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Bansal S, Molloy EJ, Rogers E, Bidegain M, Pilon B, Hurley T, Lemmon ME. Families as partners in neonatal neuro-critical care programs. Pediatr Res 2024:10.1038/s41390-024-03257-6. [PMID: 38886506 DOI: 10.1038/s41390-024-03257-6] [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: 11/20/2023] [Revised: 04/07/2024] [Accepted: 04/15/2024] [Indexed: 06/20/2024]
Abstract
Parents of neonates with neurologic conditions face a specific breadth of emotional, logistical, and social challenges, including difficulties coping with prognostic uncertainty, the need to make complex medical decisions, and navigating new hopes and fears. These challenges place parents in a vulnerable position and at risk of developing mental health issues, which can interfere with bonding and caring for their neonate, as well as compromise their neonate's long-term neurodevelopment. To optimize neurologic and developmental outcomes, emerging neonatal neuro-critical care (NNCC) programs must concurrently attend to the unique needs of the developing newborn brain and of his/her parents. This can only be accomplished by embracing a family-centered care environment-one which prioritizes effective parent-clinician communication, longitudinal parent support, and parents as equitable partners in clinical care. NNCC programs offer a multifaceted approach to critical care for neonates at-risk for neurodevelopmental impairments, integrating expertise in neonatology and neurology. This review highlights evidence-based strategies to guide NNCC programs in developing a family-partnered approach to care, including primary staffing models; staff communication, implicit bias, and cultural competency trainings; comprehensive and tailored caregiver training; single-family rooms; flexible visitation policies; colocalized neonatal and maternal care; uniform mental health screenings; follow-up care referrals; and connections to peer support. IMPACT: Parents of neonates with neurologic conditions are at high-risk for experiencing mental health issues, which can adversely impact the parent-neonate relationship and long-term neurodevelopmental outcomes of their neonates. While guidelines to promote families as partners in the neonatal intensive care unit (NICU) have been developed, no protocols integrate the unique needs of parents in neonatal neurologic populations. A holistic approach that makes families true partners in the care of their neonate with a neurologic condition in the NICU has the potential to improve mental and physical well-being for both parents and neonates.
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Affiliation(s)
- Simran Bansal
- Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA
| | - Eleanor J Molloy
- Paediatric Research Laboratory, Trinity Translational Medicine Institute (TTMI), St. James' Hospital, Dublin, Ireland
- Discipline of Paediatrics, Dublin Trinity College, The University of Dublin, Dublin, Ireland
- Trinity Research in Childhood Centre (TriCC), Children's Health Ireland & Coombe Hospital, Dublin, Ireland
| | - Elizabeth Rogers
- Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA
| | - Margarita Bidegain
- Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA
| | | | - Tim Hurley
- Paediatric Research Laboratory, Trinity Translational Medicine Institute (TTMI), St. James' Hospital, Dublin, Ireland
- Discipline of Paediatrics, Dublin Trinity College, The University of Dublin, Dublin, Ireland
| | - Monica E Lemmon
- Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA.
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA.
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Worrall S, Christiansen P, Khalil A, Silverio SA, Fallon V. Measurement invariance analysis of the Postpartum Specific Anxiety Scale - Research Short Form in mothers of premature and term infants. BMC Res Notes 2024; 17:75. [PMID: 38486271 PMCID: PMC10941354 DOI: 10.1186/s13104-024-06746-3] [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: 09/29/2023] [Accepted: 03/08/2024] [Indexed: 03/17/2024] Open
Abstract
OBJECTIVE Mothers of premature infants are more likely to develop anxiety during the first postpartum year than mothers of term infants. However, commonly used measures of anxiety were developed for general adult populations and may produce spurious, over-inflated scores when used in a postpartum context. Although perinatal-specific tools such as the Postpartum Specific Anxiety Scale [PSAS] offer a promising alternative form of measurement, it is not clear whether the measure performs similarly in mothers of premature infants as it does in mothers of term infants. The objective of the current study was to identify whether items on the Postpartum Specific Anxiety Scale - Research Short Form (PSAS-RSF) are being interpreted in the same manner in mothers of term infants and mothers of premature infants. Mothers (N = 320) participated in an international on-line survey between February 2022 and March 2023 (n = 160 mothers of premature infants, n = 160 mothers of term infants) where they completed the PSAS-RSF. Data were analysed using a measurement invariance analysis to assess whether constructs of the PSAS-RSF are performing in a similar manner across the two groups. RESULTS Whilst the PSAS-RSF achieved configural invariance and so retains its four-factor structure, metric invariance was not reached and so items are being interpreted differently in mothers of premature infants. Items concerning infant-separation, finance, and anxieties surrounding infant health are potentially problematic. Future research must now modify the PSAS-RSF for specific use in mothers of premature infants, to ensure measurement of anxiety in this population is valid.
