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Dereddy N, Moats RA, Ruth D, Pokelsek A, Pepe J, Wadhawan R, Oh W. Maternal recorded voice played to preterm infants in incubators reduces her own depression, anxiety and stress: a pilot randomized control trial. J Matern Fetal Neonatal Med 2024; 37:2362933. [PMID: 38910112 DOI: 10.1080/14767058.2024.2362933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 05/29/2024] [Indexed: 06/25/2024]
Abstract
OBJECTIVE To study the effects of playing mother's recorded voice to preterm infants in the NICU on their mothers' mental health as measured by the Depression, Anxiety and Stress Scale -21 (DASS-21) questionnaire. DESIGN/METHODS This was a pilot single center prospective randomized controlled trial done at a level IV NICU. The trial was registered at clinicaltrials.gov (NCT04559620). Inclusion criteria were mothers of preterm infants with gestational ages between 26wks and 30 weeks. DASS-21 questionnaire was administered to all the enrolled mothers in the first week after birth followed by recording of their voice by the music therapists. In the interventional group, recorded maternal voice was played into the infant incubator between 15 and 21 days of life. A second DASS-21 was administered between 21 and 23 days of life. The Wilcoxon rank-sum test was used to compare DASS-21 scores between the two groups and Wilcoxon signed-rank test was used to compare the pre- and post-intervention DASS-21 scores. RESULTS Forty eligible mothers were randomized: 20 to the intervention group and 20 to the control group. The baseline maternal and neonatal characteristics were similar between the two groups. There was no significant difference in the DASS-21 scores between the two groups at baseline or after the study intervention. There was no difference in the pre- and post-interventional DASS-21 scores or its individual components in the experimental group. There was a significant decrease in the total DASS-21 score and the anxiety component of DASS-21 between weeks 1 and 4 in the control group. CONCLUSION In this pilot randomized control study, recorded maternal voice played into preterm infant's incubator did not have any effect on maternal mental health as measured by the DASS-21 questionnaire. Data obtained in this pilot study are useful in future RCTs (Randomized Controlled Trial) to address this important issue.
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Affiliation(s)
- Narendra Dereddy
- AdventHealth for Children, Orlando, FL, USA
- University of Central Florida College of Medicine, Orlando, FL, USA
| | | | - Deborah Ruth
- AdventHealth Research Institute, Orlando, FL, USA
| | - Ann Pokelsek
- AdventHealth Research Institute, Orlando, FL, USA
| | - Julie Pepe
- AdventHealth Research Institute, Orlando, FL, USA
| | | | - William Oh
- AdventHealth for Children, Orlando, FL, USA
- AdventHealth Research Institute, Orlando, FL, USA
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Wang LY, Tsai HM, Chen YW, Jhang JY, Wu PJ, Huang YT, Lee MY, Chen LC, Yu WP, Chiang MC. A preliminary study of the effectiveness of video visitation on depression and stress in mothers with preterm infants during the pandemic. Pediatr Neonatol 2024:S1875-9572(24)00092-5. [PMID: 38910078 DOI: 10.1016/j.pedneo.2023.12.011] [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: 04/18/2023] [Revised: 11/26/2023] [Accepted: 12/05/2023] [Indexed: 06/25/2024] Open
Abstract
BACKGROUND AND PURPOSE Parents of preterm infants experience anxiety and stress in the neonatal intensive care unit (NICU). Visitation restrictions due to COVID-19 have increased maternal pressure and limited bonding opportunities. Little research exists in Taiwan on using video conferencing as a solution. This study investigates depression and stress levels in mothers of preterm infants and evaluates the effectiveness of video visitation during NICU restrictions. METHODS This study adopts a cross-sectional design and a qualitative survey. Mothers of premature infants were recruited and they participated in the study. Interventions for video visits were scheduled on the third day of admission to the NICU (T1) and during the second week of the study (T2). After each video visit, participants completed an online survey. The study's online survey used structured questionnaires including demographics, the Edinburgh Postnatal Depression Scale (EPDS) and the Parental Stress Scale (PSS): Infant Hospitalization (IH). RESULTS A total of 51 mothers of preterm infants participated in the study. During the T1 and T2 periods, single mothers with lower educational levels and those aged below 30 experienced depression and high levels of stress. Lower birth weight and gestational age were associated with maternal depression. Video visitation intervention led to a significant decrease in depression scores (EPDS, T1: 11.3 ± 5.5 vs. T2: 10.1 ± 5.2, p = 0.039). Positive correlations were observed between EPDS and PSS: IH scores (p < 0 .005). CONCLUSION Video visitation intervention can reduce maternal depression in mothers with preterm infants. Since it is practical, video visitation may be applied even after the pandemic.
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Affiliation(s)
- Ling-Ying Wang
- Department of Nursing, Chang Gung Memorial Hospital, Linkou, Taiwan; MSc Program in Innovation for Smart Medicine, College of Management, Chang Gung University, Taoyuan, Taiwan
| | - Hsiu-Min Tsai
- College of Nursing, Hungkuang University, Taichung, Taiwan
| | - Yi-Wen Chen
- Department of Nursing, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Jing-Yi Jhang
- Department of Nursing, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Pei-Jhen Wu
- Department of Nursing, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Yu-Ting Huang
- Department of Nursing, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Ming-Ying Lee
- Department of Nursing, Chang Gung Memorial Hospital, Linkou, Taiwan; College of Nursing, Chang Gung University, Taoyuan, Taiwan
| | - Li-Chen Chen
- Department of Nursing, Chang Gung Memorial Hospital, Linkou, Taiwan; Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Wen-Pin Yu
- Department of Nursing, Chang Gung Memorial Hospital, Linkou, Taiwan; Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan.
| | - Ming-Chou Chiang
- Division of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Linkou, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
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de Bijl-Marcus K, Benders MJNL, Dudink J, Ahaus K, Kahlmann M, Groenendaal F. Morbidity and trends in length of hospitalisation of very and extremely preterm infants born between 2008 and 2021 in the Netherlands: a cohort study. BMJ Open 2024; 14:e078842. [PMID: 38834326 PMCID: PMC11163635 DOI: 10.1136/bmjopen-2023-078842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 05/14/2024] [Indexed: 06/06/2024] Open
Abstract
OBJECTIVES This study investigated changes in the length of stay (LoS) at a level III/IV neonatal intensive care unit (NICU) and level II neonatology departments until discharge home for very preterm infants and identified factors influencing these trends. DESIGN Retrospective cohort study based on data recorded in the Netherlands Perinatal Registry between 2008 and 2021. SETTING A single level III/IV NICU and multiple level II neonatology departments in the Netherlands. PARTICIPANTS NICU-admitted infants (n=2646) with a gestational age (GA) <32 weeks. MAIN OUTCOME MEASURES LoS at the NICU and overall LoS until discharge home. RESULTS The results showed an increase of 5.1 days (95% CI 2.2 to 8, p<0.001) in overall LoS in period 3 after accounting for confounding variables. This increase was primarily driven by extended LoS at level II hospitals, while LoS at the NICU remained stable. The study also indicated a strong association between severe complications of preterm birth and LoS. Treatment of infants with a lower GA and more (severe) complications (such as severe retinopathy of prematurity) during the more recent periods may have increased LoS. CONCLUSION The findings of this study highlight the increasing overall LoS for very preterm infants. LoS of very preterm infants is presumably influenced by the occurrence of complications of preterm birth, which are more frequent in infants at a lower gestational age.
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Affiliation(s)
- Karen de Bijl-Marcus
- Department of Neonatology, Universitair Medisch Centrum Utrecht-Locatie Wilhelmina Kinderziekenhuis, Utrecht, The Netherlands
| | - Manon J N L Benders
- Department of Neonatology, Universitair Medisch Centrum Utrecht-Locatie Wilhelmina Kinderziekenhuis, Utrecht, The Netherlands
| | - Jeroen Dudink
- Department of Neonatology, Universitair Medisch Centrum Utrecht-Locatie Wilhelmina Kinderziekenhuis, Utrecht, The Netherlands
| | - Kees Ahaus
- Erasmus School of Health Policy & Management, Erasmus Universiteit Rotterdam, Rotterdam, The Netherlands
| | - Marijn Kahlmann
- Department of Neonatology, Universitair Medisch Centrum Utrecht-Locatie Wilhelmina Kinderziekenhuis, Utrecht, The Netherlands
| | - Floris Groenendaal
- Department of Neonatology, Universitair Medisch Centrum Utrecht-Locatie Wilhelmina Kinderziekenhuis, Utrecht, The Netherlands
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Osborne AD, Worsley D, Cullen C, Martin A, Christ L. Enhancing NICU Care and Communication: Perspectives of Moderately Preterm Infant Parents. Pediatrics 2024; 153:e2023064419. [PMID: 38716568 DOI: 10.1542/peds.2023-064419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 03/05/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND Moderately preterm infants (MPTI) comprise a large proportion of NICU admissions and are an understudied population. The unique experience of families with MPTIs has yet to be examined in the literature. Describing MPTI parent needs and preferences may inform interventions to improve care and outcomes for this population. METHODS Semistructured qualitative interviews were performed with English-speaking birth parents of infants born between 32 and 34 weeks gestation to describe their NICU experience and identify areas for improvement specifically surrounding care team inclusion, education, discharge, and communication. Interviews were recorded, transcribed, and analyzed using directed content analysis. Enrollment ceased when the data reached thematic saturation. RESULTS Sixteen birth parents participated. Four themes emerged around parent-medical team connectedness, parental confusion, discharge readiness, and the desire for a use of a mix of in-person and electronic communication methods (e-mail, texting, apps, etc) for communication. MPTI parents valued a strong connection with the medical team; however, they described a lack of knowledge regarding the reasons for admission and ongoing management. Near discharge, parents desired more information regarding feeding, reflux, and breathing patterns. Parents preferred in-person discussions but described a role for electronic methods to improve their understanding of their infant and discharge readiness. CONCLUSIONS From the MPTI parent perspective, clinicians can focus improvement efforts on communication, specifically around reasons for admission, discharge planning, and anticipatory guidance. These results may serve as a foundation for initiatives to improve the MPTI parent experience and potentially parent and MPTI outcomes.
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Affiliation(s)
- Ashley D Osborne
- Shawn Jenkins Children's Hospital, Medical University of South Carolina, Charleston, South Carolina
| | - Diana Worsley
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Catherine Cullen
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Ashley Martin
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Lori Christ
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
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Suonpera E, Gallagher K, Marlow N, Lanceley A. 'I don't want him to always be so far behind': Parental perceptions of child independence in the context of extreme prematurity; a qualitative study. J Child Health Care 2024:13674935241256545. [PMID: 38798176 DOI: 10.1177/13674935241256545] [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] [Indexed: 05/29/2024]
Abstract
This study addresses the paucity of research on parents of extremely preterm adolescents (born <27 weeks of gestation) and their experiences within the framework of parental determinism. We conducted semi-structured interviews with twenty-two mothers and one father. Data were analysed thematically, revealing three overarching themes and eight subthemes shaping parental accounts. These themes centred on parental ambitions for their children, their perceptions of their child's abilities, and the parenting behaviours employed to support parental aspirations. Parents' actions were influenced by their ambitions and the belief that they could impact their child's future independence. While some parents adopted 'trusting', non-intensive parenting behaviours, those anticipating challenges for their child's future independence resorted to intensive parenting practices. These findings align with the concept of parental determinism, emphasising the perceived causal link between present parental actions and future child outcomes. In the context of extreme prematurity, a nuanced understanding of parental perceptions regarding their child's future independence aligned with a delicate balance between hope and realistic aspiration is crucial for enhancing parental support and well-being.
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Affiliation(s)
- Emmi Suonpera
- UCL EGA Institute for Women's Health, University College London, London, UK
| | - Katie Gallagher
- UCL EGA Institute for Women's Health, University College London, London, UK
| | - Neil Marlow
- UCL EGA Institute for Women's Health, University College London, London, UK
| | - Anne Lanceley
- UCL EGA Institute for Women's Health, University College London, London, UK
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Buccione E, Scarponcini Fornaro D, Pieragostino D, Natale L, D’Errico A, Chiavaroli V, Rasero L, Bambi S, Della Pelle C, Di Valerio S. Parents' Participation in Care during Neonatal Intensive Care Unit Stay in COVID-19 Era: An Observational Study. NURSING REPORTS 2024; 14:1212-1223. [PMID: 38804425 PMCID: PMC11130904 DOI: 10.3390/nursrep14020092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Revised: 05/01/2024] [Accepted: 05/10/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND Parents play a crucial role in the care of infants during their stay in the neonatal intensive care unit (NICU). Recent studies have reported a decrease in parental participation due to the coronavirus disease (COVID-19) pandemic, which has led to restricted access policies in hospitals. The aim of this study was to describe the barriers to good parental participation during their stay in the neonatal intensive care unit in the COVID-19 era. METHODS This was a quantitative, observational study. RESULTS A total of 270 parents participated in this study. Mothers' participation in care was higher than that of fathers (p = 0.017). Parents who lived at the birth of their first child reported a better level of participation in care compared to those who lived at the birth of their second-born (p = 0.005). Parents of extremely preterm neonates reported a lower interaction with their infants than parents of term newborns (p < 0.001). CONCLUSIONS Some disadvantaged categories reported lower scores for cultural and linguistic minorities, parents of multiple children, and fathers. The COVID-19 pandemic has made several family-centred care activities impossible, with a higher impact on those who benefited most of these facilities. This study was prospectively approved by the IRB-CRRM of the University "G. d'Annunzio" Chieti-Pescara on 23 January 2024 (approval number CRRM: 2023_12_07_01).
