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Moon SH, Park HR, Kim DY. Differences in perceived parental stress between parents with very low birth weight infants and nurses in neonatal intensive care units, South Korea. CHILD HEALTH NURSING RESEARCH 2021; 27:297-307. [PMID: 35004518 PMCID: PMC8650857 DOI: 10.4094/chnr.2021.27.3.297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 06/26/2021] [Accepted: 07/14/2021] [Indexed: 11/12/2022] Open
Abstract
PURPOSE This descriptive study compared the perceived parental stress levels between parents with very low birth weight infants (VLBWIs) and nurses in the neonatal intensive care unit (NICU). METHODS In total, 83 parents of VLBWIs and 78 NICU nurses were enrolled. Data were collected with the Parental Stress Scale (PSS) and analyzed using the t-test and analysis of variance in SAS version 9.4. RESULTS The average PSS score was 3.31 among parents and 3.45 among nurses. The stress score was significantly higher among nurses with children (t=2.46, p=.016) and senior nurses (t=2.12, p=.037). There was a significant difference in the stress score according to parents' education (t=3.29, p=.002) and occupation (F=3.14, p=.049) in the sights and sounds subscale. Mothers had significantly higher stress scores than fathers in the parental role alterations subscale (t=2.32, p=.023). Parental stress scores were higher than those perceived by nurses in the infant's appearance and behaviors subscale for breathing patterns (t=2.95, p=.004), followed by jerky/restless behavior (t=2.70, p=.008). CONCLUSION Nurses should provide explanations to parents of VLBWIs in order to reduce parental stress about the appearances and behavior of VLBWIs. This is more important than aspect of the NICU environment and education about parental roles.
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Affiliation(s)
- Seol-Hee Moon
- Registered Nurse, Neonatal Intensive Care Unit, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Ho-Ran Park
- Professor Emeritus, College of Nursing, The Catholic University of Korea, Seoul, Korea
| | - Dong Yeon Kim
- Unit Manager, Hematology Intensive Care Unit, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
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Mousavi SS, Keramat A, Chaman R, Mohagheghi P, Mousavi SA, Khosravi A. Impact of Maternity Support Program on the Stress of Mothers in the First Encounter with the Preterm Infants. Int J Prev Med 2021; 12:68. [PMID: 34447510 PMCID: PMC8356949 DOI: 10.4103/ijpvm.ijpvm_314_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 04/18/2020] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Mothers of premature infants experience a high level of stress. The current study was conducted aiming at investigating the impact of maternity support program on the stress of mothers in the first encounter with infants. METHODS This experimental study began in neonatal intensive care units (NICUs) of two hospitals of Tehran; that is, Mahdieh (intervention) and Shahid Akbar-Abadi (control), from Feb 14, 2016, to May 14, 2016. Both are educational and referral centers including three levels of NICU that were randomly allocated to intervention and control sites. In the span of study period all 75 infants and mothers with inclusion/exclusion criteria in the Mahdieh hospital were included in the intervention group and vis-à -vis all 68 infants and mothers in Shahid-Akbar-Abadi were enrolled in the control group. The designed intervention was conducted based on the support system pattern of mothers with premature infants in the interventional group. In the first stage of intervention, in the intervention group, mothers were provided informational, emotional, and spiritual support before and during the first exposure and were empowered for comfortable interactions. The control group received routine care. After the first exposure, the mothers' stress was measured by the Parental Stressor Scale: Neonatal Intensive Care Unit (PSS: NICU). The data were analyzed by STATA software as well as t-test, Chi-square, and average treatment effects (ATEs) were estimated using inverse probability treatment weights (IPTW). RESULTS After adjusting pre-treatment variables by IPTW, the adjusted average difference in the stress score over the NICU environment, infant's behavior and appearance, the special treatments on him/her, and the change in the parental role and total stress were 1.47 (1.19-1.75), 1.06 (0.73-1.14), 1.21 (0.93-1.49), and 1.18 (0.93-1.44), which were lower than the control group (P < 0.001). CONCLUSIONS The intervention reduced significantly the stress of mothers. The policy-makers are suggested to conduct this method.
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Affiliation(s)
- Seyedeh S. Mousavi
- Nursing Care Research Center (NCRC), Department of Midwifery and Reproductive Health, Iran University of Medical Sciences, Tehran, Iran
| | - Afsaneh Keramat
- Department of Reproductive Health, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Reza Chaman
- Department of Epidemioligy, School of Health, Shiraz University of Medical Science, Shiraz, Iran
| | - Parisa Mohagheghi
- Hazrate Rasoul Medical Center, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed A. Mousavi
- Department of Psychiatry, Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ahmad Khosravi
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
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Giroux SDS, Dias BTP, Silva ERD, Reis JHSD, Lopes Alves SF, Cunha KDC, Chermont AG. Support provided by healthcare professionals to the mothers of newborns in the neonatal unit. REVISTA CIÊNCIAS EM SAÚDE 2021. [DOI: 10.21876/rcshci.v11i2.1076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Objective: To evaluate the support offered by health professionals to mothers of newborns admitted to the neonatal unit.Methods: Descriptive cross-sectional study with a quantitative approach conducted at the Regional Hospital of Tucuruí, in the state of Pará, region of the Brazilian Amazon, where 33 mothers who had newborn children admitted to the neonatal unit responded to the structured adapted version of the NPST (Nurse Parent Support Tool ). Results: Most were aged 20-34 years (48%), married or in a stable relationship (69%), multiracial (87%), housewife (57%), with up to 11 years of study (72%). The scores for the NPST subdomains were 3.39 ± 1.65 (Communication and Information Support), 4.13 ± 1.33 (Emotional Support), 3.93 ± 1.46 (Incentive Support), and 4.21 ± 1,27 (Instrumental Support). The findings revealed unsatisfactory communication and information support from health professionals to mothers, although they expressed satisfaction with the care provided. Conclusions: The perception of scarcity of human resources and health education, verified in this study, weakens the communication process during hospitalization and influences the mother's well-being, leading to a decrease in the efficiency of the support provided. The improvement in this area can lead to better results in daily practice. The replication of this study to other locations can lead to more significant assistance to mothers of hospitalized neonates and provide new technologies and strategies in health education.
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Toscano M, Royzer R, Castillo D, Li D, Poleshuck E. Prevalence of Depression or Anxiety During Antepartum Hospitalizations for Obstetric Complications: A Systematic Review and Meta-analysis. Obstet Gynecol 2021; 137:881-891. [PMID: 33831928 PMCID: PMC8087456 DOI: 10.1097/aog.0000000000004335] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 01/14/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To systematically review the prevalence of antenatal depression and anxiety in women hospitalized in an antepartum unit for obstetric complications. DATA SOURCES We searched PubMed, EMBASE, CINAHL, PsycINFO, and ClinicalTrials.gov for English-language articles published from database inception through March 2020. METHODS OF STUDY SELECTION We included cross-sectional, cohort, case-control, quasi-experimental, and randomized controlled studies from any country that reported the proportion of pregnant women with an elevated depression or anxiety screening scale or diagnostic interview during antepartum hospitalization of any duration and at any gestational age. TABULATION, INTEGRATION, AND RESULTS We identified 8,799 articles and reviewed 79, 39 of which were included in a systematic review and 18 in meta-analysis of the primary outcome. Two raters independently assessed quality of individual studies using a 14-question tool. A random effects meta-analysis model was used to estimate prevalence and 95% CI of depression or anxiety. Heterogeneity was examined with the I2 test, and funnel plots were used to assess publication bias. After meta-analysis, the estimated prevalence of depression was 34% (95% CI 27-41%) and of anxiety 29% (95% CI 16-43%). There was expected substantial clinical and methodologic heterogeneity between studies that persisted even after planned a priori subgroup analyses and meta-regression. Even so, the direction of effect was consistent across studies. No publication bias was found. CONCLUSION The current meta-analysis suggests that one in three women hospitalized during pregnancy for obstetric complications report clinical levels of depression or anxiety symptoms, twice the reported prevalence of antenatal depression or anxiety in the general obstetric population. SYSTEMATIC REVIEW REGISTRATION PROSPERO, CRD42020172111.
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Affiliation(s)
- Marika Toscano
- Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, the Edward G. Miner Library, Institute for Innovative Education, the Department of Public Health Sciences, the Department of Obstetrics & Gynecology, and the Department of Psychiatry, University of Rochester Medical Center, and the School of Medicine and Dentistry, University of Rochester, Rochester, New York
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Preeclampsia and Its Complications Exacerbate Development of Postpartum Depression: A Retrospective Cohort Study. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6641510. [PMID: 33977108 PMCID: PMC8087462 DOI: 10.1155/2021/6641510] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 04/09/2021] [Accepted: 04/15/2021] [Indexed: 11/18/2022]
Abstract
Background Hypertensive disorders were proved to be associated with the development of depression. But it is unclear if pregnancy-induced hypertensive diseases, especially preeclampsia (PE), will affect postpartum moods. We aimed to determine the incidence rate of postpartum depression (PPD) in PE patients and comprehensively evaluate the association between PPD and PE, including its severity and complications. Methods 425 participants including 130 PE mothers were enrolled in this retrospective cohort study. Each woman was asked to complete a questionnaire integrating the Edinburgh Postnatal Depression Scale (EPDS), the Leakage Index Questionnaire, and a pain scale questionnaire within 6 weeks after delivery. The EPDS cut-off score above 13 was recognized as screening positive for PPD. Data between groups were compared by bivariate analysis. Results PE mothers showed a direct tendency to PPD development. The positive screening for PPD in the PE group was significantly higher than that of the control group (30.77% vs. 14.58%). Based on the results of the regression model, women diagnosed with severe PE and fetal growth restriction were more inclined to develop PPD than normal ones (AOR: 2.759, 95% CI: 1.206-6.315 and AOR: 3.450, 95% CI: 1.596-7.458). It is also indicated that postpartum pain exacerbated the odds of PPD in PE patients (AOR: 1.509, 95% CI: 1.078-2.114). Conclusions PE was an independent risk factor for PPD. Its severity and complications exacerbate the development of PPD. Doctors and society should pay more attention to PE patients after delivery against the development of PPD.
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Staver MA, Moore TA, Hanna KM. An integrative review of maternal distress during neonatal intensive care hospitalization. Arch Womens Ment Health 2021; 24:217-229. [PMID: 32851469 DOI: 10.1007/s00737-020-01063-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 08/21/2020] [Indexed: 11/26/2022]
Abstract
To synthesize literature addressing maternal distress and associated variables in response to infant hospitalization in the NICU. CINAHL, Medline, PubMed, PsychINFO, and Scopus were searched for studies addressing maternal distress during NICU hospitalization published between January 2009 and August 2019. The initial literature search yielded 862 articles. Articles were included for analysis if (a) they were peer-reviewed, (b) maternal distress was defined or measured, and (c) maternal distress occurred in the NICU. Ultimately, 33 articles were included for analysis. Distress symptoms were not consistently measured across the literature by one specific instrument. However, despite the variety of instruments, distress was prevalent in this population. Individual elements of maternal distress in the NICU include depression, anxiety, trauma, and post-traumatic stress symptoms. These elements often occur together and tend to follow a specific trajectory during hospitalization. This body of literature was inconsistent regarding the timing of distress measurement as well as the relationship between relevant associated variables (e.g., marital status or infant illness severity) and maternal distress. Additionally, researchers often excluded mothers of non-preterm infants and infants with congenital anomalies from investigation. Researchers and clinicians should carefully consider timing and instrumentation in their interpretations of maternal distress measurement during a NICU hospitalization. Future work should focus on developing a comprehensive, valid, and reliable screening tool for clinicians and researchers to use to identify maternal distress in the NICU. Additionally, future research should address gaps in the populations included in studies.
