From NICU monitoring to home caregiving: a qualitative study of parents of preterm infants

When a preterm infant leaves neonatal intensive care, parents take over feeding, observation, infection prevention and help-seeking without the monitors and staff that previously framed infant safety. Discharge education often tells parents what to do, but gives less attention to how they interpret uncertain infant cues once they are at home. A qualitative descriptive study using individual semi-structured interviews was conducted at a tertiary hospital in China. Purposive sampling recruited 24 parents, comprising 16 mothers and eight fathers representing 22 preterm infants, one to twelve weeks after discharge. Verbatim transcripts were analysed inductively using reflexive thematic analysis. Following initial theme development, Meleis’ Transitions Theory, Mishel’s Uncertainty in Illness Theory and the Family Management Style Framework were introduced as complementary sensitising interpretive lenses. A visual transition matrix synthesised transition moments, caregiving tasks, nursing touchpoints and transition challenges. Four themes were developed: becoming the monitor after leaving monitored safety; learning care in fragments and needing embodied rehearsal; negotiating family management under fragile normality; and rebuilding confidence through accessible nursing connection. Feeding adequacy, breathing, colour change, temperature, weight gain and thresholds for urgent care were the main areas of uncertainty. Preterm infant discharge is a staged family transition, not a single handover of information. Nursing support is likely to be most useful when it is organised around transition touchpoints: early co-care in hospital, rehearsal before discharge, observable thresholds for home decisions and prompt post-discharge access to neonatal nurses.