Enhancing maternal participation in NICU care: A behavioral counseling perspective

This letter to the editor critically examines the study by Elmaoğlu and Çelik (2026), which reported that mother–infant interaction training for neonatal intensive care unit (NICU) nurses improved maternal participation in care. While the findings support the role of nurse-focused interventions in enhancing family-centred care, several limitations warrant attention. First, the study lacks explicit theoretical grounding, making it difficult to identify the behavioral mechanisms through which the intervention influenced maternal participation. Second, the measurement of maternal participation is insufficiently defined, limiting interpretation of whether observed improvements reflect meaningful changes in caregiving behavior. Third, the intervention primarily targets nurses, with limited attention to maternal behavioral barriers such as anxiety and avoidance, which may affect sustained engagement. Drawing on behavioral theory, this commentary highlights the importance of reinforcement, modelling, and structured support, while emphasizing the need for theory-driven intervention design and more precise outcome measures. Integrating nurse training with direct behavioral support for mothers may lead to more sustained improvements in maternal engagement and neonatal outcomes.