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Culbreth R, Self-Brown S, Spratling R, Spears CA, Osborne MC, Melnyk BM. Adaptation of SafeCare, an evidence-based parenting program, for caregivers of infants in the neonatal intensive care unit. Appl Nurs Res 2024; 78:151817. [PMID: 39053997 DOI: 10.1016/j.apnr.2024.151817] [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: 12/04/2022] [Revised: 07/30/2023] [Accepted: 06/25/2024] [Indexed: 07/27/2024]
Abstract
BACKGROUND While there are several parenting programs for NICU caregivers, no studies, to our knowledge, have developed parenting programs aimed at preventing child maltreatment that specifically address these parental factors: parental stress, parental self-efficacy, and positive parent-infant interaction. OBJECTIVES The objectives of this study were to: 1) Identify adaptations and/or augmentations needed to optimize SafeCare® for NICU caregivers, and 2) Examine the acceptability and preliminary effects of the adapted SafeCare NICU (SCNC) program with NICU caregivers. METHODS This study consisted of two phases: formative (phase one) and pilot (phase two). For phase one, 5 NICU former caregivers and 5 NICU staff were interviewed to make relevant, NICU-specific adaptations for SCNC. Phase two consisted of a pilot study, where 13 current NICU caregivers were enrolled in the adapted SCNC program. Outcomes included acceptability and preliminary effects of parental stress, parental self-efficacy, and parent-infant interaction. RESULTS Adaptations to SafeCare consisted of adding a pre-session to discuss individualized experiences, incorporation of adjusted developmental milestones, a NICU-specific resource sheet, and individualized adaptations to activities based on relevant medical concerns. Out of the 13 participants, 8 completed SCNC (61.5 % retention rate). Participants indicated significant reductions in stress after SCNC (Parental stress index score = 61.7) compared to baseline (79.2, p = 0.02). Among participants who completed SCNC (n = 8), all stated they supported this program for implementation among NICU caregivers. DISCUSSION The adapted SCNC demonstrated acceptability among NICU caregivers.
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Affiliation(s)
- Rachel Culbreth
- American College of Medical Toxicology, 10645 N Tatum Blvd, Phoenix, AZ 85028-3068, USA; Department of Respiratory Therapy, Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, GA 30302, USA.
| | - Shannon Self-Brown
- Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA 30302, USA
| | - Regena Spratling
- School of Nursing, Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, GA 30302, USA
| | - Claire A Spears
- Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA 30302, USA
| | - Melissa C Osborne
- Wellstar College of Health and Human Services, Kennesaw State University, 520 Parliament Garden Way NW, MD 4102, Kennesaw, GA 30144, USA
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Garfield L, Watson-Singleton NN, Mathews HL, Witek Janusek L. Protocol for a pilot study assessing a virtual mindfulness intervention for postpartum African American women. BRAIN BEHAVIOR AND IMMUNITY INTEGRATIVE 2024; 6:100060. [PMID: 39036323 PMCID: PMC11258811 DOI: 10.1016/j.bbii.2024.100060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 07/23/2024]
Abstract
Elevated perinatal depressive symptoms are more common among disadvantaged African American women, and they are almost four times as likely to have postpartum posttraumatic stress compared to white women. For new mothers, depressive symptoms and posttraumatic stress can lead to negative parenting, poor mother-infant bonding, and delayed infant development. For African American women, a culturally adapted mindfulness-based intervention offers great potential as an acceptable approach to reduce psycho-behavioral symptoms and improve mother-infant interactions (i.e., bonding). Additionally, it is critical that mindfulness interventions consider time constraints of new mothers, provide accessible intervention delivery, address parenting, and consider the challenges of caring for an infant. Given these considerations, we describe a pilot research protocol in which we evaluate a culturally adapted mindfulness program: Mindfulness for African Americans Postpartum (MAAP). The intervention is based upon Kabat-Zinn's Mindfulness Based Stress Reduction program, but is adapted to include culturally relevant concepts of spirituality, inter-dependence, self-empowerment, and storytelling, which are salient to African American culture. To accommodate the needs of new mothers, a certified mindfulness interventionist delivers each session virtually using Zoom. The investigation uses a randomized controlled design in which African American women within 12 months of giving birth are randomized either to the MAAP intervention or to an Education Program. The primary aim is to determine the extent to which the MAAP intervention decreases maternal psycho-behavioral symptoms (perceived stress, depressive symptoms, anxiety, poor sleep, posttraumatic stress, and fatigue) and improves mother-infant bonding. A secondary aim is to explore the effects of MAAP on proinflammatory cytokines and oxytocin. Culturally adapted mindfulness interventions delivered virtually will make mindfulness more accessible and meaningful to populations, like African American new mothers, who are at higher risk for postpartum mood disorders and poor infant outcomes.