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Affiliation(s)
- Semra Worrall
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, UK.
| | - Paul Christiansen
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Asma Khalil
- Fetal Medicine Unit, Liverpool Women's NHS Foundation Trust, Liverpool, UK
- Fetal Medicine Unit, St. George's University Hospitals NHS Foundation Trust, University of London, London, UK
| | - Sergio A Silverio
- Department of Women & Children's Health, School of Life Course & Population Sciences, King's College London, London, UK
- School of Psychology, Faculty of Health, Liverpool John Moores University, Liverpool, UK
| | - Victoria Fallon
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, UK
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Hale ME, George AM, Caughy MO, Suveg C. Resting respiratory sinus arrythmia and cognitive reappraisal moderate the link between political climate stress and anxiety symptoms in Latina and Black mothers. ANXIETY, STRESS, AND COPING 2024; 37:100-113. [PMID: 37075162 DOI: 10.1080/10615806.2023.2199207] [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: 04/22/2022] [Accepted: 03/29/2023] [Indexed: 04/21/2023]
Abstract
Guided by the Family Stress Model for minority families, the present study examined the potential buffering effect of resting respiratory sinus arrythmia (RRSA), cognitive reappraisal, and mindfulness on the association between political climate stress (PCS) and anxiety symptoms in a sample of Latina and Black mothers. Participants were 100 mothers living in the southeastern United States. Mothers reported on PCS, cognitive reappraisal, mindfulness, and symptoms of anxiety. RRSA were measured during a resting task. Moderation analyses tested the influence of these three factors (RRSA, cognitive reappraisal, mindfulness) on the relation between PCS and anxiety. Results showed that the relation between PCS and anxiety symptoms was strongest at low levels of RRSA and cognitive reappraisal. At high levels of these two factors, there was no association between PCS and anxiety symptoms. Mothers with high levels of RRSA and cognitive reappraisal may be able to interact with and evaluate environmental stimuli in such a way that allows for adaptive adjustment, buffering against the negative impact of PCS. RRSA and cognitive reappraisal may be important targets of interventions designed to address the rising rates of anxiety symptoms in Latina and Black mothers.
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Affiliation(s)
- Molly E Hale
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - Andrea M George
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - Margaret O Caughy
- Department of Human Development and Family Sciences, University of Georgia, Athens, GA, USA
| | - Cynthia Suveg
- Department of Psychology, University of Georgia, Athens, GA, USA
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Njoroge WFM, Gerstein ED, Lean RE, Paul R, Smyser CD, Rogers CE. Neonatal Intensive Care Unit Latent Profiles of Maternal Distress: Associations With 5-Year Maternal and Child Mental Health Outcomes. J Am Acad Child Adolesc Psychiatry 2023; 62:1123-1133. [PMID: 37084882 PMCID: PMC10543383 DOI: 10.1016/j.jaac.2023.02.015] [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: 02/15/2022] [Revised: 01/23/2023] [Accepted: 04/12/2023] [Indexed: 04/23/2023]
Abstract
OBJECTIVE To examine profiles of distress of mothers of preterm infants in the neonatal intensive care unit (NICU) and relate profiles to maternal and child outcomes at child age 5 years. METHOD A racially and economically diverse sample of mothers (n = 94; 39% African American, 52% White) of preterm infants (≤30 weeks of gestation) completed validated questionnaires assessing depression, anxiety (state and trait), NICU stress, and life stress at NICU discharge of their infant. Mothers reported on their own and their children's symptomatology at child age 5. A latent profile analysis was conducted to categorize maternal symptomatology. RESULTS Latent profile analysis yielded 4 distinct maternal profiles: low symptomatology, high NICU stress, high depression and anxiety, and high state anxiety. Social determinants of health factors including age, education, neighborhood deprivation, and infant clinical risk distinguished the profiles. Mothers in the high depression and anxiety profile reported more anxiety and life stress at follow-up and reported their children experienced more anxious/depressed symptoms. CONCLUSION Existing literature has gaps related to examining multiple dimensions of NICU distress and understanding how patterns of mood/affective symptoms, life stressors, and related social determinants of health factors vary across mothers. In this study, one specific profile of maternal NICU distress demonstrated enduring risks for poorer maternal and child mental health outcomes. This new knowledge underscores sources of disparate health outcomes for mothers of preterm infants and the infants themselves. Universal screening is needed to identify at-risk dyads for poor health outcomes in need of individualized interventions that address both maternal and child well-being. DIVERSITY & INCLUSION STATEMENT We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list.
