Stress and Coping Strategies among Mothers for Caring Premature Infant at Home


  • Ayut Merdikawati Faculty of Health Sciences, Brawijaya University, Kota Malang, Jawa Timur 65145, Indonesia
  • Rinik Eko Kapti Faculty of Health Sciences, Brawijaya University, Kota Malang, Jawa Timur 65145, Indonesia
  • Yuni Sufyanti Arief Faculty of Nursing, Airlangga University, Surabaya, Jawa Timur 60115, Indonesia
  • Sholihatul Amaliya Faculty of Health Sciences, Brawijaya University, Kota Malang, Jawa Timur 65145, Indonesia
  • Nurona Azizah Faculty of Health Sciences, Brawijaya University, Kota Malang, Jawa Timur 65145, Indonesia
  • Evi Harwiati Ningrum Faculty of Health Sciences, Brawijaya University, Kota Malang, Jawa Timur 65145, Indonesia
  • Ari Damayanti Wahyuningrum Faculty of Nursing Science, STIKES Widyagama Husada Health Science College, Jawa Timur 65142, Malang, Indonesia



Background: Mothers with premature babies have higher stress levels than mothers with full-term babies and experience barriers to becoming mothers, so mothers need to adjust coping strategies continuously. This research aims to correlate coping strategies and stress among mothers caring for their premature babies at home. Methods: The data collected from 188 mothers was analyzed using descriptive and inferential statistics (Spearman test). Results: Most respondents are in the moderate stress category (70.2%). The three coping strategies used by mothers, namely praying, getting closer to the baby, and accepting the situation, were mostly in the good category (94.7%, 76.6%, and 68.1%), while coping for seeking support was mostly in the moderate category (60.6%). There was a correlation between coping and maternal stress (coping with prayer: p-value 0.008, coping with attachment: p-value 0.000, coping with accepting situations: p-value 0.000, and coping with seeking information: p-value 0.000). The strongest correlation was the coping strategy with accepting the situation (r = 0.561), which means that the better the coping with accepting the situation, the less stress. This study shows a correlation between mothers coping strategies and the stress of caring for premature babies at home. Conclusion: Support by health workers is crucial in developing appropriate coping strategies for mothers to reduce maternal stress when caring for premature babies at home.


Coping Strategies, Mother, Premature, Stress


Download data is not yet available.


Abimana, M. C., Karangwa, E., Hakizimana, I., Kirk, C. M., Beck, K., Miller, A. C., ... & Nshimyiryo, A. (2020). Assessing factors associated with poor maternal mental health among mothers of children born small and sick at 24–47 months in rural Rwanda. BMC Pregnancy and Childbirth, 20(1), 1-12.

Arzani, A., Valizadeh, L., Zamanzadeh, V., & Mohammadi, E. (2015). Mothers' strategies in handling the prematurely born infant: a qualitative study. Journal of Caring Sciences, 4(1), 13. Accessed on 12th July, 2022

Baron, M. G. B., & Ragay, A. K. S. (2020). From agony to adaptation: journey of mothers as primary caregiver for their children with pda. The Malaysian Journal of Nursing (MJN), 11(4), 20-40.

Bener, A. (2013). Psychological distress among postpartum mothers of preterm infants and associated factors: a neglected public health problem. Brazilian Journal of Psychiatry, 35, 231-236.

Biggs, A., Brough, P., & Drummond, S. (2017). Lazarus and Folkman's psychological stress and coping theory. The Handbook of Stress and Health: A Guide to Research and Practice, 349-364.

Binti Ab Latif, R. (2018). Prevalence of Depression, Anxiety and Stress Among Post-Natal Mothers Having Low Birth Weight (Lbw) Infants. Malaysian Journal of Medical Research (MJMR), 2(2), 18-29.

Breivold, K., Hjaelmhult, E., Sjöström‐Strand, A., & Hallström, I. K. (2019). Mothers’ experiences after coming home from the hospital with a moderately to late preterm infant–a qualitative study. Scandinavian Journal of Caring Sciences, 33(3), 632-640.

Çaksen, H. (2023). The Role of Religious Coping in Neonatal Intensive Care Unit. Journal of Child Science, 13(01), e54-e57.

Çelik, R., & Altay, N. (2023). The Role of Nurses in Preparing Mothers of Premature Infants for Discharge and Home Care. Journal of Education and Research in Nursing, 20(4), 387-392.

de Castro Pereira, F., Aparecida Baggio, M., Silveira Viera, C., de Oliveira Toso, B. R. G., & Kaliska Piva, E. (2019). Premature Newborn Post-Discharge Maternal Stress. Journal of Nursing UFPE/Revista de Enfermagem UFPE, 13. . Accessed on 12th July, 2022

Doupnik, S. K., Hill, D., Palakshappa, D., Worsley, D., Bae, H., Shaik, A., ... & Feudtner, C. (2017). Parent coping support interventions during acute pediatric hospitalizations: a meta-analysis. Pediatrics, 140(3).

