-low-birth-weight and they are: - Transforming in Corporeal - Embodying Motherhood - Changing in Temporal - Living with Uncertainty - Changing Relationships - Shaping the Caring Labyrinth - Interacting with the Environment - Anticipating and Intervening. The remaining three metathemes reveal the transcendent meanings of the experience are: - Getting To Know and Understand - Asserting Life in Pending Loss - Transcending to Spirituality. Together with the metathemes and themes central to this experience of extremely-low-birth-weight, a metaphor: Surmounting barriers one after another over the long journey emerged. Further reflecting on the metathemes and metaphor, the unity meaning: A Meaning of Life: Each Day a New Day was revealed. This research suggests an imperative notion that nurses and healthcare professional should emphasize a holistic care approach engaging into the mothers' psycho-social-spiritual world so as to get a closer focus on to the complexity of their needs. Recognizing the experiential knowledge of mothers, healthcare professionals should involve mothers as partners within caring interactions and decision-making. Nurses are encouraged to maintain an inter-subjective relationship with the mothers to achieve mutual planning of care with mothers in facilitating their care management of ELBW children at preschool ages.