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Affiliation(s)
- Lindsey Garfield
- Marcella Niehoff School of Nursing, 2160 S. First Ave, Maywood, IL 60153, United States
| | - Natalie N. Watson-Singleton
- Spelman College, Department of Psychology, 350 Spelman Lane, Box 1657 Giles Hall 317, Atlanta, GA 30314, United States
| | - Herbert L. Mathews
- Stritch School of Medicine, Department of Microbiology and Immunology, Loyola University Chicago, United States
| | - Linda Witek Janusek
- Marcella Niehoff School of Nursing, Loyola University Chicago, United States
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Ghaedi-Heidari F, Izadi M, Seyedbagheri S, Ahmadi A, Sayadi AR, Sadeghi T. The Effect of Mindfulness on Posttraumatic Growth of Mothers of Premature Infants Admitted to Neonatal Intensive Care Unit. J Clin Psychol Med Settings 2024; 31:19-25. [PMID: 37178339 DOI: 10.1007/s10880-023-09961-5] [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] [Accepted: 04/25/2023] [Indexed: 05/15/2023]
Abstract
The purpose of this study was to determine the effect of Mindfulness-Based Stress Reduction (MBSR) on Posttraumatic Growth (PTG) in mothers of premature infants admitted to the Neonatal Intensive Care Unit (NICU) in Iran. Sixty mothers were selected by convenience sampling and assigned to the intervention and control groups. The intervention group received two MBSR sessions each week over the course of three weeks. The Posttraumatic Growth Inventory (PTGI) was used to collect data before, immediately after, and 1 month after the intervention. Based on repeated measures ANOVA, group-by-time interaction effect was significant and there was a statistically significant difference in the mean PTG scores of mothers in the two groups over time (p = 0.004). MBSR increased PTG in mothers. As a result, it is suggested that this approach be used in psychological support programs for mothers who have premature infants admitted to neonatal intensive care units.
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Affiliation(s)
- Fatemeh Ghaedi-Heidari
- Department of Psychiatric Nursing, Nursing and Midwifery School, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoomeh Izadi
- Student Research Committee, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Seyedhamid Seyedbagheri
- Deptartment of Pediatric Nursing, Nursing and Midwifery School, Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
| | - Atefeh Ahmadi
- Nursing Research Center, Razi Nursing and Midwifery Faculty, Kerman University of Medical Sciences, Kerman, Iran
| | - Ahmadreza-Reza Sayadi
- Social Determinants of Health Research Center, Department of Psychiatric Nursing, School of Nursing and Midwifery, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Tabandeh Sadeghi
- Non-Communicable Diseases Research Center, Department of Pediatric Nursing, Nursing and Midwifery School, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
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Featherston R, Barlow J, Song Y, Haysom Z, Loy B, Tufford L, Shlonsky A. Mindfulness-enhanced parenting programmes for improving the psychosocial outcomes of children (0 to 18 years) and their parents. Cochrane Database Syst Rev 2024; 1:CD012445. [PMID: 38197473 PMCID: PMC10777456 DOI: 10.1002/14651858.cd012445.pub2] [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: 01/11/2024]
Abstract
BACKGROUND Emotional and behavioural difficulties (EBD) in children are common, characterised by externalising or internalising behaviours that can be highly stable over time. EBD are an important cause of functional disability in childhood, and predictive of poorer psychosocial, academic, and occupational functioning into adolescence and adulthood. The prevalence, stability, and long-term consequences of EBD highlight the importance of intervening in childhood when behavioural patterns are more easily modified. Multiple factors contribute to the aetiology of EBD in children, and parenting plays an important role. The relationship between parenting and EBD has been described as bidirectional, with parents and children shaping one another's behaviour. One consequence of bidirectionality is that parents with insufficient parenting skills may become involved in increasingly negative behaviours when dealing with non-compliance in children. This can have a cyclical effect, exacerbating child behavioural difficulties and further increasing parental distress. Behavioural or skills-based parenting training can be highly effective in addressing EBD in children. However, emotional dysregulation may intercept some parents' ability to implement parenting skills, and there is recognition that skills-based interventions may benefit from adjunct components that better target parental emotional responses. Mindful parenting interventions have demonstrated some efficacy in improving child outcomes via