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Shinohara S, Shinohara R, Kojima R, Otawa S, Kushima M, Miyake K, Yui H, Ooka T, Akiyama Y, Horiuchi S, Yokomichi H, Yamagata Z. Neonatal transfer and duration of hospitalization of newborns as potential risk factors for impaired mother-infant bonding: The Japan Environment and Children's Study. J Affect Disord 2024; 360:314-321. [PMID: 38838787 DOI: 10.1016/j.jad.2024.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 04/19/2024] [Accepted: 06/02/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND Currently, there is no consensus regarding the relationship between neonatal transfer and duration of hospitalization in cases of impaired mother-infant bonding (MIB). This study aimed to determine whether neonatal transfer and duration of hospitalization of newborns increase the risk for impaired MIB. METHODS The MIB Scale was used to assess impaired MIB 1 year after delivery, using data from the Japan Environment and Children's Study. A score ≥ 5 points indicated impaired MIB. Multiple logistic regression analyses were performed to estimate the association between neonatal transfer and duration of hospitalization of newborns with the risk of impaired MIB. RESULTS A total of 66,402 pregnant women were included in the study. The overall incidence rate of impaired MIB was 11.2 %. The mean duration of hospitalization of newborns was 7.1 ± 6.4 days. After adjusting for potential confounders, neonatal transfer (adjusted odd ratio (OR): 1.13 [95 % confidence interval (CI)), 1.01-1.27]) and duration of hospitalization of newborns (adjusted OR 1.007; 95 % CI 1.003-1.010) were associated with impaired MIB. The area under the receiver operating characteristic curve for the duration of hospitalization of newborns for impaired MIB was 0.53. LIMITATIONS Maternal childhood abuse and neglect history were not evaluated, and information regarding whether the infants were admitted to the neonatal intensive care unit was unavailable. CONCLUSIONS Japanese women whose newborns underwent neonatal transfer should be followed up for at least 1 year after delivery, regardless of the duration of hospitalization of newborns.
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Affiliation(s)
- Satoshi Shinohara
- Department of Obstetrics and Gynecology, Yamanashi Prefectural Central Hospital, 1-1-1 Fujimi, Kofu, Yamanashi 400-8506, Japan.
| | - Ryoji Shinohara
- Center for Birth Cohort Studies, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan
| | - Reiji Kojima
- Department of Health Sciences, School of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan
| | - Sanae Otawa
- Center for Birth Cohort Studies, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan
| | - Megumi Kushima
- Center for Birth Cohort Studies, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan
| | - Kunio Miyake
- Department of Epidemiology and Environmental Medicine, School of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan
| | - Hideki Yui
- Center for Birth Cohort Studies, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan
| | - Tadao Ooka
- Department of Health Sciences, School of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan
| | - Yuka Akiyama
- Department of Health Sciences, School of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan
| | - Sayaka Horiuchi
- Department of Epidemiology and Environmental Medicine, School of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan
| | - Hiroshi Yokomichi
- Department of Epidemiology and Environmental Medicine, School of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan
| | - Zentaro Yamagata
- Center for Birth Cohort Studies, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan; Department of Health Sciences, School of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan
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Müller HS, Becker-Peth M, Kuntz L. Webcam technology on neonatal wards-examining the objective and subjective workload of nurses: a combined observational and survey study. BMC Nurs 2024; 23:449. [PMID: 38956601 PMCID: PMC11218283 DOI: 10.1186/s12912-024-02107-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 06/18/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND This study was conducted to estimate the additional objective and perceived workload of nurses resulting from the use of webcams. The successful implementation of webcam technology into routine care requires an analysis to prevent adverse events of increased nursing workload. METHODS The study took place on three neonatal wards in two University Hospitals in Germany. In the first Hospital, the study was conducted from February to July 2021; in the second one it was conducted between June and November 2021. Data were collected using a combined approach of a standardised diary questionnaire study and passive observations. The participants were accompanied in their daily work and their activities were recorded 65 nurses participated. RESULTS 2,031 h were observed in 1,630 observation blocks. In 14.74% of the observation blocks webcam activities were detected. The extent to which the nurses had webcam-related additional workloads was rated as no additional workload in 82.16% of the daily questionnaires (n = 1,026). CONCLUSION The observed low workload due to the webcams is in line with the nurses' perception. The observational data revealed, on a number of different analysis levels, that a limited additional workload was generated. There was no decrease in activity performance observed and no clear indication for interruptions due to the webcam-related activities for the nurses. However, it is important to raise awareness about the individual workload levels for the successful implementation. Additional education programs can be provided for nurses. TRIAL REGISTRATION The Neo-CamCare study is registered at the German Clinical Trials Register. DRKS-ID DRKS00017755 .
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Affiliation(s)
- Helena Sophie Müller
- Department of Business Administration and Health Care Management, Faculty of Management, Economics and Social Sciences, University of Cologne, Cologne, Germany.
| | - Michael Becker-Peth
- Department of Technology and Operations Management, Rotterdam School of Management, Erasmus University, Rotterdam, The Netherlands
| | - Ludwig Kuntz
- Department of Business Administration and Health Care Management, Faculty of Management, Economics and Social Sciences, University of Cologne, Cologne, Germany
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Pavlyshyn Н, Sarapuk I, Saturska U. Maternal Stress Experience in the Neonatal Intensive Care Unit after Preterm Delivery. Am J Perinatol 2024; 41:1155-1162. [PMID: 36029767 DOI: 10.1055/s-0042-1747942] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE Preterm delivery with the admission of a child in the neonatal intensive care unit (NICU) is extremely challenging for parents. Being separated from the baby and seeing her infant feeling pain and being sick together with the complexity of the NICU environment, the mother experiences great anxiety, fear, and stress. The purpose of the study was to assess NICU-related stress and to identify maternal and infant factors associated with increased stress in mothers of preterm infants. STUDY DESIGN The maternal stress level was assessed in 122 mothers of preterm infants using the Parental Stressor Scale: NICU (PSS: NICU) in which items were distributed in three subscales as follows: Sights and Sounds of NICU-subscale 1 (S1), Infant Appearance and Behavior-S2, and Parental Role Alteration-S3. RESULTS Maternal total PSS: NICU score was 3.46 ± 0.71. Parenteral Role Alteration was the most stressful (4.20 ± 0.79) followed by Infant Appearance and Behavior (3.51 ± 0.91) and Sights and Sounds subscale (2.28 ± 0.95); p (S1-S2) < 0.001, p (S1-S3) < 0.001, and p (S2-S3) < 0.001. Total PSS: NICU and Infant Appearance and Behavior scores correlated positively with maternal age (r = 0.189; p = 0.040 and r = 0.204; p = 0.027, respectively) and duration of NICU treatment (r = 0.188; p = 0.044 and r = 0.190; p = 0.042). More visits in NICU by a mother were associated with a lower PSS: NICU score (p = 0.049) and neonatal seizures and invasive ventilation in infants were associated with higher stress scores (p = 0.007 and p = 0.042). CONCLUSION Mothers of preterm infants admitted in the NICU experience significant stress which is correlated with maternal age and NICU treatment duration and is associated with frequency of NICU visits, presence of neonatal seizures, and need for ventilator support. Parental role alteration is the greatest stressor followed by Infant Appearance and Behavior and NICU-surrounding stressor factors which show the need for interventions and counseling focused on mothers' role, their involvement in infant's care, and thus, family-centered care implementation. KEY POINTS · Mothers of preterm infants experience significant stress.. · Parental role alteration is the greatest maternal stressor.. · Maternal stress is correlated with age and NICU duration, and is associated with the frequency of NICU visits and infant's health status.
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Affiliation(s)
- Нalyna Pavlyshyn
- Department of Pediatrics No 2, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
| | - Iryna Sarapuk
- Department of Pediatrics No 2, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
| | - Uliana Saturska
- Department of Pediatrics No 2, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
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Hendy A, El-sayed S, Bakry S, Mohammed SM, Mohamed H, Abdelkawy A, Hassani R, Abouelela MA, Sayed S. The Stress Levels of Premature Infants' Parents and Related Factors in NICU. SAGE Open Nurs 2024; 10:23779608241231172. [PMID: 38384386 PMCID: PMC10880535 DOI: 10.1177/23779608241231172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 12/10/2023] [Accepted: 01/20/2024] [Indexed: 02/23/2024] Open
Abstract
Introduction Parental stress related to their infants' hospitalization is a significant concern that affects both parents and their infants. Fathers' experiences tend to be understudied compared to mothers. Further research on fathers' stress levels is necessary. While parental stress has been correlated with infant health severity, the specific causes and risk factors contributing to heightened stress levels in parents of neonatal intensive care unit (NICU) infants are not yet fully understood and require further investigation. Objective This study aimed to examine the stress levels experienced by parents of premature infants in the NICU and to explore the factors associated with parental stress in this specific context. Methods A cross-sectional observational design was used to accomplish this study, which was carried out on 743 parents from nine different NICUs located in governmental hospitals across various locations in Egypt. We used characteristics of parents and premature infants, and Parent Stress Scale was used for data collection. Results A majority of parents reported experiencing high stress in the following domains: sight and sound (80.3%), infants' appearance (69%), and the parent-infant relationship (81.4%). Additionally, about three-quarters (73.6%) of parents experienced high stress overall, with a mean score of 167.56 (21.3). Conclusion About three-quarters of the parents experienced high overall stress levels. Also, factors that were found to affect parents' stress levels included premature infants connected to mechanical ventilators, previous neonatal death, parents living far from hospitals, infants delivered through cesarean section, insufficient income, and prolonged hospitalization beyond 5 days.