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Affiliation(s)
- Emanuele Buccione
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
- Neonatal Intensive Care Unit, Health Local Authority 3 Pescara, 65124 Pescara, Italy; (D.S.F.); (V.C.); (S.D.V.)
| | - Davide Scarponcini Fornaro
- Neonatal Intensive Care Unit, Health Local Authority 3 Pescara, 65124 Pescara, Italy; (D.S.F.); (V.C.); (S.D.V.)
| | - Damiana Pieragostino
- Department of Innovative Technologies and Medicine & Odontoiatry, University G. D’Annunzio, Chieti-Pescara, 66100 Chieti, Italy; (D.P.); (L.N.)
- Analytical Biochemistry and Proteomics Laboratory, Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Luca Natale
- Department of Innovative Technologies and Medicine & Odontoiatry, University G. D’Annunzio, Chieti-Pescara, 66100 Chieti, Italy; (D.P.); (L.N.)
- Analytical Biochemistry and Proteomics Laboratory, Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Adelaide D’Errico
- Neonatal Intensive Care Unit, Santobono-Pausilipon Children’s Hospital, 80129 Naples, Italy;
| | - Valentina Chiavaroli
- Neonatal Intensive Care Unit, Health Local Authority 3 Pescara, 65124 Pescara, Italy; (D.S.F.); (V.C.); (S.D.V.)
| | - Laura Rasero
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (L.R.); (S.B.)
| | - Stefano Bambi
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (L.R.); (S.B.)
| | - Carlo Della Pelle
- Medical Department, Health Local Authority 2 Chieti, 66100 Chieti, Italy;
| | - Susanna Di Valerio
- Neonatal Intensive Care Unit, Health Local Authority 3 Pescara, 65124 Pescara, Italy; (D.S.F.); (V.C.); (S.D.V.)
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Erdei C, Forde M, Cherkerzian S, Conley MS, Liu CH, Inder TE. "My Brigham Baby" Application: A Pilot Study Using Technology to Enhance Parent's Experience in the Neonatal Intensive Care Unit. Am J Perinatol 2024; 41:e1135-e1144. [PMID: 36452968 DOI: 10.1055/a-1990-2414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
OBJECTIVE This study aimed to describe the family psychosocial experience in a level-III neonatal intensive care unit (NICU), and to assess how it evolved after rollout of an educational smartphone application (App) called "My Brigham Baby." STUDY DESIGN We surveyed 25 NICU parents pre-App rollout (before coronavirus disease 2019 [COVID-19] pandemic) and 25 parents post-App rollout (during pandemic). Collected data included parental self-reported discharge readiness, symptoms of stress and anxiety, and parenting skill confidence. Survey scores were assessed as total or mean scores, and by category of severity. RESULTS Pre-and post-App parents had comparable demographics, and their infants had similar clinical characteristics during their NICU stay. Discharge readiness differed by group status (p = 0.02) and was characterized by a greater frequency in being "very ready" for discharge among the post-App rollout parent group compared with the pre-App group (56 vs. 20%, p = 0.027), and parenting confidence shifted toward more optimal scores post-App rollout. Parental stress and anxiety symptoms did not significantly differ between groups despite possible stress contagion from the COVID-19 pandemic. CONCLUSION This pilot study suggests that technology Apps are feasible interventions within NICU settings and may enhance parental experiences related to NICU hospitalization. KEY POINTS · Parents' experience increased psychological distress during the time their infant is cared for in the NICU, which has downstream consequences for the family unit.. · In our study, surveyed parents reported higher discharge readiness and parenting confidence shifted toward improvement after rollout of a family education and support smartphone application in a level-III NICU.. · This pilot study suggests that technology applications are feasible interventions that might enhance parental experiences during NICU hospitalization..
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Affiliation(s)
- Carmina Erdei
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, Massachusetts
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Madison Forde
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Sara Cherkerzian
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, Massachusetts
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Maria S Conley
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Cindy H Liu
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, Massachusetts
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Terrie E Inder
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, Massachusetts
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
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Schmid SV, Arnold C, Jaisli S, Bubl B, Harju E, Kidszun A. Parents' and neonatal healthcare professionals' views on barriers and facilitators to parental presence in the neonatal unit: a qualitative study. BMC Pediatr 2024; 24:268. [PMID: 38658901 PMCID: PMC11040849 DOI: 10.1186/s12887-024-04758-3] [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: 12/01/2023] [Accepted: 04/11/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Parent and infant separation in the neonatal unit is associated with adverse health outcomes. Family-integrated care has several advantages and the potential to reduce these adverse outcomes but requires parental presence. This study aimed to explore the views of parents and neonatal healthcare professionals (nHCPs) on barriers and facilitators to parental presence in a Swiss neonatal unit and to identify possible differences between nHCPs and parents, and between mothers and fathers. METHODS Data were collected through semi-structured interviews with parents and focus group discussions with nHCPs. Inductive content analysis was used to identify barriers and facilitators to parental presence in the neonatal unit. RESULTS Twenty parents (10 mothers and 10 fathers) and 21 nHCPs (10 nurses and 11 physicians) participated in the study. Parents and nHCPs experienced barriers and facilitators related to: (1) Structural factors of the institution, such as infrastructure or travel and distance to the neonatal unit. (2) Organization and time management of parental presence, daily activities, and work. (3) Resources, which include factors related to the legal situation, support services, family, and friends. (4) Physical and psychological aspects, such as pain, which mainly affected mothers, and aspects of emotional distress, which affected both parents. Self-care was an important physical and psychological facilitator. (5) Parent-professional interaction. Parental presence was influenced by communication, relationship, and interaction in infant care; and (6) Cultural aspects and language. Some perspectives differed between mothers and fathers, while the overall views of parents and nHCPs provided complementary rather than conflicting insights. Using visit plans to support the organization, educating nHCPs in knowledge skills and available resources to improve encouragement and information to parents, strengthening parent self-care, and improving nHCPs' attitudes towards parental presence were seen as possible improvements. CONCLUSIONS Multifactorial barriers and facilitators determine parental presence and experience in the neonatal unit. Parents and nHCPs made specific recommendations to improve parental presence.
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Affiliation(s)
- Stephanie Vanessa Schmid
- Division of Neonatology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Friedbühlstrasse 19, Bern, 3010, Switzerland
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, Lucerne, 6002, Switzerland
| | - Christine Arnold
- Division of Neonatology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Friedbühlstrasse 19, Bern, 3010, Switzerland.
| | - Sophie Jaisli
- Division of Neonatology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Friedbühlstrasse 19, Bern, 3010, Switzerland
| | - Benedikt Bubl
- Division of Neonatology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Friedbühlstrasse 19, Bern, 3010, Switzerland
| | - Erika Harju
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, Lucerne, 6002, Switzerland
- School of Health Sciences, ZHAW Zurich University of Applied Sciences, Katharina-Sulzer-Platz 9, Winterthur, 8401, Switzerland
| | - André Kidszun
- Division of Neonatology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Friedbühlstrasse 19, Bern, 3010, Switzerland
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Suonpera E, Lanceley A, Ni Y, Marlow N. Parenting stress and health-related quality of life among parents of extremely preterm born early adolescents in England: a cross-sectional study. Arch Dis Child Fetal Neonatal Ed 2024; 109:253-260. [PMID: 37879883 DOI: 10.1136/archdischild-2023-325429] [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: 02/07/2023] [Accepted: 09/27/2023] [Indexed: 10/27/2023]
Abstract
OBJECTIVE To determine whether extremely preterm (EP) birth exerts persisting effects on parents in early adolescence. DESIGN Cross-sectional survey conducted between March 2017 and October 2018. SETTING Evaluation of a longitudinal population-based birth cohort in England at 11 years of age (EPICure2@11 Study). PARTICIPANTS Parents of EP (<27 weeks of gestation) adolescents and control parents of term born (≥37 weeks of gestation) classmates of similar age and sex. MAIN OUTCOME MEASURES The Parenting Stress Index Short Form (PSI-4-SF) and the Short Form Health Survey (SF-12v1). RESULTS The 163 EP and 125 comparison respondents were most commonly mothers in their mid-40s. EP parents reported higher total parenting stress scores compared with controls, overall (adjusted difference in means: 14 (95% CI 9 to 20)) and after exclusion of moderate and severe child disability and multiples (9 (95% CI 3 to 15). Average physical and mental health-related quality of life scores were similar in the two groups (adjusted difference in means physical health: -2 (95% CI -4 to 1) and mental health: -1 (95% CI -4 to 1)). Among EP parents, 12% (20/164) reported the combination of high parenting stress and low mental health scores. With increasing child age, parenting stress scores for preterm parents were lower in contrast to controls who reported increasing parenting stress. CONCLUSIONS In early adolescence, compared with parents of term-born children, EP parents experience increased levels of parenting stress that are particularly high among a proportion of parents and associated with lower mental health-related quality of life. Practitioner awareness of this continuing risk throughout childhood is important to support parental abilities and well-being.
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Affiliation(s)
- Emmi Suonpera
- EGA UCL Institute for Women's Health, University College London, London, UK
| | - Anne Lanceley
- EGA UCL Institute for Women's Health, University College London, London, UK
| | - Yanyan Ni
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Neil Marlow
- EGA UCL Institute for Women's Health, University College London, London, UK
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Bua J, Dalena P, Mariani I, Girardelli M, Ermacora M, Manzon U, Plet S, Travan L, Lazzerini M. Parental stress, depression, anxiety and participation in care in neonatal intensive care unit: a cross-sectional study in Italy comparing mothers versus fathers. BMJ Paediatr Open 2024; 8:e002429. [PMID: 38589039 PMCID: PMC11002394 DOI: 10.1136/bmjpo-2023-002429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 03/06/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND This study aimed at documenting the levels of stress, depression, anxiety and participation in care among mothers versus fathers of newborns hospitalised in a third-level neonatal intensive care unit (NICU) in Northern Italy. METHODS Parental stress, depression and anxiety were assessed by the Parental Stressor Scale in NICU (PSS:NICU), the Edinburgh Postnatal Depression Scale (EPDS) and the State-Trait Anxiety Inventory (STAI). Participation in care was evaluated with the Index of Parental Participation. Differences between mothers and fathers were assessed with the Mood's median test and z-test, respectively for continuous and discrete variables. Multivariate analyses controlling for potential confounders were performed to confirm gender differences. RESULTS 191 parents (112 mothers and 79 fathers) were enrolled. Mothers reported significantly higher median scores for stress (2.9 vs 2.2, p<0.001) and trait anxiety (37 vs 32, p=0.004) and higher depression rates (EPDS ≥12: 43.8% vs 19.0%, p<0.001). 'High stress' (PSS:NICU ≥3) was reported by 45.5% of mothers compared with 24.1% of fathers (p=0.004). The frequency of the three conditions simultaneously was significantly higher among mothers (20.0% vs 3.8%, p=0.016), with the vast majority of mothers (76.0%) suffering from at least one condition compared with less than half of fathers (45.3%, p<0.001). Participation in care was more frequent in mothers (median score: 19 vs 15, p<0.001), with the exception of activities related to advocacy (median 5 vs 4, p=0.053). In a multivariate analysis, gender differences in mental health outcomes did not change. CONCLUSIONS Routine screening of mental distress among parents of infants in NICU is warranted, and gender differences need to be acknowledged in order to deliver tailored support and to promote collaboration with the family of vulnerable newborns. Knowledge and skills on how to prevent and cope with mental distress of parents should be part of the core curriculum of staff working in NICU.