improvements in parental emotion regulation, and there is potential for mindfulness training to enhance the effectiveness of standard parent training programmes. OBJECTIVES To assess the effectiveness of mindfulness-enhanced parent training programmes on the psychosocial functioning of children (aged 0 to 18 years) and their parents. SEARCH METHODS We searched the following databases up to April 2023: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL Plus, PsycINFO, Sociological Abstracts, Social Sciences Citation Index, Conference Proceedings Citation Index - Social Science & Humanities, AMED, ERIC, ProQuest Dissertations & Theses, Cochrane Database of Systematic Reviews, Campbell Collaboration Library of Systematic Reviews, as well as the following trials registers: ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP). We also contacted organisations/experts in the field. SELECTION CRITERIA We included randomised and quasi-randomised trials. Participants were parents or caregivers of children under the age of 18. The intervention was mindfulness-enhanced parent training programmes compared with a no-intervention, waitlist, or attentional control, or a parent training programme with no mindfulness component. The intervention must have combined mindfulness parent training with behavioural or skills-based parent training. We defined parent training programmes in terms of the delivery of a standardised and manualised intervention over a specified and limited period, on a one-to-one or group-basis, with a well-defined mindfulness component. The mindfulness component must have included mindfulness training (breath, visualisation, listening, or other sensory focus) and an explicit focus on present-focused attention and non-judgemental acceptance. DATA COLLECTION AND ANALYSIS We followed standard Cochrane procedures. MAIN RESULTS Eleven studies met our inclusion criteria, including one ongoing study. The studies compared a mindfulness-enhanced parent training programme with a no-treatment, waitlist, or attentional control (2 studies); a parent training programme with no mindfulness component (5 studies); both a no-treatment, waitlist, or attentional control and a parent training programme with no mindfulness component (4 studies). We assessed all studies as being at an unclear or high risk of bias across multiple domains. We pooled child and parent outcome data from 2118 participants to produce effect estimates. No study explicitly reported on self-compassion, and no adverse effects were reported in any of the studies. Mindfulness-enhanced parent training programmes compared to a no-treatment, waitlist, or attentional control Very low certainty evidence suggests there may be a small to moderate postintervention improvement in child emotional and behavioural adjustment (standardised mean difference (SMD) -0.46, 95% confidence interval (CI) -0.96 to 0.03; P = 0.06, I2 = 62%; 3 studies, 270 participants); a small improvement in parenting skills (SMD 0.22, 95% CI 0.06 to 0.39; P = 0.008, I2 = 0%; 3 studies, 587 participants); and a moderate decrease in parental depression or anxiety (SMD -0.50, 95% CI -0.96 to -0.04; P = 0.03; 1 study, 75 participants). There may also be a moderate to large decrease in parenting stress (SMD -0.79, 95% CI -1.80 to 0.23; P = 0.13, I2 = 82%; 2 studies, 112 participants) and a small improvement in parent mindfulness (SMD 0.21, 95% CI -0.14 to 0.56; P = 0.24, I2 = 69%; 3 studies, 515 participants), but we were not able to exclude little to no effect for these outcomes. Mindfulness-enhanced parent training programmes compared to parent training with no mindfulness component Very low certainty evidence suggests there may be little to no difference postintervention in child emotional and behavioural adjustment (SMD -0.09, 95% CI -0.58 to 0.40; P = 0.71, I2 = 64%; 5 studies, 203 participants); parenting skills (SMD 0.13, 95% CI -0.16 to 0.42; P = 0.37, I2 = 16%; 3 studies, 319 participants); and parent mindfulness (SMD 0.11, 95% CI -0.19 to 0.41; P = 0.48, I2 = 44%; 4 studies, 412 participants). There may be a slight decrease in parental depression or anxiety (SMD -0.24, 95% CI -0.83 to 0.34; P = 0.41; 1 study, 45 participants; very low certainty evidence), though we cannot exclude little to no effect, and a moderate decrease in parenting stress (SMD -0.51, 95% CI -0.84 to -0.18; P = 0.002, I2 = 2%; 3 studies, 150 participants; low certainty evidence). AUTHORS' CONCLUSIONS Mindfulness-enhanced parenting training may improve some parent and child outcomes, with no studies reporting adverse effects. Evidence for the added value of mindfulness training to skills-based parenting training programmes is suggestive at present, with moderate reductions in parenting stress. Given the very low to low certainty evidence reviewed here, these estimates will likely change as more high-quality studies are produced.