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Affiliation(s)
- Abdelaziz Hendy
- Pediatric Nursing, Faculty of Nursing, Ain Shams University, Cairo, Egypt
| | - Salma El-sayed
- Pediatric Nursing, Faculty of Nursing, Ain Shams University, Cairo, Egypt
| | - Salma Bakry
- Psychiatric Mental Health Nursing, Ain Shams University, Cairo, Egypt
| | - Shimmaa M Mohammed
- Pediatric Nursing, Faculty of Nursing, Zagazig University, Zagazig, Egypt
- Department of Nursing, College of Applied Medical Sciences, University of Bisha, Bisha, Saudi Arabia
| | - Hossam Mohamed
- General Secretariat of Mental Health and Addiction Treatment, Cairo, Egypt
| | | | - Rym Hassani
- Department of Biology, University College Al-Darb, Jazan University, Jazan, Saudi Arabia
| | | | - Salwa Sayed
- Technical Health Institute, General Authority for Health Insurance, Benha, Egypt
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Ahn HY, Jo HJ, Ko HJ. Effects of a Noncontact Visit Program in the NICU for the Prevention of COVID-19. Healthcare (Basel) 2023; 11:2152. [PMID: 37570392 PMCID: PMC10419116 DOI: 10.3390/healthcare11152152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 07/13/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND With the spread of COVID-19, neonatal intensive care units restricted visiting hours to prevent infection. As a result, mothers of high-risk newborns were restricted from making contact with their children. Various problems could be encountered for hospitalized children and mothers of high-risk newborns due to restrictions on visits in the neonatal intensive care unit. Therefore, during the pandemic, continuous nursing support for mothers of high-risk newborns was needed. METHODS In this study, a nonequivalent control group non-synchronized design was employed. The subjects of the study were 36 mothers of high-risk neonates (20 in the experimental group and 16 in the control group) in E University Hospital, D Metropolitan City, from July to September 2022. The experimental group received a 10 min program performed by a nurse from 7:00 p.m. to 9:00 p.m. three times per week. RESULTS There were significant differences in nurses' support between the experimental and control groups (F = 25.594, p < 0.001), changes over time (F = 16.178, p < 0.001), and time-group interactions (F = 9.663, p = 0.003). CONCLUSIONS It was interpreted that the real-time noncontact visitation program could transcend time and space for many mothers of high-risk newborn babies, who suffered psychologically due to restrictions and bans on visitations during the COVID-19 pandemic.
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Affiliation(s)
- Hye Young Ahn
- College of Nursing, Eulji University, Uijeongbu 11759, Republic of Korea
| | | | - Hyun Jeong Ko
- College of Nursing, Eulji University, Uijeongbu 11759, Republic of Korea
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Younge T, Jacobs M, Tuchman L, Streisand R, Soghier L, Fratantoni K. Sociodemographic risk factors, parental stress and social support in the neonatal intensive care unit. Arch Dis Child Fetal Neonatal Ed 2023; 108:165-169. [PMID: 36805477 DOI: 10.1136/archdischild-2022-324119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 08/15/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Investigate relationships among neonatal intensive care unit (NICU) parent demographics, reported stress and social support. DESIGN Cross-sectional observation. SETTING Tertiary referral NICU in Mid-Atlantic USA. PATIENTS Parents (n=300) in the Giving Parents Support trial at enrolment. MEASURES Psychometric scales measured general stress, parental stress, NICU stress and social support. Demographic variables included education level, health insurance type, race, relationship status, age and gender. Length of stay was used to control for illness severity. Associations and potential modifying effects were evaluated using linear regression. RESULTS Having less than a college degree (b=-2.52, SE=0.91) and female parent gender (b=-3.42, SE=1.47) were associated with lower parental stress scores. Older age in years was associated with higher parental stress scores (b=0.21, SE=0.07) but lower NICU stress scores (b=-0.01, SE=0.01). Greater social support scores were associated with lower scores of general (b=-2.76, SE=0.39) and parental stress (b=-1.71, SE=0.47). Less than a college degree (b=-0.26, SE=0.11), Medicaid insurance (b=-0.43, SE=0.11) and black race (b=-0.56, SE=0.12) were associated with decreased social support scores. Level of social support modified the relationship between education and parental stress, with higher social support decreasing education-based differences in parental stress scores (p=0.049). CONCLUSION Sociodemographic risk factors may not infer stress or risk in the anticipated direction. Practice and future research should focus on identifying and supporting NICU families at high risk for stress and low support. TRIAL REGISTRATION NUMBER NCT02643472.
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Affiliation(s)
- Tamiko Younge
- Division of Neonatology, Children's National Hospital, Washington, DC, USA
| | - Marni Jacobs
- Division of Biostatistics and Study Methodology, Children's National Hospital, Washington, DC, USA.,Department of OBGYN & Reproductive Sciences, UCSD, La Jolla, California, USA
| | - Lisa Tuchman
- Division of Adolescent and Young Adult Medicine, Children's National Hospital, Washington, DC, USA
| | - Randi Streisand
- Division of Psychology and Behavioral Health, Children's National Hospital, Washington, DC, USA
| | - Lamia Soghier
- Division of Neonatology, Children's National Hospital, Washington, DC, USA
| | - Karen Fratantoni
- Division of General and Community Pediatrics, Children's National Hospital, Washington, DC, USA
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Kubicka Z, Fiascone J, Williams D, Zahr E, Ditzel A, Perry D, Rousseau T, Lacy M, Arzuaga B. Implementing modified family integrated care in a U.S. neonatal intensive care unit: nursing perspectives and effects on parents. J Perinatol 2023; 43:503-509. [PMID: 36627393 PMCID: PMC9838294 DOI: 10.1038/s41372-023-01601-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 12/20/2022] [Accepted: 01/04/2023] [Indexed: 01/11/2023]
Abstract
OBJECTIVES (1) Assess effects of a modified Family Integrated Care (FICare) model on U.S. Neonatal Intensive Care Unit (NICU) parents; (2) Evaluate NICU nurses' perspectives. DESIGN Case -control design with parental stress assessed before and after NICU-wide FICare implementation using Parent Stressor Scale: NICU (PSS:NICU) questionnaire. In addition, stratification by degree of participation evaluated associations with parental stress, parental-staff communication and discharge readiness. Questionnaires captured nursing perspectives on FICare. RESULTS 79 parents (88%) participated prior to FICare; 90 (90%) after. Parent stress was lower (p < 0.001) with FICare. Parents learning 5-15 infant-care skills had lower stress compared to those learning <5 (p = 0.008). Parent utilization of an educational app was associated with improved communication frequency (p = 0.007) and quality (p = 0.012). Bedside NICU nurses reported multiple positive associations of FICare for parents and staff. CONCLUSIONS Any degree of FICare participation decreases parental stress; increased participation has multiple positive associations.
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Affiliation(s)
- Zuzanna Kubicka
- Department of Pediatrics, South Shore Hospital, Weymouth, MA, USA. .,Division of Newborn Medicine, Boston Children's Hospital, Boston, MA, USA. .,Harvard Medical School, Boston, MA, USA.