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Affiliation(s)
- Morgan A Staver
- University of Nebraska Medical Center College of Nursing, Omaha, NE, USA.
| | - Tiffany A Moore
- University of Nebraska Medical Center College of Nursing, Omaha, NE, USA
| | - Kathleen M Hanna
- University of Nebraska Medical Center College of Nursing, Omaha, NE, USA
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Aita M, Héon M, Lavallée A, De Clifford Faugère G, Altit G, Le May S, Dorval V, Lippé S, Larone Juneau A, Remmer E, Rennick JE. Nurturing and quiet intervention (NeuroN-QI) on preterm infants' neurodevelopment and maternal stress and anxiety: A pilot randomized clinical trial protocol. J Adv Nurs 2021; 77:3192-3203. [PMID: 33719093 DOI: 10.1111/jan.14819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 02/02/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Primary objective of this pilot study is to evaluate the feasibility and acceptability of the NeuroN-QI and the study procedures. Secondary objectives are to assess the feasibility and acceptability of the NeuroN-QI by the nurses, assess the nurses' training needs about the components of the NeuroN-QI, and estimate the preliminary effects of the NeuroN-QI on infants' neurodevelopment as well as maternal stress and anxiety at infants' 36 weeks of gestational age. DESIGN A two-group pilot parallel randomized clinical trial stratified by center. METHODS The pilot study will be conducted in two neonatal intensive care units (NICUs). A sample of 24 mother-infant dyads born between 26 and 316/7 gestational age will be randomized into an experimental or control group. Fifty nurses will be recruited. The NeuroN-QI consists of four 2-hour skin-to-skin contact sessions/week with a 15-minute auditory stimulation by mothers with controlled ambient levels of light and noise. A 1-hour quiet period will follow where infants will rest in their incubator/crib with their mother's milk for olfactory stimulation and where the light and noise control will be continued. In the control group, mother-infant dyads will do four skin-to-skin contacts per week and receive standard care. Acceptability and feasibility of the NeuroN-QI in addition to maternal stress and anxiety will be measured through questionnaires, while infants' neurodevelopment will be assessed with Assessment of Preterm Infant Behaviour and General Movement Assessment. CONCLUSIONS This pilot trial will address knowledge gaps and generate evidence in neonatal care by evaluating the feasibility and acceptability of a multi-component developmental care intervention. IMPACT This project is an innovative step towards optimizing the neurodevelopmental trajectory of infants in NICUs and consequently promoting their long-term health outcomes. TRIAL REGISTRATION NCT04593095.
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Affiliation(s)
- Marilyn Aita
- Faculty of Nursing, Université de Montréal, Montréal, Canada.,CHU Sainte-Justine Research Centre, Montréal, Canada.,Quebec Network on Nursing Intervention Research (RRISIQ), Montréal, Canada
| | - Marjolaine Héon
- Faculty of Nursing, Université de Montréal, Montréal, Canada.,Quebec Network on Nursing Intervention Research (RRISIQ), Montréal, Canada
| | - Andréane Lavallée
- Faculty of Nursing, Université de Montréal, Montréal, Canada.,CHU Sainte-Justine Research Centre, Montréal, Canada.,Quebec Network on Nursing Intervention Research (RRISIQ), Montréal, Canada
| | | | - Gabriel Altit
- Department of Pediatrics, Division of Neonatology, Montreal Children's Hospital - McGill University Health Center (MUHC), Montréal, Canada.,Research Institute MUHC, Montréal, Canada.,Department of Pediatrics, Faculty of Medicine and Health Sciences, McGill University, Montréal, Canada
| | - Sylvie Le May
- Faculty of Nursing, Université de Montréal, Montréal, Canada.,CHU Sainte-Justine Research Centre, Montréal, Canada.,Quebec Network on Nursing Intervention Research (RRISIQ), Montréal, Canada
| | | | - Sarah Lippé
- CHU Sainte-Justine Research Centre, Montréal, Canada.,Faculty of Arts and Science, Department of Psychology, Université de Montréal, Montréal, Canada
| | | | - Elissa Remmer
- NICU, Montreal Children's Hospital (MCH, MUHC), Montréal, Canada
| | - Janet E Rennick
- Quebec Network on Nursing Intervention Research (RRISIQ), Montréal, Canada.,Research Institute MUHC, Montréal, Canada.,Department of Pediatrics, Faculty of Medicine and Health Sciences, McGill University, Montréal, Canada.,Ingram School of Nursing, Faculty of Medicine and Health Sciences, McGill University, Montréal, Canada.,Department of Nursing, MCH, MUHC, Montréal, Canada
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58
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Chen Y, Jones C, Dunse N. Coronavirus disease 2019 (COVID-19) and psychological distress in China: Does neighbourhood matter? THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 759:144203. [PMID: 33333329 PMCID: PMC7832354 DOI: 10.1016/j.scitotenv.2020.144203] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 11/24/2020] [Accepted: 11/24/2020] [Indexed: 05/02/2023]
Abstract
Using individual data (n = 937) obtained from an online questionnaire between 20th January and 13th February, the early stage of the outbreak of the Coronavirus Disease 2019 (COVID-19) in 2020, we explore the direct association between people's perceptions of Coronavirus Disease 2019 (COVID-19) and psychological distress. We further examine the moderating role of neighbourhood environment and this distress. We find that people living in infected communities tend to perceive higher level of psychological distress compared to people living in uninfected communities. People's expected duration of COVID-19 is associated with higher psychological distress and this is partially moderated by the perception of neighbourhood noise level and overall environment quality. Additional results quantify the evidence that a quiet and well maintained neighbourhood environment could reduce the negative influences of expectation of a long duration of COVID-19 on people's psychological distress.
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Affiliation(s)
- Yiyi Chen
- The Urban Institute, Heriot-Watt University, Edinburgh EH14 4AS, UK.
| | - Colin Jones
- The Urban Institute, Heriot-Watt University, Edinburgh EH14 4AS, UK.
| | - Neil Dunse
- The Urban Institute, Heriot-Watt University, Edinburgh EH14 4AS, UK.
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Hames JL, Gasteiger C, McKenzie MR, Rowley S, Serlachius AS, Juth V, Petrie KJ. Predictors of parental stress from admission to discharge in the neonatal special care unit. Child Care Health Dev 2021; 47:243-251. [PMID: 33171525 DOI: 10.1111/cch.12829] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 11/02/2020] [Accepted: 11/03/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Exacerbated parental stress during a stay in the neonatal intensive care unit can negatively impact the development of the hospitalized infant, strain the dyadic relationship and put parents at risk for poor mental health. It is therefore important to identify risk factors of stress throughout the duration of a hospitalization. This longitudinal study aimed to investigate sources of stress for mothers and fathers who had a baby in the neonatal special care unit. METHODS Parents of 57 singletons and 11 twins (68 infants) admitted to a neonatal special care unit (46% for prematurity) were recruited. Sixty-four mothers and 20 fathers were assessed at admission, and 60 mothers and 16 fathers at discharge. Participants reported their satisfaction with hospital information and completed the Perceived Stress Scale, the Brief Illness Perception Questionnaire and the Dyadic Adjustment Scale. RESULTS Parents demonstrated similar stress trajectories, with stress on average declining over time. Higher maternal stress at admission was associated with a belief that the baby's illness would have a longer timeline, lower perceptions of treatment efficacy and lower satisfaction with the information received from medical staff. Younger age and lower levels of education predicted higher maternal stress at discharge. Fathers had higher stress at discharge when they were older, had a baby born at younger gestation and felt they had less control. At admission, information satisfaction was positively associated with parental beliefs about treatment efficacy and understanding the infant's condition. At discharge, information satisfaction was negatively associated with beliefs about illness severity and the likely time frame of the illness. CONCLUSION The findings highlight that parents' perceptions of their baby's illness and treatment at admission and discharge have a significant association with stress. Clinical staff can use these factors to identify parents who are at risk of exhibiting a greater level of stress over the hospitalization period.
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Affiliation(s)
- Jessica L Hames
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Chiara Gasteiger
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Melanie R McKenzie
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Simon Rowley
- Newborn Services, Auckland City Hospital, Auckland, New Zealand
| | - Anna S Serlachius
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Vanessa Juth
- Sue and Bill Gross School of Nursing, College of Health Sciences, University of California Irvine, Irvine, California, USA
| | - Keith J Petrie
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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Lisanti AJ, Demianczyk AC, Vaughan K, Martino GF, Ohrenschall RS, Quinn R, Chittams JL, Medoff-Cooper B. Parental role alteration strongly influences depressive symptoms in mothers of preoperative infants with congenital heart disease. Heart Lung 2021; 50:235-241. [PMID: 33340826 PMCID: PMC7969439 DOI: 10.1016/j.hrtlng.2020.12.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 12/02/2020] [Accepted: 12/03/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Mothers of infants with congenital heart disease are at risk for depression. OBJECTIVES This study explored the influence on maternal depressive symptoms of several known factors for mothers in the pediatric cardiac intensive care unit, including perceived stressors, attachment, and anxiety. METHODS This study was a secondary analysis of 30 mothers of infants awaiting cardiac surgery. Linear regressions were calculated to determine the relationships between perceived stressors, maternal attachment, anxiety, and maternal depressive symptoms. RESULTS Nearly half of mothers reported depressive symptoms above the measure cut-off score, indicating they were at risk for likely clinical depression. Subscales of perceived stress explained 61.7% of the variance in depressive symptoms (F = 11.815, p<0.0001) with parental role alteration subscale as the strongest predictor (standardized beta=0.694, p = 0.03). CONCLUSIONS Findings underscore the importance of mental health screening and instituting nursing practices to enhance parental role for mothers of infants awaiting cardiac surgery.
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Affiliation(s)
- Amy J Lisanti
- Nursing and Clinical Care Services, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, United States of America; University of Pennsylvania School of Nursing, 418 Curie Blvd, Philadelphia, PA 19104, United States of America.
| | - Abigail C Demianczyk
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, United States of America.
| | - Kayla Vaughan
- Nursing and Clinical Care Services, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, United States of America.
| | - Giordana Fraser Martino
- Nursing and Clinical Care Services, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, United States of America.
| | - Rachel Schaake Ohrenschall
- Nursing and Clinical Care Services, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, United States of America.
| | - Ryan Quinn
- University of Pennsylvania School of Nursing, 418 Curie Blvd, Philadelphia, PA 19104, United States of America.
| | - Jesse L Chittams
- University of Pennsylvania School of Nursing, 418 Curie Blvd, Philadelphia, PA 19104, United States of America.
| | - Barbara Medoff-Cooper
- University of Pennsylvania School of Nursing, 418 Curie Blvd, Philadelphia, PA 19104, United States of America; Research Institute, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, United States of America.
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Lebel V, Charette S. Nursing Interventions to Reduce Stress in Families of Critical Care Patients: An Integrative Review. Crit Care Nurse 2021; 41:32-44. [PMID: 33560437 DOI: 10.4037/ccn2021188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND Having a family member admitted to an intensive care unit is a stressful experience that may lead to psychological symptoms including depression, anxiety, and posttraumatic stress disorder. OBJECTIVE To better understand the phenomenon of stress experienced by families of intensive care unit patients and identify nursing interventions that may help reduce it. METHODS An integrative literature review was performed to identify principal stressors for families of patients receiving care in neonatal, pediatric, and adult intensive care units and recommended nursing interventions. RESULTS The principal stressors in the 3 types of intensive care units were change in parental role or family dynamics, appearance and behavior of the patient, the care setting, and communication with the health care staff. Nursing interventions should focus on valuing the role of family members in patient care, improving communication, and providing accurate information. CLINICAL RELEVANCE Family members of intensive care patients will benefit from nursing interventions that adequately acknowledge and address the stress they experience. CONCLUSION Nurses play a crucial role in helping to reduce the stress experienced by family members of intensive care unit patients.
