Suonpera, Emmi Maria; (2021) Making the “Miracles” Happen – Parenting Stress and Experiences among Parents of Extremely Preterm Young Adolescents in England: A Convergent Mixed Methods Study. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

Caring for a child born at an extremely low gestational age places stresses on parents in the context of worries about the child’s mental and physical development. This convergent multistrand mixed methods inquiry aimed to improve our understanding of experiences of parents of children born extremely preterm (EP) entering adolescence. In the systematic narrative review of literature, I collated findings from current publications assessing long-term parent outcomes following preterm birth. The empirical data comprised qualitative semi-structured telephone interviews with parents of EP children and cross-sectional survey data of parenting stress among parents of EP and full-term born children as they transitioned into adolescence at 11 years of age, collected as part of a longitudinal national birth cohort study of extreme prematurity in England (EPICure 2). The findings were reflected against the modern Western understanding of parenting, namely the framework of parental determinism, to place them in a wider sociocultural context. Three hundred parents (175 EP parents and 125 full-term parents) completed a postal Parent Questionnaire and 22 parents of EP children participated in an interview. The data were analysed statistically and thematically as appropriate and the outcomes were narratively integrated. The systematic review results indicated that the research on long-term parent outcomes following EP/VP birth had methodological limitations and the findings were inconclusive. Yet publications reported a trend towards increased family impact among families with adolescents born preterm. EP parents reported higher levels of parenting stress in comparison with the parents of full-term born children. High parenting stress among EP parents was associated with younger child age, child attendance at a special educational needs school or unit, and higher parent educational level. Parental ambitions and the parents’ perceptions of their child’s ability to reach adult independence guided how they described their parenting behaviour. Parents who anticipated their children to have challenges with future independence described varying parental behavioural responses to support their child’s development in accord with parental determinism. Findings from this study suggest that wider social factors influence parenting stress and experiences, and therefore affect the way in which parents approach their roles. This study has further directed attention to the health and well-being of parents who care for children with long-term morbidities.

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