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Affiliation(s)
- Jenny Bua
- Neonatal Intensive Care Unit, Institute for Maternal and Child Health IRCCS 'Burlo Garofolo', Trieste, Italy
| | - Paolo Dalena
- Institute for Maternal and Child Health IRCCS 'Burlo Garofolo', Trieste, Italy
- University of Trieste, Trieste, Italy
| | - Ilaria Mariani
- WHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health IRCCS 'Burlo Garofolo', Trieste, Italy
| | - Martina Girardelli
- Department of Pediatrics, Institute for Maternal and Child Health-IRCCS 'Burlo Garofolo', Trieste, Italy
| | - Maddalena Ermacora
- Neonatal Intensive Care Unit, Institute for Maternal and Child Health IRCCS 'Burlo Garofolo', Trieste, Italy
| | - Ursula Manzon
- Neonatal Intensive Care Unit, Institute for Maternal and Child Health IRCCS 'Burlo Garofolo', Trieste, Italy
| | - Sabrina Plet
- Neonatal Intensive Care Unit, Institute for Maternal and Child Health IRCCS 'Burlo Garofolo', Trieste, Italy
| | - Laura Travan
- Neonatal Intensive Care Unit, Institute for Maternal and Child Health IRCCS 'Burlo Garofolo', Trieste, Italy
| | - Marzia Lazzerini
- WHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health IRCCS 'Burlo Garofolo', Trieste, Italy
- Maternal Adolescent Reproductive and Child Health Care Centre, London School of Hygiene & Tropical Medicine Faculty of Epidemiology and Public Health, London, UK
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LaManna S, Hatfield B, McCann E. Considering the Influence of Social Determinants of Health on Parent Feeding Practices: A Case Example. Adv Neonatal Care 2024; 24:110-118. [PMID: 38241685 DOI: 10.1097/anc.0000000000001138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2024]
Abstract
BACKGROUND Social determinants of health (SDOH) are the nonmedical factors that influence health outcomes. SDOH can be grouped into 5 domains: economic stability, education access and quality, healthcare access and quality, neighborhood and built environment, and social and community context. SDOH impact people's health and quality of life but may also contribute to disparities in access to food, education, and healthcare. SDOH uniquely influence parent feeding practices in the neonatal intensive care unit (NICU) in a variety of ways, ranging from logistical considerations for parent visitation to cultural beliefs such as family perception of human milk feeding. EVIDENCE ACQUISITION A hypothetical case example of a preterm infant with a feeding disorder in the NICU is used to connect SDOH that influence prenatal health, parental lived experience, and postnatal medical care to maternal and infant outcomes with implications for feeding practices. Barriers and facilitators to successful feeding practices in the NICU and at discharge are considered for each SDOH domain. RESULTS This case example increases awareness of SDOH and how they influence parent feeding practices in the NICU, focusing on the intersection of SDOH, parent stress, and oral feeding outcomes. Examples were provided for how to support applying findings into practice. IMPLICATIONS FOR PRACTICE AND RESEARCH By being creating a culture of SDOH awareness, NICU staff can assist families in overcoming barriers by putting supports in place to increase equitable participation in developmentally supportive feeding practices during the NICU stay.
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Affiliation(s)
- Stefanie LaManna
- Author Affiliation: American Speech-Language-Hearing Association, Rockville, Maryland (Mss LaManna and Hatfield); and Independent Researcher, Voorhees, New Jersey (Ms McCann)
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Schwab I, Dresbach T, Ohnhäuser T, Horenkamp-Sonntag D, Scholten N. Pressure to provide milk among mothers of very low birth weight infants: an explorative study. BMC Pregnancy Childbirth 2024; 24:134. [PMID: 38350865 PMCID: PMC10863276 DOI: 10.1186/s12884-024-06315-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 02/02/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Pump-dependent mothers of very low birth weight (VLBW, < 1500g) infants experience specific challenges achieving sufficient milk supply in the neonatal intensive care unit (NICU) and are therefore less frequently able to achieve (exclusive) breast milk feeding. Stress due to the limitations on participating in the infant's care may contribute to this problem. Some explorative studies suggest that pressure to provide milk may be an additional stressor in mothers. However, the type of pressure to provide milk perceived by mothers of VLBW infants has rarely been examined. METHODS A retrospective and anonymous questionnaire was conducted with mothers of VLBW infants aged 6 to 24 months at the time of data collection. Quantitative data and written comments were used to examine the mothers' perceptions. Descriptive and bivariate tests (Spearman´s rho, Pearson's chi2) were performed to show correlations between pressure to provide breast milk, parental stress (PSS:NICU: role alteration subscale), milk volume, and maternal factors. Pressure to provide milk was measured through two self-developed single items to differentiate between internal and external pressures. RESULTS Data of n = 533 mothers of VLBW infants was analysed. More than 70% of the mothers agreed that they pressured themselves to provide milk for their infant. In contrast, 34% of the mothers agreed that they felt pressure from outside to provide milk. Higher milk volume 14 days post-partum was significantly correlated with higher internal (Spearman´s rho = 0.2017, p = 0.000) and higher external pressure to provide milk (Spearman´s rho = 0.2991; p = 0.000). Higher PSS:NICU parental role alteration scores were significantly correlated with more internal (Spearman´s rho = -0.2865, p = 0.000) and more external pressure to provide milk (Spearman´s rho = -0.1478; p = 0.002). Milk volume 14 days post-partum and the PSS:NICU were not significantly correlated (Spearman´s rho = -0.0190; p = 0.701). Qualitative analyses highlighted these results and enhanced the bidirectional relationships between maternal pressure to provide milk and milk volume. CONCLUSIONS Especially internal pressure to provide milk is perceived by many mothers, being mutually dependent on milk supply and parental stress. Pressure to provide milk may be an important factor to decrease maternal stress in the NICU and, therefore, lead to more positive pumping and breastfeeding experiences. More research and validated instruments are needed to adequately measure pressure to provide milk with its different psychological, social, and environmental dimensions.
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Affiliation(s)
- Isabella Schwab
- Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Health Services Research University of Cologne, Faculty of Medicine and University Hospital Cologne, Eupener Straße 129, Cologne, 50933, Germany.
| | - Till Dresbach
- Department of Neonatology and Pediatric Intensive Care, Children's Hospital, University of Bonn, Venusberg-Campus 1, Bonn, 53127, Germany
| | - Tim Ohnhäuser
- Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Health Services Research University of Cologne, Faculty of Medicine and University Hospital Cologne, Eupener Straße 129, Cologne, 50933, Germany
| | | | - Nadine Scholten
- Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Health Services Research University of Cologne, Faculty of Medicine and University Hospital Cologne, Eupener Straße 129, Cologne, 50933, Germany
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Tager JB, Hinojosa JT, LiaBraaten BM, Balistreri KA, Aniciete D, Charleston E, Frader JE, White DB, Clayman ML, Sorce LR, Davies WH, Rothschild CB, Michelson KN. Challenges of Families of Patients Hospitalized in the PICU: A Preplanned Secondary Analysis From the Navigate Dataset. Pediatr Crit Care Med 2024; 25:128-138. [PMID: 37889100 PMCID: PMC10840810 DOI: 10.1097/pcc.0000000000003385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
OBJECTIVES To describe challenges experienced by parents of children hospitalized in the PICU during PICU admission as reported by family navigators. DESIGN A preplanned secondary analysis of open-response data coded via inductive qualitative approach from the Navigate randomized controlled trial (RCT) dataset (ID NCT02333396). SETTING Two university-affiliated PICUs in the Midwestern United States as part of an RCT. PATIENTS Two hundred twenty-four parents of 190 PICU patients. INTERVENTIONS In 2015-2017, trained family navigators assessed and addressed parent needs, offered weekly family meetings, and provided post-PICU discharge parent check-ins as part of a study investigating the effectiveness of a communication support intervention ("PICU Supports"). MEASUREMENTS AND MAIN RESULTS We analyzed qualitative data recorded by family navigators weekly across 338 encounters. Navigators described families' "biggest challenge," "communication challenges," and ways the team could better support the family. We used an inductive qualitative coding approach and a modified member-checking exercise. The most common difficulties included home life , hospitalization , and diagnosis distress (45.2%, 29.0%, and 17.2% of families, respectively). Navigators often identified that parents had co-occurring challenges. Communication was identified as a "biggest challenge" for 8% of families. Communication challenges included lack of information, team communication , and communication quality (7.0%, 4.8%, and 4.8% of families, respectively). Suggestions for improving care included better medical communication, listening, rapport, and resources. CONCLUSIONS This study describes families' experiences and challenges assessed throughout the PICU stay. Family navigators reported families frequently experience stressors both internal and external to the hospital environment, and communication challenges between families and providers may be additional sources of distress. Further research should develop and assess interventions aimed at improving provider-family communication and reducing stressors outside the hospitalization itself, such as home life difficulties.
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Affiliation(s)
- Julia B Tager
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI
| | - Jessica T Hinojosa
- Department of Psychology, Southern Illinois University-Carbondale, Carbondale, IL
| | - Brynn M LiaBraaten
- Department of Anesthesiology, Medical College of Wisconsin & Jane B. Pettit Pain and Headache Center, Children's Wisconsin, Milwaukee, WI
| | | | | | - Elizabeth Charleston
- Department of Psychology, DePaul University, Chicago, IL
- Division of Child Abuse Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Joel E Frader
- Division of Pediatric Critical Care Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Douglas B White
- Program on Ethics and Decision Making in Critical Illness, CRISMA Center, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Marla L Clayman
- Department of Veterans Affairs, Center for Healthcare Organization and Implementation Research, Bedford, MA
- Department of Population and Quantitative Health Sciences, UMass Chan School of Medicine, Worcester, MA
| | - Lauren R Sorce
- Division of Pediatric Critical Care Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL
- Department of Nursing, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - W Hobart Davies
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI
| | - Charles B Rothschild
- Division of Critical Care Medicine, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI
| | - Kelly N Michelson
- Division of Pediatric Critical Care Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL
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Malin KJ, Vittner D, Darilek U, McGlothen-Bell K, Crawford A, Koerner R, Pados BF, Cartagena D, McGrath JM, Vance AJ. Application of the Adverse Childhood Experiences Framework to the NICU. Adv Neonatal Care 2024; 24:4-13. [PMID: 38061194 DOI: 10.1097/anc.0000000000001122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
BACKGROUND Infants and families requiring neonatal intensive care unit (NICU) care often experience significant stress and trauma during the earliest period of the infant's life, leading to increased risks for poorer infant and family outcomes. There is a need for frameworks to guide clinical care and research that account for the complex interactions of generational stress, pain, toxic stress, parental separation, and lifelong health and developmental outcomes for infants and families. PURPOSE Apply the Adverse Childhood Experiences (ACEs) framework in the context of the NICU as a usable structure to guide clinical practice and research focused on infant neurodevelopment outcomes and parental attachment. METHODS An overview of ACEs is provided along with a detailed discussion of risk at each level of the ACEs pyramid in the context of the NICU. Supportive and protective factors to help mitigate the risk of the ACEs in the NICU are detailed. RESULTS NICU hospitalization may be considered the first ACE, or potentially an additional ACE, resulting in an increased risk for poorer health outcomes. The promotion of safe, stable, and nurturing relationships and implementation of trauma-informed care and individualized developmental care potentially counter the negative impacts of stress in the NICU. IMPLICATIONS FOR PRACTICE AND RESEARCH Nurses can help balance the negative and positive stimulation of the NICU through activities such as facilitated tucking, skin-to-skin care, mother's milk, and active participation of parents in infant care. Future research can consider using the ACEs framework to explain cumulative risk for adverse health and well-being in the context of NICU care.
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Affiliation(s)
- Kathryn J Malin
- College of Nursing, Marquette University, Milwaukee, Wisconsin (Dr Malin); Children's Wisconsin, Milwaukee (Dr Malin); Egan School of Nursing & Health Studies, Fairfield University, Fairfield, Connecticut (Dr Vittner); Department of Pediatrics (Dr Darilek) and School of Nursing (Drs McGlothen-Bell, Crawford, and McGrath), The University of Texas Health Science Center at San Antonio; University of Florida, Gainesville (Dr Koerner); Infant Feeding Care, Wellesley, Massachusetts (Dr Pados); School of Nursing, Old Dominion University, Norfolk, Virginia (Dr Cartagena); and Center for Health Policy and Health Services Research, Henry Ford Health, Detroit, Michigan (Dr Vance)
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Ettenberger M, Bieleninik Ł, Stordal AS, Ghetti C. The effect of paternal anxiety on mother-infant bonding in neonatal intensive care. BMC Pregnancy Childbirth 2024; 24:55. [PMID: 38212696 PMCID: PMC10782755 DOI: 10.1186/s12884-023-06179-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 12/06/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND The hospitalization of a preterm infant in the NICU can lead to mental health difficulties in parents, but not much is known how paternal anxiety might affect the mother-infant relationship. METHODS This prospective cohort study is a secondary analysis investigating how paternal anxiety levels might affect maternal bonding in the NICU using the dataset of the multinational pragmatic randomized controlled trial LongSTEP. A linear mixed-effects model was used for correlations of paternal anxiety (GAD-7) and maternal bonding (PBQ) at NICU discharge, and at 6 and 12 months infant corrected age. Secondary analyses examined effects on paternal anxiety related to: site (Argentina, Colombia, Israel, Norway, and Poland), maternal depression (EPDS), infant gestational age at birth, paternal age, and type of pregnancy. RESULTS Paternal anxiety did not predict maternal bonding at NICU discharge (p = 0.096), at 6 months (p = 0.316), or at 12 months infant corrected age (p = 0.473). Secondary outcomes showed a statistically significant site effect, with higher paternal anxiety levels at the two Colombian sites at baseline (p = 0.014 and p = 0.020) and for one site at discharge (p = 0.012), but not for paternal age (p = 0.925 and p = 0.793), infant gestational age at birth (p = 0.974 and p = 0.686 and p = 0.340), or type of pregnancy (p = 0.381). Maternal depression predicted paternal anxiety at baseline (p < 0.001) and at discharge (p = 0.003). CONCLUSIONS In this study, paternal anxiety did not predict maternal bonding. Paternal anxiety varied by site, indicating a need for research on potential cultural differences in manifestation of paternal anxiety. Maternal depression predicted paternal anxiety, confirming a previously reported correlation. Further research on variations in paternal mental health in the neonatal period is warranted, as well as exploration of the social contagion of mental health in preterm parents. TRIAL REGISTRATION ClinicalTrials.gov NCT03564184.
