A Feasibility Study of the Parental Sensitivity Intervention on Attachment and Self-Efficacy of Mothers and Fathers of Preterm Infants


  • Kulwara Phianching Faculty of Nursing Burapha University
  • Nujjaree Chaimongkol Faculty of Nursing, Burapha University
  • Yunee Pongjaturawit Faculty of Nursing, Burapha University


attachment, feasibility, parental sensitivity, preterm infants, self-efficacy


This pre-experimental design with pretest-posttest and follow-up measures aimed to determine the feasibility of the parental sensitivity intervention by comparing mother-infant attachment, maternal self-efficacy, father-infant attachment and paternal self-efficacy among mothers and fathers in the care of preterm infants. A pre-experimental design with pretest, posttest and follow-up measures was employed. The participants were recruited through a purposive sampling method with four triads of mother, father and preterm infants who were admitted to a sick newborn ward at a hospital in Thailand. The research instruments for data collection included the Postpartum Bonding Questionnaire and the Maternal/Paternal Confidence Questionnaire with Cronbach’s alpha reliability of 0.73 and 0.75, respectively. The parental sensitivity intervention contained four sessions with 60-90 minutes per session. Descriptive statistics and Friedman test were used to analyze the data.

The results found that a significant difference over the three time measures of the outcome variables. Mother-infant attachment, mother’s self-efficacy, father-infant attachment and father’s self-efficacy at posttest and follow-up periods were better than those at pretest (p<.05). These findings indicate that the parental sensitivity intervention would be appropriate and feasible for further implementation.


Download data is not yet available.


1. Forcada-Guex, M., Pierrehumbert, B., Borghini, A., Moessinger, A., & Muller-Nix, C. Early dyadic patterns of mother–infant interactions and
outcomes of prematurity at 18 months. Pediatrics. 2006; 118(1): 107-114.

2. Muller-Nix, C., Forcada-Guex, M., Pierrehumbert, B., Jaunin, L., Borghini, A., & Ansermet, F. Prematurity, maternal stress and mother–child
interactions. Early human development. 2004; 79(2): 145-158.

3. Grant, K. A., McMahon, C., & Austin, M. P. Maternal anxiety during the transition to parenthood: a prospective study. Journal of affective
disorders. 2008; 108(1): 101-111.

4. Greisen, G., Mirante, N., Haumont, D., Pierrat, V., Pallas-Alonso, C. R., Warren, I., & Cuttini, M. Parents, siblings and grandparents in the
Neonatal Intensive Care Unit A survey of policies in eight European countries. Acta paediatrica. 2009; 98(11): 1744-1750.

5. Honda, M., Som, R., Seang, S., Tung, R., & Iwamoto, A. One year outcome of high-risk newborn infants discharged from the neonatal care unit of the National Maternal and Child Health Center in Cambodia. Heliyon, 2019; 5(4): e01446.

6. McInnes, R. J., & Chambers, J. Infants admitted to neonatal units–interventions to improve breastfeeding outcomes: a systematic review
1990–2007. Maternal & child nutrition. 2008; 4(4): 235-263.

7. Bowlby, J. Attachment. New York: Basic book; 1969.

8. Klaus, M. H., & Kennell, J. H. Parent-infant bonding. CV Mosby; 1982.

9. Kleebpan, S., Phahuwatanakorn, W., Yusamran, C., & Putdivarnichapong, W. Factors Influencing Parental Competence in First-Time Postpartum
Mothers. Journal of The Royal Thai Army Nurses. 2019; 20(2): 140-149. (in Thai)

10. Yakasem, P., Chaimongkol, N., & Pongjaturawit, Y. Experience of becoming a Thai early adolescent mother. Journal of The Royal Thai Army Nurses. 2018; 19(3): 89-96. (in Thai)

11. Littleton, L. Y., & Engebretson, J. C. Maternal, Neonatal and women’s Health Nursing. Delmar, Thomson Learning; 2002.

12. Satipan, C. Marital Relationship, Father–infant Attachment and Father Involvement in Postpartum Period [Thesis]: Chiangmai University; 2014. (in Thai)

13. Tapanya, S. Attributions and attitudes of mothers and fathers in Thailand. Parenting. 2011; 11 (2-3): 190-198. (in Thai)

14. Shin, H., Park, Y-J., & Kim, M. J. Predictors of maternal sensitivity during the early postpartum period. Journal of Advanced Nursing. 2006;
55(4): 425-434.

15. Sevigny, P. R., & Loutzenhiser, L. Predictors of parenting self-efficacy in mothers and fathers of toddlers. Child: Care, Health and Development. 2010; 36: 179–189.

16. Coleman, P. K., & Karraker, K. H. Maternal self-efficacy beliefs, competence in parenting, and toddlers’ behavior and developmental status. Infant Mental Health Journal: Official Publication of the World Association for Infant Mental Health. 2003; 24(2): 126-148.

