Effect of QR Code-Supported Infant Care Education on Maternal Self-Confidence, Maternal Attachment, and Infant Health in the NICU (NICU-QR)

This randomized controlled trial was conducted to evaluate the effects of a Quick Response (QR) code-supported infant care education program based on Meleis' Transitions Theory on maternal self-confidence, maternal attachment, and infant health among primiparous mothers of infants hospitalized in a neonatal intensive care unit (NICU). Data were collected using the Descriptive Information Form, the Pharis Self-Confidence Scale, the Maternal Attachment Scale, and the Infant Health Assessment Form. Participants were randomly assigned to the intervention (n=42) and control (n=42) groups using block randomization. Mothers in the intervention group received face-to-face infant care education based on Meleis' Transitions Theory before discharge, a printed infant care guide containing QR codes linked to educational videos, and instructions on how to use the mobile application developed for the study. Mothers in the control group received routine care and follow-up services provided by the neonatal intensive care unit. Maternal self-confidence, maternal attachment, and infant health outcomes were assessed before discharge and at one and three months after discharge. The intervention group demonstrated higher maternal self-confidence and maternal attachment scores throughout the follow-up period compared with the control group. Infants in the intervention group also showed more favorable health outcomes, including improved growth indicators, higher breastfeeding frequency, and lower rates of common health problems and hospital visits. The findings suggest that Meleis' Transitions Theory-based QR code-supported infant care education is an effective strategy for improving maternal self-confidence, maternal attachment, and infant health outcomes following NICU discharge.