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Affiliation(s)
- Valérie Lebel
- Valérie Lebel is a professor, Department of Nursing, Université du Québec en Outaouais, Quebec, Canada
| | - Sylvie Charette
- Sylvie Charette is a professor, Department of Nursing, Université du Québec en Outaouais
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Rosenthal JL, Sauers-Ford HS, Williams J, Ranu J, Tancredi DJ, Hoffman KR. Virtual Family-Centered Rounds in the Neonatal Intensive Care Unit: A Randomized Controlled Pilot Trial. Acad Pediatr 2021; 21:1244-1252. [PMID: 33746043 PMCID: PMC8429071 DOI: 10.1016/j.acap.2021.03.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 03/08/2021] [Accepted: 03/13/2021] [Indexed: 01/18/2023]
Abstract
OBJECTIVES To measure the feasibility, reach, and potential impact of a virtual family-centered rounds (FCR) intervention in the neonatal intensive care unit. METHODS We conducted a randomized controlled pilot trial with a 2:1 intervention-to-control arm allocation ratio. Caregivers of intervention arm neonates were invited to participate in virtual FCR plus standard of care. We specified 5 feasibility objectives. We profiled intervention usage by neonatal and maternal characteristics. Exploratory outcomes included FCR caregiver attendance, length of stay, breast milk feeding at discharge, caregiver experience, and medical errors. We performed descriptive analyses to calculate proportions, means, and rates with 95% confidence intervals (CI). RESULTS We included 74 intervention and 36 control subjects. Three of the five feasibility objectives were met based on the point estimates. The recruitment and intervention uptake objectives were not achieved. Among intervention arm subjects, recruitment of a caregiver occurred for 47 (63.5%, 95% CI 51.5%-74.4%) neonates. Caregiver use of the intervention occurred for 36 (48.6%, 95% CI 36.8%-60.6%) neonates in the intervention arm. Feasibility objectives assessing technical issues, burden, and data collection were achieved. Among the attempted virtual encounters, 95.0% (95% CI 91.5%-97.3%) had no technical issues. The survey response rate was 87.5% (95% CI 78.2%-93.8%). Intervention arm neonates had 3.36 (95% CI 2.66%-4.23) times the FCR caregiver attendance rate of subjects in the control arm. CONCLUSIONS A randomized trial to compare virtual FCR to standard of care in neonatal subjects is feasible and has potential to improve patient and caregiver outcomes.
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Affiliation(s)
- Jennifer L. Rosenthal
- Department of Pediatrics, University of California Davis, Sacramento, California, USA
| | - Hadley S. Sauers-Ford
- Department of Pediatrics, University of California Davis, Sacramento, California, USA
| | - Jacob Williams
- Department of Pediatrics, University of California Davis, Sacramento, California, USA
| | - Jaskiran Ranu
- Department of Pediatrics, University of California Davis, Sacramento, California, USA
| | - Daniel J. Tancredi
- Department of Pediatrics, University of California Davis, Sacramento, California, USA
| | - Kristin R. Hoffman
- Department of Pediatrics, University of California Davis, Sacramento, California, USA
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Bua J, Mariani I, Girardelli M, Tomadin M, Tripani A, Travan L, Lazzerini M. Parental Stress, Depression, and Participation in Care Before and During the COVID-19 Pandemic: A Prospective Observational Study in an Italian Neonatal Intensive Care Unit. Front Pediatr 2021; 9:737089. [PMID: 34660492 PMCID: PMC8515023 DOI: 10.3389/fped.2021.737089] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 09/03/2021] [Indexed: 11/25/2022] Open
Abstract
Background: Recent studies reported, during the COVID-19 pandemic, increased mental distress among the general population and among women around the childbirth period. COVID-19 pandemic may undermine the vulnerable well-being of parents in Neonatal Intensive Care Units (NICUs). Objective: Our study aimed to explore whether parental stress, depression, and participation in care in an Italian NICU changed significantly over three periods: pre-pandemic (T0), low (T1), and high COVID-19 incidence (T2). Methods: Enrolled parents were assessed with the Parental Stressor Scale in the NICU (PSS:NICU), Edinburgh Postnatal Depression Scale (EPDS), and Index of Parental Participation (IPP). Stress was the study primary outcome. A sample of 108 parents, 34 for each time period, was estimated to be adequate to detect a difference in PSS:NICU stress occurrence level score (SOL) of 1.25 points between time periods. To estimate score differences among the three study periods a non-parametric analysis was performed. Correlation among scores was assessed with Spearman rank coefficient. Results: Overall, 152 parents were included in the study (62 in T0, 56 in T1, and 34 in T2). No significant differences in the median PSS:NICU, EPDS, and IPP scores were observed over the three periods, except for a slight increase in the PSS:NICU parental role sub-score in T2 (T0 3.3 [2.3-4.1] vs. T2 3.9 [3.1-4.3]; p = 0.038). In particular, the question regarding the separation from the infant resulted the most stressful aspect during T2 (T0 4.0 [4.0-5.0] vs. T2 5.0 [4.0-5.0], p = 0.008). The correlation between participation and stress scores (r = 0.19-022), and between participation and depression scores (r = 0.27) were weak, while among depression and stress, a moderate positive correlation was found (r = 0.45-0.48). Conclusions: This study suggests that parental stress and depression may be contained during the COVID-19 pandemic, while participation may be ensured.
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Affiliation(s)
- Jenny Bua
- Neonatal Intensive Care Unit, Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
| | - Ilaria Mariani
- WHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
| | - Martina Girardelli
- Department of Pediatrics, Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
| | - Murphy Tomadin
- Neonatal Intensive Care Unit, Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
| | - Antonella Tripani
- Neonatal Intensive Care Unit, Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
| | - Laura Travan
- Neonatal Intensive Care Unit, Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
| | - Marzia Lazzerini
- WHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
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64
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A global perspective on parental stress in the neonatal intensive care unit: a meta-analytic study. J Perinatol 2020; 40:1739-1752. [PMID: 32901116 DOI: 10.1038/s41372-020-00798-6] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 08/15/2020] [Accepted: 08/20/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The Parental Stressor Scale: Neonatal Intensive Care Unit (PSS:NICU) is a well-validated tool to assess different sources of stress in parents during the NICU hospitalization of their infant. The present meta-analytic study assessed the relative impact of different NICU-related sources of parental stress in a pool of studies conducted in a wide set of different countries. Also, differences in stress levels by parent gender and country, as well as the impact of infants' neonatal characteristics and clinical conditions were explored. METHODS Records were searched on PubMed, Scopus, and Web of Science (January 1993-December 2019). A purposive open search string was adopted: ["PSS:NICU"] OR ["PSS-NICU"] OR ["Parental Stressor Scale"]. A multiple random-effect meta-analysis was conducted on data from 53 studies extracted by independent coders. RESULTS Parental role alteration emerged as the greatest source of stress for both mothers and fathers. Mothers reported higher stress levels compared to fathers. A significant difference emerged only for the subscale related to sights and sounds physical stimuli. No significant effects of infants' neonatal characteristics (gestational age, birth weight) and clinical conditions (comorbidities) emerged. A marginal positive effect of NICU length of stay emerged on the global level of parents' stress. CONCLUSIONS The current meta-analysis underlines that parental stress related to NICU admission is a worldwide healthcare issue. Immediate and tailored support to parents after the birth of their at-risk infant should be prioritized to reduce parental stress and to promote mothers and fathers' emotional well-being and new-born neurodevelopmental outcomes.
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65
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Soghier LM, Kritikos KI, Carty CL, Glass P, Tuchman LK, Streisand R, Fratantoni KR. Parental Depression Symptoms at Neonatal Intensive Care Unit Discharge and Associated Risk Factors. J Pediatr 2020; 227:163-169.e1. [PMID: 32681990 DOI: 10.1016/j.jpeds.2020.07.040] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 07/09/2020] [Accepted: 07/10/2020] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To investigate the prevalence and risk factors associated with parental depressive symptoms at neonatal intensive care unit (NICU) discharge and determine the relationships among depressive symptoms, stress, and social support. STUDY DESIGN Parents participating in the Giving Parents Support trial (n = 300) were surveyed before NICU discharge. Depressive symptoms, stress, and social support were assessed using the Center for Epidemiological Studies Depression Scale (CESD-10), Parental Stressor Scale: Neonatal Intensive Care Unit (PSS:NICU), Perceived Stress Scale (PSS-10), and Multidimensional Scale of Perceived Social Support (MSPSS). Regression analyses examined relationships among depressive symptoms, stress, social support, and parent/infant factors. RESULTS At NICU discharge, 45% of parents reported depressive symptoms and 43% reported elevated perceived stress. Increased odds of elevated depressive symptoms were associated with older gestational age (P = .02), female infant (P = .02), and longer length of stay (P = .045). Odds of depression were 7.87 (95% CI, 2.15-28.75) for parents of infants with gestational age ≥37 weeks compared with gestational age <28 weeks. Parental NICU stress was higher in younger parents (P < .01). Depressive symptoms were positively associated with parental stress. Each 1-point increase in PSS:NICU score was associated with a 2.1-point (95% CI, 1.6-2.9; P < .001) increase in CESD-10 score. Social support was inversely associated with depressive symptoms. CONCLUSION The prevalence of depressive symptoms in parents at NICU discharge was high, even among parents of term infants. Older gestational age, greater parental stress, and lower levels of social support were strong correlates of depressive symptoms. Strategies to support parents, including depression screening, stress reduction strategies, and mental health referrals, are needed.
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Affiliation(s)
- Lamia M Soghier
- Department of Neonatology, Children's National Hospital, Washington, DC; Center for Translational Science, Children's Research Institute, Children's National Hospital, Washington, DC.
| | - Katherine I Kritikos
- Center for Translational Science, Children's Research Institute, Children's National Hospital, Washington, DC
| | - Cara L Carty
- Center for Translational Science, Children's Research Institute, Children's National Hospital, Washington, DC
| | - Penny Glass
- Department of Neonatology, Children's National Hospital, Washington, DC; Center for Translational Science, Children's Research Institute, Children's National Hospital, Washington, DC; Department of Psychology and Behavioral Health, Children's National Hospital, Washington, DC
| | - Lisa K Tuchman
- Center for Translational Science, Children's Research Institute, Children's National Hospital, Washington, DC; Department of Adolescent and Young Adult Medicine, Children's National Hospital, Washington, DC
| | - Randi Streisand
- Center for Translational Science, Children's Research Institute, Children's National Hospital, Washington, DC; Department of Psychology and Behavioral Health, Children's National Hospital, Washington, DC
| | - Karen R Fratantoni
- Center for Translational Science, Children's Research Institute, Children's National Hospital, Washington, DC; Division of General and Community Pediatrics, Children's National Hospital, Washington, DC
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66
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Alinejad-Naeini M, Peyrovi H, Shoghi M. Emotional disorganization: The prominent experience of Iranian mothers with preterm neonate: A qualitative study. Health Care Women Int 2020; 42:815-835. [PMID: 32886578 DOI: 10.1080/07399332.2020.1797040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
When a preterm neonate is born and needs to be taken care of in the neonatal intensive care unit (NICU), the mother experiences a different process of mothering. A grounded theory study was conducted to explore the maternal role attainment in mothers of preterm infants. The authors of this paper report the most prominent experience of Iranian mothers with preterm neonates during their stay in the NICU that emerged as part of the process of maternal role attainment. Data were collected through in-depth semi-structured interviews with mothers in the NICU. We found four categories as emerged from experiences that formed the concept of "emotional disorganization". We argue that these findings can help caregivers and nurses to provide sensitive and supportive care to mothers of preterm neonates.
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Affiliation(s)
- Mona Alinejad-Naeini
- Nursing Care Research Center, Pediatric and intensive Neonatal Nursing Department, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Hamid Peyrovi
- Nursing Care Research Center and Department of Critical Care Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Mahnaz Shoghi
- Nursing Care Research Center, Pediatric and intensive Neonatal Nursing Department, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
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67
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Dempsey AG, Keller-Margulis MA. Developmental and medical factors associated with parenting stress in mothers of toddlers born very preterm in a neonatal follow-up clinic. Infant Ment Health J 2020; 41:651-661. [PMID: 32845537 DOI: 10.1002/imhj.21890] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The purpose of this exploratory, cross-sectional study was to identify child-related factors associated with maternal parenting stress in toddlers born very preterm and followed in a neonatal follow-up (NFU) clinic. The study aimed to describe the associations of current medical complications and presence of developmental delays with total parenting stress. Participants were 53 mother-child dyads presenting in a NFU clinic. Mothers completed the Parenting Stress Index-Short Form (PSI-SF), and children were administered the Brigance Early Head Start Screen II. Medical variables were also collected from the child's medical record. Approximately 24% of mothers had at least one elevated subscale score on the PSI-SF. Regression analyses indicated that receipt of early intervention services was associated with increased parenting stress among mothers of toddlers born very preterm, though number of current medical complications was not. Parents of children born very preterm are at increased risk for parenting stress that extends beyond discharge from the neonatal intensive care unit . Clinicians working in NFU clinics are positioned to monitor for increased parenting stress, particularly among families of children with emerging signs of developmental delay.