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Affiliation(s)
- Mark Ettenberger
- Music Therapy Service, Department of Social Management, Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Music Therapy Service, Clínica de la Mujer, Bogotá, Colombia
- SONO - Centro de Musicoterapia, Bogotá, Colombia
| | - Łucja Bieleninik
- Institute of Psychology, Faculty of Social Sciences, University of Gdańsk, Gdańsk, Poland
- GAMUT - The Grieg Academy Music Therapy Research Centre, NORCE Norwegian Research Centre AS, Bergen, Norway
- Institute of Pedagogy and Languages, University of Applied Sciences, Elbląg, Poland
| | - Andreas Størksen Stordal
- NORCE Technology, NORCE Norwegian Research Centre AS, Bergen, Norway
- Department of Mathematics, University of Bergen, Bergen, Norway
| | - Claire Ghetti
- GAMUT - The Grieg Academy Music Therapy Research Centre, NORCE Norwegian Research Centre AS, Bergen, Norway.
- Dept. of Music, GAMUT - The Grieg Academy Music Therapy Research Centre, The Grieg Academy, University of Bergen, Bergen, Norway.
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Pal N, Agrawal A, Shrivastava J. Stress Levels in Mothers of Admitted Newborns in NICU and Effect of Counseling. Indian J Pediatr 2024; 91:17-22. [PMID: 37233890 DOI: 10.1007/s12098-023-04561-5] [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: 05/05/2022] [Accepted: 12/26/2022] [Indexed: 05/27/2023]
Abstract
OBJECTIVES To examine the effect of counseling on stress levels in mothers of neonates admitted to the Neonatal Intensive Care Unit (NICU). METHODS This prospective research was carried out from January 2020 to December 2020 in a central India teaching hospital providing tertiary care. Parental Stressor Scale (PSS):NICU questionnaire was used to measure maternal stress among mothers of 540 admitted infants between 3 and 7 d of admission. Counseling was done at the time of recruitment and its effect was measured after 72 h and re-counseling was done. This cycle of stress assessment and counseling was repeated every 72 h till the baby was admitted in the NICU. Overall stress levels for each subscale were determined, and pre- and post-counseling stress was compared. RESULTS For the subscales of sight and sound, appearance and behavior, change in the parental role, and staff behavior and communication, the median scores were 1.5 (IQR-1.2-1.88), 2.5 (2.3-2.9), 3.3 (3.0-3.6) and 1.3 (1.1-1.62), respectively indicating high stress in the parental role alteration. Counseling was effective in reducing stress levels among all mothers irrespective of various maternal factors (p <0.01). Stress reduces more with increasing number of counseling, as suggested by higher change in the stress score with increased number of counseling. CONCLUSIONS This study shows that NICU mothers are under remarkable stress and repeated counseling sessions targeted at particular concerns might assist.
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Affiliation(s)
- Nikita Pal
- Department of Pediatrics, Gandhi Medical College (GMC) and Kamla Nehru Hospital, Bhopal, MP, India
| | - Amit Agrawal
- Department of Pediatrics, Gandhi Medical College (GMC) and Kamla Nehru Hospital, Bhopal, MP, India.
| | - Jyotsna Shrivastava
- Department of Pediatrics, Gandhi Medical College (GMC) and Kamla Nehru Hospital, Bhopal, MP, India
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Kainth D, Thukral A. Parental Stress in NICU: Where Communication is the Key! Indian J Pediatr 2024; 91:5. [PMID: 37515680 DOI: 10.1007/s12098-023-04778-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 07/12/2023] [Indexed: 07/31/2023]
Affiliation(s)
- Deepika Kainth
- Department of Pediatrics, WHO Collaborating Center for Newborn Training and Research, All India Institute of Medical Sciences, New Delhi, 110 029, India
| | - Anu Thukral
- Department of Pediatrics, WHO Collaborating Center for Newborn Training and Research, All India Institute of Medical Sciences, New Delhi, 110 029, India.
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Gallagher K, Chant K, Mancini A, Bluebond-Langner M, Marlow N. The NeoPACE study: study protocol for the development of a core outcome set for neonatal palliative care. BMC Palliat Care 2023; 22:203. [PMID: 38114987 PMCID: PMC10729357 DOI: 10.1186/s12904-023-01326-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 12/08/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Neonatal death is the leading category of death in children under the age of 5 in the UK. Many babies die following decisions between parents and the neonatal team; when a baby is critically unwell, with the support of healthcare professionals, parents may make the decision to stop active treatment and focus on ensuring their baby has a 'good' death. There is very little evidence to support the clinical application of neonatal palliative care and/or end-of-life care, resulting in variation in clinical provision between neonatal units. Developing core outcomes for neonatal palliative care would enable the development of measures of good practice and enhance our care of families. The aim of this study is to develop a core outcome set with associated tools for measuring neonatal palliative care. METHOD This study has four phases: (1) identification of potential outcomes through systematic review and qualitative interviews with key stakeholders, including parents and healthcare professionals (2) an online Delphi process with key stakeholders to determine core outcomes (3) identification of outcome measures to support clinical application of outcome use (4) dissemination of the core outcome set for use across neonatal units in the UK. Key stakeholders include parents, healthcare professionals, and researchers with a background in neonatal palliative care. DISCUSSION Developing a core outcome set will standardise minimum reported outcomes for future research and quality improvement projects designed to determine the effectiveness of interventions and clinical care during neonatal palliative and/or end-of-life care. The core outcome set will provide healthcare professionals working in neonatal palliative and/or end-of-life support with an increased and consistent evidence base to enhance practice in this area. TRIAL REGISTRATION The study has been registered with the COMET initiative ( https://www.comet-initiative.org/Studies/Details/1470 ) and the systematic review is registered with the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42023451068).
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Affiliation(s)
- Katie Gallagher
- UCL Elizabeth Garrett Anderson Institute for Women's Health, University College London, 74 Huntley Street, WC1E 6AU, London, UK.
| | - Kathy Chant
- UCL Elizabeth Garrett Anderson Institute for Women's Health, University College London, 74 Huntley Street, WC1E 6AU, London, UK
| | - Alex Mancini
- Chelsea and Westminster Hospitals NHS Foundation Trust, London, UK
| | | | - Neil Marlow
- UCL Elizabeth Garrett Anderson Institute for Women's Health, University College London, 74 Huntley Street, WC1E 6AU, London, UK
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Malin KJ, Kruschel K, Gondwe K, Lagatta J, Carter CS, Nazarloo HP, Conley Y, White-Traut R. Feasibility of Stress Research in Premature Infant-Maternal Dyads During and After Neonatal Intensive Care Unit Hospitalization. Adv Neonatal Care 2023; 23:583-595. [PMID: 37948632 PMCID: PMC10786239 DOI: 10.1097/anc.0000000000001112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
BACKGROUND Stress from preterm infant admission to the neonatal intensive care unit (NICU) is associated with infant and maternal physiologic changes, including endocrine and epigenetic alterations. Little is known about the mechanisms connecting NICU stress to biologic changes, and whether preterm infant and maternal stress are reciprocal. As a preliminary step, feasibility and acceptability of measuring indicators of stress are required. PURPOSE This study evaluated the feasibility and acceptability of research examining perceptions and biologic markers of stress in premature infant-maternal dyads during and after NICU hospitalization. METHODS We evaluated study feasibility using a longitudinal descriptive design. Acceptability was measured via a maternal questionnaire. Exploratory data regarding hospitalization, perceptions of stress, social support and social determinants of health, and biologic markers of stress were collected during the first week of life and again 3 months after NICU. RESULTS Forty-eight mothers were eligible for the study, 36 mothers were approached, 20 mothers consented to participate, and 14 mothers completed data collection. Mothers reported high levels of study acceptability despite also voicing concern about the sharing of genetic data. Exploration of DNA methylation of SLC6A4 in preterm infants was significant for a strong correlation with perception of total chronic stress. IMPLICATIONS FOR PRACTICE AND RESEARCH Clinical practice at the bedside in the NICU should include standardized screening for and early interventions to minimize stress. Complex research of stress is feasible and acceptable. Future research should focus on linking early life stress with epigenetic alterations and evaluation of the dyad for reciprocity.
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Affiliation(s)
- Kathryn J Malin
- Marquette University, College of Nursing, Milwaukee, Wisconsin (Dr Malin); Children's Wisconsin, Milwaukee (Drs Malin and White-Traut); Medical College of Wisconsin, Milwaukee (Ms Kruschel and Dr Lagatta); University of Washington, The Department of Child, Family, and Population Health Nursing, Seattle, Washington (Dr Gondwe); The Kinsey Institute at Indiana University, Bloomington, Indiana (Drs Carter and Nazarloo); and University of Pittsburgh, School of Nursing, Pittsburgh, Pennsylvania (Dr Conley)
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Frostig T, Benjamini Y, Kehat O, Weiss-Meilik A, Mandel D, Peleg B, Strauss Z, Mitelpunkt A. Developing a length of stay prediction model for newborns, achieving better accuracy with greater usability. Int J Med Inform 2023; 180:105267. [PMID: 37918217 DOI: 10.1016/j.ijmedinf.2023.105267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 10/13/2023] [Accepted: 10/20/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND One in ten newborn children is born prematurely. The elongated length of stay (LOS) of these children in the Neonatal Intensive Care Unit (NICU) has important implications on hospital occupancy figures, healthcare and management costs, as well as the psychology of parents. In order to allow accurate planning and resource allocation, this study aims to create a generalizable and robust model to predict the NICU LOS of preterm newborns. METHODS Data were collected from a large tertiary center NICU between 2011 and 2018 and relates to 5,362 newborns. The selected model was externally validated using a data set of 8,768 newborns from another tertiary center NICU. This report compares several models, such as Random Forest (RF), quantile RF, and other feature selection methods, including LASSO and AIC step-forward selection. In addition, a novel step-forward selection based on False Discovery Rate (FDR) for quantile regression is presented and evaluated. RESULTS A high-orderquantile regression model for predicting preterm newborns' LOS that uses only four features available at birth had more attractive properties than other richer ones. The model achieved a Mean Absolute Error (MAE) of 6.26 days on the internal validation set (average LOS 27.04) and an MAE of 6.04 days on the external validation set (average LOS 29.32). The suggested model surpassed the accuracy obtained by models in the literature. It is shown empirically that the FDR-based selection has better properties than the AIC-based step-forward selection approach. CONCLUSION This paper demonstrates a process to create a predictive model for NICU LOS in preterm newborns, where each step is reasoned. We obtain a simple and robust model for NICU LOS prediction, which achieves far better results than the current model used for financing NICUs. Utilizing this model, we have created an easy-to-use online web application to ease parents' worries and to assist NICU management: https://tzviel.shinyapps.io/calcuLOS.