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Affiliation(s)
- Wanjikũ F M Njoroge
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Policy Lab, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Lifespan Brain Institute, Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, Pennsylvania.
| | | | - Rachel E Lean
- Washington University School of Medicine, St. Louis, Missouri
| | - Rachel Paul
- Washington University School of Medicine, St. Louis, Missouri
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Delanerolle G, Zeng YT, Phiri P, Phan T, Tempest N, Busuulwa P, Shetty A, Raymont V, Rathod S, Shi JQ, Hapangama DK. Mental health impact on Black, Asian and Minority Ethnic populations with preterm birth: A systematic review and meta-analysis. World J Psychiatry 2022; 12:1233-1254. [PMID: 36186507 PMCID: PMC9521531 DOI: 10.5498/wjp.v12.i9.1233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 06/16/2022] [Accepted: 08/05/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Preterm birth (PTB) is one of the main causes of neonatal deaths globally, with approximately 15 million infants are born preterm. Women from the Black, Asian, and Minority Ethnic (BAME) populations maybe at higher risk of PTB, therefore, the mental health impact on mothers experiencing a PTB is particularly important, within the BAME populations.
AIM To determine the prevalence of mental health conditions among BAME women with PTB as well as the methods of mental health assessments used to characterise the mental health outcomes.
METHODS A systematic methodology was developed and published as a protocol in PROSPERO (CRD42020210863). Multiple databases were used to extract relevant data. I2 and Egger’s tests were used to detect the heterogeneity and publication bias. A trim and fill method was used to demonstrate the influence of publication bias and the credibility of conclusions.
RESULTS Thirty-nine studies met the eligibility criteria from a possible 3526. The prevalence rates of depression among PTB-BAME mothers were significantly higher than full-term mothers with a standardized mean difference of 1.5 and a 95% confidence interval (CI) 29%-74%. The subgroup analysis indicated depressive symptoms to be time sensitive. Women within the very PTB category demonstrated a significantly higher prevalence of depression than those categorised as non-very PTB. The prevalence rates of anxiety and stress among PTB-BAME mothers were significantly higher than in full-term mothers (odds ratio of 88% and 60% with a CI of 42%-149% and 24%-106%, respectively).
CONCLUSION BAME women with PTB suffer with mental health conditions. Many studies did not report on specific mental health outcomes for BAME populations. Therefore, the impact of PTB is not accurately represented in this population, and thus could negatively influence the quality of maternity services they receive.