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Affiliation(s)
- Allison G Dempsey
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, Colorado
| | - Milena A Keller-Margulis
- Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, Texas
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68
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Guttmann K, Patterson C, Haines T, Hoffman C, Masten M, Lorch S, Chuo J. Parent Stress in Relation to Use of Bedside Telehealth, an Initiative to Improve Family-Centeredness of Care in the Neonatal Intensive Care Unit. J Patient Exp 2020; 7:1378-1383. [PMID: 33457590 PMCID: PMC7786780 DOI: 10.1177/2374373520950927] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Since the onset of the COVID-19 pandemic, telehealth technologies have become critical to providing family and patient-centered care. Little is known about the impact of these technologies on parent stress levels in the Neonatal Intensive Care Unit (NICU). We sought to determine the impact of bedside web cameras on stress levels of parents in the NICU in order to work toward interventions that might improve family-centered care. A validated survey, the Parental Stress Scale NICU, was administered to parents of babies admitted to the Children’s Hospital of Philadelphia Neonatal/Infant Intensive Care Unit on days 7 to 10 of hospitalization. Parents were also asked if they used the available AngelEye Camera while their baby was hospitalized. Stress levels were analyzed for associations with the use of the bedside cameras. Parents who reported using the bedside camera also reported lower levels of stress relating to being separated from their babies. Bedside web camera interventions may hold potential for reducing parent stress related to separation from their babies, especially in the setting of a global pandemic.
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Affiliation(s)
- Katherine Guttmann
- Division of Newborn Medicine, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Chavis Patterson
- Division of Neonatology, Department of Pediatrics, The Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Tracey Haines
- Division of Neonatology, Department of Pediatrics, The Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Casey Hoffman
- Division of Neonatology, Department of Pediatrics, The Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Marjorie Masten
- Division of Neonatology, Department of Pediatrics, The Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Scott Lorch
- Division of Neonatology, Department of Pediatrics, The Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - John Chuo
- Division of Neonatology, Department of Pediatrics, The Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
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Abstract
BACKGROUND Parental presence in the neonatal intensive care unit (NICU) may affect preterm infants' developmental outcomes. However, few studies have described predictors of parental presence in the NICU. PURPOSE To identify sociodemographic, clinical, environmental, and maternal psychological factors that predict parent presence in the NICU. METHODS Using a prospective cohort design, 66 preterm infants between 32 and 40 weeks' corrected gestational age were recruited at 2 level III NICUs in the United States. Data for length of parental presence were collected for 48 consecutive hours from daily visitation logs and medical records. A general linear model was estimated to identify significant predictors of parental presence. RESULTS Parental presence varied considerably, with a mean percentage of visitation time of 32.40%. The number of children at home (P = .003), presence of neurological comorbidity (P < .001), room type (P < .001), surgical history (P < .001), and perceived stressfulness of the NICU (P = .03) each had large main effects on parental presence, and room type and surgical history (P = .004) had a large interaction effect on parental presence. These predictors accounted for 65.8% of the variance in parental presence. IMPLICATIONS FOR RESEARCH Future research aimed at understanding predictors of parent presence is essential for developing interventions and designing NICUs that support parental presence. IMPLICATIONS FOR PRACTICE Understanding factors that contribute to parental presence may help healthcare providers identify infants at risk for low parental presence and thus be able to provide greater support to these infants and their families. As a result, this may help improve outcomes and attachment.
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70
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Levinson M, Parvez B, Aboudi D, Shah S. Impact of maternal stressors and neonatal clinical factors on post-partum depression screening scores. J Matern Fetal Neonatal Med 2020; 35:1328-1336. [PMID: 32316772 DOI: 10.1080/14767058.2020.1754394] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: Higher rates of postpartum depression (PPD) are reported in mothers of neonatal intensive care unit (NICU) hospitalized infants. The relationship of neonatal clinical risk factors and self-reported maternal stress levels to positive PPD screening is not well characterized.Objective: To determine the feasibility of postpartum depression screening in a regional perinatal center, and assess the association of NICU-specific comorbidities and maternal stress levels with PPD screening scores.Design/Methods: Prospective study of mothers of NICU-hospitalized infants conducted between 21and 30 days of their infant's life. Mothers completed the Edinburgh Postpartum Depression scale (EPDS) and the Parental Stressor Scale: NICU (PSS: NICU) in the environmental, infant behavior and parental domains. Total EPDS scores and positive PPD screening were correlated with NICU comorbidities, demographic factors and PSS: NICU scores.Results: The incidence of positive PPD screening was 19% (25/135). In bivariate analysis, positive PPD screen was associated with exclusive breastfeeding (67% vs, 35%, p < .05) and maternal age <35 years (32% vs. 12%, p < .05). No observed differences in maternal and infant demographic factors or neonatal comorbidities were seen in mothers with positive PPD screening. Mean PPD screening scores were higher in infants with intraventricular hemorrhage of any grade and necrotizing enterocolitis. In adjusted analysis, overall and domain-specific PSS: NICU scores were associated with positive PPD screening.Conclusion: Cumulatively and within each PSS: NICU domain, parental stress correlated with positive PPD screening but was unrelated to NICU comorbidities. Reducing modifiable factors which exacerbate parental stress may impact the incidence of positive PPD screening among NICU mothers.
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Affiliation(s)
- Michelle Levinson
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, New York Medical College, Maria Fareri Children's Hospital, Valhalla, NY, USA
| | - Boriana Parvez
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, New York Medical College, Maria Fareri Children's Hospital, Valhalla, NY, USA
| | - David Aboudi
- New York City Department of Health and Mental Hygiene, Division of Mental Health Statistics, New York, NY, USA
| | - Shetal Shah
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, New York Medical College, Maria Fareri Children's Hospital, Valhalla, NY, USA
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71
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Çelen Yoldaş T, Çelik HT, Özdemir G, Karakaya J, Özmert E. Do early parental postnatal depression, attachment style and perceived social support affect neurodevelopmental outcomes of premature infants? Infant Behav Dev 2020; 59:101444. [PMID: 32244071 DOI: 10.1016/j.infbeh.2020.101444] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 03/13/2020] [Accepted: 03/20/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND The birth of a premature infant is both a stressful event for both parents and associated with an increased rate of postnatal depression (PND). Additionally some mothers may have delayed feelings of attachment to their babies because of the medical procedures or possible medical complications. Social support is known as an important factor for well-being in the postnatal period. However there is scarce data about these factors for fathers. We aimed to identify the impact of parental PND, attachment style and social support on premature infant development considering the prematurity degree and risk groups. METHODS This prospective study was conducted by including 96 infants who were born preterm. Mothers and fathers were given Edinburgh Postnatal Depression Scale (EPDS), Adult Attachment Style Scale (AASS), and Multidimensional Scale of Perceived Social Support (MSPSS) to fill out when their infants' corrected age was 3 months. The developmental evaluation was conducted with Bayley III at the corrected 6 months and 18 months of age. RESULTS Postnatal depression scores were more in mothers than fathers, the rates of secure attachment and social support were similar between mothers and fathers. Factors associated with the neurodevelopmental outcomes including prematurity degree and risk groups, EPDS, AASS and MSPSS scores were analyzed for both parents. In multivariate analysis, fathers' depression scores were inversely associated with cognitive development (p = 0.030, R2 = 0.080, B=-0.283) and mothers' anxious/ambivalent attachment style was inversely associated with language development (p = 0.011, R2 = 0.108, B=-0.329) at the age of corrected 6 months old. CONCLUSIONS Our findings underscore that the efforts to improve developmental outcomes of premature infants should include parental well-being taking into account new fathers' depressive symptomatology and maternal anxious/ambivalent attachment.
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Affiliation(s)
- Tuba Çelen Yoldaş
- Hacettepe University Faculty of Medicine, Department of Pediatrics, Division of Developmental and Behavioral Pediatrics, Ankara, Turkey.
| | - Hasan Tolga Çelik
- Hacettepe University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Ankara, Turkey
| | - Gökçenur Özdemir
- Hacettepe University Faculty of Medicine, Department of Pediatrics, Division of Developmental and Behavioral Pediatrics, Ankara, Turkey
| | - Jale Karakaya
- Hacettepe University Faculty of Medicine, Department of Biostatistics, Ankara, Turkey
| | - Elif Özmert
- Hacettepe University Faculty of Medicine, Department of Pediatrics, Division of Developmental and Behavioral Pediatrics, Ankara, Turkey
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Elliott AM. Genetic Counseling and Genome Sequencing in Pediatric Rare Disease. Cold Spring Harb Perspect Med 2020; 10:cshperspect.a036632. [PMID: 31501267 DOI: 10.1101/cshperspect.a036632] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Both genome sequencing (GS) and exome sequencing (ES) have proven to be revolutionary in the diagnosis of pediatric rare disease. The diagnostic potential and increasing affordability make GS and ES more accessible as a routine clinical test in some centers. Herein, I review aspects of rare disease in pediatrics associated with the use of genomic technologies with an emphasis on the benefits and limitations of both ES and GS, complexities of variant classification, and the importance of genetic counseling. Indications for testing, the role of genetic counselors in genomic test selection, and the diagnostic potential of ES and GS in various pediatric multisystem disorders are discussed. The neonatal population represents an important cohort in pediatric rare disease. Rapid ES and GS in critically ill neonates can have an immediate impact on medical management and present unique genetic counseling challenges. This work includes reviews of recommendations for genetic counseling for families considering genome-wide sequencing, and issues of access to genetic counseling that affect clinical use and will necessitate implementation of innovative methods such as online decision aids. Finally, this work will also review the challenges of having a child with a rare disease, the impact of results from ES and GS on these families, and the role of various support agencies.
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Affiliation(s)
- Alison M Elliott
- Department of Medical Genetics, University of British Columbia Investigator, BC Children's Hospital Research Institute and BC Women's Health Research Institute, and Provincial Medical Genetics Program, Vancouver, British Columbia V6H 3N1, Canada
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73
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Delivery timing after laser surgery for twin-twin transfusion syndrome. J Perinatol 2020; 40:248-255. [PMID: 31611614 DOI: 10.1038/s41372-019-0532-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 08/12/2019] [Accepted: 08/19/2019] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To compare outcomes of twin-twin transfusion syndrome (TTTS) patients who underwent early elective delivery vs. expectant management. STUDY DESIGN Retrospective study of monochorionic diamniotic twins who underwent laser surgery for TTTS and had dual survivors at 32 weeks. Patients who underwent elective delivery between 32 0/7 to 35 6/7 weeks ("early elective group") were compared with all patients who delivered ≥36 0/7 weeks ("expectant management group"). The primary outcome was a composite of fetal and neonatal morbidity. RESULTS The final study population was comprised of 15 early elective and 119 expectant management patients. Those in the early elective group were seven times more likely to experience the primary outcome (OR 7.38 [2.01-27.13], p = 0.0026). CONCLUSION Among patients who underwent laser surgery for TTTS who had dual survivors at 32 weeks, elective delivery prior to 36 weeks did not appear to be protective.
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74
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Klawetter S, McNitt C, Hoffman JA, Glaze K, Sward A, Frankel K. Perinatal Depression in Low-Income Women: A Literature Review and Innovative Screening Approach. Curr Psychiatry Rep 2020; 22:1. [PMID: 31912372 PMCID: PMC10027381 DOI: 10.1007/s11920-019-1126-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW This paper reviews literature on perinatal depression prevalence, consequences, and screening among low-income women and women of color. We introduce the Warm Connections program's innovative perinatal depression screening protocol and explore perinatal depression patterns among WIC participants. RECENT FINDINGS Perinatal depression negatively impacts maternal and child outcomes. Research shows mixed findings of perinatal depression prevalence rates among low-income women and women of color. The Warm Connections program supports the ability of WIC staff to administer the EPDS to WIC participants. Perinatal depression rates appeared lower in the Warm Connections program than in studies using less specific perinatal depression screening instruments with similar samples. Future research should continue to explore perinatal depression patterns among low-income women and women of color. Partnering with community-based settings such as WIC provides innovative opportunities to provide screening, referral, and treatment for low income women and women of color.