| | - John Fiascone
- grid.430496.c0000 0004 0382 3942Department of Pediatrics, South Shore Hospital, Weymouth, MA USA ,grid.2515.30000 0004 0378 8438Division of Newborn Medicine, Boston Children’s Hospital, Boston, MA USA
| | - David Williams
- grid.38142.3c000000041936754XHarvard Medical School, Boston, MA USA ,grid.2515.30000 0004 0378 8438Institutional Centers for Clinical and Translational Studies, Boston Children’s Hospital, Boston, MA USA
| | - Eyad Zahr
- grid.430496.c0000 0004 0382 3942Department of Pediatrics, South Shore Hospital, Weymouth, MA USA ,grid.2515.30000 0004 0378 8438Division of Newborn Medicine, Boston Children’s Hospital, Boston, MA USA
| | - Amy Ditzel
- grid.430496.c0000 0004 0382 3942Department of Pediatrics, South Shore Hospital, Weymouth, MA USA ,grid.2515.30000 0004 0378 8438Division of Newborn Medicine, Boston Children’s Hospital, Boston, MA USA
| | - Diana Perry
- grid.430496.c0000 0004 0382 3942Department of Pediatrics, South Shore Hospital, Weymouth, MA USA ,grid.2515.30000 0004 0378 8438Division of Newborn Medicine, Boston Children’s Hospital, Boston, MA USA
| | - Tamara Rousseau
- grid.430496.c0000 0004 0382 3942Department of Pediatrics, South Shore Hospital, Weymouth, MA USA ,grid.2515.30000 0004 0378 8438Division of Newborn Medicine, Boston Children’s Hospital, Boston, MA USA
| | - Molly Lacy
- grid.430496.c0000 0004 0382 3942Department of Pediatrics, South Shore Hospital, Weymouth, MA USA ,grid.2515.30000 0004 0378 8438Division of Newborn Medicine, Boston Children’s Hospital, Boston, MA USA
| | - Bonnie Arzuaga
- grid.430496.c0000 0004 0382 3942Department of Pediatrics, South Shore Hospital, Weymouth, MA USA ,grid.2515.30000 0004 0378 8438Division of Newborn Medicine, Boston Children’s Hospital, Boston, MA USA
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Peters NJ, Kaur K, Dogra S, Kaur R, Malik MA, Solanki S, Bawa M, Menon P, Kanojia RP, Mahajan JK, Samujh R. Factors affecting stress levels in parents of surgical neonates: A prospective observational study. J Pediatr Surg 2022; 57:870-875. [PMID: 35970675 DOI: 10.1016/j.jpedsurg.2022.07.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 05/19/2022] [Accepted: 07/11/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND There is a paucity of research focusing on the stress levels in parents of newborns undergoing surgery. Resource challenged systems have to deal with overcrowding, a shortage of workforce along with demographic and socioeconomic issues like delayed presentations and out of pocket expenses. The primary objective of this study was to understand the factors associated with stress in the parents of these congenitally malformed neonates. METHODOLOGY This was a prospective cohort study, which was conducted in a neonatal surgical ICU of a tertiary care teaching hospital. Factors affecting stress levels in parents of surgical neonates were studied in 100 participants. A multi-dimensional questionnaire - The PSS: NICU score was utilized in the study. The parents were interviewed on Day 3-5 after surgery. RESULT 59% of the respondents were fathers. The majority of the parents were in the age bracket of 24 to 35 years. The mean scores for the subscales sights and sounds, looks and behavior and alteration in the parental role were 3.24±0.8, 3.52±0.63, 3.55±0.8 and 2.8 ± 0.9 respectively. The highest level of stress was found in the domains of alteration of parental role and infant appearance and behavior. Comparisons showed significantly higher maternal scores in all the domains. Overall stress scores were highest for abdominal wall defects. CONCLUSION Parents of neonates undergoing surgery suffer from significant stress levels and appropriate counseling targeted towards specific stressors is required to allay this important parental issue.
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Affiliation(s)
- Nitin James Peters
- Department of Pediatric Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India, 160012
| | - Karanbir Kaur
- RN, Neonatal Surgical Unit, Department of Pediatric Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India, 160012
| | - Shivani Dogra
- Department of Pediatric Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India, 160012.
| | - Rajinder Kaur
- RN, Neonatal Surgical Unit, Department of Pediatric Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India, 160012
| | - Muneer A Malik
- Department of Pediatric Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India, 160012
| | - Shailesh Solanki
- Department of Pediatric Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India, 160012
| | - Monika Bawa
- Department of Pediatric Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India, 160012
| | - Prema Menon
- Department of Pediatric Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India, 160012
| | - Ravi P Kanojia
- Department of Pediatric Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India, 160012
| | - J K Mahajan
- Department of Pediatric Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India, 160012
| | - Ram Samujh
- Department of Pediatric Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India, 160012
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Debelić I, Mikolčić A, Tihomirović J, Barić I, Lendić Đ, Nikšić Ž, Šencaj B, Lovrić R. Stressful Experiences of Parents in the Paediatric Intensive Care Unit: Searching for the Most Intensive PICU Stressors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11450. [PMID: 36141723 PMCID: PMC9517134 DOI: 10.3390/ijerph191811450] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/08/2022] [Accepted: 09/09/2022] [Indexed: 06/16/2023]
Abstract
Hospitalization of a child in the paediatric intensive care unit (PICU) is extremely stressful, both for the child and for his or her family. The purpose of this study was to gain deeper insight into the stressful experiences of parents of children hospitalized in the PICU. This study included 96 parents. The data were collected using a translated and standardized scale "The Parental Stressor Scale: Paediatric Intensive Care Unit (PSS: PICU)". This study confirms high exposure of parents to numerous PICU stressors. The most intense PICU stressor for parents was child's breathing depending on the ventilator (4.22 ± 1.17), and the least intense was child's demanding behaviour (1.17 ± 0.33). A significant positive correlation between the level of parents' perceived stress and the number of their children was recorded (r = 0.240, p = 0.02), while there was no significant correlation between the level of stress and other sociodemographic variables. A significantly higher level of stress was experienced by parents with primary school education (p = 0.032) and parents who are not healthcare professionals (p < 0.01). It is necessary to establish a system that will enable continuous assessment of parents' stress levels and timely prevention of stressful experiences for parents in the PICU.
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Affiliation(s)
- Ivana Debelić
- School of Nursing, Medicinska Škola Osijek, 31000 Osijek, Croatia
- Nursing Institute “Professor Radivoje Radić”, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Anamaria Mikolčić
- Nursing Institute “Professor Radivoje Radić”, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Jovana Tihomirović
- Nursing Institute “Professor Radivoje Radić”, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Iva Barić
- Nursing Institute “Professor Radivoje Radić”, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Specialist Practice of Occupational and Sports Medicine, Ilija Celebic, 31000 Osijek, Croatia
| | - Đurđica Lendić
- Nursing Institute “Professor Radivoje Radić”, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Paediatric Clinic, University Hospital Centre Osijek, 31000 Osijek, Croatia
| | - Željka Nikšić
- Nursing Institute “Professor Radivoje Radić”, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Paediatric Clinic, University Hospital Centre Osijek, 31000 Osijek, Croatia
| | - Barbara Šencaj
- Nursing Institute “Professor Radivoje Radić”, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Department of School Medicine, Teaching Institute of Public Health for the Osijek-Baranya County, 31000 Osijek, Croatia
| | - Robert Lovrić
- Nursing Institute “Professor Radivoje Radić”, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
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Mindfulness and Relaxation-Based Interventions to Reduce Parental Stress, Anxiety and/or Depressive Symptoms in the Neonatal Intensive Care Unit: A Systematic Review. J Clin Psychol Med Settings 2022:10.1007/s10880-022-09902-8. [PMID: 35984549 PMCID: PMC9388971 DOI: 10.1007/s10880-022-09902-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2022] [Indexed: 11/10/2022]
Abstract
Parents with infants in the neonatal intensive care unit (NICU) experience high levels of stress, anxiety, and depression. Mindfulness and relaxation-based interventions are effective in reducing distress in the general postpartum population. The aim of this systematic review was to evaluate whether mindfulness and/or relaxation-based interventions reduce stress, anxiety, and depression in NICU parents. A total of five studies met the inclusion criteria and were assessed for quality using the Downs & Black Checklist. The most consistent results in this review suggest that mindfulness and/or relaxation-based interventions may be effective at reducing anxiety symptoms in NICU parents, with moderate to large effect sizes, and show promise in reducing depressive symptoms. The findings show limited potential benefits on parental stress. Methodological weaknesses, heterogeneous intervention factors (including format and length), and varying participant adherence hinder the ability to make strong conclusions. Directions for future research are discussed.
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11
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Broom M, Cochrane T, Cruickshank D, Carlisle H. Parental perceptions on the impact of visiting restrictions during COVID-19 in a tertiary neonatal intensive care unit. J Paediatr Child Health 2022; 58:1747-1752. [PMID: 35775959 PMCID: PMC9350120 DOI: 10.1111/jpc.16079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 02/14/2022] [Accepted: 06/06/2022] [Indexed: 11/30/2022]
Abstract
AIM During the first wave of coronavirus disease 2019 (COVID-19), visiting guidelines in neonatal units changed to maintain the health and safety of staff, neonates, and families. In the neonatal intensive care unit/special care nursery (NICU/SCN), restrictions were placed on parental contact and extended family excluded. Our team was interested in evaluating the effect of these restrictions on parental stress and discharge confidence. METHODS A prospective descriptive study utilising survey methodology was undertaken. The survey was developed and previously used by the NICU research group to evaluate parental knowledge and understanding, parental role, communication, and parental stress (admission/discharge). We have also included a section regarding COVID19 visiting restrictions (ETH.2020.LRE.00124). The survey used a five-level Likert scale. Statistical analysis was completed using SPSS version 21. RESULTS Notably, 33 surveys were returned. Results showed visiting restrictions reduced social contact between partners 26/33 (84%), with their other children 14/16 (87.5%) and extended family 28/33 (84.8%). Parents indicated that they had high levels of confidence in understanding their babies' medical needs (78-93%) and gaining hands-on experience caring for their baby (87-100%). However, 11/33 (33%) of parents reported concerns with discharge processes and gaining consistent information as challenges during their baby's admission. Notably, 17/33 (51.5) stated their NICU/SCN experience had been very to extremely stressful. Parents openly described how the restrictions had affected their mental/emotional health identifying the need to treat parents as one unit, and a gap in the psychological support available for families. CONCLUSION Support services and consistency of communication with NICU/SCN families need to be enhanced and prioritised during periods of restrictions, especially peri-discharge.