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Affiliation(s)
- Tzviel Frostig
- Department of Statistics and Operation Research, Tel Aviv University, Ramat Aviv, 69978, Tel Aviv, Israel.
| | - Yoav Benjamini
- Department of Statistics and Operation Research, Tel Aviv University, Ramat Aviv, 69978, Tel Aviv, Israel; Sagol School of Neuroscience and the Edmond Safra Bioinformatics Center, Tel Aviv University Ramat Aviv, 69978, Tel Aviv, Israel
| | - Orli Kehat
- I-Medata AI Center, Tel Aviv Medical Center, 6 Weizmann St., 64239, Tel Aviv, Israel
| | - Ahuva Weiss-Meilik
- I-Medata AI Center, Tel Aviv Medical Center, 6 Weizmann St., 64239, Tel Aviv, Israel
| | - Dror Mandel
- Departments of Neonatology and Pediatrics, Dana Dwek Children's Hospital, Tel Aviv Medical Center, 6 Weizmann St., 64239, Tel Aviv, Israel
| | - Ben Peleg
- Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, 69978, Tel Aviv, Israel; Department of Neonatology, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-HaShomer, Israel
| | - Zipora Strauss
- Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, 69978, Tel Aviv, Israel; Department of Neonatology, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-HaShomer, Israel
| | - Alexis Mitelpunkt
- Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, 69978, Tel Aviv, Israel; Pediatric Rehabilitation, Department of Rehabilitation, Dana Dwek Children's Hospital, Tel Aviv Medical Center, 6 Weizmann St., 64239, Tel Aviv, Israel
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Wang F, Zhang S, Liu C, Ni Z. Post-traumatic growth and influencing factors among parents of premature infants: a cross-sectional study. BMC Psychol 2023; 11:388. [PMID: 37950321 PMCID: PMC10638708 DOI: 10.1186/s40359-023-01360-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 09/28/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Post-traumatic growth is a positive psychological change that may aid recovery in individuals experiencing trauma. Owing to the lack of research in the area of parental care for premature infants, we decided to explore the levels and factors influencing post-traumatic growth among parents of premature infants in neonatal intensive care units. We believe that these findings will help reassess existing care practices so that healthcare providers can promptly identify negative emotions and take necessary measures to help develop the potential to enhance post-traumatic growth. METHODS A cross-sectional survey was conducted using convenience sampling between February and September 2022. Data were analysed using independent sample t-tests and one-way analysis of variance (ANOVA). Bivariate correlations were analysed using the Pearson's or Spearman's method, and related factors were analysed using multiple linear regression. We followed the SRQR checklist throughout the study period. RESULTS A total of 217 patients were effectively treated, with a recovery rate of 98.64%. Univariate analysis showed that the length of hospital stay, presence of only one child, parents' age, marital status, education level, working status, and per capita monthly familial income were influencing factors. Bivariate analysis showed that post-traumatic growth was moderately and positively correlated with perceived social support, rumination, and family resilience. Multiple linear regression showed that purposeful contemplation, family resilience, education, family support, age, and marital status entered into the regression equation and together accounted for 47.4% of the total variation. CONCLUSIONS It is necessary to pay attention to post-traumatic growth and familial stability in these families, provide aid in building a good support system, and encourage parents to mobilise their family and favourable factors to increase post-traumatic growth levels.
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Affiliation(s)
- Fang Wang
- Children's Hospital of Soochow University, No. 92, Zhong nan St, Suzhou, 215025, Jiangsu, China
| | - Shuo Zhang
- School of Nursing, Soochow University, Suzhou, Jiangsu, China
| | - Chunyan Liu
- School of Nursing, Soochow University, Suzhou, Jiangsu, China
| | - Zhihong Ni
- Children's Hospital of Soochow University, No. 92, Zhong nan St, Suzhou, 215025, Jiangsu, China.
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Unvar F, Tas Arslan F. Effectiveness of maternal-targeted training on nonpharmacologic pain management on heel stick sampling: A randomized controlled trial. J Pediatr Nurs 2023; 73:e477-e483. [PMID: 37923615 DOI: 10.1016/j.pedn.2023.10.018] [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: 06/20/2023] [Revised: 10/16/2023] [Accepted: 10/16/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND Heel stick sampling, which is a common procedure in newborns, causes acute pain, and parents are aware of this. AIM The current study aimed to investigate the effectiveness of maternal-targeted training on newborn pain management, addressing the use of nonpharmacological methods and anxiety. METHODS The study is 2-arm, parallel-group randomized controlled trial. A total of 64 mothers were included in this study. Mothers were randomly allocated to each group; intervention (n:32) and control (n=:32). Training on nonpharmacological pain management in newborns was given to the mothers in the intervention group. Data were collected with an Introductory Information Form, Nonpharmacological Pain Management Use Checklist, and State-Trait Anxiety Inventory. RESULTS Nonpharmacological methods were used for the procedures in the control group and the intervention group, with an absolute difference of 68.8% between groups. The difference was statistically significant (p < 0.001) and had a large effect (d = -79.222; 95% CI, -9.365 to 670.143. There was no significant difference between the groups in terms of anxiety score (p = 0.558). CONCLUSION Demonstrates the clinical relevance and feasibility of training targeting maternal on neonatal pain management during the heel stick sampling procedure. PRACTICE IMPLICATIONS When non-pharmacological methods in pain management of newborns were recommended by the nurse, maternal involvement in pain management increased significantly, suggesting that nurses have a key role in ensuring parental involvement. CLINICAL TRIAL REGISTRATION NCT05173662.
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Affiliation(s)
- Fulya Unvar
- Ministry of Health, Akşehir State Hospital, 42550, Akşehir, Konya, Türkiye
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Wege M, von Blanckenburg P, Maier RF, Seifart C. Does Educational Status Influence Parents' Response to Bad News in the NICU? CHILDREN (BASEL, SWITZERLAND) 2023; 10:1729. [PMID: 38002820 PMCID: PMC10670369 DOI: 10.3390/children10111729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 10/22/2023] [Accepted: 10/23/2023] [Indexed: 11/26/2023]
Abstract
Communication in neonatal intensive care units and the relationship between families and staff have been reported to influence parental mental well-being. Research has also shown an impact of parental educational level on their well-being. However, whether different educational levels result in different reactions to breaking bad news (BBN) by physicians remains unanswered so far. We therefore examined the impact of parental level of education on their mental state after a BBN conversation and their relation to physicians. A prospective quantitative survey was conducted amongst 54 parents whose preterm or term infants were hospitalized in three German neonatal units. Parental education was classified as low (lower secondary/less (1), n: 23) or high (higher secondary/more (2), n: 31). Parents answered questions about certain aspects of and their mental state after BBN and their trust in physicians. The two groups did not differ significantly in their mental condition after BBN, with both reporting high levels of exhaustion and worries, each (median (min;max): (1): 16 (6;20) vs. (2): 14 (5;20), (scaling: 5-20)). However, lower-educated parents reported a lower trust in physicians (median (min;max): (1): 2 (0;9) vs. (2): 1 (0;6), p < 0.05 (scaling: 0-10)) and felt less safe during BBN (median (min;max): (1): 15 (9;35) vs. (2): 13 (9;33), p < 0.05). Only among higher-educated parents was trust in physicians significantly correlated with the safety and orientation provided during BBN (r: 0.583, p < 0.05, r: 0.584, p < 0.01). Concurrently, only among less-educated parents was safety correlated with the hope conveyed during BBN (r: 0.763, p < 0.01). Therefore, in BBN discussions with less-educated parents, physicians should focus more on giving them hope to promote safety.
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Affiliation(s)
- Mirjam Wege
- Children’s Hospital, University Hospital, Philipps University of Marburg, 35033 Marburg, Germany;
| | - Pia von Blanckenburg
- Department of Clinical Psychology and Psychotherapy, Philipps University of Marburg, 35032 Marburg, Germany;
| | - Rolf Felix Maier
- Children’s Hospital, University Hospital, Philipps University of Marburg, 35033 Marburg, Germany;
| | - Carola Seifart
- Faculty of Medicine, Deans Office, Research Group Medical Ethics, Philipps University of Marburg, 35033 Marburg, Germany;
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Heidary S, Heidari H, Choopani R, Sedehi M. The effect of the supportive care program based on Bandura's self-efficacy on stress and participation of the mothers of the neonates admitted to neonatal intensive care unit. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:265. [PMID: 37849880 PMCID: PMC10578563 DOI: 10.4103/jehp.jehp_899_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 09/27/2022] [Indexed: 10/19/2023]
Abstract
BACKGROUND Maternal stress can affect both the neonate and the mother and deter them from participating in the care of preterm neonates. The purpose of the study was to determine the effect of the supportive care program (SCP) based on Bandura's self-efficacy on stress and participation of mothers of neonates admitted to the neonatal intensive care unit. MATERIALS AND METHODS This quasi-experimental study was performed in 2020 on 90 mothers of premature infants admitted to the NICU of Hajar Hospital in Shahrekord, Iran. First, the control group and then the experimental group were selected and a training package based on Bandura's self-efficacy theory was implemented for the intervention group. The research instruments in this study were the Heidari mothers stress questionnaire and Melnyk mother's participation questionnaire which was completed before and after the intervention. The analysis was performed based on SPSS (version 24) and Chi-square, independent t-test, and paired tests. RESULTS The results indicated that the demographic variables of mothers and neonatal characteristics of the two groups did not have significant differences except for the history of abortion and infertility in mothers and the weight of preterm neonates (P < 0.05). Mothers in the experimental group had less stress (t (88) = 29.50, P < 0.001) and more participation than the control group (t (88) = -27.18, P < 0.001) after the intervention. CONCLUSIONS Using self-efficacy-based SCP for maternal education besides routine education could positively affect the reduction of stress and the increase of maternal participation in caring for preterm neonates during hospitalization. Thus, using this supportive program is suggested for mothers with preterm neonates admitted to NICU.
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Affiliation(s)
- Shima Heidary
- Faculty of Nursing and Midwifery, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Haydeh Heidari
- Faculty of Nursing and Midwifery, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Roya Choopani
- Department of Pediatrics, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Morteza Sedehi
- Department of Epidemiology and Biostatistics, School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran
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Stein Duker LI, Kwon J, Richter M, Pineda R. Feasibility of wearable sensors in the NICU: Psychophysiological measures of parental stress. Early Hum Dev 2023; 183:105814. [PMID: 37429198 PMCID: PMC11062485 DOI: 10.1016/j.earlhumdev.2023.105814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 06/27/2023] [Accepted: 06/27/2023] [Indexed: 07/12/2023]
Abstract
BACKGROUND Parents report elevated stress during their infant's NICU hospitalization. Real-time measures may improve our understanding of parental stress in the NICU. AIM Examine the feasibility of wearable sensors to describe parental stress in the NICU. STUDY DESIGN In this prospective feasibility study of 12 parent-infant dyads, parents wore an Empatica E4 wristband to measure psychophysiological stress via electrodermal activity (EDA) during sensory interventions (holding, massage, reading, touch, etc) with their babies. Baseline and intervention periods were delineated during which concurrent monitoring and clinical observations of infant behavior and environmental factors were recorded. Feasibility was assessed by investigating recruitment/enrollment, retention/adherence, acceptability, sensor usability, and changes in EDA waveforms based on potential stressors. For the latter, independent samples t-tests and ANOVA were used to examine differences in EDA from baseline to intervention, and the impact of environmental and infant factors on parent stress were visually analyzed against EDA waveforms. RESULTS Wearable sensor use in the NICU appeared feasible as assessed by all methods. Preliminary data analysis indicated that overall parent EDA levels during parent-infant interactions were low, and engagement in sensory intervention(s) led to a non-significant increase in parental EDA, measured by both skin conductance levels and non-specific skin conductance responses. Three main patterns of EDA emerged: a temporary increase in EDA at the beginning of the intervention followed by a decrease and plateau, a plateau in EDA from baseline to intervention, and a gradual rise in EDA throughout intervention. Specific environmental and infant factors, such as infant stress and health care providers entering the room, appeared to impact parent stress levels. CONCLUSION Although these preliminary findings provide support for use of EDA in the NICU, future studies are needed.
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Affiliation(s)
- Leah I Stein Duker
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
| | - Jenny Kwon
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA; Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA
| | - Marinthea Richter
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
| | - Roberta Pineda
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA; Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA; Gehr Family Center for Health Systems Science and Innovation, University of Southern California, Los Angeles, CA, USA.
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Noergaard B, Kofoed PE. Developing and Implementing a Father-Friendly Neonatal Intensive Care Unit Improved Nurses' Self-Efficacy. Adv Neonatal Care 2023:00149525-990000000-00078. [PMID: 37463518 PMCID: PMC10373848 DOI: 10.1097/anc.0000000000001088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
BACKGROUND The need for paternal support is rarely addressed in neonatal intensive care units (NICUs). Neonatal nurses often primarily focus on the needs of the mother and infant and may not be trained in support of fathers. PURPOSE To investigate nurses' self-efficacy (SE) in guiding and supporting fathers after implementing a father-friendly NICU. METHODS Nurses from the intervention NICU and 13 control NICUs were included in a before-and-after intervention study. Questionnaires measuring nurses' SE regarding support of fathers and mothers were obtained when starting the development process, before and 18 months after the implementation. The primary outcome was the difference between nurses' SE scores for father and mother questions in the intervention group compared with the control group. RESULTS In total, 294, 330, and 288 nurses responded to the first, second, and third questionnaires, respectively. From the first to third questionnaires, the intervention group showed a significantly higher increase in SE scores for father questions compared with the control group (0.53 vs 0.20, P = .005) and a nonsignificantly higher increase for mother questions (0.30 vs 0.09, P = .13). In the third questionnaire, the intervention group showed a higher SE score for father questions compared with the control group (9.02 vs 8.45, P = .002) and the first questionnaire (9.02 vs 8.49, P = .02). IMPLICATIONS FOR PRACTICE AND RESEARCH By implementing a father-friendly NICU, nurses' SE for providing support to fathers increased significantly. Training in a father-friendly approach increases nurses' ability to support both parents.
