Fathers' Needs and Masculinity Dilemmas in a Neonatal Intensive Care Unit in Denmark

Betty Noergaard, Jette Ammentorp, Jesper Fenger-Gron, Poul-Erik Kofoed, Helle Johannessen, Shelley Thibeau, Betty Noergaard, Jette Ammentorp, Jesper Fenger-Gron, Poul-Erik Kofoed, Helle Johannessen, Shelley Thibeau

Abstract

Background: Most healthcare professionals in neonatal intensive care units typically focus on the infants and mothers; fathers often feel powerless and find it difficult to establish a father-child relationship. In family-centered healthcare settings, exploring fathers' experiences and needs is important because men's roles in society, especially as fathers, are changing.

Purpose: To describe fathers' needs when their infants are admitted to a neonatal intensive care unit and to discuss these needs within a theoretical framework of masculinity to advance understanding and generate meaningful knowledge for clinical practices.

Methods: This qualitative study used participant observation, interviews, multiple sequential interviews, and a focus group discussion. Data were analyzed using grounded theory principles.

Results: Analysis of the fathers' needs generated 2 primary themes: (1) Fathers as caregivers and breadwinners and (2) fathers and emotions. Fathers wished to be involved and to take care of their infants but have to balance cultural and social norms and expectations of being breadwinners with their wishes to be equal coparents.

Implications for practice/research: Health professionals in neonatal intensive care units must be aware of fathers' need and desire to be equal coparents. Nurses should play a key role by, for example, showing that fathers are as important to their infants as are the mothers, helping them become involved in childcare, and ensuring that they are directly informed about their children's progress. Further research in other cultural settings would contribute to knowledge regarding fatherhood and the role of fathers in childcare.