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Affiliation(s)
- Margaret Broom
- Centenary Hospital for Women and ChildrenCanberra HospitalCanberraAustralian Capital TerritoryAustralia,SYNERGY: Nursing and Midwifery Research CentreUniversity of Canberra and ACT HealthCanberraAustralian Capital TerritoryAustralia
| | - Tim Cochrane
- Centenary Hospital for Women and ChildrenCanberra HospitalCanberraAustralian Capital TerritoryAustralia,College of Health and MedicineAustralian National University Medical SchoolCanberraAustralian Capital TerritoryAustralia
| | - Debbora Cruickshank
- Centenary Hospital for Women and ChildrenCanberra HospitalCanberraAustralian Capital TerritoryAustralia
| | - Hazel Carlisle
- Centenary Hospital for Women and ChildrenCanberra HospitalCanberraAustralian Capital TerritoryAustralia,College of Health and MedicineAustralian National University Medical SchoolCanberraAustralian Capital TerritoryAustralia
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Perceptions of Parent Stressors in the Neonatal Intensive Care Unit Among the General Public and Healthcare Professionals. J Perinat Neonatal Nurs 2022; 36:186-197. [PMID: 35476773 DOI: 10.1097/jpn.0000000000000643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Intervention efforts to improve the psychosocial well-being of parents with an infant in the neonatal intensive care unit (NICU) are high priority. This study assessed public and healthcare professionals' perceptions of prominent NICU stressors to highlight areas where NICU parents are in need of further support. Relations with sample characteristics were also examined to establish the generalizability of known parent demographic/sociofamilial risk factors. METHODS A cross-sectional design was used to assess public (n = 96) and staff (n = 55) responses on the Parental Stressor Scale: Neonatal Intensive Care Unit (PSS:NICU). RESULTS The public perceived parental stress as being low to moderate. This was significantly lower than the staff estimate and highly comparable with past parent reports. Staff communication was perceived as most stressful by the public with this influenced by gender and education. Staff with more NICU experience were more likely to overestimate parental stress, particularly those working at the highest care level. CONCLUSIONS Collectively, these findings highlight preconceived anxiety around staff communication and behaviors and indicate that education on the potential for traumatic unit experiences to influence staff-parent communication may be important.
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Mother-Infant Dyadic Synchrony in the NICU Context. Adv Neonatal Care 2022; 22:170-179. [PMID: 35703926 DOI: 10.1097/anc.0000000000000855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Dyadic synchrony is a co-constructed social process relating to the back and forth interactions between mothers and infants that are strongly associated with neurodevelopment, self-regulation, and attachment. In the neonatal intensive care unit (NICU), this process may become interrupted because of the physiological state of the infant, the emotional state of the mother, and the physical environment of the NICU. PURPOSE In applying Feldman's Biobehavioral Model of Synchrony, this empirical review deconstructs the process of dyadic synchrony in the NICU context and provides a conceptual approach to guide both research and clinical practice. METHODS First, we examine the theoretical and empirical literature to explicate the primary structural and biophysiological components of synchrony and relate these constructs to the extant research on premature infants. Next, we synthesize the maternal, infant, and contextual factors that facilitate or inhibit the ontogenesis of dyadic synchrony in the NICU. The final section highlights the state of the science in dyadic synchrony in the NICU including gaps and recommendations for future research. FINDINGS An empirical review synthesis presents a visual conceptual framework to illustrate multiple processes that depict maternal, infant, and contextual influences of mother-infant synchrony in the NICU. IMPLICATIONS FOR PRACTICE/RESEARCH Despite the challenges posed to mother-infant relationships in the NICU, high-quality mother-infant interactions are possible, dyadic synchrony can emerge, and premature infants can develop secure attachments. Clinicians and researchers can apply this conceptual framework of mother-infant dyadic synchrony in the NICU to promote evidence-based research and clinical practice.
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Schmöker A, Ericson J, Flacking R, Udo C. Needs and Perceptions Relative to Emotional Support in Parents With Preterm Infants. J Perinat Neonatal Nurs 2021; Publish Ahead of Print:00005237-900000000-99937. [PMID: 34643604 DOI: 10.1097/jpn.0000000000000604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Objectives of this study were to explore parents' needs for emotional support and how such support could be best delivered during admittance to a neonatal unit. This study took place at 6 neonatal units in Sweden. Forty-two semistructured interviews were analyzed using qualitative content analysis: 26 individual telephone interviews with mothers of preterm infants 6 to 10 months after discharge and 16 face-to-face interviews with parents of preterm infants admitted to neonatal units. The main category to emerge was needs and preferences for emotional support , which consisted of 2 generic categories: emotional needs and preferences for potential support interventions . Emotional needs define the importance of comprehending the new situation, finding meaning, and managing the situation through resources. Preferences for potential support interventions identify possible ways to deliver emotional support in the form of parental group, diary writing, professional counseling, and Internet support. The results highlight the importance of supporting parents' sense of coherence in their situation and parenthood by offering different interventions according to parent preferences. Parental groups could serve as a keystone for emotional support with the possibility to combine with other support mechanisms.
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Affiliation(s)
- Annika Schmöker
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden (Ms Schmöker); School of Education, Health and Social Studies, Dalarna University, Falun, Sweden (Ms Schmöker, and Drs Ericson, Flacking, and Udo); Center for Clinical Research Dalarna, Uppsala University, Sweden (Drs Ericson and Udo); Department of Paediatrics, County of Dalarna, Falun, Sweden (Dr Ericson); and Department of Health Care Sciences, Palliative Research Centre, Ersta Sköndal University College, Stockholm, Sweden (Dr Udo)
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15
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Use of an internet camera system in the neonatal intensive care unit: parental and nursing perspectives and its effects on stress. J Perinatol 2021; 41:2048-2056. [PMID: 33510415 PMCID: PMC7841755 DOI: 10.1038/s41372-021-00934-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 11/11/2020] [Accepted: 01/15/2021] [Indexed: 01/31/2023]
Abstract
OBJECTIVE The objective of this study is to evaluate associations between webcam use in the neonatal intensive care unit (NICU) with parental stress and nursing work-related stress and burnout. DESIGN Prospective validated and de novo questionnaires administered to NICU parents and nurses during two observation periods: (1) no webcam access (off webcam) and (2) webcam access (on webcam). RESULTS Seventy-nine "off webcam" parents, 80 "on webcam" parents, and 35 nurses were included. Parental stress levels were significantly lower "on webcam" and perceptions of the technology were overwhelmingly positive. There were no significant differences in nursing stress levels and burnout between periods. Only 14% of nurses believed that webcam use improves infant's quality of care. Majority nurses felt that webcams increase parental and nursing stress. CONCLUSIONS Webcam use in the NICU is associated with lower parental stress levels and has no effect on nursing stress levels or work-related burnout. These findings contradict nurses' beliefs that webcams increase parent and nurse stress.
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Mira A, Bastías R. Maternidad, migración y prematuridad: experiencias en una unidad de neonatología. CADERNOS BRASILEIROS DE TERAPIA OCUPACIONAL 2021. [DOI: 10.1590/2526-8910.ctoao2232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumen Los procesos migratorios son un fenómeno global que puede resultar en condiciones de vida más vulnerables. Dadas estas condiciones es que se hace relevante brindar los apoyos necesarios para las familias en situación de migración, donde algunos momentos críticos para esto serán el embarazo, el parto y la crianza. Es así como las mujeres migrantes viven su maternidad en un contexto cultural distinto y que dadas las condiciones de vida desfavorables pueden enfrentar dificultades en el embarazo, tales como el parto prematuro, lo que podría representar una experiencia traumática y estresante. Existen pocos estudios que aborden estas temáticas en Latinoamérica y es por esto que el objetivo de este estudio es describir las vivencias de madres migrantes con un hijo o hija de pretérmino hospitalizado/a en una unidad de neonatología. Se utilizó una metodología cualitativa con un enfoque fenomenológico. Se realizaron entrevistas en profundidad a 16 madres y de éstas emergieron temáticas relevantes tales como las diferencias culturales sobre la maternidad y crianza, las condiciones de vida, sus experiencias en el parto, y finalmente lo que significa ser madre es en un país diferente al suyo. Estos hallazgos permiten tener un mejor entendimiento sobre este fenómeno y podría facilitar el desarrollo de estrategias que favorecerían una maternidad respetuosa y multicultural en las unidades de neonatología.