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Affiliation(s)
- Betty Noergaard
- Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital, University Hospital of Southern Denmark, Kolding, Denmark (Dr Noergaard, Dr Kofoed); and Institute of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark (Dr Kofoed)
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van Dokkum NH, Fagan LJ, Cullen M, Loewy JV. Assessing HeartSong as a Neonatal Music Therapy Intervention: A Qualitative Study on Personal and Professional Caregivers' Perspectives. Adv Neonatal Care 2023; 23:264-271. [PMID: 37075326 DOI: 10.1097/anc.0000000000001068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Abstract
BACKGROUND The music therapy HeartSong intervention pairs newborn infant heartbeats with parents' Song of Kin. Formal evidence on professional and personal caregiver perspectives of this intervention is lacking. PURPOSE This survey study evaluates the HeartSong music therapy intervention from parent and staff perspectives. METHODS A qualitative study assessing inclusion of HeartSong for family neonatal intensive care unit (NICU) care surveyed 10 professional caregivers comprising medical and psychosocial NICU teams anonymously reflecting their impressions of the intervention. Digital survey of parents/guardians contacted through semistructured phone interviews relayed impressions of recordings: subsequent setup, Song of Kin selection, and use of HeartSong, including thoughts/feelings about it as an intervention. RESULTS Professional and personal caregivers valued the HeartSong intervention for bereavement support, family support, including parental, extended family/infant support, and to enhance bonding. Emergent themes: memory-making, connectedness/closeness, support of parent role, processing mental health needs of stressful NICU days, and subsequent plans for lifelong HeartSong use. Therapeutic experience was named as a crucial intervention aspect and participants recommended the HeartSong as a viable, accessible NICU intervention. IMPLICATIONS FOR PRACTICE AND RESEARCH HeartSong's use showed efficacy as a clinical NICU music therapy intervention for families of critically ill and extremely preterm infants, when provided by trained, specialized, board-certified music therapists. Future research focusing on HeartSong in other NICU populations might benefit infants with cardiac disease, parental stress, and anxiety attending to parent-infant bonding. Costs and time benefits related to investment are needed before implementation is considered.
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Affiliation(s)
- Nienke H van Dokkum
- The Louis Armstrong Center for Music & Medicine, Mount Sinai Hospitals, New York City, New York (Dr van Dokkum and Mss Fagan and Loewy); Department of Pediatrics, Division of Neonatology, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands (Dr van Dokkum); and Department of Neonatology, Mount Sinai West Hospital, New York City, New York (Ms Cullen)
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28
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Orr E, Ballantyne M, Gonzalez A, Jack SM. Providers' perspectives of the neonatal intensive care unit context and care provision for adolescent parents: an interpretive description. BMC Pregnancy Childbirth 2023; 23:259. [PMID: 37069591 PMCID: PMC10107570 DOI: 10.1186/s12884-023-05553-1] [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: 07/28/2022] [Accepted: 03/29/2023] [Indexed: 04/19/2023] Open
Abstract
BACKGROUND The neonatal intensive care unit (NICU) is a complex care environment, with the NICU patient population among the most vulnerable in a hospital setting. Adolescent parents are a unique group within the broader NICU parent population and admission of their infant to the NICU contributes to an already complex situation as adolescent pregnancy and parenting is often associated with a range of psychosocial challenges. How the NICU care context influences care provision for adolescent parents is a significant gap in the NICU parenting and support discourse. Therefore, this study aimed to explore health and social care providers' perspectives of the NICU care context and how providers perceive the context as influencing the experiences of adolescent parents in the NICU. METHODS This was a qualitative, interpretive description study design. In-depth interviews were conducted with providers, including nurses and social workers, caring for adolescent parents in the NICU. Data was collected between December 2019 and November 2020. Data were analyzed concurrently with data collection. Constant comparison, analytic memos, and iterative diagramming techniques were used to challenge developing analytic patterns. RESULTS Providers (n = 23) described how the unit context influenced care provision as well as experiences for adolescent parents. We learned that having a baby in the NICU was perceived by providers as a traumatic experience for parents - impacting attachment, parenting confidence and competence, and mental health. Environmental factors - such as privacy and time - and perceptions that adolescent parents are treated differently in the NICU were also seen as influencing this overall experience. CONCLUSIONS Providers involved in the care of adolescent parents in the neonatal intensive care unit described the distinctiveness of this group within the broader parent population and how quality of care may be impacted by contextual factors as well as experiences of age-related stigma. Further understanding of NICU experiences from the parents' perspectives are warranted. Findings highlight opportunities for strengthened interprofessional collaboration and trauma- and violence-informed care strategies within the neonatal intensive care environment to mitigate the potential negative influence of this experience and improve care for adolescent parents.
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Affiliation(s)
- Elizabeth Orr
- Department of Nursing, Brock University, Faculty of Applied Health Sciences, 1812 Sir Isaac Brock Way, St. Catharines, Ontario, L2S 3A1, Canada.
| | - Marilyn Ballantyne
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Andrea Gonzalez
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
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Reimer A, Mause L, Hoffmann J, Hagemeier A, Dresbach T, Scholten N. How does stress affect maternal and paternal perceptions of relationship strain after a preterm birth? Results of a retrospective survey study. Acta Paediatr 2023; 112:762-769. [PMID: 36627542 DOI: 10.1111/apa.16664] [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: 11/16/2022] [Revised: 12/29/2022] [Accepted: 01/09/2023] [Indexed: 01/12/2023]
Abstract
AIM Strain on couple relationships is associated with a lower well-being. As premature birth is known to pose stress to parents, this study explores whether interparental relationship strain comes to pass within mothers and fathers during their infant's stay in a neonatal intensive care unit. METHODS A retrospective cross-sectional survey was conducted with parents who experienced a preterm birth (September to December 2020). Linear regression was used to analyse associations between stress and relationship strain. RESULTS The study included 437 mothers and 301 fathers. Fathers experienced lower relationship strain (M = 2.49, SD = 1.00) than mothers (M = 3.37, SD = 1.04). Overall, a significant association between relationship strain and stress due to the infant's behaviour and appearance was found for mothers (β = 0.16, p = 0.02) and fathers, with a significantly higher association for fathers (β = 0.27, p ≤ 0.002). With regard to parental role alterations, only mothers showed a significant association (β = 0.21, p ≤ 0.001). CONCLUSION Although mothers showed higher levels of stress and relationship strain, stress may also have an impact on fathers. Therefore, research should focus on stress prevention measures to meet both maternal and paternal needs.
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Affiliation(s)
- Alinda Reimer
- Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Human Sciences and Faculty of Medicine, University of Cologne and University Hospital Cologne, Cologne, Germany
| | - Laura Mause
- Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Human Sciences and Faculty of Medicine, University of Cologne and University Hospital Cologne, Cologne, Germany
| | - Jan Hoffmann
- Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Human Sciences and Faculty of Medicine, University of Cologne and University Hospital Cologne, Cologne, Germany
| | - Anna Hagemeier
- Medical Faculty and University Hospital Cologne, Institute of Medical Statistics and Computational Biology, University of Cologne, Cologne, Germany
| | - Till Dresbach
- Department of Neonatology and Paediatric Intensive Care Medicine, University Hospital Bonn, Bonn, Germany
| | - Nadine Scholten
- Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Human Sciences and Faculty of Medicine, University of Cologne and University Hospital Cologne, Cologne, Germany
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Risanger LI, Kofoed PE, Noergaard B, Vahlkvist S. Parents’ Perception of Staff Support in a Father-Friendly Neonatal Intensive Care Unit. CHILDREN 2023; 10:children10040673. [PMID: 37189922 DOI: 10.3390/children10040673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/30/2023] [Accepted: 03/30/2023] [Indexed: 04/05/2023]
Abstract
Healthcare professionals, especially nurses, play a central role in supporting parents during their stay in neonatal intensive care units (NICUs). Fathers often have their own support needs; however, studies have shown that these needs are rarely met to the same degree as those of the mothers. We developed a “father-friendly NICU” with the aim of providing good-quality care to the entire family. To evaluate the impact of this concept, we adopted a quasi-experimental design; using the Nurse Parent Support Tool (NPST), we investigated the differences in the fathers’ (n = 497) and mothers’ (n = 562) perception of the nursing support received on admission and discharge between before and after the intervention. In the historical control and intervention groups, the fathers’ median NPST scores at admission were 4.3 (range, 1.9–5.0) and 4.0 (range, 2.5–4.8), respectively (p < 0.0001); at discharge, these scores were 4.3 (range, 1.6–5.0) and 4.4 (range, 2.3–5.0), respectively (difference not significant). In the historical control and intervention groups, the mothers median NPST scores at admission were 4.5 (range, 1.9–5.0) and 4.1 (range, 1.0–4.8), respectively (p < 0.001); at discharge, these scores were 4.4 (range, 2.7–5.0) and 4.4 (range, 2.6–5), respectively (difference not significant). The parental perception of support did not increase after the intervention; however, the parents reported a high level of staff support both before and after the intervention. Further studies should focus on parental support needs during the different phases of hospitalization (i.e., admission, stabilization, and discharge).
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Affiliation(s)
- Linn Iren Risanger
- Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital, University Hospital of Southern Denmark, Sygehusvej 24, 6000 Kolding, Denmark
- H.C. Andersens Children’s Hospital, Odense University Hospital, 5000 Odense, Denmark
| | - Poul-Erik Kofoed
- Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital, University Hospital of Southern Denmark, Sygehusvej 24, 6000 Kolding, Denmark
- Department of Regional Health Research, University of Southern Denmark, 5000 Odense, Denmark
| | - Betty Noergaard
- Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital, University Hospital of Southern Denmark, Sygehusvej 24, 6000 Kolding, Denmark
| | - Signe Vahlkvist
- Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital, University Hospital of Southern Denmark, Sygehusvej 24, 6000 Kolding, Denmark
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Nist MD, Robinson A, Pickler RH. Parental Participation in Preterm Infant Feeding in the Neonatal Intensive Care Unit. MCN Am J Matern Child Nurs 2023; 48:76-81. [PMID: 36472494 PMCID: PMC9974565 DOI: 10.1097/nmc.0000000000000890] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE To identify factors associated with parental participation in the feeding care of hospitalized preterm infants and determine associations between parental participation in feeding and infant neurobehavioral outcomes. STUDY DESIGN AND METHODS Secondary analysis of data collected during a larger study of preterm infants. Parental participation in gavage and oral feeding was measured as a proportion of all feeding opportunities. Neurobehavioral outcomes were measured using a neurobehavioral assessment and feeding milestones. Other data were collected from the electronic health record. RESULTS Parental participation in feeding was low. There were associations between parental participation in gavage feeding and infant sex, insurance type, maternal race, infant gestational age at birth, and birthweight. There were associations between parental participation in oral feeding and infant sex, insurance type, maternal race, and study group. Greater parental participation in feeding was associated with earlier achievement of some feeding milestones. CLINICAL IMPLICATIONS Parental participation in feeding can decrease the time required for infants to achieve feeding milestones, possibly leading to decreased length of hospitalization. Nurses should encourage parents to participate in caregiving for their preterm infants. Interventions are needed to remove barriers to parental participation in caregiving.
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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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Heidarzadeh M, Heidari H, Ahmadi A, Solati K, sadeghi N. Evaluation of parental stress in neonatal intensive care unit in Iran: a national study. BMC Nurs 2023; 22:41. [PMID: 36788549 PMCID: PMC9930338 DOI: 10.1186/s12912-023-01200-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 02/06/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND More attention is paid to the survival and treatment of the sick infant in the neonatal intensive care unit (NICU) and parental stress is not considered. The purpose of this study was to determine samples of the level of parental stress in the NICU. METHOD This study is a descriptive-analytical study in which Parental Stress and General Health were used in an analytical national survey in Iran. The research sample consists of 2456 parents of infants admitted to NICU. The sampling method was multi-stage random. We used 11- item parental stress questionnaire and 28-item general health questionnaire for the data collection. RESULT Baloch ethnicity with an average of 11.52 had the highest level of stress. The mean stress score of mothers was higher than fathers. The mean score of all dimensions of physical symptoms, anxiety, social functioning, depression, and total mental health score in mothers was higher than fathers. There was a statistically significant difference in the length of hospitalization in terms of different levels of parental stress scores (p < 0.002). Lack of decisive response to parents was one of the most stressful issues (8.1%). CONCLUSION Our result shows mothers' stress was higher than fathers. So that health policymakers should pay attention to stress risk factors to provide appropriate interventions according stress risk factors Future studies should design appropriate interventions to reduce parental stress, especially in high-risk mothers.
