Specialist in Obstetrics and Gynecology, Full Professor, Hospital Materno Mariana Grajales, Santa Clara, Cuba
The birth of a preterm infant marks the beginning of a complex journey, often unfolding within the high-technology environment
of a Neonatal Intensive Care Unit (NICU). This journey, however, is not solely the infant’s; it is a profound and challenging experience
for the parents, particularly the mother. While advances in neonatal care have significantly improved survival rates, the emotional and
psychological well-being of the mother—the primary caregiver and advocate—remains a critical, yet often under-addressed, aspect of
holistic care.
A cornerstone of this maternal experience is uncertainty. As defined by Merle Mishel’s Theory of Uncertainty in Illness, this is a cognitive
state arising when a person cannot determine the meaning of illness-related events [1,2]. For mothers of preterm, low-birth-weight
neonates, this uncertainty is pervasive. It stems from the ambiguity of their infant’s prognosis, the complexity of the NICU environment,
and the lack of familiar cues that signify a “normal” start to motherhood [3]. The literature consistently highlights that this period is
accompanied by significant psychological distress, including anxiety, depression, and stress [4,5]. The physical separation from their
neonate, the inability to perform traditional caregiving roles, and the fear of causing harm all converge to create a state of heightened
emotional vulnerability [6,7].
The work by Merconchini Machado., et al. [8] represents a significant stride in addressing this critical need. Their research is
commendable for its systematic and rigorous approach. By adopting a sequential explanatory mixed-methods design, the study moves
beyond simply identifying the problem to deeply understanding it. The initial quantitative phase provided a clear characterization of
the mothers’ uncertainty levels, while the subsequent qualitative exploration of their lived experiences and coping mechanisms offers
invaluable context [8]. This dual-pronged approach ensures that the resulting intervention is not just theoretically sound but is also
empathetic and grounded in the real-world needs of the target population.
The educational nursing program they propose, anchored in Mishel’s theory, is a practical and actionable framework. It meticulously
deconstructs the cognitive and stimulus-based sources of uncertainty, offering targeted modules that address cognitive capacity, event
familiarity, and the stimuli frame [1,8]. The three thematic blocks—”Aprende a conocer un pretérmino,” “Cuidados del neonato,” and
“Relaciones de apoyo”—clearly aim to rebuild the mother’s cognitive schema by providing structure, knowledge, and support. This is
precisely where nursing care can be most effective: transforming an unknown, threatening situation into one that is more predictable
and manageable [2,9]. Furthermore, the program’s emphasis on including the family unit and the multidisciplinary team (neonatologists,
psychologists) aligns with global best practices in family-centered care, recognizing that support systems are crucial for effective
adaptation [10,11]. The validation of the program by experts, with a Kendall’s W coefficient of 0.901 [8,12] underscores its high relevance and quality. This
strong agreement among specialists provides confidence in its potential for implementation. The editorial team at ECRONION Gynecology
views this work as a beacon for future clinical practice and research. It champions a paradigm shift from a purely biomedical model to a
biopsychosocial one, where the mental and emotional health of the mother is recognized as integral to the neonate’s well-being and long-
term family outcomes [13].
The importance of this work cannot be overstated. In a context where evidence-based interventions for maternal mental health in
Cuban NICUs are scarce, this research fills a critical void. It provides a model for how nursing science can lead the charge in humanizing
intensive care. We encourage our readership to consider the profound implications: a mother who is supported, educated, and empowered
is better equipped to bond with her infant, provide high-quality care, and navigate the challenges of prematurity both in the hospital and
after discharge [14,15].
In conclusion, the journey from uncertainty to empowerment is a pivotal narrative in the story of a preterm birth. The program developed
by Merconchini Machado and colleagues [8] offers a clear and validated map for this journey. It is time for healthcare systems to adopt
such structured, evidence-based nursing interventions, moving them from the realm of research into a standardized, compassionate, and
effective standard of care.
Declaration of Potential Conflicts of Interest
The author of this editorial declares no conflict of interest regarding the publication of this article.
Mayelin Merconchini Machado and Juan Antonio Suárez González. “From Uncertainty to Empowerment: A Nursing Imperative for Mothers of Preterm Infants”. EC Gynaecology 15.10 (2026): 01-03.
© 2026 Mayelin Merconchini Machado and Juan Antonio Suárez González. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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