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Aldridge CE, Osiovich H, Hal Siden H, Elliott AM. Rapid genome-wide sequencing in a neonatal intensive care unit: A retrospective qualitative exploration of parental experiences. J Genet Couns 2020; 30:616-629. [PMID: 33131147 DOI: 10.1002/jgc4.1353] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 09/26/2020] [Accepted: 10/01/2020] [Indexed: 12/11/2022]
Abstract
Genome-wide sequencing (GWS) is increasingly being used in neonatal intensive care units. While studies have explored its clinical utility, little is known about parental experiences with this testing post-return of results. We conducted a qualitative study, using an interpretive description framework and thematic analysis, to gain further insight into parents' perceptions of the value and utility of GWS for their infant. We sought to explore whether parents' perceptions differ if their child received a diagnosis or not, and whether their child is living or deceased. Semi-structured, telephone interviews were conducted with parents of infants who had rapid exome sequencing while in the neonatal intensive care unit at BC Women's Hospital in Vancouver, Canada. Interviews addressed perceived benefits and harms of GWS and included an evaluation of decisional regret. Parents of 27 probands were approached and 14 (52%; 13 mothers and 1 father) participated in interviews. On average, 26 months had elapsed from the time of results to the interview. Six themes were identified. Firstly, parents had a positive regard for GWS. The results of GWS helped provide context for their child's admission to the NICU, and all parents experienced relief following receiving the results. A diagnosis by GWS enabled parents to picture the future, form connections with other parents, and coordinate their child's care. Lastly, some parents experienced discomfort with the concept of a genetic diagnosis, and interestingly felt lack of a genomic diagnosis indicated a reduced severity of their infant's condition. Decisional regret post-results was found to be low. Our results highlight how parents cope with the results of GWS and suggest that a genetic counselor can have an important role in helping families understand and adjust to these results in the neonatal intensive care unit.
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Affiliation(s)
- Caitlin E Aldridge
- Department of Medical Genetics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Horacio Osiovich
- Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.,BC Children's Hospital Research Institute, Vancouver, BC, Canada.,Women's Health Research Institute, Vancouver, BC, Canada
| | - Harold Hal Siden
- Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.,BC Children's Hospital Research Institute, Vancouver, BC, Canada
| | | | | | - Alison M Elliott
- Department of Medical Genetics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.,BC Children's Hospital Research Institute, Vancouver, BC, Canada.,Women's Health Research Institute, Vancouver, BC, Canada
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18
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Schmöker A, Flacking R, Udo C, Eriksson M, Hellström‐Westas L, Ericson J. Longitudinal cohort study reveals different patterns of stress in parents of preterm infants during the first year after birth. Acta Paediatr 2020; 109:1778-1786. [PMID: 31977110 DOI: 10.1111/apa.15185] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 01/17/2020] [Accepted: 01/20/2020] [Indexed: 01/22/2023]
Abstract
AIM To compare experiences of stress in mothers and fathers of preterm infants during the first year of life, assess changes in parental stress and explore potential predictors of parental stress. METHODS Between 2013 and 2015, data on parental stress were collected at 8 weeks after discharge and at 6 and 12 months postpartum from 493 mothers and 329 fathers of 547 preterm infants in Sweden. The Swedish Parenting Stress Questionnaire was used as a secondary outcome in a randomised clinical trial of breastfeeding support. RESULTS At the three time points, mothers perceived more role restriction and fathers more social isolation (P < .001). Stress decreased in mothers during the first year (P = .018), whereas stress increased in fathers between 6 and 12 months (P = .048). Mothers of very preterm infants (P = .024), parents of twins (P = .038) and parents with lower perceived general health (P = .003) reported higher levels of stress during the first year after birth. CONCLUSION This study identified several factors that influenced parental stress. Mothers and fathers showed different patterns of stress levels during the first year after birth. This finding indicates different needs for mothers and fathers regarding the time at which parental support after discharge might be most beneficial.
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Affiliation(s)
- Annika Schmöker
- Department of Women's and Children's Health Uppsala University Uppsala Sweden
- School of Education, Health and Social Studies Dalarna University Falun Sweden
| | - Renée Flacking
- School of Education, Health and Social Studies Dalarna University Falun Sweden
| | - Camilla Udo
- School of Education, Health and Social Studies Dalarna University Falun Sweden
- Center for Clinical Research Dalarna Falun Sweden
- The Department of Health Care Sciences Ersta Sköndal University College Stockholm Sweden
| | - Mats Eriksson
- Faculty of Medicine and Health School of Health Sciences Örebro University Örebro Sweden
| | | | - Jenny Ericson
- School of Education, Health and Social Studies Dalarna University Falun Sweden
- Center for Clinical Research Dalarna Falun Sweden
- Department of Paediatrics County of Dalarna Falun Sweden
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Early for Everyone: Reconceptualizing Palliative Care in the Neonatal Intensive Care Unit. Adv Neonatal Care 2020; 20:109-117. [PMID: 31990696 DOI: 10.1097/anc.0000000000000707] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Palliative care (PC) in the neonatal intensive care unit (NICU) is often provided exclusively to infants expected to die. Standards of care support providing PC early after diagnosis with any condition likely to impact quality of life. PURPOSE To determine the state of early PC practice across populations to derive elements of early PC applicable to neonates and their families and demonstrate their application in practice. SEARCH STRATEGY Multiple literature searches were conducted from 2016 to 2019. Common keywords used were: palliative care; early PC; end of life, neonate; NICU; perinatal PC; pediatric PC; family-centered care; advanced care planning; palliative care consultant; and shared decision-making. FINDINGS Early PC is an emerging practice in adult, pediatric, and perinatal populations that has been shown to be helpful for and recommended by families. Three key elements of early PC in the NICU are shared decision-making, care planning, and coping with distress. A hypothetical case of a 24-week infant is presented to illustrate how findings may be applied. Evidence supports expansion of neonatal PC to include infants and families without terminal diagnoses and initiation earlier in care. IMPLICATIONS FOR PRACTICE Involving parents more fully in care planning activities and decision-making and providing structured support for them to cope with distress despite their child's prognosis are essential to early PC. IMPLICATIONS FOR RESEARCH As early PC is incorporated into practice, strategies should be evaluated for feasibility and efficacy to improve parental and neonatal outcomes. Researchers should consider engaging NICU parent stakeholders in leading early PC program development and research.
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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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Tosca CF, Rimolo ML, Breigeiron MK. Support offered to newborns’ parents by the nursing team. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2020. [DOI: 10.1590/1806-93042020000100004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Abstract Objectives: to know the perception of parents of newborns regarding the support received from the nursing team during their child’s hospitalization. Methods: prospective study. Sample of 127 mothers and fathers of newborns hospitalized for at least 72 hours in neonatal units of a hospital in the southern region of Brazil. Data collected from May to September 2018 through application of a proposed questionnaire and consultation of medical records. Descriptive and analytical statistics were used. Results: participants were aged 28.2 (SD = 6.8) years, mostly composed of mothers (76.4%), primiparous (51.2%). Full support was declared by 66.0% of participants in the appreciative domain and 65.5% in the instrumental, 51.7% in the informational and 46.2% in the emotional domains. Mothers declared they felt supported mainly in the instrumental (p=0.009) and informational (p=0.039) domains. There was a positive correlation between the emotional, appreciative and informational domains (p<0.001). Conclusion: for most participants, in the informational domain, there was a demand for knowledge provided by the team, inclusion in decisions and encouragement to ask questions; in the emotional, there was concern for wellbeing and attention to anguish. Greater support for parents in the informational and emotional domains must be reinforced with the use of training strategies for the nursing team.
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Evaluation of Mother's Stress during Hospitalization Can Influence the Breastfeeding Rate. Experience in Intensive and Non Intensive Departments. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041298. [PMID: 32085465 PMCID: PMC7068435 DOI: 10.3390/ijerph17041298] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 12/25/2019] [Accepted: 01/23/2020] [Indexed: 11/16/2022]
Abstract
A mother’s milk offers several benefits to infant’s health, but, some factors may lead to a reduction in the duration of breastfeeding, such as maternal stress. The objective of our study is to determine if the rate of breastfeeding can be influenced by stress induced by infants’ hospitalization. A preliminary observational non-randomized study was carried out in Bambino Gesù Children’s Hospital between October 2016 and January 2017, in order to elucidate a possible relationship between breastfeeding and maternal stress, linked to hospitalization. We modeled the modified version of the PSS NICU (Parental Stressor Scale—neonatal intensive care unit) questionnaire, which investigated parental stress during hospitalization. This included 33 items with a score from 0 to 5. The overall score, high stress, was established at 85 points or higher. The principal statistically significant correlation was between ‘high PSS score’ and reduced breastfeeding during hospitalization (p-value: 0.048; OR: 2.865, 95%; CI: 1.008–8.146). This relation was not influenced by other descriptive characteristics of the mother. The PSS questionnaire can be an instrument to evaluate the influence of stress in breastfeeding and to monitor the rate and success of lactation. Our study highlights that the stress from hospitalization could influence the success of breastfeeding, mostly in intensive settings and during long hospitalizations.
