Effect of multimedia-based education on maternal self-efficacy for preterm infant care in the NICU: a randomized controlled trial

Mothers of preterm infants admitted to neonatal intensive care units (NICUs) often experience stress and diminished confidence in their caregiving abilities. Maternal self-efficacy plays a crucial role in parental adaptation and successful implementation of family-centered care. Multimedia education may provide an effective and accessible strategy for enhancing maternal confidence. This study aimed to evaluate the effect of a multimedia-based educational program on maternal self-efficacy in caring for preterm infants in the NICU. A single-blind, two-group randomized controlled trial with a pretest–posttest design was conducted in the NICU of a tertiary referral hospital in Rasht, Iran. Eighty first-time mothers of preterm infants were randomly allocated using block randomization to either a multimedia educational intervention group (n = 40) or a routine education control group (n = 40). The intervention was developed based on Bandura’s Social Cognitive Theory and consisted of 25 educational videos delivered through DVD and smartphone platforms over four weeks, supplemented by weekly follow-up contacts. Maternal self-efficacy was assessed at baseline and four weeks after the intervention using the Barnes Maternal Self-Efficacy Scale. The study was approved by the institutional ethics committee but was not prospectively registered in a clinical trial registry. Maternal self-efficacy improved significantly in both groups, with greater gains observed in the intervention group. Mean self-efficacy scores increased from 55.90 ± 6.73 to 64.95 ± 6.09 in the intervention group and from 58.13 ± 6.36 to 61.43 ± 5.30 in the control group. Post-intervention scores were significantly higher in the intervention group (mean difference = 3.52, 95% CI 1.02–6.02; p = 0.007). After adjustment for covariates, the intervention remained a significant predictor of maternal self-efficacy ( p = 0.002). A structured multimedia educational intervention significantly improved maternal self-efficacy among mothers of preterm infants hospitalized in the NICU. Integrating multimedia education into routine neonatal care may enhance parental confidence and preparedness for infant caregiving.