Guided participation and development of care-giving competencies for families of low birth-weight infants

The concept of guided participation is central to theory for supporting fam ilies in developing competencies for care of their low birth-weight infants . Guided participation is a process through which an experienced person hel ps another person who has less experience to become competent in practices that are personally and socially meaningful practices of everyday life. A p ractice is made up of socially formed activities directed to accomplishing a recurring goal. For a parent, infant care-giving encompasses protecting, comforting and nurturing activities, including feeding. For premature infan ts, a mother's care-giving begins during the neonatal intensive care unit s tay and continues, after the infant's discharge from hospital, in the home. Care-giving competencies are addressed through guided participation of a m other in her care-giving practice. In this process, her working model of he rself as parent, her infant, and feeding is constructed and revised through the guided participation process. In this paper, a general theory of guide d participation that could be used to promote care-giving competencies is d escribed. Two cases from a pilot study are presented to illustrate the appl ication of the theory to a mother's feeding practice with infants who were born prematurely and who developed problems with feeding during the first y ear of life. These cases indicate that guided participation offers a means of precisely tailoring support for care-giving to the mother's needs and go als for development of competencies. Further research on how guided partici pation is best introduced to families of varying resources and life circums tances, how it is best implemented across settings as the infant moves from hospital to home, and how nurses can apply its principles with available r esources and opportunities is needed.