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Affiliation(s)
- Gayathri Delanerolle
- Nuffield Department of Primary Care Health Science, University of Oxford, Oxford OX3 7JX, United Kingdom
- Research and Innovation, Southern Health NHS Foundation Trust, Southampton SO30 3JB, United Kingdom
| | - Yu-Tian Zeng
- Southern University of Science and Technology, Shenzhen 518055, Guangdong Province, China
| | - Peter Phiri
- Research and Innovation, Southern Health NHS Foundation Trust, Southampton SO30 3JB, United Kingdom
- Psychology Department, Faculty of Environmental and Life Sciences, University of Southampton, Southampton SO17 1BJ, United Kingdom
| | - Thuan Phan
- Department of Women's and Children's Health, University of Liverpool, Liverpool L7 8TX, United Kingdom
| | - Nicola Tempest
- Department of Women's and Children's Health, University of Liverpool, Liverpool L7 8TX, United Kingdom
- Gynaecology Directorate and Hewitt Centre for Reproductive Medicine, Liverpool Women's NHS Foundation, Liverpool L8 7SS, United Kingdom
| | - Paula Busuulwa
- Department of Women's and Children's Health, University of Liverpool, Liverpool L7 8TX, United Kingdom
| | - Ashish Shetty
- National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London W1T 4AJ, United Kingdom
| | - Vanessa Raymont
- Department of Psychiatry, University of Oxford, Oxford OX3 7JX, United Kingdom
| | - Shanaya Rathod
- Research and Innovation, Southern Health NHS Foundation Trust, Southampton SO30 3JB, United Kingdom
| | - Jian-Qing Shi
- National Centre for Applied Mathematics Shenzhen, Shenzhen 518055, Guangdong Province, China
- Department of Statistics, Southern University of Science and Technology, Shenzhen 518055, Guangdong Province, China
| | - Dharani K Hapangama
- Department of Women's and Children's Health, University of Liverpool, Liverpool L7 8TX, United Kingdom
- Gynaecology Directorate and Hewitt Centre for Reproductive Medicine, Liverpool Women's NHS Foundation, Liverpool L8 7SS, United Kingdom
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Ong SL, Soh KL, Hussin EOD, Japar S, Soh KG, Vorasiha P, Daud A. Quality of life among mothers of preterm newborns in a Malaysian neonatal intensive care unit. BELITUNG NURSING JOURNAL 2022; 8:93-100. [PMID: 37521892 PMCID: PMC10386805 DOI: 10.33546/bnj.1872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 10/25/2021] [Accepted: 01/08/2022] [Indexed: 08/01/2023] Open
Abstract
Background As Quality of Life (QoL) becomes progressively vital in health care services, its importance in mother and child health is of no exception too. Quality of life among mothers with a premature newborn is an issue that has led to growing concerns in the health care system. Yet, despite the knowledge about mother's QoL being essential to family-centered planning on prematurity integrated healthcare, current evidence has been scant. Objective To examine factors related to the QoL of mothers having preterm newborns hospitalized in the neonatal critical unit. Methods A non-probability convenience survey was used in a public hospital in Malaysia, covering 180 mothers whose preterm newborns were hospitalized into level III Neonatal Intensive Care Unit (NICU) through the completion of a 26-questions survey of the World Health Organization Quality of Life (WHOQOL-BREF) and the 26-questions of Parental Stress Scale: Neonatal Intensive Care Unit (PSS: NICU). The data were analyzed using descriptive statistics, bivariate analysis, and Pearson correlation coefficients. Result The mean scores for mothers' quality of life were (M = 3.67, SD = 0.73) and maternal stress (M = 3.03, SD = 0.90) out of 5. A mother's occupation was found to be the only factor associated with the quality of life among mothers who have preterm newborns admitted to the NICU. Furthermore, maternal role change was found to have a moderate negative relationship with the quality of life (r = 0.310, p = 0.05). Conclusion The findings of this study revealed that the main factors contributing to the mother's QoL during their preterm newborns' NICU admission were role change-related stress. Thus, to maintain a better QoL among this group of mothers during this traumatic period, a special nursing intervention program must be implemented immediately, right after the preterm newborns' admission, to relieve the mothers' stress which has been proven to have a direct effect on the mothers' QoL. The study results will alert healthcare providers, particularly neonatal nurses, on the need to support mothers psychologically in terms of role change. This is to ensure a better quality of life among mothers whose newborns were admitted to the NICU.