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Affiliation(s)
- Mohammad Heidarzadeh
- grid.488433.00000 0004 0612 8339Zahedan University of Medical Sciences, Zahedan, Iran
| | - Haydeh Heidari
- Faculty of Nursing and Midwifery, Modeling in Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran.
| | - Ali Ahmadi
- grid.440801.90000 0004 0384 8883Department of Epidemiology and Biostatistics, School of Health and Modeling in Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Kamal Solati
- grid.440801.90000 0004 0384 8883Modeling in Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Narges sadeghi
- grid.411757.10000 0004 1755 5416Islamic Azad University, Isfahan, Iran
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Ataş N, Kılıçaslan F. The Effect of Hopelessness on Depressive Symptoms in Mothers of Infants Hospitalized at Neonatal Intensive Care Unit: The Mediating Role of Anxiety. Psychiatry 2023; 86:187-199. [PMID: 36688831 DOI: 10.1080/00332747.2022.2161260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Objective: Mothers of infants admitted to the neonatal intensive care unit (NICU) are at high risk for depressive symptoms. This study investigated whether anxiety symptoms mediate the relationships between hopelessness and depressive symptoms in mothers with newborn infants admitted to the NICU.Methods: This cross-sectional descriptive study was conducted in the NICU of a university hospital in Turkey between October 2021 and March 2022. A total of 100 mothers whose infants were hospitalized in the NICU participated in the study. The data were collected using the Sociodemographic Data Form, Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI) and Beck Hopelessness Scale (BHS). Linear regression analysis was used to examine the effect of demographic characteristics on scale scores. In order to test whether the anxiety score has a mediating role in the relationship between hopelessness and depression, the analysis was made based on the bootstrap method and the Maximum Likelihood method.Results: Levels of the depression, anxiety and hopelessness levels of the NICU mothers were not affected by the demographic variables of the parent and the infant. Hopelessness was found to predict depressive symptoms (β = 0.476; p < .050). In addition, according to the mediator variable analysis results, it was found that anxiety had a mediating role between the level of hopelessness and depressive symptoms (β = 0.596; p < .050). Accordingly, hopelessness explains 52.5% of the change in depression along with anxiety.Conclusion: Our study detailed the specific process of depressive symptoms caused by hopelessness in NICU mothers.
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Fatores associados ao estresse de pais em Unidade de Terapia Intensiva Neonatal. ACTA PAUL ENFERM 2023. [DOI: 10.37689/acta-ape/2023ao02061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
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NeoConnect: The Design, Implementation, and Impact of a Virtual Family-Centered NICU Program. J Perinat Neonatal Nurs 2023; 37:61-67. [PMID: 36707750 DOI: 10.1097/jpn.0000000000000698] [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: 01/29/2023]
Abstract
BACKGROUND Familial involvement in the neonatal intensive care unit (NICU) reduces parental stress and strengthens parental-infant bonding. However, parents often face barriers to in-person visitation. The coronavirus disease-2019 COVID-19 pandemic has exacerbated limitations to parental bedside presence. OBJECTIVE To design, implement, and evaluate a technology-based program to connect NICU babies with their families during the COVID-19 pandemic. METHODS We created NeoConnect at our level IV NICU, which included parental audio recordings and video chats between parents and their babies. Parental and NICU staff input on NeoConnect was gathered via preimplementation surveys. Inaugural families and staff members completed a postparticipation survey. RESULTS Prior to implementation, all parents who were surveyed (n = 24) wished they could be more involved in their baby's care. In the first 3 months of NeoConnect, 48 families participated in the audio recording project and 14 families participated in the video chat initiative. Following implementation, 85% of surveyed staff (28/33) reported that the patients became calmer when listening to their parents' recorded voice and 100% of surveyed parents (6/6) reported that video chats reduced their stress level. CONCLUSION Harnessing technology as a tool to increase parental involvement in the NICU is feasible and beneficial for NICU patients and their families.
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Provenzi L, Roberti E, Capelli E. Envisioning translational hyperscanning: how applied neuroscience might improve family-centered care. Soc Cogn Affect Neurosci 2022; 18:6953329. [PMID: 36542821 PMCID: PMC9910277 DOI: 10.1093/scan/nsac061] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 11/17/2022] [Accepted: 12/20/2022] [Indexed: 12/24/2022] Open
Abstract
From the very beginning of their life, human beings are immersed in a social and interactive environment that contributes to shaping their social and cognitive development under typical and at-risk conditions. In order to understand human development in its bidirectional relationship with the social environment, we need to develop a 'complexity-sensitive' approach in neuroscience. Recent advances have started to do so with the application of hyperscanning techniques which involve recording adult and child neural activity simultaneously and highlighting the presence of similar patterns of brain activity in the dyad. Numerous studies focused on typically developing children have been published in recent years with the application of this technique to different fields of developmental research. However, hyperscanning techniques could also be extremely beneficial and effective in studying development in atypical and clinical populations. Such application, namely translational hyperscanning, should foster the transition toward a two-brain translational neuroscience. In this paper, we envision how the application of hyperscanning to atypical and clinical child populations can inform family-centered care for children and their parents.
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Affiliation(s)
- Livio Provenzi
- Correspondence should be addressed to Livio Provenzi, Department of Brain and Behavioral Sciences, University of Pavia, via Mondino 2, Pavia 27100, Italy. E-mail:
| | - Elisa Roberti
- Developmental Psychobiology Lab, IRCCS Mondino Foundation, Pavia 27100, Italy
| | - Elena Capelli
- Developmental Psychobiology Lab, IRCCS Mondino Foundation, Pavia 27100, Italy
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Cristóbal-Cañadas D, Parrón-Carreño T, Nievas-Soriano BJ. Effect of the Kangaroo Mother Method after Preterm Delivery on Maternal Stress and Anxiety in the Context of the COVID-19 Pandemic-A Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16432. [PMID: 36554312 PMCID: PMC9778417 DOI: 10.3390/ijerph192416432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 12/04/2022] [Accepted: 12/06/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND The kangaroo mother method (KMM) may benefit infants and mothers in many ways. However, few studies focused on its efficacy on maternal anxiety and stress, especially in the context of the COVID-19 pandemic. OBJECTIVE To examine the effect of the kangaroo mother method (KMM) on postnatal stress and anxiety in mothers of preterm infants in neonatal intensive care, in the context of the COVID-19 pandemic. METHODS A cohort study of two groups of 56 mother-infant dyads recruited from a neonatal intensive care unit was conducted. Two groups were compared in terms of the mean duration of KMM during the twelve days of the study: the intervention group (mean duration of more than ninety minutes per day) and the control group (less than ninety minutes). Maternal stress was measured using the Parental Stressor: Neonatal Intensive Care Unit (PSS: NICU) scale and STAI E/R questionnaire before and after intervention (KMM). Demographic and other maternal covariates were extracted from medical records. Daily NICU records were used to track the frequency and duration of KMM sessions. RESULTS Mothers of the intervention group scored lower on the PSS: NICU and STAI E/R, although no statistically significant differences were found (p > 0.05). CONCLUSIONS Contrary to research based on biological and physiological parameters in newborns or performed before the COVID-19 pandemic, the differences found in applying subjective scales in mothers in the context of the COVID-19 pandemic were not significant. Therefore, mothers' perception of physical contact with their preterm infants may not have been as positive due to their fear of transmitting COVID.
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Affiliation(s)
- Delia Cristóbal-Cañadas
- Neonatal and Pediatric Intensive Care Unit, Torrecárdenas University Hospital, 04009 Almeria, Spain
| | - Tesifón Parrón-Carreño
- Nursing, Physiotherapy and Medicine Department, University of Almeria, 04120 Almeria, Spain
- Andalusian Council of Health at Almeria Province, 04005 Almeria, Spain
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De Clifford‐Faugère G, Aita M, Arbour C, Colson S. Development, evaluation and adaptation of a critical realism informed theory of procedural pain management in preterm infants: The
PAIN‐Neo
theory. J Adv Nurs 2022; 79:2155-2166. [DOI: 10.1111/jan.15525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 11/01/2022] [Accepted: 11/24/2022] [Indexed: 12/07/2022]
Affiliation(s)
- Gwenaëlle De Clifford‐Faugère
- Faculty of Nursing Université de Montréal Montréal Québec Canada
- CHU Sainte‐Justine Research Centre Montréal Québec Canada
- EA3279‐CEReSS, School of Nursing, Faculty of Medical and Paramedical Sciences Aix‐Marseille Université Marseille France
| | - Marilyn Aita
- Faculty of Nursing Université de Montréal Montréal Québec Canada
- CHU Sainte‐Justine Research Centre Montréal Québec Canada
- Quebec Network on Nursing Intervention Research (RRISIQ) Montréal Québec Canada
| | - Caroline Arbour
- Faculty of Nursing Université de Montréal Montréal Québec Canada
- Quebec Network on Nursing Intervention Research (RRISIQ) Montréal Québec Canada
- Hôpital du Sacré‐Cœur de Montréal, CIUSSS du Nord‐de‐l'Île‐de‐Montréal Montréal Québec Canada
| | - Sébastien Colson
- EA3279‐CEReSS, School of Nursing, Faculty of Medical and Paramedical Sciences Aix‐Marseille Université Marseille France
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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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Longitudinal Follow-up of Preterm Breastfeeding to 12 Weeks Corrected Gestational Age. Adv Neonatal Care 2022; 22:571-577. [PMID: 34743110 DOI: 10.1097/anc.0000000000000925] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Preterm infants have shorter breastfeeding duration than that of term infants. Details of postdischarge feeding methods and difficulties are needed to inform the care of preterm breastfeeding dyads. PURPOSE To describe postdischarge breastfeeding characteristics of mother-preterm infant dyads up to 12 weeks corrected gestational age (CGA). METHODS A prospective observational study of preterm dyads (birth 24-33 weeks' gestation) that fed their mother's own milk (MOM) at discharge from a neonatal unit in Perth, Western Australia. Feeding method and frequency, breastfeeding duration, difficulties, and nipple shield use were recorded at 2, 6, and 12 weeks CGA. RESULTS Data were obtained for 49 mothers (singleton infant n = 39, twins n = 10). At 12 weeks CGA, 59% fed any MOM with 47% exclusively fed MOM and 31% fully breastfed. Nipple shield use reduced from 42% at 2 weeks CGA to 11% at 12 weeks CGA. Compared with mothers who exclusively fed MOM at discharge (n = 41) those who fed both MOM and infant formula (n = 8) were more likely to wean before 12 weeks CGA ( P < .001). Weaning occurred before 2 weeks CGA in 12/19 (63%), with low milk supply the most frequently cited reason. IMPLICATIONS FOR PRACTICE Most mothers with a full milk supply at discharge successfully transition to predominant breastfeeding. Frequent milk removal needs to be prioritized throughout the preterm infant's hospital stay. IMPLICATIONS FOR RESEARCH Examination of facilitators and barriers to early and continued frequent milk removal across the postpartum period is required to identify strategies to optimize lactation after preterm birth.
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Mengesha EW, Amare D, Asfaw LS, Tesfa M, B Debela M, Ambaw Getahun F. Parental experiences in neonatal intensive care unit in Ethiopia: a phenomenological study. Ann Med 2022; 54:121-131. [PMID: 35001740 PMCID: PMC8745364 DOI: 10.1080/07853890.2021.2004320] [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] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION Neonatal intensive care unit is important to save the lives of a sick neonate; however, parents are challenged by several stressful conditions during their stay. Therefore, this study aimed to explore the lived experiences of parents in neonatal intensive care units in Ethiopia. METHODS We used a phenomenological study design. The data were collected using an in-depth interview method from purposively selected parents. In addition, we followed a thematic analysis approach and used Open Code Software Version 4.02 to process the data. RESULTS In this study, 18 parents were interviewed. The researchers have identified six themes. Parents complained of psychological problems like anxiety, stress, worries, hopelessness, and a state of confusion. In addition, anger, crying, sadness, frustration, dissatisfaction, regret, disappointment, feeling bad, self-blaming, nervousness, disturbance, and lack of self-control were major emotional problems raised by the parents. Parents expressed that health care providers showed indiscipline, lack of commitment, and uncooperative behaviour. Likewise, shortage of medicines, money, and limited time to visit their neonates were the other concerns of many parents. At the same time, parents were provided minimal information and limited cooperation from health care providers. CONCLUSION Parents whose infants admitted to the NICU were suffered from various psychological and emotional problems. Researchers recommend that health care providers should be supported parents with psycho-emotional problems, strengthen parents-healthcare workers' interaction, and scale up neonatal intensive care unit services to the primary health care centres.KEY MESSAGESParents whose infants admitted to the NICU were suffered from psychological and emotional problems.Poor NICU environment, shortage of equipment, long hospital stay, the presence of pandemic COVID-19, and lack of parental involvement in the care were identified barriers that affected parents' stay.