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Fróes GF, Mendes ENW, Pedroza GDA, Cunha MLCD. Stress experienced by mothers of preterm newborns in a neonatal intensive care unit. ACTA ACUST UNITED AC 2019; 41:e20190145. [PMID: 31800799 DOI: 10.1590/1983-1447.2020.20190145] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 08/15/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To evaluate the stress level of mothers of preterm infants with gestational age ≤34 weeks, hospitalized in neonatal intensive care. METHOD A cross-sectional study with 74 mothers of premature infants in neonatal intensive care, who answered the "Parental Stress Scale: Neonatal Intensive Care Unit" instrument, validated in Brazil. RESULTS The mean stress level was 4.41 (± 0.77) and the general stress level was 4.36 (± 0.76), with a significant difference (p <0.001) between the subscale "Alteration in parental roles" and other subscales, meaning that mothers were in a very stressful situation. CONCLUSION All items in the subscale "Alteration in parental roles" of the "Parental Stress Scale: Neonatal Intensive Care Unit" were identified as the main source of stress experienced by mothers. This study suggests carrying out further studies with other methodologies to increase the knowledge of maternal stress in the national context, applying care interventions involving the parents.
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Affiliation(s)
- Graciela Feier Fróes
- Universidade Federal do Rio Grande do Sul (UFRGS). Escola de Enfermagem, Curso de Pós-Graduação em Enfermagem. Porto Alegre, Rio Grande do Sul, Brasil.,Hospital de Clínicas de Porto Alegre (HCPA). Porto Alegre, Rio Grande do Sul, Brasil
| | - Eliane Norma Wagner Mendes
- Universidade Federal do Rio Grande do Sul (UFRGS). Escola de Enfermagem, Curso de Graduação em Enfermagem. Porto Alegre, Rio Grande do Sul, Brasil
| | - Géssica de Almeida Pedroza
- Universidade Federal do Rio Grande do Sul (UFRGS). Escola de Enfermagem, Curso de Graduação em Enfermagem. Porto Alegre, Rio Grande do Sul, Brasil
| | - Maria Luzia Chollopetz da Cunha
- Universidade Federal do Rio Grande do Sul (UFRGS). Escola de Enfermagem, Curso de Pós-Graduação em Enfermagem. Porto Alegre, Rio Grande do Sul, Brasil
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Lee SJ, Choi EK, Park J, Kim HS. Correlations between a Flexible Parental Visiting Environment and Parental Stress in Neonatal Intensive Care Units. CHILD HEALTH NURSING RESEARCH 2019; 25:377-387. [PMID: 35004429 PMCID: PMC8650991 DOI: 10.4094/chnr.2019.25.4.377] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Revised: 03/25/2019] [Accepted: 03/27/2019] [Indexed: 12/11/2022] Open
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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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Petty J, Jarvis J, Thomas R. Listening to the parent voice to inform person-centred neonatal care. ACTA ACUST UNITED AC 2019. [DOI: 10.1016/j.jnn.2019.01.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Lee CH, Jang MH, Choi YS, Shin H. [The Relationship between Parental Stress and Nurses' Communication as Perceived by Parents of High-risk Newborns]. CHILD HEALTH NURSING RESEARCH 2019; 25:184-195. [PMID: 35004411 PMCID: PMC8650925 DOI: 10.4094/chnr.2019.25.2.184] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 02/26/2019] [Accepted: 03/30/2019] [Indexed: 11/06/2022] Open
Abstract
PURPOSE This study aimed to characterize the relationship between parental stress and nurses' communication as perceived by parents of high-risk newborns in a neonatal intensive care unit (NICU). METHODS The participants were 54 parents of high-risk newborns in a NICU. Data were collected from January to March 2018. Parental stress and parents' perceptions of nurses' communication ability and styles were measured using a questionnaire. RESULTS The average scores for parental stress and nurses' communication ability were 3.39 and 4.38 respectively, on a 5-point scale. Parents most commonly reported that nurses showed a friendly communication style, followed by informative and authoritative styles. Mothers and fathers reported significantly different levels of parental stress. Parental stress showed a negative correlation with nurses' perceived verbal communication ability. Higher scores for nurses' verbal communication ability and for friendly and informative communication styles were associated with lower parental stress induced by the environment, the baby's appearance and behaviors, and treatments in the NICU. CONCLUSION The findings of this study suggest that nurses need to offer proper information for parents and to support parents by encouraging them to express their emotions of stress and by providing parents with therapeutic communication and opportunities to participate in care.
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Affiliation(s)
| | | | | | - Hyunsook Shin
- Corresponding author Hyunsook Shin https://orcid.org/0000-0002-2795-5582 College of Nursing Science, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea TEL +82-2-961-9141 FAX +82-2-961-9398 E-MAIL
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Hunter LML, Blake S, Simmons C, Thompson J, Derouin A. Implementing a Parent Education Program in the Special Care Nursery. J Pediatr Health Care 2019; 33:131-137. [PMID: 30146361 DOI: 10.1016/j.pedhc.2018.06.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 06/11/2018] [Accepted: 06/16/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND Parents of preterm hospitalized infants, whose lengths of stay can range from a few days to several months, often experience emotional liability. Because the Neonatal Intensive Care Unit (NICU) or Special Care Nursery (SCN) is a stressful and intimidating environment, prompt attention should be given to reducing parental stress and increasing parental confidence in preparation to care for their child post-discharge. METHODS A quality improvement pilot project was designed to evaluate the parent education and support program, titled HUG Your Baby, in a Level II SCN for its ability to decrease stress and increase confidence for postpartum mothers of preterm infants born at less than 35 weeks gestation during the infant's hospitalization. RESULTS The outcomes demonstrated a statistically significant decrease in maternal stress and a statistically significant increase in maternal confidence. DISCUSSION The HUG Your Baby program is an effective parent education and support program that would benefit NICU and SCN families.
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Affiliation(s)
- La Monica L Hunter
- La Monica L. Hunter, Certified Pediatric Nurse Practitioner, Duke Regional Hospital, Durham, NC.
| | - Stephanie Blake
- Stephanie Blake, Neonatal Nurse Practitioner-Board Certified, Duke University Medical Center, Durham, NC
| | - Catherine Simmons
- Catherine Simmons, Neonatal Nurse Practitioner-Board Certified, Duke University Medical Center, Durham, NC
| | - Julie Thompson
- Julie Thompson, Statistical Consulting Associate, Duke University, Durham, NC
| | - Anne Derouin
- Anne Derouin, Certified Pediatric Nurse Practitioner and Associate Professor, Duke University, Durham, NC
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Månsson C, Sivberg B, Selander B, Lundqvist P. The impact of an individualised neonatal parent support programme on parental stress: a quasi‐experimental study. Scand J Caring Sci 2019; 33:677-687. [DOI: 10.1111/scs.12663] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 01/08/2019] [Indexed: 01/30/2023]
Affiliation(s)
- Catrin Månsson
- Department of Health Sciences Faculty of Medicine Lund University Lund Sweden
- Department of Neonatology Skåne University Hospital Lund Sweden
| | - Bengt Sivberg
- Department of Health Sciences Faculty of Medicine Lund University Lund Sweden
| | - Bo Selander
- Department of Pediatrics Central Hospital Kristianstad Sweden
| | - Pia Lundqvist
- Department of Health Sciences Faculty of Medicine Lund University Lund Sweden
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Kegler JJ, Neves ET, Silva AMD, Jantsch LB, Bertoldo CDS, Silva JHD. Stress in Parents of Newborns in a Neonatal Intensive Care Unit. ESCOLA ANNA NERY 2019. [DOI: 10.1590/2177-9465-ean-2018-0178] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Objective: To identify the level of stress and the most stressful situations for the parents of newborns hospitalized in a Neonatal Intensive Care Unit. Methods: A descriptive study, with a quantitative approach, performed with parents of newborns admitted to the Neonatal Intensive Care Unit. For the data collection, the Brazilian version of the Parental Stress Scale: Neonatal Intensive Care Unit (PSS: NICU) was used. The analysis was performed using descriptive statistics. Results: The change in the role of mother/father was the subscale in which the highest level of stress was obtained (mean=3.49) and the items considered more stressful in this subscale were "Separated from my baby" (mean=4.00) and "Feeling helpless and unable to protect my baby from pain and painful procedures" (mean=3.78). Conclusion: Hospitalization of a child in a neonatal unit is a stressful experience for parents and there are situations that trigger higher levels of stress.