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Affiliation(s)
- Susanne Klawetter
- Portland State University, School of Social Work, PO Box 751-SSW, Portland, OR, 97207, USA.
| | - Cassidy McNitt
- Department of Psychiatry, University of Colorado School of Medicine, 13001 E 17th Pl, Aurora, CO, 80045, USA
| | - Jill A Hoffman
- Portland State University, School of Social Work, PO Box 751-SSW, Portland, OR, 97207, USA
| | - Kelly Glaze
- Department of Psychiatry, University of Colorado School of Medicine, 13001 E 17th Pl, Aurora, CO, 80045, USA
| | - Ashley Sward
- Department of Psychiatry, University of Colorado School of Medicine, 13001 E 17th Pl, Aurora, CO, 80045, USA
| | - Karen Frankel
- Departments of Psychiatry and Pediatrics, University of Colorado School of Medicine, 13001 E 17th Pl, Aurora, CO, 80045, USA
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Abstract
The admission of an infant to the neonatal intensive care unit (NICU) presents specialized barriers to the maternal-infant bonding (MIB) process. Virtual visitation (VV) provides a mother with the opportunity to have continual access to her hospitalized infant via a one-way live Web camera. While increasingly used in the NICU, VV remains a novel concept. The objective of this study was to introduce a conceptual model that incorporates the use of VV into the NICU MIB process. Adapted from the Model of Mother-Infant Bonding After Antenatal HIV Diagnosis, a newly developed model of MIB using VV as a bonding enhancement tool is offered. A Model of NICU Maternal-Infant Bonding Incorporating Virtual Visitation presents the NICU bonding process in a chronological manner, with 5 primary propositions and an explanation of their related themes. Virtual visitation is introduced into the bonding process and is shown to act as a moderated variable. A Model of NICU Maternal-Infant Bonding Incorporating Virtual Visitation introduces VV as a tool to enhance the MIB process that occurs in the NICU. The model provides the basis for the development of a research program to examine the multiple potential effects of VV in the NICU.
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76
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Bonacquisti A, Geller PA, Patterson CA. Maternal depression, anxiety, stress, and maternal-infant attachment in the neonatal intensive care unit. J Reprod Infant Psychol 2019; 38:297-310. [DOI: 10.1080/02646838.2019.1695041] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Alexa Bonacquisti
- Graduate Counseling Psychology Department, Holy Family University, Philadelphia, PA, USA
| | - Pamela A. Geller
- Department of Psychology, Drexel University, Philadelphia, PA, USA
| | - Chavis A. Patterson
- Division of Neonatology, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
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77
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Ringham CL, MacKinnon K. Mothering Work and Perinatal Transfer: An Institutional Ethnographic Investigation. Can J Nurs Res 2019; 53:27-38. [PMID: 31684752 DOI: 10.1177/0844562119884388] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND While maternal or infant transfer is generally the safest course of action when health complications arise, the process of shifting from one hospital to another is stressful for mothers and their infants. There is limited understanding of how institutional processes coordinate patient transfer in ways that increase tensions for women and their families who are trying to navigate the institutional systems during health crises. METHODS This institutional ethnographic study explored womens' experience of transfer. Interviews were conducted with a purposive sample of six childbearing women. The analysis highlights tensions and contradictions between patient care and institutional demands and shows how ordinary institutional decision-making practices impacted participants in unexpected ways. RESULTS Women experienced uncertainty and stress when trying to convince health-care providers they needed care. Before, during, and after transfer, participants navigated home responsibilities, childcare, and getting care closer to home in difficult circumstances. CONCLUSION The effort and skill women need to care for their infants and families as they are transferred is extraordinary. This study offers insight into the resources and support childbearing women need to accomplish the work of caring for their families in the face of perinatal crisis and multiple transfers.
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Affiliation(s)
- Catherine L Ringham
- Faculty of Nursing and Alberta Health Services, University of Calgary, Calgary, AB, Canada
| | - Karen MacKinnon
- School of Nursing, University of Victoria, Victoria, BC, Canada
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Domínguez-Martínez V, Cortés-Escárcega I. Adaptación cultural y validación de Parental Stressor Scale: Neonatal Intensive Care Unit en padres mexicanos. ENFERMERÍA UNIVERSITARIA 2019. [DOI: 10.22201/eneo.23958421e.2019.4.641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Introducción: La hospitalización de un recién nacido prematuro en la Unidad de Cuidados Intensivos Neonatales (UCIN), constituye un suceso estresante para los padres, como consecuencia de factores ambientales y psicosociales de la UCIN. Así, la identificación del grado de estrés de los padres a través de instrumentos adaptados y validados a su contexto, establecerá protocolos para disminuirlo durante la hospitalización de su hijo.
Objetivo: Adaptar culturalmente y validar la Escala de Estrés Parental: Unidad de Cuidados Intensivos Neonatales (PSS: NICU) para su aplicación en un grupo de madres y padres mexicanos.
Métodos: Estudio descriptivo y transversal, con una muestra intencional de 130 padres de recién nacidos prematuros hospitalizados en la Unidad de Cuidados Intensivos Neonatales. El estrés parental se midió utilizando la PSS: NICU, que fue adaptada y validada para su aplicación en padres mexicanos. La información se procesó con el paquete estadístico SPSS v.24.
Resultados: El instrumento adaptado al contexto cultural en población mexicana presentó una consistencia interna de .945, probando así su confiabilidad para su aplicación en padres mexicanos. El estrés parental total promedio fue de 2.48 + .986, considerado poco estresante.
Conclusiones: La adaptación cultural y validación de la PSS: NICU en población mexicana, resultó una herramienta válida y confiable para su aplicación en padres mexicanos. El factor más asociado con el incremento del nivel de estrés fue la alteración del rol parental, por lo que es importante establecer intervenciones dirigidas a mejorar la participación de los padres que apunten hacia el bienestar emocional de los mismos.
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Pisoni C, Spairani S, Manzoni F, Ariaudo G, Naboni C, Moncecchi M, Balottin U, Tinelli C, Gardella B, Tzialla C, Stronati M, Bollani L, Orcesi S. Depressive symptoms and maternal psychological distress during early infancy: A pilot study in preterm as compared with term mother-infant dyads. J Affect Disord 2019; 257:470-476. [PMID: 31310909 DOI: 10.1016/j.jad.2019.07.039] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 07/01/2019] [Accepted: 07/04/2019] [Indexed: 01/09/2023]
Abstract
BACKGROUND Preterm birth does not only affect infants but also represents an unexpected and traumatic event for parents. There are few reports on parenting stress during early infancy comparing preterm and term mothers, with the results being somewhat inconsistent. METHODS As part of a longitudinal study, preterm mother-infant and term mother-infant dyads were enrolled. Dyads were assessed twice: during hospitalisation in the neonatal intensive care unit (NICU) and at 3 months of infant age (corrected age for preterm). Each mother completed a self-report set of psychological questionnaire in both time points. All the children underwent a neurological examination at 40 weeks post conceptional age and at 3 months (corrected age for preterm). RESULTS 20 preterm and 20 term dyads were included. NICU mothers reported elevated postnatal depressive symptoms and high stress level, even if the preterm infants were with low perinatal risk and normal neurological examination. Comparing preterm infant with low perinatal risk and normal neurological examination with term-born children at 3 months, we found higher parental stress in term mothers than in preterm mothers. LIMITATIONS This study was limited by a relatively small sample size; findings are preliminary and warrant further investigation in larger-scale study. CONCLUSIONS Findings confirm that becoming a mother of a preterm infant is an event associated with emotional distress. These symptoms may resolve with time, and sometimes are independent of the infant's clinical severity. Assessing parental sources of stress and subsequent follow-up is essential to promote parental support, both for preterm and term mothers.
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Affiliation(s)
- C Pisoni
- Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
| | - S Spairani
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - F Manzoni
- Epidemiology and Biometric Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - G Ariaudo
- Child Neurology and Psychiatry Unit, Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
| | - C Naboni
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - M Moncecchi
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - U Balottin
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy; Child Neurology and Psychiatry Unit, Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
| | - C Tinelli
- Epidemiology and Biometric Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - B Gardella
- Department of Obstetrics and Gynecology, Fondazione IRCCS Policlinico San Matteo and University of Pavia, Pavia, Italy
| | - C Tzialla
- Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - M Stronati
- Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - L Bollani
- Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - S Orcesi
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy; Child Neurology and Psychiatry Unit, Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
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Duran S, Kaynak S, Karadaş A. The relationship between breastfeeding attitudes and perceived stress levels of Turkish mothers. Scand J Caring Sci 2019; 34:456-463. [PMID: 31487080 DOI: 10.1111/scs.12749] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 08/09/2019] [Indexed: 11/30/2022]
Abstract
AIMS In the present study, it was aimed to investigate the relationships between breastfeeding attitude and perceived stress levels of Turkish mothers. METHODS In this descriptive study, the Personal Information Form prepared by the researchers, Perceived Stress Scale (PSS) and Iowa Infant Feeding Attitude Scale (IIFAS) were used to collect the study data. The present study included 788 mothers having 0-6 month-old infants. The data obtained were with the independent t-test, one-way ANOVA and Pearson correlation analyses. FINDINGS The mean scores of the participants obtained from the PSS and IIFAS were 25.60 ± 7.3 and 61 ± 6.6, respectively. At the end of the correlation analysis, it was observed that breastfeeding attitude decreased as the perceived stress level increased in mothers. CONCLUSIONS The results of the research indicated that as the perceived stress levels of mothers in the postpartum period increased, their breastfeeding attitudes decreased. It is suggested that nurses should support women by providing education and counselling during pregnancy and postpartum period.
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Affiliation(s)
- Songül Duran
- Elderly Care Program, Demokrasi University Vocational School of Health Services, İzmir, Turkey
| | - Serap Kaynak
- Department of Nursing, Balıkesir University Faculty of Health, Balıkesir, Turkey
| | - Ayşe Karadaş
- Department of Nursing, Balıkesir University School of Health, Balıkesir, Turkey
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Das A, Gordon-Ocejo G, Kumar M, Kumar N, Needlman R. Association of the previous history of maternal depression with post-partum depression, anxiety, and stress in the neonatal intensive care unit. J Matern Fetal Neonatal Med 2019; 34:1741-1746. [PMID: 31327298 DOI: 10.1080/14767058.2019.1647162] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND A history of depression in post-partum women who have infants admitted to the neonatal intensive care unit (NICU), is associated with higher risk for anxiety and stress. These conditions, which can be harmful to neonates, may be missed if maternal mental health screening is confined to depression. OBJECTIVE To determine if the history of a previously diagnosed depression would be associated with an increased risk of both postpartum depression and other stress-related disorders (i.e. anxiety and stress) among mothers with infants in the NICU. DESIGN Prospective survey questionnaire-based study conducted over a period of 9 months. SETTING Urban inpatient hospital-based setting, serving mainly low-income population. PARTICIPANTS A total of 118 mothers of newborns who had been in the NICU for 7-29 days were approached for enrollment. Out of 118, 96 mothers consented to be screened and were asked to fill out the 21-item Depression Anxiety and Stress Scale-21 (DASS-21) questionnaire. OUTCOME Primary outcome was to determine whether the history of a previously diagnosed depression is associated with an increased risk of both postpartum depression and other stress-related disorders (i.e. anxiety and stress). RESULTS Out of the 96 subjects, 36 (37.5%) had a previous history of depression before delivery (Group A) while 60/96 (62.5%) did not (Group B) and 46/96 (48%) of the mothers were positive for either depression, anxiety, or stress. This included 22/96 (22.9%) mothers who screened positive for depression; 37/96 (38.5%) who screened positive for anxiety; and 32/96 (33.3%) who screened positive for stress. After adjusting for maternal drug abuse, birth weight and maternal gravidity, the association between a previous history of depression and current depression scores were statistically significant (p = .04), as were the associations between previous depression and current anxiety and stress scores (p = .02 and p = .003, respectively). CONCLUSIONS AND RELEVANCE A history of depression, documented in the antepartum medical record, identifies post-partum women who are at higher risk for anxiety and stress. Screening for depression alone may lead to missing these mental health issues.