References

    1. Provenzi L, Santoro E. The lived experience of fathers of preterm infants in the neonatal intensive care unit: a systematic review of qualitative studies. J Clin Nurs. 2015;24(13–14):1784–1794.
    1. Ireland J, Minesh K, Cescutti-Butler L, van Teijlingen E, Hewitt-Taylor J. Experiences of fathers with babies admitted to neonatal care units: a review of the literature. J Neonatal Nurs. 2016;22(4):171–176.
    1. Sarkadi A, Kristiansson R, Oberklaid F, Bremberg S. Fathers' involvement and children's developmental outcomes: a systematic review of longitudinal studies. Acta Paediatrica. 2008;97(2):153–158.
    1. Ottosen MH. The long-term impacts of early paternal involvement in childcare in Denmark: what happens after nuclear family dissolution. The long-term impacts of early paternal involvement in childcare in Denmark: what happens after nuclear family dissolution. In: Eydal GB, Rostgaard T, eds. Fatherhood in the Nordic Welfare States. 2015:251–274. Bristol, UK: Policy Press.
    1. Koliouli F, Gaudron CZ, Raynaud J-P. Life experiences of French premature fathers: a qualitative study. J Neonatal Nurs. 2016;22(5):244–249.
    1. Walmsley R. Are fathers supported by neonatal teams?: An exploration of the literature. J Neonatal Nurs. 2016;22:292–296.
    1. Pohlman S. Fathering premature infants and the technological imperative of the neonatal intensive care unit: an interpretive inquiry. Adv Neonatal Care. 2009;32(3):E1–E16.
    1. Cleveland LM. Parenting in the neonatal intensive care unit. J Obstet Gynecol Neonatal Nurs. 2008;37(6):666–691.
    1. Hynan MT. Supporting fathers during stressful times in the nursery: an evidence-based review. Newborn Infant Nurs Rev. 2005;5(2):87–92.
    1. Martel MJ, Milette I, Bell L, Tribble DS, Payot A. Establishment of the relationship between fathers and premature infants in neonatal units. Adv Neonatal Care. 2016;16(5):390–398.
    1. Abdeyazdan Z, Shahkolahi Z, Mehrabi T, Hajiheidari M. A family support intervention to reduce stress among parents of preterm infants in neonatal intensive care unit. Iran J Nurs Midwifery Res. 2014;19(4):349–353.
    1. Ahn YM, Kim NH. Parental perception of neonates, parental stress and education for NICU parents. Asian Nurs Res. 2007;1(3):199–210.
    1. Beheshtipour N, Baharlu SM, Montaseri S, Razavinezhad Ardakani SM. The effect of the educational program on Iranian premature infants' parental stress in a neonatal intensive care unit: a double-blind randomized controlled trial. Int J Community Based Nurs Midwifery. 2014;2(4):240–250.
    1. Cano Gimenez E, Sanchez-Luna M. Providing parents with individualised support in a neonatal intensive care unit reduced stress, anxiety and depression. Acta Paediatr. 2015;104(7):e300–e305.
    1. Kaaresen PI, Ronning JA, Ulvund SE, Dahl LB. A randomized, controlled trial of the effectiveness of an early-intervention program in reducing parenting stress after preterm birth. Pediatrics. 2006;118(1):e9–e19.
    1. Maguire CM, Bruil J, Wit JM, Walther FJ. Reading preterm infants' behavioral cues: an intervention study with parents of premature infants born <32 weeks. Early Hum Dev. 2007;83(7):419–424.
    1. Matricardi S, Agostino R, Fedeli C, Montirosso R. Mothers are not fathers: differences between parents in the reduction of stress levels after a parental intervention in a NICU. Acta Paediatr. 2013;102(1):8–14.
    1. Melnyk BM, Feinstein NF, Alpert-Gillis L, et al. Reducing premature infants' length of stay and improving parents' mental health outcomes with the Creating Opportunities for Parent Empowerment (COPE) neonatal intensive care unit program: a randomized, controlled trial. Pediatrics. 2006;118(5):e1414–e1427.
    1. Ravn I, Lindemanna R, Smebyb NA, Bunchc EH, Sandvikd L, Smithe L. Stress in fathers of moderately and late preterm infants: a randomised controlled trial. Early Child Dev Care. 2012;182:537–552.
    1. Turan T, Basbakkal Z, Ozbek S. Effect of nursing interventions on stressors of parents of premature infants in neonatal intensive care unit. J Clin Nurs. 2008;17(21):2856–2866.
    1. Weis J, Zoffmann V, Greisen G, Egerod I. The effect of person-centred communication on parental stress in a NICU: a randomized clinical trial. Acta Paediatr. 2013;102(12):1130–1136.
    1. Johnson AN. Engaging fathers in the NICU: taking down the barriers to the baby. J Perinat Neonatal Nurs. 2008;22(4):302–306.
    1. Reason P, Bradley RH. Introduction. In: Reason P, Bradbury H, eds. The SAGE Handbook of Action Research Participatory Inquiry and Practice. 2008;1–10. London, UK: SAGE Publications Ltd.
    1. Noergaard B, Johannessen H, Fenger-Gron J, Kofoed P, Ammentorp J. Participatory action research in the field of neonatal intensive care. Developing an intervention to meet the fathers' needs—a case study. J Public Health Res. 2016;5:744–751.
    1. Connell RW, Messerschmidt JW. Hegemonic masculinity: rethinking the concept. Gend Soc. 2005;19(6):829–859.
    1. Connell RW. The social organization of masculinity. In: Masculinities. 2005:67–86. Cambridge, UK: Polity Press.
    1. Reinicke K. Den hele mand—manderollen i forandring. [The entire man—the role of man is changed] [in Danish]. Det Schønbergske Forlag. 2002:1–218.
    1. Reinicke K. Mænd—køn under forvandling. [Men—sex in transition] [in Danish]. Aarhus Universitetsforlag. 2013:1–195.