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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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Akkoyun S, Tas Arslan F. Investigation of stress and nursing support in mothers of preterm infants in neonatal intensive care units. Scand J Caring Sci 2018; 33:351-358. [PMID: 30427555 DOI: 10.1111/scs.12630] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 10/09/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND The birth and hospitalisation of a premature infant in a neonatal intensive care unit (NICU) are stressful experiences for the mother and the family. The support of neonatal nurses is necessary to control and reduce the stress of mothers. And nurse-parent support may play a role in effective stress management and make a positive contribution to the health of mothers. AIM To determine the correlation of stress and nurse-parent support levels with mothers' age and educational status, number of children, gestational week of the infant and the hospitalisation period of the infant among mothers of premature infants hospitalised in the NICU. METHODS This descriptive and cross-sectional study was conducted in the NICUs of two medical faculties. The study was conducted between March and June 2017 with the participation of 106 mothers with hospitalised premature infants. The data of the study were collected using a 'mother information form', Parental Stressor Scale: Neonatal Intensive Care Unit and Nurse-Parent Support Tool. Number, percentage, mean, standard deviation, t-test, analysis of variance test, Pearson's correlation and multiple regression analysis were used to analyse the data. RESULTS It was determined that the stress levels were high in mothers regarding their PSS: NICU parental role subscale. The stress levels of mothers with infants connected to mechanical ventilation and fed parenterally were high (p < 0.05). The nurse support levels of mothers with middle- and low-income status were high. Multiple regression analysis, mechanical ventilation was determined to be effective in the use of the PSS:NICU total score (p < 0.05). CONCLUSIONS As a result, it was determined that mechanical ventilation and parenteral nutrition of the infant increased the stress level of mothers. Furthermore, in the study, the Nurse-Parent Support score of the mothers with middle- and low-income status was higher.
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Affiliation(s)
| | - Fatma Tas Arslan
- Nursing Department, Selcuk University Faculty of Health Science, Konya, Turkey
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Balbino FS, Balieiro MMFG, Mandetta MA. Measurement of Family-centered care perception and parental stress in a neonatal unit. Rev Lat Am Enfermagem 2017; 24:e2753. [PMID: 27508921 PMCID: PMC4990048 DOI: 10.1590/1518-8345.0710.2753] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 01/18/2016] [Indexed: 11/22/2022] Open
Abstract
Objective: to evaluate the effects of the implementation of the Patient and Family-Centered
Care Model on parents and healthcare perceptions and parental stress. Method: a quasi-experimental study developed in a neonatal unit of a university hospital
in the municipality of São Paulo, Brazil, with the implementation of this model of
care. Data collection were performed by two sample groups, one using
non-equivalent groups of parents, and another using equivalent groups of
healthcare professionals. The instruments Perceptions of Family-Centered
Care-Parent Brazilian Version, Perceptions of Family-Centered Care-Staff Brazilian
Version and Parental Stress Scale: Neonatal Intensive Care Unit, were applied to
132 parents of newborns hospitalized and to 57 professionals. Results: there was a statistically significant improvement in the perceptions of the
parents in most items assessed (p ≤0,05) and for the staff in relation to the
family welcome in the neonatal unit (p = 0.041) and to the comprehension of the
family's experience with the infant´s hospitalization (p = 0,050). There was a
reduction in the average scores of parental stress, with a greater decrease in the
Alteration in Parental Role from 4,2 to 3,8 (p = 0,048). Conclusion: the interventions improved the perceptions of parents and healthcare team related
to patient and family-centered care and contributed to reducing parental
stress.
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Affiliation(s)
- Flávia Simphronio Balbino
- RN, PhD, Departamento de Enfermagem Pediátrica, Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Maria Magda Ferreira Gomes Balieiro
- PhD, Adjunct Professor, Departamento de Enfermagem Pediátrica, Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Myriam Aparecida Mandetta
- PhD, Associate Professor, Departamento de Enfermagem Pediátrica, Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, SP, Brazil
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Fernández Medina IM, Granero-Molina J, Fernández-Sola C, Hernández-Padilla JM, Camacho Ávila M, López Rodríguez MDM. Bonding in neonatal intensive care units: Experiences of extremely preterm infants' mothers. Women Birth 2017; 31:325-330. [PMID: 29191725 DOI: 10.1016/j.wombi.2017.11.008] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 10/04/2017] [Accepted: 11/21/2017] [Indexed: 12/18/2022]
Abstract
BACKGROUND The birth of an extremely preterm infant can disrupt normal mother-infant physical contact and the care provided by the mother. This situation has an impact on the process of bonding between the mother and the child. AIM The objective of this study was to describe and understand the experiences of mothers who have extremely preterm infants admitted in Neonatal Intensive Care Units with regard to their bonding process. METHODS An interpretive, qualitative research methodology using Gadamer's philosophical hermeneutics was carried out. A focus group and eleven in-depth, semi-structured interviews were conducted. Data were collected between June and September of 2016. FINDINGS Sixteen women with a mean age of 34.4 years participated in the study. Two themes emerged from the data analysis: (1) premature labour and technological environment, a distorted motherhood, with the subthemes 'feeling of emptiness and emotional crisis' and 'the complexity of the environment and care generate an emotional swing'; (2) learning to be the mother of an extremely preterm infant, with the subthemes "the difficulty of relating to a stranger" and 'forming the bond in spite of difficulties'. CONCLUSIONS The bonding with extremely preterm infants is interrupted after giving birth. The maternal emotional state and the environment of the neonatal intensive care unit limit its development. Nursing care can facilitate mother-infant bonding by encouraging communication, participation in care, massaging or breastfeeding.
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Affiliation(s)
| | - José Granero-Molina
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, Spain; Faculty of Health Sciences, Universidad Autónoma de Chile, Temuco, Chile.
| | - Cayetano Fernández-Sola
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, Spain; Faculty of Health Sciences, Universidad Autónoma de Chile, Temuco, Chile.
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Gallagher K, Partridge C, Tran HT, Lubran S, Macrae D. Nursing & parental perceptions of neonatal care in Central Vietnam: a longitudinal qualitative study. BMC Pediatr 2017; 17:161. [PMID: 28697746 PMCID: PMC5505145 DOI: 10.1186/s12887-017-0909-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Accepted: 06/29/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Neonatal mortality accounts for nearly three quarters of all infant deaths in Vietnam. The nursing team are the largest professional group working with newborns, however do not routinely receive neonatal training and there is a lack of research into the impact of educational provision. This study explored changes in nursing perceptions towards their role following a neonatal educational intervention. Parents perceptions of nursing care were explored to determine any changes as nurses gained more experience. METHOD Semi-Structured qualitative interviews were conducted every 6 months over an 18 month period with 16 nurses. At each time point, parents whose infant was resident on the neonatal unit were invited to participate in an interview to explore their experiences of nursing care. A total of 67 parents participated over 18 months. Interviews were conducted and transcribed in Vietnamese before translation into English for manifest content analysis facilitated by NVivo V14. RESULTS Analysis of nursing transcripts identified 14 basic categories which could be grouped (23) into 3 themes: (1) perceptions of the role of the neonatal nurse, (2) perception of the parental role and (3) professional recollections. Analysis of parent transcripts identified 14 basic categories which could be grouped into 3 themes: (1) information sharing, (2) participation in care, and (3) personal experience. CONCLUSIONS Qualitative interviews highlighted the short term effect that the introduction of an educational intervention can have on both nursing attitudes towards and parental experience of care in one neonatal unit in central Vietnam. Nurses shared a growing awareness of their role along with its ethical issues and challenges, whilst parents discussed their overall desire for more participation in their infants care. Further research is required to determine the long term impact of the intervention, the ability of nurses to translate knowledge into clinical practice through assessment of nursing knowledge and competence, and the impact and needs of parents. A greater understanding will allow us to continue to improve the experiences of nurses and parents, and highlight how these areas may contribute towards the reduction of infant mortality and morbidity in Vietnam.
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Affiliation(s)
- Katie Gallagher
- Institute for Women's Health, University College London, 74 Huntley Street, London, WC1E 6AU, UK.
| | - Colin Partridge
- Department of Pediatrics, University of California, San Francisco, USA
| | - Hoang T Tran
- Neonatal Unit, Da Nang Hospital for Women and Children, Da Nang, Vietnam
| | | | - Duncan Macrae
- Pediatric Intensive Care, Royal Brompton and Harefield NHS Trust, London, UK
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Enke C, Oliva Y Hausmann A, Miedaner F, Roth B, Woopen C. Communicating with parents in neonatal intensive care units: The impact on parental stress. PATIENT EDUCATION AND COUNSELING 2017; 100:710-719. [PMID: 27923673 DOI: 10.1016/j.pec.2016.11.017] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 11/12/2016] [Accepted: 11/19/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To analyse stress in parents whose infants with very low birth weight have just concluded high-level care in a Neonatal Intensive Care Unit (NICU). More specifically, we aimed 1) to identify groups of parents in the NICU who are particularly at risk of experiencing stress, and 2) to explore the effects of clinical staffś communication on parental stress. METHODS Our multi-center-study evaluated views from 1277 parents about care for 923 infants in 66 German NICUs. Answers were linked with separately evaluated medical outcomes of the infants. Separate generalised mixed models estimated the influence of personal, medical and communication-related characteristics on specific parental stress. RESULTS Parents of a younger age and those of infants with severe prognoses were more likely to experience stress. While empathetic communication as one aspect of staffś communication was shown as appropriate in reducing parental stress, an initial introduction and the quantity of information were only slightly associated with lower levels of stress. CONCLUSION Results provide evidence for the need to involve parents empathetically from the beginning of their child's stay in the NICU. PRACTICE IMPLICATIONS Staff in the NICU should communicate empathetically and help to reduce stress in parents particularly at risk.