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Affiliation(s)
- Rebecca Featherston
- Department of Social Work, School of Primary and Allied Health Care, Faculty of Medicine Nursing & Health Sciences, Monash University, Caulfield, Australia
| | - Jane Barlow
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - Yunshan Song
- Department of Social Work, School of Primary and Allied Health Care, Faculty of Medicine Nursing & Health Sciences, Monash University, Caulfield, Australia
| | - Zoe Haysom
- Department of Social Work, School of Primary and Allied Health Care, Faculty of Medicine Nursing & Health Sciences, Monash University, Caulfield, Australia
| | - Brenda Loy
- Department of Social Work, School of Primary and Allied Health Care, Faculty of Medicine Nursing & Health Sciences, Monash University, Caulfield, Australia
| | - Lea Tufford
- School of Nursing and Allied Health Professions, Laurentian University, Ontario, Canada
| | - Aron Shlonsky
- Department of Social Work, School of Primary and Allied Health Care, Faculty of Medicine Nursing & Health Sciences, Monash University, Caulfield, Australia
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Grieb SM, McAtee H, Sibinga E, Mendelson T. Exploring the Influence of a Mindfulness Intervention on the Experiences of Mothers with Infants in Neonatal Intensive Care Units. Mindfulness (N Y) 2023; 14:218-229. [PMID: 36684062 PMCID: PMC9838379 DOI: 10.1007/s12671-022-02060-w] [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] [Accepted: 12/18/2022] [Indexed: 01/11/2023]
Abstract
Objectives Mothers with infants in the neonatal intensive care unit (NICU) are at increased risk of psychological distress, which can have lasting negative impacts on both mother and infant. However, few interventions are available to promote these mothers' mental health and wellbeing. In the context of a pilot randomized controlled trial testing a mindfulness intervention for mothers with infants in the NICU, we explore the experiences of the mothers participating in the mindfulness-based intervention, with mothers in the control group as comparison, and the ways they felt it influenced their time in the NICU. Method Twenty-six participants (15 participants in the intervention arm and 11 participants in the control arm) recruited from two NICUs in an urban center in Eastern United States completed semi-structured interviews. Interviews explored the mothers' NICU experience as well as experience with the mindfulness and health education (control) programs. Data was analyzed using an iterative, thematic constant comparison process informed by grounded theory. Results Mothers reported that participation in the mindfulness intervention helped them to calm the chaos through recentering and fostering connections, find comfort through non-judgmental acceptance, gain perspective on the situation, and facilitate self-care. These were experienced only among the mothers in the intervention arm. These themes did not vary based on demographics of the mothers in the mindfulness study arm or their pre-study awareness of mindfulness. Conclusions Mindfulness interventions may foster new practices and perspectives for mothers with infants in the NICU, potentially leading to improved mental health wellbeing.
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Affiliation(s)
- Suzanne M. Grieb
- Department of Pediatrics, Center for Child and Community Health Research, Johns Hopkins University School of Medicine, 5200 Eastern Ave., Mason F. Lord Center Bldg, Suite 4200, Baltimore, MD 21224 USA
| | - Hannah McAtee
- General Pediatrics, Johns Hopkins All Children’s Hospital, 601 5th Street South, St. Petersburg, FL 33701 USA
| | - Erica Sibinga
- Department of Pediatrics, Center for Child and Community Health Research, Johns Hopkins University School of Medicine, 5200 Eastern Ave., Mason F. Lord Center Bldg, Suite 4200, Baltimore, MD 21224 USA
| | - Tamar Mendelson
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, 624 N. Broadway, Hampton House 853, Baltimore, MD 21205 USA
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Long DA, Waak M, Doherty NN, Dow BL. Brain-Directed Care: Why Neuroscience Principles Direct PICU Management beyond the ABCs. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121938. [PMID: 36553381 PMCID: PMC9776953 DOI: 10.3390/children9121938] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 12/02/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022]
Abstract
Major advances in pediatric intensive care (PICU) have led to increased child survival. However, the long-term outcomes among these children following PICU discharge are a concern. Most children admitted to PICU are under five years of age, and the stressors of critical illness and necessary interventions can affect their ability to meet crucial developmental milestones. Understanding the neuroscience of brain development and vulnerability can inform PICU clinicians of new ways to enhance and support the care of these most vulnerable children and families. This review paper first explores the evidence-based neuroscience principles of brain development and vulnerability and the impact of illness and care on children's brains and ultimately wellbeing. Implications for clinical practice and training are further discussed to help optimize brain health in children who are experiencing and surviving a critical illness or injury.
