Fletcher, Amira; (1996) A psychodynamic investigation of a premature baby unit: The implementation of an action research strategy. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

The thesis explores a malfunctioning Intensive Care premature baby Unit. An action research strategy is followed in order both to enhance understanding of infant, parent and staff experiences and to facilitate change. The project explores 3 groups: staff, parents and the premature babies, their interaction and impact on each other. The hypothesis of the dynamic and systemic source of the difficulties present on the Unit was reached after interviewing groups of staff, nursing students and some informal observations of interaction between staff and parents and staff and their patients. A picture of a part-object culture in which human concerns and feelings were reduced to a very low state was revealed, mechanical discharge of duty was observed. The second stage of the project deals with creating the tools to facilitate some work to change the culture on the unit. The nature of the emotional difficulties and the defensive strategy of the staff is explored in a staff group where the task is exploring these difficulties, identifying them and working to bring about some understanding and change. The impact of premature birth on parents is studied via individual cases and the parents' support group. Evidence for the traumatisation of the "adult" personality of the parent emerged from these sources. Primitive anxieties and defences take centre stage in "the premature parents". Some intervention with exploration, understanding and support is offered in the Parents Group, started by this project. The premature infant's object relation is considered in the last chapter of this work. His early life experience is very different from that of the full-term baby. Some of the psycho-analytical theories on mother-infant relationship are reconsidered in the light of observations conducted on the Unit. It is clear that some further work is needed. One model is proposed. Some observations are discussed and further work in this field is planned.

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