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Affiliation(s)
- Anirudha Das
- Department of Neonatology, Cleveland Clinic Foundation, Cleveland, OH, USA
| | | | | | | | - Robert Needlman
- Department of Neonatology, Cleveland Clinic Foundation, Cleveland, OH, USA
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Effects of early communication intervention on speech and communication skills of preterm infants in the neonatal intensive care unit (NICU): A systematic review. ACTA ACUST UNITED AC 2019. [DOI: 10.1016/j.jnn.2019.04.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Validation of the Arabic Version of the Parental Stressor Scale: Neonatal Intensive Care Unit (PSS: NICU). J Clin Psychol Med Settings 2019; 27:593-602. [DOI: 10.1007/s10880-019-09643-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Herbell K, Zauszniewski JA. Stress Experiences and Mental Health of Pregnant Women: The Mediating Role of Social Support. Issues Ment Health Nurs 2019; 40:613-620. [PMID: 31021665 DOI: 10.1080/01612840.2019.1565873] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Stress in pregnancy is an exceedingly common issue that impacts the mother's mental health and the health of her baby. Yet, women with a supportive network of friends and family may experience lower stress and improved mental health. Therefore, the aims of this secondary analysis were to (a) examine relationships between stress experiences (i.e. perceived stress, pregnancy-specific stress) and indicators of mental health (i.e. absence of depressive symptoms and resourcefulness), (b) determine the effects of social support on stress experiences and indicators of mental health, and (c) determine if social support mediates the relationship between stress experiences and indicators of mental health. A convenience sample of 82 women in their second and third trimester of pregnancy participated in the parent study. Findings indicate that stress experiences were moderately correlated with indicators of mental health and social support predicted stress experiences and indicators of mental health. All social support mediation models were not significant with the exception of social support mediating the relationship between pregnancy-specific stress and resourcefulness. This was the first study to investigate the mediating role of social support on the relationship between pregnancy-specific stress and resourcefulness. Pregnant women may benefit from social support interventions to meaningfully reduce their stress and promote mental health. Such interventions may be physical activity, group prenatal care, or even peripartum home visits.
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Affiliation(s)
- Kayla Herbell
- a aUniversity of Missouri Sinclair School of Nursing, S235 School of Nursing, University of Missouri , Columbia , Missouri , USA
| | - Jaclene A Zauszniewski
- a aUniversity of Missouri Sinclair School of Nursing, S235 School of Nursing, University of Missouri , Columbia , Missouri , USA.,b bFrances Payne Bolton School of Nursing, Case Western Reserve University , Cleveland , Ohio , USA
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Iwata M, Han S, Hays R, Doorenbos AZ. Predictors of Depression and Anxiety in Family Members 3 Months After Child's Admission to a Pediatric ICU. Am J Hosp Palliat Care 2019; 36:841-850. [PMID: 31256606 DOI: 10.1177/1049909119859517] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Family members of children admitted to intensive care units (ICUs) suffer from severe stress, which sometimes results in long-term psychological problems. We aimed to identify associations between demographic and psychosocial variables at early stages of a child's admission to the ICU and depression and anxiety in family members at approximately 3 months after admission. We also explored predictive models for depression and anxiety at 3 months after admission. METHODS This study is a secondary analysis of data from a previous clinical trial of palliative care for family members in ICUs, in which 380 family members of 220 children reported demographic and psychosocial status at approximately 1 week after ICU admission (baseline), at discharge from the ICUs, and at 3 months after the child's admission to the ICU. Clinical data were extracted from the children's medical records. We used linear regression models and stepwise linear regression for the analyses. RESULTS After controlling for significant confounders of gender (female) and child mortality, worse psychological status at baseline, represented by reported depression, anxiety, and acute stress symptoms, was associated with more severe depression and anxiety at 3 months. Also, a better family relationship at baseline was associated with lower depression and anxiety at 3 months. CONCLUSION We suggest a need to screen family members of children admitted to the ICU with validated scales and intervening with those at high risk of depression and anxiety. CLINICAL TRIALS Registry number NCT02144779 on ClinicalTrials.gov . https://clinicaltrials.gov/ct2/show/NCT02144779?term=NCT02144779&rank=1 .
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Affiliation(s)
- Masayuki Iwata
- 1 Graduate School of Health Management, Keio University, Shinjuku, Japan.,2 Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, WA, USA
| | - Soojeong Han
- 2 Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, WA, USA
| | - Ross Hays
- 3 Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA.,4 Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, USA
| | - Ardith Z Doorenbos
- 2 Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, WA, USA.,5 Department of Anesthesiology and Pain Medicine, School of Medicine, University of Washington, Seattle, WA, USA
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Macedo-Poma K, Marquina-Curasma PG, Corrales-Reyes IE, Mejía CR. Factors associated to depressive symptoms in mothers with children hospitalized in pediatric and neonatology units of Peru: a case-control study. Medwave 2019; 19:e7649. [PMID: 31442219 DOI: 10.5867/medwave.2019.05.7649] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 04/01/2019] [Indexed: 11/27/2022] Open
Abstract
Introduction Postpartum depression has increased significantly worldwide, but in the central Peruvian mountain, there are no studies that address this problem. Objectives To identify and to establish risk factors for postpartum depression in mothers whose children are hospitalized in pediatrics/neonatology units in Huancayo. Methods This is a case-control study. Medical records of mothers whose children were hospitalized in pediatrics/neonatology units during 2017 were included. The cases were defined as patients who had symptoms of postpartum depression." This variable was crossed with other variables using logistical regression, odds ratio were obtained, their confidence intervals were set to 95%, and the p values were calculated. Results Sixty-one medical records of mothers with postpartum depression (cases) and 61 medical records of mothers without postpartum depression (control) were evaluated. In the multivariate analysis, the unemployed mothers had a bigger chance of postpartum depression (p < 0.001), as well as single mothers (p < 0.001), and those with an unplanned pregnancy (p = 0.003). Conversely, mothers who reported having serious problems with their partner had a smaller chance of postpartum depression (p = 0.003). Conclusions Different factors were found to be related to postpartum depression: marital situation, relationship with their partners, work conditions, and having an unplanned pregnancy.
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Affiliation(s)
- Kelly Macedo-Poma
- Facultad de Medicina Humana, Universidad Continental, Huancayo, Perú.
| | | | | | - Christian R Mejía
- Facultad de Medicina Humana, Universidad Continental, Huancayo, Perú
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Stress and feelings in mothers and fathers in NICU: identifying risk factors for early interventions. Prim Health Care Res Dev 2019; 20:e81. [PMID: 32799977 PMCID: PMC6567892 DOI: 10.1017/s1463423619000021] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
AIMS The aims of this study were to explore parents' stress levels and negative feelings after premature births and to identify the risk factors related to parents' stress and negative feelings during their children's neonatal intensive care unit (NICU) stay. BACKGROUND Preterm birth is a multi-problematic event that may put the babies in danger for both their medical and neurophysiological conditions and could have a negative impact on both the mother-father relationship and the parent-child interactions. METHODS The study involved 43 mothers and 38 fathers of preterm infants. All participants filled out the Parental Stressor Scale: Neonatal Intensive Care Unit and the Profile of Mood States. FINDINGS The results revealed significant differences between mothers' and fathers' responses to preterm births in terms of both stress and negative feelings. We found that, for mothers, their own young age and the baby's need for respiratory support were significant predictors of stress; for fathers, their own young age and the baby's lower gestational age and worse condition at birth were significant predictors of stress and negative feelings. The NICU may be a stressful place both for mothers and fathers. Identifying which mothers and fathers are at risk immediately after their children are born could help to direct specific interventions that can reduce these parents' stress and prevent them from negative feelings.
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Vizcarrondo-Oppenheimer M, García-Coll C, Martínez-González J, Reyes-Bou Z, García-Fragoso L, Sanchez D, Torres A, Diaz M, García-García I. Cumulative risk factors and mental health of mothers of infants admitted to the neonatal intensive care unit. J Matern Fetal Neonatal Med 2019; 34:660-662. [PMID: 31106618 DOI: 10.1080/14767058.2019.1610732] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose: The present study examined predictive linkages between multiple risk factors and their contribution to the development of anxiety and depression in Puerto Rican mothers of infants admitted to the Neonatal Intensive Care Unit (NICU).Method: The scales used were: the Hamilton Anxiety Rating Scale, the Edinburgh Postpartum Depression Scale, the Hollingshead, and a Demographic Questionnaire was constructed to obtain information about mother and infant characteristics.Results: Both the cumulative psychosocial risk factor (B = 0.267, p = .011) and the cumulative neonatal risk factor (B = -0.220, p = .039) were significant predictors of mothers' anxiety.Discussion: It could be beneficial to create psychosocial interventions in the NICU to address parents' needs and promote emotional resilience. Also, training staff to provide an adequate explanation to mothers, regarding the infants' recovery process is of particular importance.
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Affiliation(s)
| | - Cynthia García-Coll
- School of Medicine, University of Puerto Rico, Río Piedras Campus, San Juan, Puerto Rico
| | | | - Zayhara Reyes-Bou
- School of Medicine, University of Puerto Rico, Río Piedras Campus, San Juan, Puerto Rico
| | - Lourdes García-Fragoso
- School of Medicine, University of Puerto Rico, Río Piedras Campus, San Juan, Puerto Rico
| | - Daniris Sanchez
- Biology Department, University of Puerto Rico, Río Piedras Campus, San Juan, Puerto Rico
| | - Alessandra Torres
- Biology Department, University of Puerto Rico, Río Piedras Campus, San Juan, Puerto Rico
| | - Mariela Diaz
- Biology Department, University of Puerto Rico, Río Piedras Campus, San Juan, Puerto Rico
| | - Inés García-García
- School of Medicine, University of Puerto Rico, Río Piedras Campus, San Juan, Puerto Rico
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Bellido-González M, Robles-Ortega H, Castelar-Ríos MJ, Díaz-López MÁ, Gallo-Vallejo JL, Moreno-Galdó MF, de Los Santos-Roig M. Psychological distress and resilience of mothers and fathers with respect to the neurobehavioral performance of small-for-gestational-age newborns. Health Qual Life Outcomes 2019; 17:54. [PMID: 30922371 PMCID: PMC6437857 DOI: 10.1186/s12955-019-1119-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Accepted: 03/11/2019] [Indexed: 01/04/2023] Open
Abstract
Background The existence of psychological distress (PD) during pregnancy is well established. Nevertheless, few studies have analyzed the PD and resilience of mothers and fathers during high-risk pregnancy. This study analyzes the differences between parents’ PD and resilience and the relation between them and the neurobehavioral performance of their SGA newborns. Methods This prospective study compares two groups of parents and newborns: case group (52 parents and 26 SGA fetuses) and comparison group (68 parents and 34 appropriate-for-gestational-age, AGA, fetuses). In each group, the parents were evaluated during the last trimester of pregnancy, to obtain standardized measures of depression, stress, anxiety, and resilience. At 40 ± 1 weeks corrected gestational age, psychologists evaluated the state of neonatal neuromaturity achieved. Results Multivariate analysis of variance showed, in gender comparisons, that mothers obtained higher scores than fathers for psychological distress but lower ones for resilience. Similar differences were obtained in the comparison of parents’ distress to intrauterine growth by SGA vs. AGA newborns. Mothers of SGA newborns were more distressed than the other groups. However, there were no differences between the fathers of SGA vs. AGA newborns. Regarding neurobehavioral performance, the profiles of SGA newborns reflected a lower degree of maturity than those of AGA newborns. Hierarchical regression analyses showed that high stress and low resilience among mothers partially predict low neurobehavioral performance in SGA newborns. Conclusions These findings indicate that mothers of SGA newborns may need psychological support to relieve stress and improve their resilience. Furthermore, attention should be paid to the neurobehavioral performance of their babies in case early attention is needed.
