Maternal Self-Efficacy, Social Support, and Adaptation to Motherhood in Mothers of Preterm Infants in Neonatal Intensive Care Units

Abstract

Objective: This cross-sectional study examined maternal role adaptation among mothers of preterm infants in Neonatal Intensive Care Units (NICUs), and assessed whether self-efficacy and social support explain additional variance in adaptation beyond global self-esteem.

Method: A cross-sectional correlational design was employed with a convenience sample of 350 mothers of preterm infants (gestational age < 37 weeks) admitted to the NICU at Imam Al-Sadiq Teaching Hospital in Hilla city, Iraq. Participants completed validated Arabic versions of the Rosenberg Self-Esteem Scale, the Arabic Parental Self-Efficacy Scale (APSES), the Multidimensional Scale of Perceived Social Support (MSPSS), and a Maternal Role Adaptation Questionnaire. Data were analyzed using descriptive statistics, Pearson correlations, and hierarchical linear regression.

Results: Overall maternal role adaptation was poor in 61.4% of mothers (mean score 23.72 ± 5.31). Self-efficacy showed the strongest correlation with adaptation (r = 0.56, P < 0.001), followed by social support (r = 0.51, P < 0.001) and self-esteem (r = 0.44, P < 0.001). Hierarchical regression revealed that after controlling for demographic covariates, self-efficacy (β = 0.41, 95% CI: 0.31-0.50, P < 0.001) and social support (β = 0.33, 95% CI: 0.23-0.42 P < 0.001) were independently associated with adaptation, while self-esteem was not significant in the final model (β = 0.08, 95% CI: -0.03-0.19, P = 0.14). The full model explained 44% of the variance in adaptation scores (R² = 0.44).

Conclusion: Maternal self-efficacy and perceived social support demonstrate stronger associations with adaptation to motherhood than global self-esteem among mothers of preterm infants in NICUs. Interventions to enhance NICU mothers' adaptation should prioritize skill-based self-efficacy building and social support mobilization