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Affiliation(s)
- Debbie A. Long
- School of Nursing, Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, QLD 4059, Australia
- Paediatric Intensive Care Unit, Queensland Children’s Hospital, Brisbane, QLD 4101, Australia
- Centre for Children’s Health Research, The University of Queensland, Brisbane, QLD 4101, Australia
- Correspondence: ; Tel.: +61-7-3138-3834
| | - Michaela Waak
- Paediatric Intensive Care Unit, Queensland Children’s Hospital, Brisbane, QLD 4101, Australia
- Centre for Children’s Health Research, The University of Queensland, Brisbane, QLD 4101, Australia
| | - Nicola N. Doherty
- Regional Trauma Network, SPPG, DOH, Belfast BT2 8BS, Northern Ireland, UK
- School of Psychology, Faculty of Life and Health Sciences, Coleraine Campus, Ulster University, Coleraine BT52 1SA, Northern Ireland, UK
| | - Belinda L. Dow
- School of Nursing, Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, QLD 4059, Australia
- Centre for Children’s Health Research, The University of Queensland, Brisbane, QLD 4101, Australia
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Ni ZH, Ding S, Wu JH, Wang F. Family caregivers' experiences of caring for neonates undergoing enterostomy in China: A qualitative study. Nurs Open 2022; 10:817-827. [PMID: 36040011 PMCID: PMC9834189 DOI: 10.1002/nop2.1350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 08/07/2022] [Accepted: 08/22/2022] [Indexed: 01/16/2023] Open
Abstract
AIM To describe the nursing experiences and care needs of family caregivers caring for neonates with enterostomies in China. DESIGN A qualitative study. METHODS We conducted semi-structured interviews with family caregivers who care for neonates undergoing enterostomy. Family caregivers were selected using a purposive sampling method from three children's hospitals until no new data were generated (N = 26). Data analysis applied the thematic analysis method. The caregivers' experiences were described using qualitative content analysis. RESULTS The experience of family caregivers was described as growing in adaptation, where five main themes emerged: (1) complex emotional responses; (2) uncertainty about everything; (3) lack of confidence, anxiety and helplessness; (4) eagerness for professional support; (5) active adaptation, gain-harvest and gain-growth. These findings increased understanding and added knowledge on this topic that is rarely studied in China. Healthcare authorities and professionals should recognize and understand the lives and situations of family caregivers (whose neonates undergo enterostomy) to better identify their difficulties and needs.
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Affiliation(s)
- Zhi Hong Ni
- Children's Hospital of Soochow UniversitySuzhouChina
| | - Sheng Ding
- Children's Hospital of Soochow UniversitySuzhouChina
| | - Jin Hua Wu
- Children's Hospital of Soochow UniversitySuzhouChina
| | - Fang Wang
- Children's Hospital of Soochow UniversitySuzhouChina
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Martínez-Shaw ML, Sánchez-Sandoval Y. Effective stress intervention programs for parents of premature children: A systematic review. Stress Health 2022; 39:236-254. [PMID: 36029285 DOI: 10.1002/smi.3194] [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: 12/23/2021] [Revised: 07/25/2022] [Accepted: 08/16/2022] [Indexed: 11/10/2022]
Abstract
The birth of a child alters family dynamics and can be stressful for parents, especially in the case of prematurity. This article carried out a systematic review on interventions in parents to reduce the stress experienced by the birth of a premature infant. The aims were to describe and classify the different interventions and to have an overview of their effectiveness. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guide and the PICO model. For searching the bibliography, we used Web of Science, Science Direct, PubMed and PsycINFO databases. From a total of 450 articles identified, this review finally included 46 studies with empirical evidence. The articles clustered into different types of interventions, such as psychoeducational and parental or maternal support programs, relaxation techniques, expressive writing, art therapy, music therapy and interventions related to interaction and tactile stimulation. There is a wide range of effectiveness in reducing parental stress to a greater or lesser degree. There is a great heterogeneity of interventions. Despite that, they all have a parental educational component that needs to be studied in greater depth.
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Affiliation(s)
- Melissa Liher Martínez-Shaw
- Departamento de Psicología, Instituto de Investigación e Innovación Biomédica de Cádiz (INIBICA), Universidad de Cádiz, Cádiz, Spain
| | - Yolanda Sánchez-Sandoval
- Departamento de Psicología, Instituto de Investigación e Innovación Biomédica de Cádiz (INIBICA), Universidad de Cádiz, Cádiz, Spain
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The Effect of Mindfulness-Based Stress Reduction on Posttraumatic Stress of Mothers With Premature Neonates Admitted to a Neonatal Intensive Care Unit. Holist Nurs Pract 2022; 36:149-155. [PMID: 35435876 DOI: 10.1097/hnp.0000000000000513] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Mothers experience posttraumatic stress disorder with the birth of a premature neonate. The purpose of this study was to determine the effect of mindfulness-based stress reduction on posttraumatic stress of mothers with premature neonates in Iran. Sixty mothers with premature neonates were selected by using convenience sampling and stratified random allocation. Mindfulness-based stress reduction was trained and mean posttraumatic stress disorder was measured. Mean posttraumatic stress scores of the 2 groups were statistically significant immediately and 1 month after the intervention (independent t test, P < .05). Posttraumatic stress of both groups reduced over time, but this reduction was more significant in the intervention group (repeated-measures analysis of variance, P < .05). Concerning the positive role of mindfulness-based stress reduction in posttraumatic stress disorder of mothers, it is recommended to use this approach in care programs of mothers with premature neonates.