17. Badr, L. K. Further psychometric testing and use of the Maternal Confidence Questionnaire. Issues in Comprehensive Pediatric Nursing. 2005; 28(3): 163-174.

18. Ahn, H. Y., Lee, J., & Shin, H. J. Kangaroo care on premature infant growth and maternal attachment and post-partum depression in South Korea. Journal of tropical pediatrics. 2010; 56(5): 342-344.

19. Chen, E. M., Gau, M. L., Liu, C. Y., & Lee, T. Y. Effects of Father-Neonate Skin-to-Skin Contact on Attachment: A Randomized Controlled Trial. Nursing research and practice. 2017.

20. Holditch-Davis, D., White-Traut, R. C., Levy, J. A., O’Shea, T. M., Geraldo, V., & David, R. J. Maternally administered interventions for preterm infants in the NICU: Effects on maternal psychological distress and mother–infant relationship. Infant Behavior and Development. 2014; 37(4): 695-710.

21. Moore, E. R., Anderson, G. C., Bergman, N., & Dowswell, T. Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database Syst Rev. 2012; 5(5).

22. Sunanta, S., Yusamran, C., & Phahuwatanakorn, W. Effect of Providing Knowledge and Support Primiparous Adolescent Mother and Grandmother on Maternal Role Attainment. Journal of The Royal Thai Army Nurses. 2016; 17(2): 125-134. (in Thai)

23. Promneramit P. The effects of the paternal role promotion program on paternal-infant attachment and paternal role adaptation for first-time fathers. [Thesis]: Mahidol University; 2005. (in Thai)

24. Shorey, S., He, H. G., & Morelius, E. Skin-to-skin contact by fathers and the impact on infant and paternal outcomes: an integrative review. Midwifery. 2016; 40: 207-217.

25. Varela, N., Dclinpsy, P. M., Tessier, R., & Charpak, N. Indian Fathers and Their Premature Baby An Early Beginning: A Pilot Study of Skin-to-Skin
Contact, Culture and Fatherhood. Fathering. 2014; 12(2): 211.

26. Yang, H. L., Chen, Y. C., Mao, H. C., Gau, B. S., & Wang, J. K. Effect of a systematic discharge nursing plan on mothers’ knowledge and confidence in caring for infants with congenital heart disease at home. 2004; 103(1): 47-52.

27. Kusanagi, M., Hirose, T., Mikuni, K., & Okamitsu, M. Effect of early intervention using state modulation and cue reading on mother-infant
interactions in preterm infants and their mothers in Japan. Journal of medical and dental sciences 2011; 58(3): 89-96.

28. Brockington, I. F., Oates, J., George, S., Turner, D., Vostanis, P., Sullivan, M & Murdoch, C. A screening questionnaire for mother-infant bonding disorders. Archives of Women’s Mental Health. 2001; 3(4): 133-140.

29. Parker, S., & Zahr, L. K.The maternal confidence questionnaire. Boston, MA: Boston City Hospital; 1985.

30. Bostanabad, M. A., Areshtanab, H. N., Balila, M., Jafarabadi, M. A., & Ravanbakhsh, K. Effect of a Supportive-Training Intervention on Mother-Infant Attachment. Iranian Journal of Pediatrics. 2017; 27(6).

31. Chung, F. F., Wan, G. H., Kuo, S. C., Lin, K. C., & Liu, H. E. Mother–infant interaction quality and sense of parenting competence at six months
postpartum for first-time mothers in Taiwan: a multiple time series design. BMC pregnancy and childbirth. 2018; 18(1): 365.

32. Newnham, C. A., Milgrom, J., & Skouteris, H. Effectiveness of a modified mother–infant transaction program on outcomes for preterm infants from 3 to 24 months of age. Infant behavior and development. 2009; 32(1): 17-26.

33. Lawrence, P. J., Davies, B., & Ramchandani, P. G. Using video feedback to improve early father–infant interaction: A pilot study. Clinical child psychology and psychiatry. 2013; 18(1):61-71.

34. Kadivar, M., & Mozafarinia, S. M. Supporting fathers in a NICU: Effects of the HUG Your Baby program on fathers’ understanding of preterm
infant behavior. The Journal of perinatal education. 2013; 22(2): 113.




How to Cite

Phianching K, Chaimongkol N, Pongjaturawit Y. A Feasibility Study of the Parental Sensitivity Intervention on Attachment and Self-Efficacy of Mothers and Fathers of Preterm Infants. J Royal Thai Army Nurses [Internet]. 2020 Apr. 27 [cited 2022 Jun. 26];21(1):66-74. Available from: https://he01.tci-thaijo.org/index.php/JRTAN/article/view/241382



Research Articles