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Affiliation(s)
- Swee Leong Ong
- School of Nursing, Faculty of Medicine, Universiti Sultan Zainal Abidin, Terengganu, Malaysia
| | - Kim Lam Soh
- Department of Nursing and Rehabilitation, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Emni Omar Daw Hussin
- Department of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Salimah Japar
- Department of Nursing and Rehabilitation, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Kim Geok Soh
- Department of Sports Studies, Faculty of Education, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Ponpun Vorasiha
- College of Nursing and Health, Suan Sunandha Rajabhat University, Dusit, Bangkok, Thailand
| | - Azlina Daud
- Department of Medical Surgical Nursing, International Islamic University Malaysia, Malaysia
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Staver MA, Moore TA, Hanna KM. An integrative review of maternal distress during neonatal intensive care hospitalization. Arch Womens Ment Health 2021; 24:217-229. [PMID: 32851469 DOI: 10.1007/s00737-020-01063-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 08/21/2020] [Indexed: 11/26/2022]
Abstract
To synthesize literature addressing maternal distress and associated variables in response to infant hospitalization in the NICU. CINAHL, Medline, PubMed, PsychINFO, and Scopus were searched for studies addressing maternal distress during NICU hospitalization published between January 2009 and August 2019. The initial literature search yielded 862 articles. Articles were included for analysis if (a) they were peer-reviewed, (b) maternal distress was defined or measured, and (c) maternal distress occurred in the NICU. Ultimately, 33 articles were included for analysis. Distress symptoms were not consistently measured across the literature by one specific instrument. However, despite the variety of instruments, distress was prevalent in this population. Individual elements of maternal distress in the NICU include depression, anxiety, trauma, and post-traumatic stress symptoms. These elements often occur together and tend to follow a specific trajectory during hospitalization. This body of literature was inconsistent regarding the timing of distress measurement as well as the relationship between relevant associated variables (e.g., marital status or infant illness severity) and maternal distress. Additionally, researchers often excluded mothers of non-preterm infants and infants with congenital anomalies from investigation. Researchers and clinicians should carefully consider timing and instrumentation in their interpretations of maternal distress measurement during a NICU hospitalization. Future work should focus on developing a comprehensive, valid, and reliable screening tool for clinicians and researchers to use to identify maternal distress in the NICU. Additionally, future research should address gaps in the populations included in studies.
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Affiliation(s)
- Morgan A Staver
- University of Nebraska Medical Center College of Nursing, Omaha, NE, USA.
| | - Tiffany A Moore
- University of Nebraska Medical Center College of Nursing, Omaha, NE, USA
| | - Kathleen M Hanna
- University of Nebraska Medical Center College of Nursing, Omaha, NE, USA
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Akinbode TD, Pedersen C, Lara-Cinisomo S. The Price of Pre-adolescent Abuse: Effects of Sexual Abuse on Perinatal Depression and Anxiety. Matern Child Health J 2020; 25:1083-1093. [PMID: 33206305 DOI: 10.1007/s10995-020-03088-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Childhood abuse is a major public health concern and a risk factor for subsequent poor maternal mental health. This study of 176 racially diverse women explored the associations between the histories of childhood sexual abuse and depression and anxiety during pregnancy, at six weeks postpartum, and 12 weeks postpartum. METHODS Data on depressive and anxiety symptoms were gathered during pregnancy, at six weeks postpartum, and 12 weeks postpartum. Sociodemographic data were collected during pregnancy, while data on childhood sexual abuse were gathered during the 12-week postpartum period. Bivariate analyses and repeated mixed-effects linear regression with bootstrapping were used to assess the association between childhood sexual abuse and perinatal depressive and anxiety symptoms. RESULTS Childhood sexual abuse was significantly associated with depressive symptoms (β = 2.52, 95% CI 1.72, 3.32, p < .001) and anxiety symptoms (β = 4.44, 95% CI 3.70, 5.81, p < .001) over time, while controlling for demographic characteristics and lifetime major depression and anxiety. Depressive and anxiety symptoms decreased over the perinatal period and were highest during pregnancy. Black women were more likely to report higher depressive symptoms (β = 1.35, 95% CI 0.51, 2.19, p = .002) and anxiety symptoms (β = 3.29 95% CI 1.72, 4.87, p < .001) over time compared to White women. DISCUSSION The results highlight the importance of assessing the long-term effects of childhood sexual abuse on perinatal depressive and anxiety symptoms to help inform the development of interventions for women, particularly Black women.