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10
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Vohr BR, McGowan EC, Brumbaugh JE, Hintz SR. Overview of Perinatal Practices with Potential Neurodevelopmental Impact for Children Affected by Preterm Birth. J Pediatr 2022; 241:12-21. [PMID: 34673090 DOI: 10.1016/j.jpeds.2021.10.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 09/27/2021] [Accepted: 10/15/2021] [Indexed: 12/16/2022]
Affiliation(s)
- Betty R Vohr
- Department of Pediatrics, Alpert Medical School of Brown University and Women & Infants Hospital, Providence, RI.
| | - Elisabeth C McGowan
- Department of Pediatrics, Alpert Medical School of Brown University and Women & Infants Hospital, Providence, RI
| | - Jane E Brumbaugh
- Children's Center of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN
| | - Susan R Hintz
- Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Palo Alto, CA
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Landry MA, Kumaran K, Tyebkhan JM, Levesque V, Spinella M. Mindful Kangaroo Care: mindfulness intervention for mothers during skin-to-skin care: a randomized control pilot study. BMC Pregnancy Childbirth 2022; 22:35. [PMID: 35033000 PMCID: PMC8761274 DOI: 10.1186/s12884-021-04336-w] [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: 01/07/2021] [Accepted: 12/13/2021] [Indexed: 11/25/2022] Open
Abstract
Background Parents of babies admitted to the Newborn Intensive Care Unit (NICU) undergo considerable stress. There is evidence that mindfulness reduces stress in these parents. Kangaroo Care (KC) is practiced in NICUs across the world and is stress-relieving. Whether mindfulness practiced during KC in the NICU reduces parental distress has not yet been studied. The objective was to explore the feasibility and acceptability of teaching and practicing mindfulness during KC for mothers of premature babies. The objective was also to document preliminary outcomes of Mindful Kangaroo Care (MKC) on maternal stress, anxiety, depression, and mindful awareness. Methods In this pilot randomized controlled study, mothers of premature babies who were expected to stay in the NICU for at least four weeks were taught two mindfulness exercises to practice during KC and compared to mothers who received standard care with no mindfulness teaching. Mothers filled out stress, anxiety, depression and mindful awareness scales at recruitment and after four weeks. Acceptability and feasibility questionnaires were also completed. Results Fifteen mothers per group completed the study. The MKC group demonstrated a significant within-group reduction in anxiety (p = 0.003), depression (p = 0.02) and stress (p = 0.002), and a significant increase in both the curiosity (p = 0.008) and decentering (p = 0.01) scores of the Toronto Mindfulness Scale, all of which had medium to large effect sizes. Only the increases in curiosity and decentering were significant between groups. Fourteen mothers found the intervention acceptable, one neutral. Conclusion MKC was acceptable, feasible and led to a reduction in stress, anxiety and depression in mothers who practiced mindfulness exercises during KC. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-04336-w.
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Affiliation(s)
- Marc-Antoine Landry
- Department of Pediatrics, University of Alberta, Edmonton, Canada. .,Stollery Children's Hospital, Newborn Intensive Care Unit, Royal Alexandra Site, Edmonton, Canada. .,Edmonton NIDCAP Training Centre Canada (ENTCC), Edmonton, Canada.
| | - Kumar Kumaran
- Department of Pediatrics, University of Alberta, Edmonton, Canada.,Stollery Children's Hospital, Newborn Intensive Care Unit, Royal Alexandra Site, Edmonton, Canada.,Edmonton NIDCAP Training Centre Canada (ENTCC), Edmonton, Canada
| | - Juzer M Tyebkhan
- Department of Pediatrics, University of Alberta, Edmonton, Canada.,Stollery Children's Hospital, Newborn Intensive Care Unit, Royal Alexandra Site, Edmonton, Canada.,Edmonton NIDCAP Training Centre Canada (ENTCC), Edmonton, Canada
| | - Valerie Levesque
- Stollery Children's Hospital, Newborn Intensive Care Unit, Royal Alexandra Site, Edmonton, Canada
| | - Marcello Spinella
- School of Social and Behavioral Sciences, Stockton University, Galloway, NJ, USA
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12
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Khoramirad A, Abedini Z, Khalajinia Z. Relationship between mindfulness and maternal stress and mother - Infant bonding in neonatal intensive care unit. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:337. [PMID: 34761023 PMCID: PMC8552262 DOI: 10.4103/jehp.jehp_1620_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 03/17/2021] [Indexed: 05/27/2023]
Abstract
BACKGROUND Having a baby admitted to a neonatal intensive care unit (NICU) is so stressful, has a negative impact on mother well-being, and also disrupts mother-infant bonding process because the infant spend the first several weeks or months in the NICU. Previous studies have shown the positive association of the mindfulness and various health conditions. This study investigated the relationship between mothers' dispositional mindfulness and level of stress and bonding in mothers with infants in the NICU. MATERIALS AND METHODS A cross-sectional study was performed during 2019 on 140 mothers with newborns admitted to the NICUs in two hospitals in Qom city in Iran. The self-report measures of dispositional mindfulness, Parental Stressor Scale: NICU, and the Postpartum Bonding Questionnaire were administered to mothers on the 2nd-5th day after birth. The data analysis was carried out by using a stepwise multiple regression model. RESULTS The mean scores of mindfulness, stress, and bonding were 3.32 ± 0.52, 2.32 ± 0.77, and 0.47 ± 0.37, respectively. There was a statistically significant inverse relationship between total mindfulness score and stress (P < 0.001). Furthermore, high scores of mindfulness were associated with better bonding (P = 0.04). CONCLUSIONS Improvement in mindfulness helps mothers to reduce stress and make better bonding with infants. It is recommended that mindfulness interventions use during pregnancy also after birth, especially for mothers that their infants admitted to in the NICUs.