Emad B. Algorani, V. G. (2021). Coping Mechanisms. StatPearls Publishing. . Accessed on 14th July, 2022

Galeano, M. D., & Carvajal, B. V. (2016). Coping in mothers of premature newborns after hospital discharge. Newborn and Infant Nursing Reviews, 16(3), 105-109.

Ginja, S., Jackson, K., Newham, J. J., Henderson, E. J., Smart, D., & Lingam, R. (2020). Rural-urban differences in the mental health of perinatal women: a UK-based cross-sectional study. BMC Pregnancy and Childbirth, 20(1), 1-11.

González, M. P. O., & Espitia, E. C. (2014). Caring for a premature child at home: from fear and doubt to trust. Texto & Contexto-Enfermagem, 23, 828-835.

Gurgani, S., & Jogi, S. (2018). A Study to Estimate the Level of Stress and Coping Strategies among Mothers Whose Neonates are Admitted in Neonatal Intensive Care Unit (NICU) at Lalla Ded Hospital, Srinagar, Kashmir. International Journal of Midwifery Nursing, 1(2), 1-44.

Hamon, E., Bourdin, B., & Le Driant, B. (2023). Parental representations after preterm birth: a narrative review. Frontiers in Psychology, 14.

Ionio, C., Brazzoduro, V., Mascheroni, E., Colombo, C., Olivari, M. G., Introvini, P., Confalonieri, E., Banfi, A., Bonanomi, A., Lista, G., & Vettore, B. (2016A ). Mother-child Interaction in Preterm Dyads. July, 13–14. . Accessed on 22th July, 2022

Ionio, C., Colombo, C., Brazzoduro, V., Mascheroni, E., Confalonieri, E., Castoldi, F., & Lista, G. (2016B). Mothers and fathers in NICU: the impact of preterm birth on parental distress. Europe's Journal of Psychology, 12(4), 604.

Ionio, C., Giannoni, V., Colombo, C., Ciuffo, G., Landoni, M., Banfi, A., ... & Lista, G. (2023). Impact of Maternal emotional experiences at birth and self-regulation in preterm children: The role of early interactions. Journal of Neonatal Nursing, 29(1), 43-49.

Jabraeili, M., Hassankhani, H., Negarandeh, R., Abbaszadeh, M., & Cleveland, L. M. (2018). Mothers' emotional experiences providing care for their infants within the culture of an Iranian neonatal unit. Advances in Neonatal Care, 18(4), E3-E12.

Kaliampos, A., & Roussi, P. (2017). Religious beliefs, coping, and psychological well-being among Greek cancer patients. Journal of Health Psychology, 22(6), 754-764.

Kapti, R. E., Arief, Y. S., Triharini, M., Azizah, N., & Supriati, L. (2022). Maternal Coping Strategies for Premature Infant: A Systematic Review. Kesmas: Jurnal Kesehatan Masyarakat Nasional (National Public Health Journal), 17(sp1).

Karbandi, S., Momenizadeh, A., Heidarzadeh, M., Mazlom, S. R., Hassanzadeh, M. H., & Zeraati, H. (2018). Effects of empowering mothers of premature infants on their stress coping strategies. Iranian Journal of Psychiatry and Behavioral Sciences, 12(2).

Khaleghipour, M., Akbari, N., Hajaty, S., Shirmohammadi Fard, S., Jamalimoghaddam, M., Sabzi, Z., & Asadi, L. (2022). Evaluation of the effect of narrative writing on the stress sources of the fathers of preterm neonates admitted to the NICU. The Journal of Maternal-Fetal & Neonatal Medicine, 35(4), 651-656.

Mahwasane, T., Netshisaulu, K. G., Malwela, T. N., & Maputle, M. S. (2023). Support needs of parents with preterm infants at resource-limited neonatal units in Limpopo province: A qualitative study. Curationis, 46(1), 2409.

Malliarou, M., Karadonta, A., Mitroulas, S., Paralikas, T., Kotrotsiou, S., Athanasios, N., & Sarafis, P. (2021). Preterm Parents’ Stress and Coping Strategies in a Neonatal Intensive Care Unit in a University Hospital of Central Greece. Materia Socio-Medica, 33(4), 244.

Meyers, E. C., Solorzano, B. R., James, J., Ganzer, P. D., S., E., Rennaker, R. L., & Kilgard, M. P. S. H. (2018). Development of Parenting Self-Efficacy in Mothers of High-Risk Infants. Physiology & Behavior, 176(1), 100–106.