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Affiliation(s)
- Tanitoluwa Demilade Akinbode
- College of Agricultural, Consumer & Environmental Sciences, Department of Human Development & Family Studies, University of Illinois at Urbana-Champaign, 222 Bevier Hall, 905 S. Goodwin Avenue, Urbana, 61801, IL, USA.
| | - Cort Pedersen
- Department of Psychiatry, The University of North Carolina at Chapel Hill, CB #7160, Chapel Hill, 27599, NC, USA
| | - Sandraluz Lara-Cinisomo
- College of Applied Health Sciences, Department of Kinesiology & Community Health, University of Illinois at Urbana-Champaign, 1206 S. Fourth St, Champaign, 61820, IL, USA
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Music Therapy Self-Care Group for Parents of Preterm Infants in the Neonatal Intensive Care Unit: A Clinical Pilot Intervention. MEDICINES 2018; 5:medicines5040134. [PMID: 30558347 PMCID: PMC6313327 DOI: 10.3390/medicines5040134] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 12/07/2018] [Accepted: 12/13/2018] [Indexed: 11/17/2022]
Abstract
Background: The parents of preterm infants face major mental health challenges in the Neonatal Intensive Care Unit (NICU). Family-centered music therapy actively integrates and empowers parents in their infants' care. With the aim to better understand and address parental needs separately from their babies' needs, a music therapy (MT) self-care group was implemented as part of clinical practice at the hospital Clínica de la Mujer, in Bogotá, Colombia. Methods: The group was provided for both parents, twice a week, in the NICU. Music guided relaxations, breathing techniques, and self-expression were at the center of the MT group sessions. The parents completed a pre/post self-administered Numeric Rating Scale (NRS), including anxiety levels, stress levels, mood and motivation. Results: The parents highly valued the MT self-care group in the NICU. On average, there was a 37% improvement in anxiety levels, 28% improvement in stress levels, and 12% improvement in mood, restfulness and motivation. Being able to relax, to distract themselves from their worries and having time for themselves are amongst the most frequently mentioned benefits. Conclusions: Addressing parents' needs separately from their babies' treatment, with culturally sensitive interventions aimed at improving parental mental health, is essential for continuing the development of family-centered music therapy interventions in the NICU.
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Ong SL, Abdullah KL, Danaee M, Soh KL, Soh KG, Japar S. Stress and anxiety among mothers of premature infants in a Malaysian neonatal intensive care unit. J Reprod Infant Psychol 2018; 37:193-205. [PMID: 30480464 DOI: 10.1080/02646838.2018.1540861] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE This study aims to determine maternal stress and anxiety as perceived by mothers whose premature infants were admitted to the neonatal intensive care unit (NICU) and to identify maternal stress and its relationship with maternal and infant characteristics and anxiety. BACKGROUND Vulnerable premature infants commonly require special care in the NICUs. In most cases, prolonged hospitalization results in stress and anxiety for the mothers. METHODS A non-probability convenience survey was used in a public hospital, with 180 mothers completing the 26-item Perceived Stress Scale (PSS) and a 40-item State-Trait Anxiety Inventory (STAI). RESULTS 56.5% of mothers had high levels of stress, 85.5% of mothers had a high level of state-anxiety and 67.8% of mothers had a high level of trait-anxiety. The stress experienced by these mothers had a significant relationship with anxiety, and was found to be associated with state and trait anxiety levels, but not with maternal and infant characteristics. CONCLUSION Mothers in this setting revealed high levels of stress and anxiety during their premature infants' NICU admission. An immediate interventional programme focusing on relieving mothers' anxiety and stress is needed to prevent maternal stress and anxiety at an early stage.