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Affiliation(s)
- Ashraf Khoramirad
- Department of Nursing, School of Nursing and Midwifery, Qom University of Medical Sciences, Qom, Iran
| | - Zahra Abedini
- Department of Nursing, School of Nursing and Midwifery, Qom University of Medical Sciences, Qom, Iran
| | - Zohre Khalajinia
- Department of Midwifery, School of Nursing and Midwifery, Qom University of Medical Sciences, Qom, Iran
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Anand L, Sadowski I, Per M, Khoury B. Mindful parenting: a Meta-analytic review of intrapersonal and interpersonal parental outcomes. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02111-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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14
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Mousavi SS, Keramat A, Chaman R, Mohagheghi P, Mousavi SA, Khosravi A. Impact of Maternity Support Program on the Stress of Mothers in the First Encounter with the Preterm Infants. Int J Prev Med 2021; 12:68. [PMID: 34447510 PMCID: PMC8356949 DOI: 10.4103/ijpvm.ijpvm_314_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 04/18/2020] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Mothers of premature infants experience a high level of stress. The current study was conducted aiming at investigating the impact of maternity support program on the stress of mothers in the first encounter with infants. METHODS This experimental study began in neonatal intensive care units (NICUs) of two hospitals of Tehran; that is, Mahdieh (intervention) and Shahid Akbar-Abadi (control), from Feb 14, 2016, to May 14, 2016. Both are educational and referral centers including three levels of NICU that were randomly allocated to intervention and control sites. In the span of study period all 75 infants and mothers with inclusion/exclusion criteria in the Mahdieh hospital were included in the intervention group and vis-à -vis all 68 infants and mothers in Shahid-Akbar-Abadi were enrolled in the control group. The designed intervention was conducted based on the support system pattern of mothers with premature infants in the interventional group. In the first stage of intervention, in the intervention group, mothers were provided informational, emotional, and spiritual support before and during the first exposure and were empowered for comfortable interactions. The control group received routine care. After the first exposure, the mothers' stress was measured by the Parental Stressor Scale: Neonatal Intensive Care Unit (PSS: NICU). The data were analyzed by STATA software as well as t-test, Chi-square, and average treatment effects (ATEs) were estimated using inverse probability treatment weights (IPTW). RESULTS After adjusting pre-treatment variables by IPTW, the adjusted average difference in the stress score over the NICU environment, infant's behavior and appearance, the special treatments on him/her, and the change in the parental role and total stress were 1.47 (1.19-1.75), 1.06 (0.73-1.14), 1.21 (0.93-1.49), and 1.18 (0.93-1.44), which were lower than the control group (P < 0.001). CONCLUSIONS The intervention reduced significantly the stress of mothers. The policy-makers are suggested to conduct this method.
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Affiliation(s)
- Seyedeh S. Mousavi
- Nursing Care Research Center (NCRC), Department of Midwifery and Reproductive Health, Iran University of Medical Sciences, Tehran, Iran
| | - Afsaneh Keramat
- Department of Reproductive Health, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Reza Chaman
- Department of Epidemioligy, School of Health, Shiraz University of Medical Science, Shiraz, Iran
| | - Parisa Mohagheghi
- Hazrate Rasoul Medical Center, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed A. Mousavi
- Department of Psychiatry, Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ahmad Khosravi
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
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15
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Abstract
The experience of having a child in the neonatal intensive care unit (NICU) is often unexpected, traumatic, and presents numerous stressors for new fathers. Past research has shown that parents of all genders with children in the NICU experience clinically significant psychological symptoms, yet the bulk of research and intervention efforts to date have focused on the needs of mothers. This paper will provide a review of the literature, outline current knowledge about the specific needs of men with children in the NICU, and recommend areas of focus for future research. The paper will also highlight the need to tailored interventions that specifically address the unique needs of fathers.
