Self-reinforcement: Coping strategies of Iranian mothers with preterm neonate during maternal role attainment in NICU; A qualitative study

•Having a baby in the hospital is one of the most stressful experience for parents.•The environment of the NICU can also increase the mother's stress and cause emotional damage to mothers who are trying to adjust to the situation.•Coping strategies are key factors that allow parents to handle the stresses experienced in the NICU.•Nurses need to understand the factors that lead to emotional distress (anxiety, hostility and depression) and the strategies for parental psychosocial adjustment of parents whose infants need NICU care.•Qualitative research may help health care providers understand what parents are doing to manage their conditions at the NICU, and lead to more information-based efforts to support parents. Introduction: Having a preterm neonate in the neonatal intensive care unit (NICU) is one of the most stressful experience for parents. In facing these stressors, mothers need to find ways to adapt and control resources to maintain stability. The aim of this paper is to report coping strategies of mothers with preterm neonate during maternal role attainment in NICU. Methods: This paper reports a part of the findings of a grounded theory study that investigated how the mothers of preterm neonates go through maternal role attainment. The data were collected through in-depth semi-structured interviews with 12 mothers with preterm neonate admitted to the NICU and 5 nurses working in NICU. Data were analyzed according to Corbin and Strauss's (2015) approach using constant comparative analysis technique. Findings: Four themes, emerged from experiences of the participants, formed the concept of “Self-reinforcement” as the prominent strategy of mothers: “support seeking”, “Spiritual getting in the mood”, “Hope creation” and “Getting energy from the baby”. Conclusion: These findings showed that mothers use strategies to calm and support themselves and their neonates, and recognize that their lives had changed and need to adjust to their new circumstances.