Distress After Preterm Birth: A Discourse Analysis of Parents' Accounts and Photographs

2.50
Hdl Handle:
http://hdl.handle.net/10755/295437
Category:
Abstract
Type:
Dissertation
Level of Evidence:
Qualitative Study, Other
Research Approach:
Qualitative Research
Title:
Distress After Preterm Birth: A Discourse Analysis of Parents' Accounts and Photographs
Author(s):
Kantrowitz-Gordon, Ira; Vandermause, Roxanne
Lead Author STTI Affiliation:
Psi-at-Large
Author Details:
Ira Kantrowitz-Gordon, MN, CNM, email:irakg@uw.edu; Roxanne Vandermause, PhD, RN, rvandermause@wsu.edu
Abstract:

Project Aims:  Preterm birth is a distressing experience for parents.  This distress may continue into early childhood, with negative consequences for parents’ mental health and child development.  The purpose of this study was to take an in-depth look at how parents formed their accounts of premature birth, postpartum distress, and lives as parents and partners. 

Theoretical Framework:  This study used a social constructionist approach toward understanding distress.  Parents construct their understanding of distress based on cultural expectations and ideals, which are called discourses.  These discourses make certain explanations and actions available to subjects as they react to their life circumstances.  Two theoretical approaches were used in this study:  discursive psychology and Foucauldian discourse. The psychological approach focuses on the individual’s utilization of available discursive resources in order to accomplish specific goals through communicative action.  The Foucauldian approach focuses on institutional and societal discourses and structures that constrain individual action. 

Methods:  Discourse analysis of semi-structured interviews and photo-elicitation assignments were used to analyze the parents’ experiences in the context of the couple relationship.  The study population included 8 parents of premature infants born from 24 to 30 weeks gestation, who had experienced significant distress in and out of the hospital.  Parents participated in the study when their children were between 15 months and 8 years old.  In the initial interview parents described their experience of prematurity, emotional distress, and parenting.  Participants returned for a second interview where they further described their distress using photographs they had newly taken or selected.  Transcribed interviews and photographs were interpreted by a team of qualitative researchers and analyzed for discourses of distress and how the discourses constructed the participants while allowing participants to choose among available discourses in order to achieve social objectives.

Findings:  Parents described the preterm birth, hospitalization, and aftermaths as ongoing traumatic events.  Discourses of distress included the perfect child, the good mother, and the good father.  Parents engaged these discourses in reconciling their loss of idealized birth and parenting and their roles after prematurity.  Social isolation and disciplinary power were discourses that showed how parents struggled with interaction with their social networks and with health care providers and institutions.  The use of photo-elicitation enabled participants to engage in their accounts in new ways, including locating their distress in space and time, use of visual metaphors, and reappraisal of past images.

Recommendations:  Findings highlighted how parents described their trauma and distress in ways not captured by psychiatric diagnoses such as depression and anxiety.  There is a need for more education of nurses and the public on parents’ emotional experiences after preterm birth.  Nurses need increased experience and comfort with being present with the suffering of these parents.  Findings from this study may help nurses be aware of the negative effects of preterm birth and respond to the parents’ emotional needs. 