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16
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Ruskin D, Young M, Sugar C, Nofech-Mozes J. Mindfulness and Acceptance Interventions for Parents of Children and Adolescents Diagnosed with Chronic Medical Conditions: A Systematic Review. J Altern Complement Med 2020; 27:120-135. [PMID: 33151744 DOI: 10.1089/acm.2020.0191] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Background: Mindfulness and acceptance interventions (MAIs) have been identified as potentially beneficial for parents of children and adolescents diagnosed with chronic medical conditions. Objective: The objective of this review was to provide a descriptive summary of the existing literature on MAIs delivered to parents of children and adolescents diagnosed with chronic medical conditions. Data sources: Electronic searches were conducted by a Library Information Specialist familiar with the field by using EMBASE, MEDLINE, PsycINFO, EBM Reviews Databases, and Cochrane Database of Systematic Reviews. Study eligibility, participants, and interventions: Peer-reviewed journal articles of MAIs delivered to parents of children and adolescents (birth to 18 years of age) diagnosed with a chronic medical condition were eligible for inclusion. Study appraisal and synthesis methods: A total of 18 studies involving 793 parents met inclusion criteria and thus were included in this review. The majority of studies were either pre/post design (n = 8) or randomized controlled trials (n = 6). Most interventions were delivered within a group (n = 6) or individually (n = 5). Nearly all studies (n = 14) reported statistically significant outcomes following the MAI intervention. Conclusions and implications of key findings: Descriptive information yielded from this review provides promising evidence that MAIs are being delivered to parents across the world and many researchers are using similar outcome measures when assessing the psychological flexibility, acceptance, and mindfulness skills following participation in MAIs among this population of parents.
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Affiliation(s)
- Danielle Ruskin
- Department of Psychology, The Hospital for Sick Children, Toronto, Canada.,Department of Psychology, York University, Toronto, Canada
| | - Melissa Young
- Department of Psychology, The Hospital for Sick Children, Toronto, Canada
| | - Carly Sugar
- Department of Psychology, The Hospital for Sick Children, Toronto, Canada.,Department of Psychology, Western University, London, Canada
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Ouyang JX, Mayer JLW, Battle CL, Chambers JE, Inanc Salih ZN. Historical Perspectives: Unsilencing Suffering: Promoting Maternal Mental Health in Neonatal Intensive Care Units. Neoreviews 2020; 21:e708-e715. [PMID: 33139508 DOI: 10.1542/neo.21-11-e708] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Mothers of infants in the NICU suffer higher rates of psychological distress, anxiety, and depression compared with the general population. Often, their mental health concerns remain underidentified and undertreated, which can have deleterious effects on the offspring, both in short-term outcomes while in the NICU as well as long-term neurodevelopmental and behavioral outcomes. In this review, we present an overview of existing empirical evidence about how maternal mental health affects the health of infants, special considerations regarding the mental health needs of NICU mothers, and the findings about existing and developing interventions to address mental health concerns in this vulnerable population.
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Affiliation(s)
- Jessica X Ouyang
- Warren Alpert Medical School of Brown University, Women & Infants Hospital of Rhode Island, Providence, RI
| | - Jessica L W Mayer
- Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, IN
| | - Cynthia L Battle
- Warren Alpert Medical School of Brown University, Butler Hospital, Women & Infants Hospital of Rhode Island, Providence, RI
| | - Joanna E Chambers
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN
| | - Zeynep N Inanc Salih
- Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, IN
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18
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Harrison TM. Improving neurodevelopment in infants with complex congenital heart disease. Birth Defects Res 2019; 111:1128-1140. [PMID: 31099484 DOI: 10.1002/bdr2.1517] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 05/02/2019] [Indexed: 12/15/2022]
Abstract
Worldwide, more than 400,000 infants are born each year with complex congenital heart disease (CCHD) requiring surgical intervention within the first months of life. Although improvements in perioperative care have resulted in increased rates of survival, more than half of infants with CCHD have neurodevelopmental impairments affecting subsequent educational achievements, job opportunities, and mental health. Brain maturity and impaired outcomes in infants with CCHD are similar to those of prematurely born infants. Developmentally supportive care, including foundational application of kangaroo care (KC), improves neurodevelopment in premature infants. Provision of developmentally supportive care with KC during the early hospitalization of infants with CCHD has the potential to similarly improve neurodevelopment. The purposes of the article are to describe common congenital heart defects, describe developmentally supportive care with an emphasis on KC, and to offer specific recommendations for KC and research in infants with CCHD.
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