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Affiliation(s)
- Mercedes Bellido-González
- Department of Developmental Psychology and Education, Faculty of Education Sciences, University of Granada, Granada, Spain. .,Department of Developmental Psychology and Education, Faculty of Education Sciences, University of Granada, Campus de Cartuja, 18071, Granada, Spain.
| | - Humbelina Robles-Ortega
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Granada, Granada, Spain
| | - María José Castelar-Ríos
- Department of Developmental Psychology and Education, Faculty of Education Sciences, University of Granada, Granada, Spain
| | | | | | | | - Macarena de Los Santos-Roig
- Department of Methodology of Behavioral Sciences, Faculty of Psychology, University of Granada, Granada, Spain
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Fowler C, Green J, Elliott D, Petty J, Whiting L. The forgotten mothers of extremely preterm babies: A qualitative study. J Clin Nurs 2019; 28:2124-2134. [PMID: 30786101 PMCID: PMC7328789 DOI: 10.1111/jocn.14820] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 01/17/2019] [Accepted: 02/12/2019] [Indexed: 12/13/2022]
Abstract
AIMS AND OBJECTIVES To explore the experiences of mothers of extremely premature babies during their Neonatal Intensive Care Unit stay and transition home. BACKGROUND Mothers of extremely preterm infants (28 weeks' gestation or less) experience a continuum of regular and repeated stressful and traumatic events, during the perinatal period, during the Neonatal Intensive Care Unit stay, and during transition home. METHOD An interpretive description method guided this study. Ten mothers of extremely premature infants who had been at home for less than six months were recruited via a Facebook invitation to participate in semi-structured telephone interviews exploring their experiences in the Neonatal Intensive Care Unit and the transition home. The data were examined using a six-phase thematic analysis approach. The COREQ checklist has been used. RESULTS Two main themes emerged: (a) things got a bit dire; and (b) feeling a failure as a mother. Participants had a heightened risk of developing a mental disorder from exposure to multiple risk factors prior to and during birth, as well as during the postnatal period in the Neonatal Intensive Care Unit and their infant's transition to home. Mothers highlighted the minimal support for their mental health from healthcare professionals, despite their regular and repeated experience of traumatic events. CONCLUSION The mothers were at high risk of developing post-traumatic stress symptoms and/or other mental health issues. Of note, study participants relived the trauma of witnessing their infant in the Neonatal Intensive Care Unit, demonstrated hypervigilance behaviour and identified lack of relevant support needed when their infant was at home. RELEVANCE TO CLINICAL PRACTICE This study highlights the need for nurses to include a focus on the mothers' psychosocial needs. Supporting maternal mental health both improves maternal well-being and enables mothers to be emotionally available and responsive to their extremely preterm infant.
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Affiliation(s)
- Cathrine Fowler
- University of Technology Sydney, Sydney, New South Wales, Australia
| | - Janet Green
- University of Technology Sydney, Sydney, New South Wales, Australia
| | - Doug Elliott
- University of Technology Sydney, Sydney, New South Wales, Australia
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González-Hernández A, González-Hernandez D, Fortuny-Falconi CM, Tovilla-Zárate CA, Fresan A, Nolasco-Rosales GA, Juárez-Rojop IE, López-Narváez ML, Gonzalez-Castro TB, Escobar Chan YM. Prevalence and Associated Factors to Depression and Anxiety in Women with Premature Babies Hospitalized in a Neonatal Intensive-Care Unit in a Mexican Population. J Pediatr Nurs 2019; 45:e53-e56. [PMID: 30655115 DOI: 10.1016/j.pedn.2019.01.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 01/09/2019] [Accepted: 01/09/2019] [Indexed: 01/10/2023]
Abstract
PURPOSE The aims of this study were to investigate the frequency of depression and anxiety in mothers of children hospitalized in a neonatal intensive care unit, and to determine the characteristics associated with depression and anxiety in a sample of Mexican mothers. METHOD We studied 188 mothers who had premature babies in a neonatal intensive-care. Sociodemographic and clinical characteristics were collected through a face to face interview performed by professional staff. We assessed depression using the Beck Depression Inventory (BDI) and clinical anxiety using the Hamilton Anxiety Rating Scale (HAM-A). RESULTS Clinical anxiety was reported in more than one-third of women (34.0%, n = 64) followed by depression (19.7%, n = 37), while twenty-six women reported both significant depression and anxiety (13.8%). Women with both clinical symptoms were younger, they were more frequently students and were living within extended families. Women who presented only symptoms of depression reported lower educational level (elementary school 29.7%, n = 11). CONCLUSION Our results show a high incidence of anxiety, depression, and both emotional disorders in Mexican mothers of premature babies hospitalized in a neonatal intensive care unit. Demographic features such as occupation or age may impact the occurrence and severity of joint symptoms of depression and anxiety which should be monitored by the health team and referred to a mental health service.
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Affiliation(s)
| | | | - Carlos Mario Fortuny-Falconi
- Universidad Juárez Autónoma de Tabasco, División Académica Multidisciplinaria de Comalcalco, Comalcalco, Tabasco, Mexico
| | - Carlos Alfonso Tovilla-Zárate
- Universidad Juárez Autónoma de Tabasco, División Académica Multidisciplinaria de Comalcalco, Comalcalco, Tabasco, Mexico.
| | - Ana Fresan
- Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñíz, Ciudad de México, Mexico.
| | | | - Isela Esther Juárez-Rojop
- Universidad Juárez Autónoma de Tabasco, División Académica de Ciencias de la Salud, Villahermosa, Tabasco, Mexico
| | | | - Thelma Beatriz Gonzalez-Castro
- Universidad Juárez Autónoma de Tabasco, División Académica Multidisciplinaria de Jalpa de Méndez, Jalpa de Méndez, Tabasco, Mexico
| | - Yudy Merady Escobar Chan
- Universidad Juárez Autónoma de Tabasco, División Académica Multidisciplinaria de Comalcalco, Comalcalco, Tabasco, Mexico
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92
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Laudi A, Peeples E. The relationship between neonatal encephalopathy and maternal postpartum depression. J Matern Fetal Neonatal Med 2019; 33:3313-3317. [PMID: 30651011 DOI: 10.1080/14767058.2019.1571574] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Purpose: Neonatal hypoxic-ischemic encephalopathy (HIE) is a type of brain injury resulting from insufficient oxygen and blood supply. The standard treatment for HIE is therapeutic hypothermia (TH), which involves a 72-h period of hypothermia, during which time the infant is isolated from his/her parents. The primary objective of this study was to assess the effects of the diagnosis of neonatal encephalopathy and subsequent separation on rates of maternal postpartum depression (PPD) as compared to other hospitalized infants.Materials and methods: Case-control analysis of newborns admitted to the neonatal intensive care unit from 2015 to 2018 was carried out. Maternal PPD symptoms were determined by the Edinburgh Postnatal Depression Scale (EPDS). Demographics, diagnoses, and outcomes were abstracted from clinical records. Associations between EPDS scores and HIE diagnosis and severity, insurance type, marital status, markers of overall illness severity, and the need for neonatal transport were evaluated. Student's t-test and Fisher's exact test were used to compare differences in continuous and categorical variables, respectively. A multiple regression model was used to adjust for markers of illness severity.Results: The study found no association between EPDS scores and marital status, overall illness severity, or the need for transport. A trend toward higher EPDS scores was noted in mothers of infants with HIE versus other admission diagnoses (21 versus 10%, p = .09). A similar trend was seen in mothers of infants with severe versus moderate encephalopathy (30 versus 7%, p = .12). Mothers of infants with no insurance (20%) or Medicaid (16%) had higher rates of PPD than those with private (6%) or military insurance (6%) (p = .02).Conclusions: Mothers of infants with HIE are at high risk for PPD, which may be in part related to TH interfering with maternal-infant bonding. These findings support the need for continued universal depression screening with investigation of new methods to reduce stress and improve the bonding experience during and after TH.
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Affiliation(s)
- Andrea Laudi
- Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE, USA
| | - Eric Peeples
- Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE, USA
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93
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The Experiences of Parents in the Neonatal Intensive Care Unit: An Integrative Review of Qualitative Studies Within the Transactional Model of Stress and Coping. J Perinat Neonatal Nurs 2019; 33:340-349. [PMID: 31651628 DOI: 10.1097/jpn.0000000000000436] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Having a child hospitalized in the neonatal intensive care unit (NICU) is a deviation from the norms expected for pregnancy and childbirth. A NICU admission may be traumatic for some parents, causing psychological distress and altered parenting roles. The aim of this integrative review is to examine the experiences and perceptions of a NICU hospitalization from the perspective of both parents to inform clinical practice and future research. A systematic search of 3 databases was conducted and included studies were evaluated by the Critical Skills Appraisal Programme checklist for qualitative studies. The Whittemore and Knafl integrative review methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis methodology were followed to provide a structure for searching and reporting findings. There were 248 participants (153 mothers and 95 fathers) from 9 countries and of varying socioeconomic backgrounds in the 16 primary qualitative studies included in this review. The resulting major themes included panic sequence, emotional upheaval, social support, faith, and adjusting. Interventions directed at managing parents' emotions, supporting their spiritual needs, facilitating parenting skills and infant attachment, and adapting the environment to parents' needs can help improve the NICU experience.
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94
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Smith EE, du Souich C, Dragojlovic N, Elliott AM. Genetic counseling considerations with rapid genome-wide sequencing in a neonatal intensive care unit. J Genet Couns 2018; 28:263-272. [DOI: 10.1002/jgc4.1074] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 11/05/2018] [Accepted: 11/07/2018] [Indexed: 01/03/2023]
Affiliation(s)
- Emma E. Smith
- Department of Medical Genetics; University of British Columbia; Vancouver BC Canada
| | - Christèle du Souich
- Department of Medical Genetics; University of British Columbia; Vancouver BC Canada
- BC Children’s Hospital Research Institute; Vancouver BC Canada
| | - Nick Dragojlovic
- Collaboration for Outcomes Research and Evaluation, Faculty of Pharmaceutical Sciences; University of British Columbia; Vancouver BC Canada
| | - Alison M. Elliott
- Department of Medical Genetics; University of British Columbia; Vancouver BC Canada
- BC Children’s Hospital Research Institute; Vancouver BC Canada
- BC Women’s Health Research Institute; Vancouver BC Canada
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95
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Jannes C, Miedaner F, Langhammer K, Enke C, Göpel W, Kribs A, Nitzsche A, Riedel R, Woopen C, Kuntz L, Roth B. Increased parental satisfaction by unrestricted visiting hours and developmentally supportive care in NICUs - results of a German multicenter study. J Matern Fetal Neonatal Med 2018; 33:1874-1880. [PMID: 32216530 DOI: 10.1080/14767058.2018.1532499] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: This study aims to provide insights into the impact of organizational family-centered care characteristics at German neonatal intensive care units (NICUs) on the satisfaction of parents of very low birthweight (VLBW) infants.Materials and methods: Using multilevel modeling, this study analyzed whether organizational characteristics of NICUs fostering parent-infant interaction (by way of the existence of a recreation room, possibility of rooming in, existence of unrestricted visiting hours for parents, existence of parental classes, and the connection to parent associations as well as the existence of standards on developmentally supportive care) increase the satisfaction of parents after the infants' high-intensive care phase within the NICU.Results: Nine hundred and twenty-three VLBW infants from 66 NICUs in Germany born between May and October 2013 were enrolled in this multicenter study. We retrieved 1493 questionnaires completed by 1277 parents. The existence of unrestricted visiting hours (adjusted odds ratio (AOR): 1.967; 95% CI [1.118, 3.459]) and standardized procedures for developmentally supportive care (AOR: 1.775; 95% CI [1.166, 2.704]) were positively associated with parental satisfaction.Conclusions: Fostering the parent-infant interaction through the provision of developmentally supportive care and unrestricted visiting hours for parents whose infants are hospitalized within an NICU significantly contributes to the satisfaction of parents.
