Neonatal intensive care: communication and attachment

Birth has traditionally been recognized as a family-centred event where immediate exposure to the infant occurs and where the family begins, through direct contact, touch and voice, to form an attachment to the infant. In high-risk pregnancy and delivery, medical and technological advances distance the family from the birth event. This article describes some aspects of a research project with identified factors that facilitate and hinder family and mother attachment to the infant during periods of separation subsequent to premature delivery or other problems which require management in a neonatal intensive care unit (NICU). The project was exploratory. It involved observation of care, participation in care, individual unstructured interviews, focus group interviews and also use of Leske's (1986, 1991a,b) critical care family needs inventory, which was modified and responded to by family members (n = 109) in an attempt to quantify and validate their needs. Six constructs were derived from the inventory and then ranked by mothers (n = 100). The findings from this process were triangulated to observation and interview data in order to confirm factors that facilitate and hinder the process of attachment during family and mother-infant separation. The results of the study imply that when the family and mother are supported by an individualized approach to care and appropriate communication is used, attachment can be facilitated.