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Persistence of Maternal Concerns Surrounding Neonatal Jaundice
An Exploratory Study
Patricia R. Hannon, MD;
Sharla K. Willis, DrPH;
Susan C. Scrimshaw, PhD
Arch Pediatr Adolesc Med. 2001;155:1357-1363.
Objectives To explore whether mothers currently express concerns about neonatal
jaundice and perceive it as a serious condition; if so, to identify factors
influencing these perceptions; and to elicit maternal recommendations for
improved health care interactions.
Design Ethnographic interviews using grounded theory methods. Audiotaped data
were transcribed and analyzed for themes using a qualitative data analysis
software program.
Setting University and community hospitals.
Participants Forty-seven Spanish- and English-speaking breastfeeding mothers of otherwise
healthy infants with a diagnosis of neonatal jaundice and treated in inpatient
and/or outpatient settings.
Interventions None.
Main Outcome Measure Qualitative descriptions of maternal experiences with neonatal jaundice.
Results Mothers continued to voice concerns about jaundice and perceive it as
serious. They expressed misconceptions, wished to have jaundice explained
further, and offered suggestions to improve communications with medical staff.
Guilt was common, with mothers believing that they had caused the jaundice.
Mothers voiced alarm about the yellow skin and discomfort about jaundice management
and worried about perceived short- and long-term effects. Maternal perceptions
were exacerbated by cultural differences, language barriers, and subtlety
of language and its meaning. Key factors in creating perceptions of jaundice
as serious included unexpectedness of and lack of knowledge about jaundice,
quality of information received, levels of intervention, and prolonged duration
of illness and yellow color. Interactions with health care professionals and
other mothers with personal experience with jaundice were important mediators
in the way mothers reacted to information.
Conclusion Practitioners need to address these persisting misconceptions and concerns
about neonatal jaundice with mothers.
From the Department of Pediatrics, College of Medicine (Dr Hannon),
and the School of Public Health (Dr Scrimshaw), University of Illinois at
Chicago; and the School of Public Health, Ohio State University, Columbus
(Dr Willis).
Corresponding author and reprints: Patricia R. Hannon, MD, Department
of Pediatrics, Mail Code 856, University of Illinois at Chicago, 840 S Wood
St, Chicago, IL 60612 (e-mail: phannon{at}uic.edu).
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