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Affiliation(s)
- Endalkachew Worku Mengesha
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Desalegne Amare
- School of Health Science, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | | | - Mulugeta Tesfa
- Department of Epidemiology, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Mitiku B Debela
- School of Public Health, College of Medicine and Health Sciences, Maddawalabu University, Balie, Ethiopia
| | - Fentie Ambaw Getahun
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Parental resilience and psychological distress in the neonatal intensive care unit. J Perinatol 2022; 42:1504-1511. [PMID: 35927487 DOI: 10.1038/s41372-022-01478-3] [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] [Received: 11/26/2021] [Revised: 07/15/2022] [Accepted: 07/25/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To evaluate the associations between parental resilience and psychological distress during the neonatal intensive care unit (NICU) hospitalization. STUDY DESIGN Observational cohort study of parents of preterm infants (n = 45) admitted to a NICU between December 2017-October 2019. Data on resilience and psychological distress were collected using validated scales. Regression analysis was used to evaluate associations. RESULT One-third of NICU parents screened positive for depression or anxiety. There were no identified sociodemographic factors or parental engagement activities associated with resilience. Parents with higher resilience had lower scores on depression and anxiety screens. However, resilience alone was not a predictor for a positive depression or anxiety screen (aOR 0.93, CI 0.86-1.00; aOR 0.95, CI 0.89-1.02, respectively). CONCLUSION Resilience may be associated with lower scores on depression and anxiety screens but is not an independent predictor for a positive screen during the early NICU hospitalization.
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Howden A, McFerran KS, Thompson GA. Reflective Lullaby Writing with two mother--infant dyads who recently experienced an admission to a neonatal intensive care unit. NORDIC JOURNAL OF MUSIC THERAPY 2022. [DOI: 10.1080/08098131.2022.2115531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Amy Howden
- The Faculty of Fine Arts and Music, University of Melbourne, Melbourne, Australia
| | | | - Grace Anne Thompson
- The Faculty of Fine Arts and Music, University of Melbourne, Melbourne, Australia
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Depressive Symptoms in Fathers during the First Postpartum Year: The Influence of Severity of Preterm Birth, Parenting Stress and Partners’ Depression. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159478. [PMID: 35954832 PMCID: PMC9368501 DOI: 10.3390/ijerph19159478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 07/29/2022] [Accepted: 07/29/2022] [Indexed: 11/29/2022]
Abstract
Although preterm birth constitutes a risk factor for postpartum depressive symptomatology, perinatal depression (PND) has not been investigated extensively in fathers of very low (VLBW) and extremely low birth weight (ELBW) infants. This study explored paternal depression levels at 3, 9, and 12 months of infant corrected age, investigating also the predictive role played by the severity of prematurity, maternal and paternal PND levels, and parenting stress. We recruited 153 fathers of 33 ELBW, 42 VLBW, and 78 full-term (FT) infants, respectively. Depression was investigated by the Edinburgh Postnatal Depression Scale (EPDS) and distress by the Parenting Stress Index-Short Form-PSI-SF (Total and subscales: Parental Distress, Parent–Child Dysfunctional Interaction, and Difficult Child). ELBW fathers showed a significant decrease (improvement) in EPDS, total PSI-SF, and Parental Distress mean scores after 3 months. Paternal EPDS scores at 12 months were significantly predicted by VLBW and FT infants’ birth weight categories, fathers’ EPDS scores at 3 and 9 months, Parent–Child Dysfunctional Interaction subscale at 3 months, and Difficult Child subscale at 9 months. This study strengthens the relevance of including early routine screening and parenting support for fathers in perinatal health services, with particular attention to fathers who might be more vulnerable to mental health difficulties due to severely preterm birth.
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Hoyt-Austin AE, Miller IT, Kuhn-Riordon KM, Rosenthal JL, Chantry CJ, Marcin JP, Hoffman KR, Kair LR. Bonding, Relaxation, Separation, and Connection: Expressing Human Milk While Videoconferencing with the Hospitalized Premature Infant. Breastfeed Med 2022; 17:653-659. [PMID: 35605051 PMCID: PMC9464082 DOI: 10.1089/bfm.2021.0214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: Breast milk feeding is an essential component of safe and effective care of the hospitalized premature infant. There are numerous barriers that impact breast milk expression during a preterm infant's hospitalization. We aimed to explore the experience of using videoconferencing with one's hospitalized premature infant while expressing breast milk. Materials and Methods: We conducted a qualitative study using purposive sampling to recruit lactating parents of premature (<34 weeks) hospitalized infants. We conducted semistructured interviews using an interview guide with 14 open-ended questions regarding the breast milk expression experience. Data collection and analysis were performed iteratively and were analyzed using inductive thematic analysis with a constant comparative approach. Data were organized into themes. Interview recruitment was discontinued when thematic saturation was reached. Results: Seventeen participants completed the interviews and four themes were identified: (1) videoconferencing promotes bonding and connection with the hospitalized infant, (2) videoconferencing provides motivation to pump, (3) videoconferencing reminds participants of the realities of separation from their infant, and (4) videoconferencing connects the whole family to the hospitalized infant. Conclusions: Users of videoconferencing with their hospitalized neonate reported an improved pumping experience while expressing milk for their premature infant. Videoconferencing is also a tool that can connect the whole family to the infant. This study was registered at clinicaltrials.gov (clinicaltrials.gov Identifier: NCT03957941) under the title "FamilyLink and Breastfeeding."
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Affiliation(s)
| | - Iesha T. Miller
- Department of Pediatrics, University of California, Davis, Sacramento, California, USA
| | - Kara M. Kuhn-Riordon
- Department of Pediatrics, University of California, Davis, Sacramento, California, USA
| | - Jennifer L. Rosenthal
- Department of Pediatrics, University of California, Davis, Sacramento, California, USA
| | - Caroline J. Chantry
- Department of Pediatrics, University of California, Davis, Sacramento, California, USA
| | - James P. Marcin
- Department of Pediatrics, University of California, Davis, Sacramento, California, USA
| | - Kristin R. Hoffman
- Department of Pediatrics, University of California, Davis, Sacramento, California, USA
| | - Laura R. Kair
- Department of Pediatrics, University of California, Davis, Sacramento, California, USA
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Ruhe K, van den Hoogen A, Bröring‐Starre T, Wielenga JM, van Weissenbruch MM. Getting a grip in the middle of chaos: Preparing for preterm parenthood during a high-risk pregnancy - Parental experiences and needs. Acta Paediatr 2022; 111:1324-1330. [PMID: 35429200 PMCID: PMC9321692 DOI: 10.1111/apa.16361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 03/23/2022] [Accepted: 04/13/2022] [Indexed: 12/05/2022]
Abstract
Aim Admitting an infant to a neonatal intensive care unit (NICU) is stressful for parents. A great source of stress is the loss of their desired parental role. This study explores parents’ experiences and needs during a high‐risk pregnancy in preparation for their role as parents of a preterm infant. Methods An exploratory qualitative study was conducted among parents with a preterm infant admitted to two level‐III NICUs in the Netherlands. A thematic analysis was performed. Results Nineteen interviews were conducted with parents of preterm infants (26–34 weeks gestational age). Getting a grip in the middle of chaos was identified as the central theme. In the pre‐admission phase, coping with potential preterm parenthood was a theme, with coping strategies as subthemes that changed over time from avoidance to being ready to parent a preterm infant. The theme envisioning the NICU emerged in the NICU admission phase, with subthemes preterm care journey and opportunities for involvement fostering parental empowerment. Conclusion Timing and content of information about a parental role in the NICU should be tailored to the individual expectant parent. A customisable intervention bundle may provide a vision of the NICU and the parents’ active role in care.
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Affiliation(s)
- Kiki Ruhe
- Department of Neonatology Amsterdam University Medical Centers, location VUmc Amsterdam The Netherlands
| | - Agnes van den Hoogen
- Department of Neonatology Wilhelmina Children’s Hospital University Medical Center Utrecht Utrecht The Netherlands
| | - Tinka Bröring‐Starre
- Department of Child Psychiatry and Psychosocial Care Amsterdam University Medical Centers Amsterdam The Netherlands
| | - Joke M. Wielenga
- Department of Neonatology Emma Children's Hospital Amsterdam University Medical Centers, AMC Amsterdam The Netherlands
| | - Mirjam M. van Weissenbruch
- Department of Neonatology Amsterdam University Medical Centers, location VUmc Amsterdam The Netherlands
- Department of Neonatology Amsterdam University Medical Centers Vrije Universiteit Amsterdam The Netherlands
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48
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Benefits of Kangaroo Mother Care on the Physiological Stress Parameters of Preterm Infants and Mothers in Neonatal Intensive Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127183. [PMID: 35742429 PMCID: PMC9223087 DOI: 10.3390/ijerph19127183] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/08/2022] [Accepted: 06/09/2022] [Indexed: 11/30/2022]
Abstract
It is well documented that the stress of separation of mother and baby can lead to short-term physiological instability as well as neurological, sociological or psychological consequences that may last a lifetime. Objective: The goal was to estimate the effect of kangaroo mother care (KMC) on physiological and biochemical parameters of preterm infant stress and maternal stress in neonatal intensive care. Methods: The investigation involved 112 preterm infants. Two groups were compared according to the mean duration of KMC during 12 days of study: the KMC group (mean duration more than 90 min daily) and the control group (less than 90 min). Results: Kangaroo mother care for more than 90 min on average per day in preterm infants is associated 12 days after the intervention with lower mean cortisol levels (p = 0.02), greater weight gain and less need for parenteral nutrition in preterm infants, as well as less postpartum depression (p = 0.02) and lower cortisol levels (p = 0.002) in the mothers of preterm infants. Conclusions: This study suggests that KMC can be used to improve the stress of preterm infants and their mothers, and that the greater weight gain observed in these preterm infants could contribute to a shorter average hospital stay and lower healthcare expenditure.
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49
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Screening for Postpartum Depression in a Neonatal Intensive Care Unit. Adv Neonatal Care 2022; 22:E102-E110. [PMID: 34966058 DOI: 10.1097/anc.0000000000000971] [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 Postpartum depression (PPD) is a common mental health condition that affects approximately 13% of postpartum women in the United States. However, the prevalence in the neonatal intensive care unit (NICU) has been shown to be higher. Routine screening for maternal PPD is recommended at infant primary care well-child visits up to 6 months of age. The absence of a routine PPD screening program in a level IV NICU created a large gap in screening in an at-risk population. PURPOSE To develop and implement a screening program in the NICU to increase the identification of maternal PPD symptoms and to develop both a referral algorithm for NICU staff to follow and a referral resource packet to be given to mothers with positive PPD screenings. METHODS Mothers with infants in the NICU were screened for PPD using the Edinburgh Postnatal Depression Scale (EPDS). Bedside nurses administered the screening tool and used a referral algorithm to determine appropriate follow-up. EPDS scores of 10 or more were considered positive and indicated a need for referral. RESULTS The overall EPDS screening compliance was 66% with a positive rate of 26%. Nurses followed the referral algorithm appropriately 100% of the time. It was confirmed that 93% of the mothers with positive EPDS screenings sought help from a mental health provider. IMPLICATIONS FOR PRACTICE AND RESEARCH Routine maternal PPD screening should be implemented in all NICU settings. Postpartum mental health issues should not be the sole responsibility of obstetricians, mental health providers, or maternal primary care providers.
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50
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van den Hoogen A, Ketelaar M. Parental involvement and empowerment in paediatric critical care: Partnership is key! Nurs Crit Care 2022; 27:294-295. [PMID: 35526086 PMCID: PMC9325392 DOI: 10.1111/nicc.12727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 10/21/2021] [Indexed: 11/25/2022]
Affiliation(s)
- Agnes van den Hoogen
- Department of Neonatology, University Medical Centre Utrecht, Wilhelmina Children's Hospital, Utrecht, The Netherlands.,Department of Clinical Health Science, Utrecht University, Utrecht, The Netherlands
| | - Marjolijn Ketelaar
- Centre of Excellence for Rehabilitation Medicine, Brain Centre University Medical Centre Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
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