Fathers of infants born preterm

Introduction: Most of the studies on the preterm infants’ development focused mainly or exclusively on infants and their mothers. This dissertation focused on fathers, and presents a literature review, a protocol study, and three empirical studies that have been carried out to deepen the investigation of fathers’ experiences during their preterm infants’ hospitalization in the NICU. More precisely, the main aims were to explore: (a) the presence of interactive contingencies between parental communicative behaviors with their preterm infant in a heated cot in the NICU and infant behaviors, particularly gaze direction, at around 34-35 weeks PMA; (b) the fathers’ experiences of- and reactions to- the preterm birth and the subsequent stay in the NICU; (c) the fathers’ experiences of supporting their partners during their preterm infant’s stay in NICU. Methods and analyses: A multi-method approach was used and included: ethnographic observation in a level-III-NICU located in Verona (Italy) for a duration of 18 months; 3-minute video recordings of 20 father–infant and mother–infant dyads interaction in the NICU; a semi-structured interview with 20 fathers during the infants’ hospital stay; self-report questionnaires for both parents on depression and quality of the couple relationship; the collection of infants’ clinical information. Data were analyzed using a mixed-method has integrated both qualitative and quantitative data. Results: About objective (a), sequential analysis showed that parent-preterm infant interactive contingencies are already present at around 35 weeks PMA. In particular, both paternal and maternal affiliative behavior (co-occurrence of Gaze at Infant, Affectionate Touch, Affectionate Talk, and Positive Facial Affect) elicits infant attention in terms of gazing at parent’s face; and infants’ activation has encouraged parents’ affectionate behaviors, showing a bidirectional link between. About objective (b), two clusters were identified. The ‘fathers-of-preterm-infants’ were actively engaged in their infant’s care. In contrast, only 63% of the “preterm-fathers” were actively engaged in their infant’s care. Clusters were associated with the infant’s gestational age (mean GA: 32.5 weeks vs 29.1 weeks). About objective (c), four main themes were identified: support for mother; satisfaction with NICU nurses’ support for mother; mother’s care for infant; and couple relationship. Conclusions: Our findings suggest that could be crucial to realize parent-specific interventions aimed to improves and sustain positive engagement in parents. Furthermore, fathers of preterm infants should receive personalized support specifically addressed to them and based on the infant’s GA. Finally, the present study suggests the possibility to use the interview as a routine tool to give voice to fathers’ needs and feelings which are often hidden and silent. This may assists the NICU staff to provide tailored supportive intervention for fathers, and in so doing also to both mothers and infants.