Preterm birth represents a major health challenge and is the subject of intensive research in perinatal medicine worldwide. Pregnancy, childbirth, and the postnatal period are emotionally demanding times in a woman's childbearing years, bringing many changes and challenges for the expectant mother. Preterm birth, for which most mothers are unprepared, causes even more stress. In addition to physical complications and long-term consequences for the newborn, it can significantly affect their mental health and the quality of their attachment to their child.
The mental health of mothers after preterm birth plays a key role in the overall experience of motherhood and affects the long-term well-being of both the mother and her child. Maintaining stable mental health during this critical period is essential for improving the quality of life for the entire family.
In the PhD thesis, we explored the complex relationship between preterm birth and mothers’ mental health. We focused on understanding the psychological and emotional factors that affect mothers after preterm birth. Additionally, we analysed the effects of mothers’ mental health problems on their children’s well-being and explored strategies to prevent and treat these problems. The aim of the PhD thesis was to contribute to a better understanding of the complex interactions between preterm birth and mothers’ mental health and to design a programme to improve mothers’ mental health after preterm birth.
The PhD thesis, Group therapy model for mothers of premature infants based on relational family therapy, consists of a theoretical and an empirical section. The theoretical part reviews the literature on preterm birth in relation to mothers’ mental health and the mother-child relationship. The empirical part presents and evaluates a therapeutic programme for mothers of preterm infants based on the relational family therapy (RFT) method, using both quantitative and qualitative approaches. In the first phase of the quantitative study, we examined the prevalence of depressive, anxiety, and post-traumatic stress symptoms among mothers of term and preterm infants within one year postpartum. The sample comprised 257 participants (227 mothers of term infants and 30 mothers of preterm infants). Using the Edinburgh Postnatal Depression Scale (EPDS), the State–Trait Anxiety Inventory (STAI), and the Modified Posttraumatic Stress Disorder Perinatal Questionnaire (Modified PPQ), we confirmed the first hypothesis: compared with mothers of term infants, mothers of preterm infants reported significantly higher levels of depressive symptoms, anxiety, and post-traumatic stress symptoms.
In the second quantitative phase, 12 mothers of preterm infants with birth weight less than 1 500 g participated. We assessed depressive, anxiety, and post-traumatic stress symptoms and the mother–infant relationship before and after participation in the RFT-based group programme. Using the STAI, EPDS, Modified PPQ, and the Maternal Postnatal Attachment Scale (MPAS), we partially confirmed the fifth hypothesis; the remaining hypotheses could not be confirmed. Hypotheses 2, 4, and 6 could neither be confirmed nor rejected because statistical comparisons between the experimental and control groups were not feasible due to the small and heterogeneous samples. Hypotheses 3, 7, and 8 were rejected because pre–post differences in depressive, anxiety, and post-traumatic stress symptoms did not reach statistical significance.
The qualitative component traced changes mothers experienced during the therapeutic group. We described specific features of therapeutic work with mothers after preterm birth and examined the effectiveness of the new RFT-based group model. Findings indicate that, by the end of the process, participants reported markedly fewer depressive symptoms, guilt, sadness, and helplessness. Initial feelings of being misunderstood, inadequate, inferior, and exhausted were no longer reported. Anxiety decreased and remained primarily linked to the child’s development and challenges at home. By the end of treatment, participants managed concerns regarding feeding, weight, and oxygen, as well as fears for the child’s health, more effectively. Regarding post-traumatic stress, some mothers still described overprotectiveness and avoidance of reminders of the preterm birth. The greatest gains were observed in the mother–infant relationship: stronger connectedness, improved recognition of the infant’s needs, greater patience, and an increased desire to spend time together. The results of the research are encouraging and represent an important contribution to strengthening the mental health of mothers after preterm birth and the quality of life of the whole family with a premature baby.
|