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Affiliation(s)
- Christiane Jannes
- Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health (ceres), University of Cologne; and Research Unit Ethics, Medical Faculty, University of Cologne, Cologne, Germany
| | - Felix Miedaner
- Department of Business Administration and Healthcare Management, University of Cologne, Cologne, Germany
| | - Kristina Langhammer
- Department of Neonatology and Pediatric Intensive Care, Children's Hospital, University Clinic Cologne, Cologne, Germany
| | - Christian Enke
- Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health (ceres), University of Cologne; and Research Unit Ethics, Medical Faculty, University of Cologne, Cologne, Germany
| | - Wolfgang Göpel
- Department of Pediatrics, University of Lübeck, Lübeck, Germany
| | - Angela Kribs
- Department of Neonatology and Pediatric Intensive Care, Children's Hospital, University Clinic Cologne, Cologne, Germany
| | - Anika Nitzsche
- Faculty of Human Sciences and Faculty of Medicine, Institute of Medical Sociology, Health Services Research and Rehabilitation Science, University of Cologne, Cologne, Germany
| | - Rainer Riedel
- Institute for Medical Economics and Health Services Research, Rheinische Fachhochschule Cologne, Cologne, Germany
| | - Christiane Woopen
- Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health (ceres), University of Cologne; and Research Unit Ethics, Medical Faculty, University of Cologne, Cologne, Germany
| | - Ludwig Kuntz
- Department of Business Administration and Healthcare Management, University of Cologne, Cologne, Germany
| | - Bernhard Roth
- Department of Business Administration and Healthcare Management, University of Cologne, Cologne, Germany.,Department of Neonatology and Pediatric Intensive Care, Children's Hospital, University Clinic Cologne, Cologne, Germany
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96
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Trumello C, Candelori C, Cofini M, Cimino S, Cerniglia L, Paciello M, Babore A. Mothers' Depression, Anxiety, and Mental Representations After Preterm Birth: A Study During the Infant's Hospitalization in a Neonatal Intensive Care Unit. Front Public Health 2018; 6:359. [PMID: 30581812 PMCID: PMC6293875 DOI: 10.3389/fpubh.2018.00359] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 11/22/2018] [Indexed: 12/04/2022] Open
Abstract
Aim: This paper aimed to explore psychological functioning and mental representations in mothers of preterm infants during the child's hospitalization in a Neonatal intensive care unit (NICU). Methods: A sample including 62 mothers of premature infants (gestational age < 37 weeks) was recruited in a NICU. According to the gestational age at the time of delivery, we considered two groups: Group A included mothers whose children were born before 32 weeks of pregnancy; Group B included mothers whose children were born at or after 32 weeks of pregnancy. Within one week of childbirth, mothers were administered two self-report questionnaires: the Edinburgh Postnatal Depression Scale (EPDS) and the State-Trait Anxiety Inventory (STAI). When their infants' medical conditions became stable, the Clinical Interview for Parents of High-Risk Infants (CLIP) was administered to mothers. Results: The results showed high levels of depression and anxiety in both groups of mothers, with higher state anxiety scores in Group A than Group B. Besides, a series of hierarchical regression analyses were conducted with STAI, EPDS, and gestational age as predictors on the CLIP scores. Results indicated that EPDS scores predicted CLIP scores on parental self-image, support system, and readiness for discharge (p < 0.001); moreover, the interaction among depression, anxiety, and gestational age predicted the CLIP dimension of feeling of mutual recognition (p < 0.005). Conclusions: These findings suggested that a premature birth and the child's hospitalization might exert a negative effect on the mothers' emotional state, their perception of parental self-image and, consequently, the early bond with the child—independent from the infants' gestational age at the time of the preterm delivery. The data underlined the importance of involving NICU nurses and clinicians in order to optimize the care for mothers immediately after the preterm birth and during the infant's hospitalization, taking into account psychological needs of mothers of both very preterm and moderately preterm infants.
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Affiliation(s)
- Carmen Trumello
- Department of Psychological, Health and Territorial Sciences, Università degli studi G.D'Annunzio Chieti Pescara, Chieti, Italy
| | - Carla Candelori
- Department of Psychological, Health and Territorial Sciences, Università degli studi G.D'Annunzio Chieti Pescara, Chieti, Italy
| | - Marika Cofini
- Department of Psychological, Health and Territorial Sciences, Università degli studi G.D'Annunzio Chieti Pescara, Chieti, Italy
| | - Silvia Cimino
- Department of Dynamic and Clinical Psychology, Faculty of Psychology, Sapienza University of Rome, Rome, Italy
| | - Luca Cerniglia
- Università Telematica Internazionale Uninettuno, Rome, Italy
| | | | - Alessandra Babore
- Department of Psychological, Health and Territorial Sciences, Università degli studi G.D'Annunzio Chieti Pescara, Chieti, Italy
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97
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Mairesse J, Zinni M, Pansiot J, Hassan-Abdi R, Demene C, Colella M, Charriaut-Marlangue C, Rideau Batista Novais A, Tanter M, Maccari S, Gressens P, Vaiman D, Soussi-Yanicostas N, Baud O. Oxytocin receptor agonist reduces perinatal brain damage by targeting microglia. Glia 2018; 67:345-359. [PMID: 30506969 DOI: 10.1002/glia.23546] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 09/08/2018] [Accepted: 09/10/2018] [Indexed: 11/06/2022]
Abstract
Prematurity and fetal growth restriction (FGR) are frequent conditions associated with adverse neurocognitive outcomes. We have previously identified early deregulation of genes controlling neuroinflammation as a putative mechanism linking FGR and abnormal trajectory of the developing brain. While the oxytocin system was also found to be impaired following adverse perinatal events, its role in the modulation of neuroinflammation in the developing brain is still unknown. We used a double-hit rat model of perinatal brain injury induced by gestational low protein diet (LPD) and potentiated by postnatal injections of subliminal doses of interleukin-1β (IL1β) and a zebrafish model of neuroinflammation. Effects of the treatment with carbetocin, a selective, long lasting, and brain diffusible oxytocin receptor agonist, have been assessed using a combination of histological, molecular, and functional tools in vivo and in vitro. In the double-hit model, white matter inflammation, deficient myelination, and behavioral deficits have been observed and the oxytocin system was impaired. Early postnatal supplementation with carbetocin alleviated microglial activation at both transcriptional and cellular levels and provided long-term neuroprotection. The central anti-inflammatory effects of carbetocin have been shown in vivo in rat pups and in a zebrafish model of early-life neuroinflammation and reproduced in vitro on stimulated sorted primary microglial cell cultures from rats subjected to LPD. Carbetocin treatment was associated with beneficial effects on myelination, long-term intrinsic brain connectivity and behavior. Targeting oxytocin signaling in the developing brain may be an effective approach to prevent neuroinflammation - induced brain damage of perinatal origin.
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Affiliation(s)
- Jérôme Mairesse
- PROTECT, Inserm U1141, Université Paris Diderot, Paris, France.,Division of Neonatology and Pediatric Intensive Care, Children's University Hospital of Geneva, Geneva, Switzerland.,Laboratory of Child Growth and Development, University of Geneva, Geneva, Switzerland
| | - Manuela Zinni
- PROTECT, Inserm U1141, Université Paris Diderot, Paris, France
| | - Julien Pansiot
- PROTECT, Inserm U1141, Université Paris Diderot, Paris, France
| | | | - Charlie Demene
- Institut Langevin, CNRS UMR 7587, Inserm U979, ESPCI Paris, PSL Research University, Paris, France
| | - Marina Colella
- PROTECT, Inserm U1141, Université Paris Diderot, Paris, France
| | | | | | - Mickael Tanter
- Institut Langevin, CNRS UMR 7587, Inserm U979, ESPCI Paris, PSL Research University, Paris, France
| | - Stefania Maccari
- International Associated Laboratory (LIA) "Prenatal Stress and Neurodegenerative Diseases, University of Lille 1 - CNRS UMR8576 Lille, France and Sapienza University of Rome - IRCCS Neuromed, Rome, Italy
| | - Pierre Gressens
- PROTECT, Inserm U1141, Université Paris Diderot, Paris, France.,PremUP Foundation, Paris, France
| | - Daniel Vaiman
- PremUP Foundation, Paris, France.,Institut Cochin, Inserm U1016, UMR8104 CNRS, Paris, France
| | | | - Olivier Baud
- PROTECT, Inserm U1141, Université Paris Diderot, Paris, France.,Division of Neonatology and Pediatric Intensive Care, Children's University Hospital of Geneva, Geneva, Switzerland.,Laboratory of Child Growth and Development, University of Geneva, Geneva, Switzerland.,PremUP Foundation, Paris, France
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98
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Ong SL, Abdullah KL, Danaee M, Soh KL, Soh KG, Japar S. Stress and anxiety among mothers of premature infants in a Malaysian neonatal intensive care unit. J Reprod Infant Psychol 2018; 37:193-205. [PMID: 30480464 DOI: 10.1080/02646838.2018.1540861] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE This study aims to determine maternal stress and anxiety as perceived by mothers whose premature infants were admitted to the neonatal intensive care unit (NICU) and to identify maternal stress and its relationship with maternal and infant characteristics and anxiety. BACKGROUND Vulnerable premature infants commonly require special care in the NICUs. In most cases, prolonged hospitalization results in stress and anxiety for the mothers. METHODS A non-probability convenience survey was used in a public hospital, with 180 mothers completing the 26-item Perceived Stress Scale (PSS) and a 40-item State-Trait Anxiety Inventory (STAI). RESULTS 56.5% of mothers had high levels of stress, 85.5% of mothers had a high level of state-anxiety and 67.8% of mothers had a high level of trait-anxiety. The stress experienced by these mothers had a significant relationship with anxiety, and was found to be associated with state and trait anxiety levels, but not with maternal and infant characteristics. CONCLUSION Mothers in this setting revealed high levels of stress and anxiety during their premature infants' NICU admission. An immediate interventional programme focusing on relieving mothers' anxiety and stress is needed to prevent maternal stress and anxiety at an early stage.
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Affiliation(s)
- Swee Leong Ong
- a School of Nursing Science, Faculty of Medicine , Universiti Sultan Zainal Abidin , Terengganu , Malaysia
| | - Khatijah Lim Abdullah
- b Department of Nursing Science , University Malaya , Kuala Lumpur , Malaysia.,c Faculty of Nursing , Universitas Airlangga , Surabaya , East Java Indonesia
| | - Mahmoud Danaee
- d Academic Development Center (ADeC) , University Malaya , Kuala Lumpur , Malaysia
| | - Kim Lam Soh
- e Department of Nursing, Faculty of Medicine and Health Sciences , Universiti Putra Malaysia , Serdang , Malaysia
| | - Kim Geok Soh
- f Department of Sport Studies, Faculty of Education , Universiti Putra Malaysia , Serdang , Malaysia
| | - Salimah Japar
- e Department of Nursing, Faculty of Medicine and Health Sciences , Universiti Putra Malaysia , Serdang , Malaysia
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99
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Marthinsen GN, Helseth S, Fegran L. Sleep and its relationship to health in parents of preterm infants: a scoping review. BMC Pediatr 2018; 18:352. [PMID: 30419873 PMCID: PMC6231258 DOI: 10.1186/s12887-018-1320-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 10/24/2018] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND Sleep is essential for human health and functioning. Parents of preterm infants are susceptible to sleep disturbances because of stress related to the preterm birth. Poor sleep has the potential to affect parental health and well-being. The aim of this study was to identify and map evidence on sleep and its relationship to health in parents of preterm infants. No review has summarized the evidence on this topic. METHODS A scoping review was conducted. Seven health and medical electronic research databases were searched for relevant quantitative and qualitative primary studies, including grey literature. The search was performed March 2-7, 2017. RESULTS Ten American studies and one Australian study were included in the review. Most research was quantitative and focused on maternal sleep and mental health within the first two weeks after the childbirth. Both objective and subjective sleep measures were used to study sleep at the hospital; actigraphs were not used after discharge. Maternal sleep was poor early postpartum, and this was associated with negative health outcomes. Two cohort studies compared sleep in mothers of preterm and term infants, but the results were conflicting. In one qualitative study, fathers described their inability to catch up on sleep after homecoming with a preterm baby. CONCLUSIONS Quantitative studies reporting on maternal sleep early postpartum was most frequently occurring in the results. Qualitative research on the topic was identified as a knowledge gap. More cultural and geographical breadth, including research on fathers' sleep, is recommended in future research.
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Affiliation(s)
- Gunhild Nordbø Marthinsen
- Department of Health and Nursing Sciences, Faculty of Health and Sports Science, University of Agder, 4604 Kristiansand, Norway
| | - Sølvi Helseth
- Department of Health and Nursing Sciences, Faculty of Health and Sports Science, University of Agder, 4604 Kristiansand, Norway
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet- Oslo Metropolitan University, NO-0130 Oslo, Norway
| | - Liv Fegran
- Department of Health and Nursing Sciences, Faculty of Health and Sports Science, University of Agder, 4604 Kristiansand, Norway
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