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Affiliation(s)
- Swee Leong Ong
- a School of Nursing Science, Faculty of Medicine , Universiti Sultan Zainal Abidin , Terengganu , Malaysia
| | - Khatijah Lim Abdullah
- b Department of Nursing Science , University Malaya , Kuala Lumpur , Malaysia.,c Faculty of Nursing , Universitas Airlangga , Surabaya , East Java Indonesia
| | - Mahmoud Danaee
- d Academic Development Center (ADeC) , University Malaya , Kuala Lumpur , Malaysia
| | - Kim Lam Soh
- e Department of Nursing, Faculty of Medicine and Health Sciences , Universiti Putra Malaysia , Serdang , Malaysia
| | - Kim Geok Soh
- f Department of Sport Studies, Faculty of Education , Universiti Putra Malaysia , Serdang , Malaysia
| | - Salimah Japar
- e Department of Nursing, Faculty of Medicine and Health Sciences , Universiti Putra Malaysia , Serdang , Malaysia
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Roque ATF, Lasiuk GC, Radünz V, Hegadoren K. Scoping Review of the Mental Health of Parents of Infants in the NICU. J Obstet Gynecol Neonatal Nurs 2017; 46:576-587. [PMID: 28506679 DOI: 10.1016/j.jogn.2017.02.005] [Citation(s) in RCA: 165] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2017] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE To synthesize and summarize evidence regarding the mental health of parents of infants in the NICU. DATA SOURCES Thirteen electronic databases were searched in October 2014 using the following terms individually and in combination: postpartum woman, mother, NICU, preterm birth, depression, anxiety, acute stress disorder (ASD), posttraumatic stress disorder (PTSD), and parental stress. STUDY SELECTION We examined the published research regarding the experiences of parents who have infants admitted to the NICU, the mental health problems that parents may develop, the tools that have been used to identify such problems, and factors related to parental mental health. DATA EXTRACTION After the exclusion of articles according to preset criteria, we included 66 articles in the full review. DATA SYNTHESIS Mental health issues are common in parents of infants in the NICU across diverse ethnocultural groups and countries. Parents report feelings of guilt and shame, high levels of stress, mood and anxiety symptoms, and the positive influence of specific coping strategies and social support. The ethnocultural meanings of these experience and thus nursing interventions may differ widely. CONCLUSION Ongoing assessments of the mental health of parents should be part of routine NICU care. Identification of mood and anxiety symptoms and testing innovative interventions to address at-risk or affected parents is imperative to ensure that there are culturally appropriate policies and services in place to respond to the mental health needs of NICU families.
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Vonderheid SC, Rankin K, Norr K, Vasa R, Hill S, White-Traut R. Health Care Use Outcomes of an Integrated Hospital-to-Home Mother-Preterm Infant Intervention. J Obstet Gynecol Neonatal Nurs 2016; 45:625-38. [PMID: 27505467 DOI: 10.1016/j.jogn.2016.05.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2016] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVE To compare health care use from initial hospital discharge through 6 weeks corrected age in two groups of mother-preterm infant dyads: those who received an intervention, Hospital to Home: Optimizing Premature Infant's Environment (H-HOPE), and an attention control group. DESIGN Prospective randomized controlled trial. SETTING Two community hospital NICUs. PARTICIPANTS Mothers (n = 147) with social-environmental risk factors and their stable preterm infants. METHODS Mother-infant dyads were randomly assigned to the H-HOPE or control group. When infants reached 6 weeks corrected age, information about health care visits since their hospital discharges was collected through an interview. RESULTS Only half of all infants received all recommended well-child visits. Infants in H-HOPE were half as likely to have acute care episodes (illness visit to the clinic or emergency department or hospital readmission) as control infants (odds ratio [OR] = 0.46, 95% confidence interval [CI] [0.22, 0.95]). Infants of mothers with high trait anxiety were nearly 3 times more likely to have an acute care episode (OR = 2.78, 95% CI [1.05, 7.26]), and mothers who had low education levels (OR = .22, 95% CI [0.08, 0.60]) were less likely to have acute care episodes. There was a trend toward fewer acute care visits for infants whose mothers preferred an English interview (OR = .47, 95% CI [0.21, 1.06]). CONCLUSION Findings emphasize the importance of reinforcing well-child visits for vulnerable preterm infants. H-HOPE, an integrated mother-infant intervention, reduces acute care episodes (visits to the clinic or emergency department or hospital readmissions) for preterm infants.
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Ettenberger M, Rojas Cárdenas C, Parker M, Odell-Miller H. Family-centred music therapy with preterm infants and their parents in the Neonatal Intensive Care Unit (NICU) in Colombia – A mixed-methods study. NORDIC JOURNAL OF MUSIC THERAPY 2016. [DOI: 10.1080/08098131.2016.1205650] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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