Keywords:
Discourse Analysis; Preterm birth; Parenting; Distress; Photography; qualitative research
Repository Posting Date:
8-Jul-2013
Date of Publication:
8-Jul-2013
Sponsors:
Sigma Theta Tau International, Psi Chapter-at-Large; Western Institute of Nursing
Description:
Ira Kantrowitz-Gordon was the recipient of the 2012 Sigma Theta Tau International/Western Institute of Nursing Research Grant.
Note:
The Sigma Theta Tau International grant application that funded this research, in whole or in part, was completed by the applicant and peer-reviewed prior to the award of the STTI grant. No further peer-review has taken place upon the completion of the STTI grant final report and its appearance in this repository.; This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen
dc.type.categoryAbstracten
dc.typeDissertationen
dc.evidence.levelQualitative Study, Otheren
dc.research.approachQualitative Researchen
dc.titleDistress After Preterm Birth: A Discourse Analysis of Parents' Accounts and Photographsen_US
dc.contributor.authorKantrowitz-Gordon, Ira-
dc.contributor.authorVandermause, Roxanne-
dc.contributor.departmentPsi-at-Largeen
dc.author.detailsIra Kantrowitz-Gordon, MN, CNM, email:irakg@uw.edu; Roxanne Vandermause, PhD, RN, rvandermause@wsu.eduen
dc.identifier.urihttp://hdl.handle.net/10755/295437-
dc.description.abstract<p><strong>Project Aims:</strong>  Preterm birth is a distressing experience for parents.  This distress may continue into early childhood, with negative consequences for parents’ mental health and child development.  The purpose of this study was to take an in-depth look at how parents formed their accounts of premature birth, postpartum distress, and lives as parents and partners. </p> <p><strong>Theoretical Framework:</strong>  This study used a social constructionist approach toward understanding distress.  Parents construct their understanding of distress based on cultural expectations and ideals, which are called discourses.  These discourses make certain explanations and actions available to subjects as they react to their life circumstances.  Two theoretical approaches were used in this study:  discursive psychology and Foucauldian discourse. The psychological approach focuses on the individual’s utilization of available discursive resources in order to accomplish specific goals through communicative action.  The Foucauldian approach focuses on institutional and societal discourses and structures that constrain individual action. </p> <p><strong>Methods: </strong> Discourse analysis of semi-structured interviews and photo-elicitation assignments were used to analyze the parents’ experiences in the context of the couple relationship.  The study population included 8 parents of premature infants born from 24 to 30 weeks gestation, who had experienced significant distress in and out of the hospital.  Parents participated in the study when their children were between 15 months and 8 years old.  In the initial interview parents described their experience of prematurity, emotional distress, and parenting.  Participants returned for a second interview where they further described their distress using photographs they had newly taken or selected.  Transcribed interviews and photographs were interpreted by a team of qualitative researchers and analyzed for discourses of distress and how the discourses constructed the participants while allowing participants to choose among available discourses in order to achieve social objectives.</p> <p><strong>Findings:</strong>  Parents described the preterm birth, hospitalization, and aftermaths as ongoing traumatic events.  Discourses of distress included <em>the</em> <em>perfect child</em>, <em>the</em> <em>good mother</em>, and <em>the</em> <em>good father</em>.  Parents engaged these discourses in reconciling their loss of idealized birth and parenting and their roles after prematurity.  <em>Social isolation </em>and <em>disciplinary power </em>were discourses that showed how parents struggled with interaction with their social networks and with health care providers and institutions.  The use of photo-elicitation enabled participants to engage in their accounts in new ways, including locating their distress in space and time, use of visual metaphors, and reappraisal of past images.</p> <p><strong>Recommendations:</strong>  Findings highlighted how parents described their trauma and distress in ways not captured by psychiatric diagnoses such as depression and anxiety.  There is a need for more education of nurses and the public on parents’ emotional experiences after preterm birth.  Nurses need increased experience and comfort with being present with the suffering of these parents.  Findings from this study may help nurses be aware of the negative effects of preterm birth and respond to the parents’ emotional needs. </p>en_GB
dc.subjectDiscourse Analysisen_GB
dc.subjectPreterm birthen_GB
dc.subjectParentingen_GB
dc.subjectDistressen_GB
dc.subjectPhotographyen_GB
dc.subjectqualitative researchen_GB
dc.date.available2013-07-08T13:01:27Z-
dc.date.issued2013-07-08-
dc.date.accessioned2013-07-08T13:01:27Z-
dc.description.sponsorshipSigma Theta Tau International, Psi Chapter-at-Largeen
dc.description.sponsorshipWestern Institute of Nursingen
dc.descriptionIra Kantrowitz-Gordon was the recipient of the 2012 Sigma Theta Tau International/Western Institute of Nursing Research Grant.en_GB
dc.description.noteThe Sigma Theta Tau International grant application that funded this research, in whole or in part, was completed by the applicant and peer-reviewed prior to the award of the STTI grant. No further peer-review has taken place upon the completion of the STTI grant final report and its appearance in this repository.en
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item.-
This item is licensed under a Creative Commons License
Creative Commons
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.