Effect of preterm infant behavioral assessment education on maternal stress and attachment: comparison of booklet-based and face-to-face education.
- 1Pediatric Department, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
- 2Neonatal Intensive Care Department, Tabriz Al-Zahra Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
- 3Pediatric Department, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, South Shariati, Tabriz, Iran. [email protected].
Abstract
Background
Mothers of preterm infants hospitalized in neonatal intensive care units (NICUs) often experience high stress levels and challenges in developing early mother-infant attachment. Educational interventions based on the Assessment of Preterm Infants' Behavior (APIB) may improve mothers' understanding of infant behavioral cues and support maternal psychological adaptation in NICU settings. This study aimed to evaluate the effect of booklet-based and face-to-face APIB-based education on stress and attachment among mothers of preterm infants.Methods
The present quasi-experimental study was conducted between February 2023 and January 2024 in the NICU of a referral hospital. This study included 90 mothers of preterm infants assigned sequentially to booklet-based education (n = 30), face-to-face education (n = 30), or routine care (n = 30). Maternal stress and attachment were assessed before and after intervention using the Parental Stressor Scale and Maternal Attachment Inventory. Data were analyzed using ANCOVA and adjusted pairwise comparisons.Findings
Maternal stress decreased significantly in all groups (p < 0.001). Adjusted comparisons showed significantly lower stress in the booklet-based education group (mean difference = - 6.09, p = 0.004) and face-to-face education group (mean difference = - 4.16, p = 0.040) versus control, with no difference between intervention groups (p = 0.338). Maternal attachment increased significantly within both intervention groups, but no significant between-group differences were observed after adjustment (F = 0.94, p = 0.394).Conclusion
APIB-based education may provide benefits beyond routine NICU support by improving maternal interpretation of infant behavioral cues. Longer follow-up may be required to detect changes in attachment. APIB-based parental education may be a feasible strategy for reducing maternal stress in NICUs and could be incorporated into family-centered neonatal care to support mothers of preterm infants.
Related
- The Effect of Prenatal Education and Home Telecare Provided According to Watson Care Model on Spouses’ Readiness for Childbirth, Fear of Childbirth, and Maternal and Paternal Attachment: A Case Report
- Effect of a Comprehensive Perinatal Education Program on Maternal Outcomes in Primigravida Mothers
- Physical Environmental Factors and Maternal Behavioral Characteristics in Toddlers ARI
- Maternal Immune Activation by Lipopolysaccharide Reduced Parvalbumin Levels and Increased Perineuronal Nets in the Prefrontal Cortex Without Inducing Schizophrenia-like Behavioral Deficits in PV-Cre Long-Evans Rats
- Effectiveness of Cognitive Behavioral Therapy Compared with Basic Health Education for Tobacco Cessation: A Systematic Review
BibTeX
@article{farshi2026effect,
title = {{Effect of preterm infant behavioral assessment education on maternal stress and attachment: comparison of booklet-based and face-to-face education.}},
author = {Mahni Rahkar Farshi and Nastaran Arabi and Mahnaz Jabraeili},
journal = {BMC pregnancy and childbirth},
year = {2026},
month = jul,
doi = {10.1186/s12884-026-09712-y},
url = {https://europepmc.org/article/MED/42907796},
note = {CC BY},
}
RIS
TY - JOUR
TI - Effect of preterm infant behavioral assessment education on maternal stress and attachment: comparison of booklet-based and face-to-face education.
AU - Mahni Rahkar Farshi
AU - Nastaran Arabi
AU - Mahnaz Jabraeili
PY - 2026
DA - 2026/07/01
JO - BMC pregnancy and childbirth
DO - 10.1186/s12884-026-09712-y
UR - https://europepmc.org/article/MED/42907796
AB - Background Mothers of preterm infants hospitalized in neonatal intensive care units (NICUs) often experience high stress levels and challenges in developing early mother-infant attachment. Educational interventions based on the Assessment of Preterm Infants' Behavior (APIB) may improve mothers' understanding of infant behavioral cues and support maternal psychological adaptation in NICU settings. This study aimed to evaluate the effect of booklet-based and face-to-face APIB-based education on stress and attachment among mothers of preterm infants.Methods The present quasi-experimental study was conducted between February 2023 and January 2024 in the NICU of a referral hospital. This study included 90 mothers of preterm infants assigned sequentially to booklet-based education (n = 30), face-to-face education (n = 30), or routine care (n = 30). Maternal stress and attachment were assessed before and after intervention using the Parental Stressor Scale and Maternal Attachment Inventory. Data were analyzed using ANCOVA and adjusted pairwise comparisons.Findings Maternal stress decreased significantly in all groups (p < 0.001). Adjusted comparisons showed significantly lower stress in the booklet-based education group (mean difference = - 6.09, p = 0.004) and face-to-face education group (mean difference = - 4.16, p = 0.040) versus control, with no difference between intervention groups (p = 0.338). Maternal attachment increased significantly within both intervention groups, but no significant between-group differences were observed after adjustment (F = 0.94, p = 0.394).Conclusion APIB-based education may provide benefits beyond routine NICU support by improving maternal interpretation of infant behavioral cues. Longer follow-up may be required to detect changes in attachment. APIB-based parental education may be a feasible strategy for reducing maternal stress in NICUs and could be incorporated into family-centered neonatal care to support mothers of preterm infants.
SN - 1471-2393
ER -