Miles, M. S., Holditch-Davis, D., Thoyre, S., & Beeber, L. (2005). Rural African-American mothers parenting prematurely born infants: An ecological systems perspective. Newborn and Infant Nursing Reviews, 5(3), 142-148.

Nolan, A., & Lawrence, C. (2009). A pilot study of a nursing intervention protocol to minimize maternal-infant separation after cesarean birth. Journal of Obstetric, Gynecologic & Neonatal Nursing, 38(4), 430-442.

Ochandorena-Acha, M., Noell-Boix, R., Yildirim, M., Cazorla-Sánchez, M., Iriondo-Sanz, M., Troyano-Martos, M. J., & Casas-Baroy, J. C. (2022). Experiences and coping strategies of preterm infants’ parents and parental competences after early physiotherapy intervention: qualitative study. Physiotherapy Theory and Practice, 38(9), 1174-1187.

Patil, S. (2014). Level of stress and coping strategies seen among parents of neonates. International Journal of Science and Research, 3(4), 579-85.

Paul, P., Pais, M., Kamath, S., Pai, M. V., Lewis, L., & Bhat, R. (2018). Perceived maternal parenting self-efficacy and parent coping among mothers of preterm infants–a crosssectional survey. Manipal Journal of Medical Sciences, 3(1), 7. Original Article_2.pdf

Rajalakshmi, S., & Kalavathi, S. (2017). A study to assess the level of stress and coping strategies among mothers of preterm infants admitted in Neonatal Intensive Care Unit at selected hospital, Puducherry. International Journal of Advances in Nursing Management, 5(1), 45-50.

Rossman, B., Greene, M. M., Kratovil, A. L., & Meier, P. P. (2017). Resilience in mothers of very-low-birth-weight infants hospitalized in the NICU. Journal of Obstetric, Gynecologic & Neonatal Nursing, 46(3), 434-445.

Schappin, R., Wijnroks, L., Uniken Venema, M. M., & Jongmans, M. J. (2013). Rethinking stress in parents of preterm infants: a meta-analysis. PloS One, 8(2), e54992. 10.1371/journal.pone.0054992

Sharma, A. (2019). A Study to Assess the Level of Stress and Coping Strategies Adopted By Parents of The Neonates Admitted in NICU In Selected Hospitals, Bangalore Mr. Journal of Nursing Research, Education and Management, 1(1), 12–16.

Moghaddam Tabrizi, F., Alizadeh, S., & Radfar, M. (2017). Barriers of parenting in mothers with a very low-birth-weight preterm infant, and their coping strategies: a qualitative study. International Journal of Pediatrics, 5(9), 5597-5608.

Tajalli, S., Kouhnavard, M., Jeshvaghanee, S. S., Fatemi, N. S., Cheraghi, M. A., & Kadivar, M. (2022). Spiritual Well-Being, Parental Stress, and Coping strategies: A cross-sectional study of Iranian Mothers with Preterm neonates. Iranian Journal of Neonatology, 13(2).

Ting, L. K., Rabbani, M., & Zahabi, A. (2020). Experience Of Homesickness And Coping Strategies Among Malaysian Young Adutls. Malaysian Journal of Medical Research (MJMR), 4(3), 42-47.

Unicef Indonesia. (2021). Health: Giving Children the Best Chance to Survive and Thrive. Accessed on 22nd January, 2022.

Wakely, L., Rae, K., & Keatinge, D. (2015). Fragile forgotten families: parenting a premature infant in a rural area, where is the evidence?. Neonatal, Paediatric & Child Health Nursing, 18(3), 8-17.

WHO. (2023). Preterm birth. World Health Organization. . Accessed on 2nd February, 2022.

Woodward, L. J., Bora, S., Clark, C. A., Montgomery-Hönger, A., Pritchard, V. E., Spencer, C., & Austin, N. C. (2014). Very preterm birth: maternal experiences of the neonatal intensive care environment. Journal of Perinatology, 34(7), 555-561.

Zelkowitz, P., Bardin, C., & Papageorgiou, A. (2007). Anxiety affects the relationship between parents and their very low birth weight infants. Infant Mental Health Journal: Official Publication of The World Association for Infant Mental Health, 28(3), 296-313.



How to Cite

Merdikawati, A. ., Eko Kapti, R. ., Sufyanti Arief, Y. ., Amaliya, S. ., Azizah, N. ., Harwiati Ningrum, E. ., & Wahyuningrum, A. D. . (2024). Stress and Coping Strategies among Mothers for Caring Premature Infant at Home. The Malaysian Journal of Nursing (MJN), 15(3), 37-46.