SPECIAL SESSION: Guided Participation to Support Parental Caregiving: Models, Processes and Outcomes

Description/Overview: This session will include three presentations on the topic of parental caregiving in conditions of threat to the offspring. First, a theoretical model for understanding parental caregiving will be presented as a framework or context for the following two presentations. The theoretical framework encompasses co-parenting, its motivations, and its qualities will be described. A longitudinal study of parents who have an infant with complex congenital heart disease will provide evidence for the model. The presentation that follows will focus on parental caregiving in the context of perinatal loss, specifically threatened abortion and stillbirth. The aspects of the theoretical model that will be examined are parental caregiving internal working models that are oriented to being sure and final acts of caregiving. The third presentation will focus on the critical importance of maternal caregiving to the development of infant physiologic regulation. The setting of maternal caregiving in this setting is mother-infant feeding interaction and the qualities of caregiving communicated through the mother's feeding behavior. The session will conclude with a panel discussion of parental caregiving of infants whose wellbeing at threatened, what remains to be studied, challenges for this study, and implications for nursing practice. Parental caregiving, including nurturing, protecting, and relating to the child, is known to make a difference for infant wellbeing. When well being is threatened or life is at risk, parental caregiving may be subject to severe challenge. Co-parenting, the work that parents do directly or indirectly in relation to each other for caregiving, may falter or be poorly developed or low in adaptive qualities. Motivations for caregiving may or may not be framed from the perspective of co-parenting. Consequently, competencies for parenting may be diminished or lacking. In particular, parental competencies for caregiving may be in need of development, shoring up or buttressing by nurses or other clinicians when loss of a pregnancy seems imminent or an infant is born with a congenital heart defect, to take two different perspectives or phases of the development of parental caregiving competencies. A theoretical framework for understanding parental competence development for caregiving in the context of co-parenting and the risks for well-being of the fetus or infant could aid nurses and other clinicians in assessing and responding to parents in health-promoting or problem-preventing ways. To date, published theoretical frameworks that are addressed to and useful for nursing practice are lacking. This session will include three presentations on the topic of parental caregiving in conditions of threat to the offspring. First, a theoretical model for understanding parental caregiving will be described as a framework or context for research studies. The theoretical framework encompasses the internal working models of parents for parental caregiving, including motivations on which the internal working model operates, expectations of self and partner as parents, the infant, and tasks of caregiving. A parent’s intentions for caregiving have implications for co-parenting in some form, whether in an independent or collaborative approach to caring for the infant. Qualities of co-parenting will be defined and described with data. First in this session, a longitudinal study of parents who have an infant with complex congenital heart disease will provide evidence for the model. The research presentation that follows will focus on parental caregiving in the context of perinatal loss, specifically threatened abortion and stillbirth. The aspects of the theoretical model that will be examined are parental caregiving internal working models are oriented to being sure and final acts of caregiving. The third research presentation focuses on the critical importance of maternal caregiving to the development of infant physiologic regulation, an outcome of importance for infants whose physical functioning, growth, and development are compromised by anatomical anomaly and physiologic malfunctioning. The setting of maternal caregiving in this setting is mother-infant feeding interaction and the qualities of caregiving are communicated through the mother's feeding behavior. The session will conclude with a panel discussion of parental caregiving of infants whose wellbeing is threatened, what remains to be studied, challenges for research investigation, and implications for nursing practice.