    1. Madsen SA. Mænds sundhed og sygdomme. [Mens' health and illness] [in Danish]. Samfundslitteratur. 2014;1–37.
    1. Reinicke K. Drenge og mænd i krise? Perspektiver og indsatsområder. [Boys and men in crisis? Perspectives and focus area] [in Danish]. Hans Reitzels Forlag, København. 2012;25–55, 251-269.
    1. Reinicke K. Mænd i lyst og nød. [Mens' desire and distress] [in Danish]. Det Schønbergske Forlag. 2004:1–222.
    1. Mosegaard MlC. “Han var en hård mand den gamle.” Far-sønrelationen set over tre generationer. [“He was a tough man the old one.” Father-son relationship viewed across three generations] [in Danish]. Dansk Sociologi. 2007;3:47–68.
    1. Nielsen SB, Westerling A. Fathering as a learning process: breaking new ground in familiar territory. In: Eydal GB, Rostgaard T, eds. Fatherhood in the Nordic Welfare States. 2015:187–208. Bristol, UK: Policy Press.
    1. Westerling A. Reflexive fatherhood in everyday life: the case of Denmark. Fam Relatsh Soc. 2015;4(2):209–223.
    1. Beskæftigelsesministeriet. Bekendtgørelse af lov om ret til orlov og dagpenge ved barsel (barselsloven). [Ministry of Employment. Danish legislation on maternity]. 2015. Available at .
    1. Bloksgaard L. Negotiating leave in the workplace: leave practices and masculinity constructions among Danish fathers. In: Eydal GB, Rostgaard T, eds. Fatherhood in the Nordic Welfare States. Old Park Hill, Bristol: Policy Press; 2015:141–161.
    1. Committee AAoP. Levels of neonatal care. Pediatrics. 2012;130(3):587–597.
    1. Emerson R, Fretz RI, Shaw LL. Writing Ethnographic Fieldnotes. Chicago, IL: The University of Chicago Press; 1999:1–16.
    1. Hammersley M, Atkinson P. Research design: problems, cases, and samples. In: Ethnography: Principles in Practice. Park Drive, United Kingdom: Psychology Press; 2007:23–53.
    1. Kvale S. Interview. En introduktion til det kvalitative forskningsinterview. [Interview. The qualitative interview—an introduction] [in Danish]. Hans Reitzels Forlag. 1997:91–186.
    1. Charmaz K. Qualitative interviewing and grounded theory analysis. In: Gubrium JF, Holstein JA, eds. Handbook of Interview Research Context and Method. Thousand Oaks, CA: Sage; 2002:675–694.
    1. Swantz M. Participatory action research as practice. In: Reason P, Bradbury, eds. The SAGE Handbook of Action Research Participatory Inquiry and Practice. London, UK: Sage; 2008:31–48.
    1. Halkier B. Fokusgrupper. [Focus groups] [in Danish]. Samfundslitteratur & Roskilde Universitetsforlag. Odder, Denmark: Narayana Press; 2002.
    1. Mills J., Bonner A., Francis K. (2006). The development of constructivist grounded theory. International Journal of Qualitative Methods, 5(1), Article 3. Retrieved [29.08.2016] from .
    1. Olsen BM. Nye fædre på orlov—en analyse af de kønsmæssige aspekter ved forældreorlovsordninger. Ph.d. afhandling. [New fathers on leave. An analysis of the gender aspects of parental leave] [PhD thesis]. København: Sociologisk Institut, København; 2000. In Danish.
    1. Carlsen S. Mænd mandeforskning ligestilling. [Men, masculinity, equality] [in Danish]. I: Mandekultur Bonde H, Rosenbeck B. 1991;Varia nr. 1: 68–82.
    1. Madsen SA. Men's mental health: fatherhood and psychotherapy. J Mens Stud. 2009;17(1):15–30.
    1. Arockiasamy V, Holsti L, Albersheim S. Fathers' experiences in the neonatal intensive care unit: a search for control. Pediatrics. 2008;121(2):e215–e222.
    1. Fegran L, Helseth S, Fagermoen M. A comparison of mothers' and fathers' experiences of the attachment process in a neonatal intensive care unit. J Clin Nurs. 2008;17(6):810–816.
    1. Lindberg B, Axelsson K, Ohrling K. Adjusting to being a father to an infant born prematurely: experiences from Swedish fathers. Scand J Caring Sci. 2008;22(1):79–85.
    1. Deeney K, Lohan M, Spence D, Parkes J. Experiences of fathering a baby admitted to neonatal intensive care: a critical gender analysis. Soc Sci Med. 2012;75(6):1106–1113.
    1. Blomqvist YT, Rubertsson C, Kylberg E, Joreskog K, Nyqvist KH. Kangaroo Mother Care helps fathers of preterm infants gain confidence in the paternal role. J Adv Nurs. 2012;68(9):1988–1996.
    1. Sullivan JR. Development of father-infant attachment in fathers of preterm infants. Neonatal Netw. 1999;18(7):33–39.
    1. Ignell Mode R, Mard E, Nyqvist KH, Blomqvist YT. Fathers' perception of information received during their infants' stay at a neonatal intensive care unit. Sex Reprod Healthc. 2014;5(3):131–136.
    1. Hugill K, Letherby G, Reid T, Lavender T. Experiences of fathers shortly after the birth of their preterm infants. J Obstet Gynecol Neonatal Nurs. 2013;42(6):655–663.
    1. Guillaume S, Michelin N, Amrani E, et al. Parents' expectations of staff in the early bonding process with their premature babies in the intensive care setting: a qualitative multicenter study with 60 parents. BMC Pediatr. 2013;13:18.
    1. Schwalbe M, Wolkomir M. The masculine self as problem and resource in interview studies of men. Men Masc. 2001;4(1):90–103.
    1. Green J, Thoroggod N. Qualitative Methods for Health Research, 3rd ed. London, UK: SAGE; 2014;3–34:93-178.
    1. Malterud K. Qualitative research: standards, challenges, and guidelines. Lancet. 2001;358(9280):483–488.

Source: PubMed

스폰서 및 공동 작업자

건강 상태

약물 개입

3
구독하다