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Affiliation(s)
- Christian Enke
- Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health (ceres), University of Cologne, Cologne, Germany.
| | - Andrés Oliva Y Hausmann
- Department of Special Education and Rehabilitation Science, University of Cologne, Cologne, Germany
| | - Felix Miedaner
- Department of Business Administration and Health Care Management, University of Cologne, Cologne, Germany
| | - Bernhard Roth
- Department of Neonatology, Children's Hospital University of Cologne, Cologne, Germany
| | - Christiane Woopen
- Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health (ceres), University of Cologne, Cologne, Germany
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Abstract
To investigate the needs of parents of premature infants hospitalized in a neonatal intensive care unit (NICU) and explore associated factors. This study includes a convenience sample of 198 parents of premature infants hospitalized in a NICU in Chenzhou, Hunan province, China. Parents completed a study-specific questionnaire and the Chinese version of Critical Care Family Need Inventory (CCFNI). Analysis was conducted by multiple linear regression. Parents rated 30 of 45 items on the Chinese version of the CCFNI as important or very important. Items on the assurance, information, and proximity subscales were perceived as the most important, while items on the comfort subscale were the least important. Gender of parents and experience of visiting a NICU were significantly associated with the total needs of the parents. These insights should be used to inform clinical practice in the NICU.
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Affiliation(s)
- Li Wang
- 1 The First People's Hospital of Chenzhou, P. R. China
| | - Jun Li He
- 1 The First People's Hospital of Chenzhou, P. R. China
| | - Shu Lan Fei
- 1 The First People's Hospital of Chenzhou, P. R. China
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The Experience of Long-Stay Parents in the ICU: A Qualitative Study of Parent and Staff Perspectives. Pediatr Crit Care Med 2016; 17:e496-e501. [PMID: 27648895 DOI: 10.1097/pcc.0000000000000949] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Meeting the needs of parents of critically ill children is increasingly being recognized as an important factor in the child's clinical outcome as well as the implications it has for future parenting. Little is specifically known about the experience of parents who have a child in the ICU for a prolonged period. Our objective was to understand the experiences of this group to assist in the identification of mechanisms for providing support. DESIGN Qualitative study based on semistructured interviews. Data were analyzed using the Framework approach. SETTING The study took place in a tertiary pediatric hospital containing three ICUs: PICU, cardiac ICU, and neonatal ICU (ICU will be used to encompass neonatal ICU, cardiac ICU, and PICU for the remainder of the article). SUBJECTS Seventeen members of staff and 26 parents of a child who had a long stay in one of the three ICUs. INTERVENTIONS Semistructured, tape-recorded interviews. MEASUREMENTS AND MAIN RESULTS Analyses identified two overarching themes, "parent process" and "parent/staff interface," and six subthemes: adjustment, normalization/institutionalization, conflict, involvement in child's care, individualized care, and transition. Themes have been modeled to account for the parental process during a long stay in the ICU and the potential implications for the relationships and interactions between parents and staff. Findings are presented from the data related to the parent process and parent/staff interface. Inclusion of an element in the model related to staff indicates where support mechanisms should be focused. CONCLUSIONS Over time, long-stay families will likely become more familiar with the environment of the ICU, more knowledgeable about their child's medical needs and more familiar with the staff looking after their child. This has a number of implications for staff working in the ICU.
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Baía I, Amorim M, Silva S, Kelly-Irving M, de Freitas C, Alves E. Parenting very preterm infants and stress in Neonatal Intensive Care Units. Early Hum Dev 2016; 101:3-9. [PMID: 27393922 DOI: 10.1016/j.earlhumdev.2016.04.001] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 04/18/2016] [Accepted: 04/19/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Assessing parental stress during infants' hospitalization in Neonatal Intensive Care Units (NICU) is essential to identify parents at risk for immediate and extended physical and emotional burden. AIMS To identify sources of stress in mothers and fathers of very preterm infants hospitalized in NICU, and their association with sociodemographic, obstetric and infants' characteristics. STUDY DESIGN Observational and cross-sectional study conducted between July 2013 and June 2014. SUBJECTS Parents of very preterm infants hospitalized in all level III NICU in the Northern Health Region of Portugal were consecutively and systematically invited to participate in this study, being included 120 mothers and 91 fathers (participation rate: 96.8%). OUTCOME MEASURES The Portuguese version of the Parental Stressor Scale: Neonatal Intensive Care Unit was used. RESULTS The overall experience of hospitalization was classified as more stressful than the median for the subscales. "Change in parental role" was classified as the most stressful subscale by mothers (Median (P25-P75): 4.1(3.2-4.7)) and fathers (Median (P25-P75): 3.2(2.4-4.0)). Mothers scored significantly higher in all subscales. For mothers, multiple pregnancy was associated with lower levels of stress regarding "change in parental role" (β=-0.597; 95% CI=-1.020 to -0.174) and "overall stress" (β=-0.603; 95% CI=-1.052 to -0.153). Being ≥30years old was found to be a significant predictor for decreased fathers' stress. CONCLUSIONS This study raises awareness for the need to develop sensitive instruments that take notice of gender, social support and family-centered care. The implementation of interventions focused on reducing parental stress is crucial to diminish disparities in family health.
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Affiliation(s)
- Inês Baía
- ISPUP-EPIUnit, Universidade do Porto, Rua das Taipas, nº 135, 4050-600 Porto, Portugal; Faculdade de Medicina, Universidade do Porto, Rua Doutor Plácido da Costa, 4200-450 Porto, Portugal.
| | - Mariana Amorim
- ISPUP-EPIUnit, Universidade do Porto, Rua das Taipas, nº 135, 4050-600 Porto, Portugal; Global Public Health Doctoral Programme, Instituto de Saúde Pública, Universidade do Porto, Portugal.
| | - Susana Silva
- ISPUP-EPIUnit, Universidade do Porto, Rua das Taipas, nº 135, 4050-600 Porto, Portugal.
| | - Michelle Kelly-Irving
- INSERM UM1027, F-3100 Toulouse, France; Université Toulouse III Paul Sabatier, UM1027, F-3100 Toulouse, France.
| | - Cláudia de Freitas
- ISPUP-EPIUnit, Universidade do Porto, Rua das Taipas, nº 135, 4050-600 Porto, Portugal; Centre for Research and Studies in Sociology (CIES), University Institute of Lisbon, Portugal.
| | - Elisabete Alves
- ISPUP-EPIUnit, Universidade do Porto, Rua das Taipas, nº 135, 4050-600 Porto, Portugal.
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Garne K, Brødsgaard A, Zachariassen G, Clemensen J. Telemedicine in Neonatal Home Care: Identifying Parental Needs Through Participatory Design. JMIR Res Protoc 2016; 5:e100. [PMID: 27392576 PMCID: PMC4958140 DOI: 10.2196/resprot.5467] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 04/01/2016] [Accepted: 04/03/2016] [Indexed: 11/22/2022] Open
Abstract
Background For the majority of preterm infants, the last weeks of hospital admission mainly concerns tube feeding and establishment of breastfeeding. Neonatal home care (NH) was developed to allow infants to remain at home for tube feeding and establishment of breastfeeding with regular home visits from neonatal nurses. For hospitals covering large regions, home visits may be challenging, time consuming, and expensive and alternative approaches must be explored. Objective To identify parental needs when wanting to provide neonatal home care supported by telemedicine. Methods The study used participatory design and qualitative methods. Data were collected from observational studies, individual interviews, and focus group interviews. Two neonatal units participated. One unit was experienced in providing neonatal home care with home visits, and the other planned to offer neonatal home care with telemedicine support. A total of 9 parents with preterm infants assigned to a neonatal home care program and 10 parents with preterm infants admitted to a neonatal unit participated in individual interviews and focus group interviews, respectively. Results Three overall themes were identified: being a family, parent self-efficacy, and nurse-provided security. Parents expressed desire for the following: (1) a telemedicine device to serve as a “bell cord” to the neonatal unit, giving 24-hour access to nurses, (2) video-conferencing to provide security at home, (3) timely written email communication with the neonatal unit, and (4) an online knowledge base on preterm infant care, breastfeeding, and nutrition. Conclusions Our findings highlight the importance of neonatal home care. NH provides parents with a feeling of being a family, supports their self-efficacy, and gives them a feeling of security when combined with nursing guidance. Parents did not request hands-on support for infant care, but instead expressed a need for communication and guidance, which could be met using telemedicine.
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Affiliation(s)
- Kristina Garne
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark.
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Provenzi L, Barello S, Fumagalli M, Graffigna G, Sirgiovanni I, Savarese M, Montirosso R. A Comparison of Maternal and Paternal Experiences of Becoming Parents of a Very Preterm Infant. J Obstet Gynecol Neonatal Nurs 2016; 45:528-41. [DOI: 10.1016/j.jogn.2016.04.004] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2016] [Indexed: 11/25/2022] Open
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