Challenges faced by nurses and parents to facilitate parent-infant bonding and attachment in a Neonatal Intensive Care Unit during COVID-19 pandemic

Abstract

Background Infants who are admitted to the Neonatal Intensive Care Unit (NICU) are a medically vulnerable population who are at risk for developmental delays, behaviour difficulties and reduced parent-infant bonding and attachment. The bonding and attachment relationship that forms between parents and their infant is a sensitive process and should be initiated and maintained immediately after birth. The COVID-19 pandemic caused several pandemic-related adversities such as hospital restrictions to parental visits, limited parental contact time with their infants and physical distancing between parents and infants. These COVID-19 related risk mitigation strategies lead to a break in the bonding and attachment process resulting in poor weight gain, failure in exclusive breastfeeding and lack of parent-infant emotional and physiological connection.

Aims and objective The aim and objective of this study is to explore and describe the challenges faced by nurses and parents to facilitate parent-infant bonding and attachment in a NICU as a result of the COVID-19 pandemic.

Research design A qualitative, explorative and descriptive design was used. In the study, the researcher used face-to-face interviews and Microsoft Teams™ meetings with parents and face-to-face interviews with neonatal nurses to explore and describe the challenges of facilitating parent-infant bonding and attachment in the NICU during the COVID-19 pandemic.

Methodology The study was conducted in a public hospital within the Gauteng province in the NICU of the hospital. The population was parents who had infants in the NICU and all the neonatal nurses who were working in the NICU the COVID-19 pandemic. Convenient sampling was used. Data was collected using face-to-face and Microsoft Teams™ semi-structured interviews. Data was analysed using Tesch’s eight steps of data analysis.

Findings Four themes emerged which are parent-infant bonding and attachment in NICU; factors facilitating parent-infant bonding and attachment challenges related to the COVID-19 pandemic; and consequences of challenges to facilitate bonding and attachment.

Conclusion This study illuminates the significant challenges confronted by nurses and parents in nurturing parent-infant bonding and attachment within the NICU amid the COVID-19 pandemic. The findings highlight the intensified emotional and communicative responsibilities placed on nurses, emphasizing the imperative for supportive protocols and resources. Moreover, the necessity to adapt practices to incorporate virtual communication and parental involvement is underscored. The study also underscores the dual impact on parents, who grapple with heightened stressors alongside diminished engagement opportunities.

Key terms /concepts: Attachment and Bonding, Challenges, COVID-19 Pandemic, Facilitate, Infant, Neonatal Intensive Care Unit, Parents, Nurses.