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Grand L, Hammami S, Bourdon S, Demarly Drumelle C, Auer J, Rolland AC, Eutrope J, Olivier M. Protective and vulnerability personality traits associated with PTSD diagnosis after preterm delivery. PLoS One 2024; 19:e0308498. [PMID: 39133706 PMCID: PMC11318917 DOI: 10.1371/journal.pone.0308498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 07/24/2024] [Indexed: 08/15/2024] Open
Abstract
Giving birth prematurely is a traumatic event that has many consequences for the mother but also for her baby and their family. Studies have shown that about a quarter of these mothers will suffer from post-traumatic stress disorder (PTSD) as a result. This study aims to identify internal personality factors associated with the development of PTSD in mothers who gave birth before 33 weeks. The results revealed significant correlations between two personality dimensions (neuroticism and extraversion) and the likeliness of developing PTSD in mothers who gave birth prematurely. Neuroticism is positively liked with the disorder while extraversion is negatively correlated with it. Studies should now focus on early detection of PTSD and better interventions for these mothers.
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Affiliation(s)
- Laurane Grand
- CHU Reims, Service de Pédopsychiatrie, Reims, France
| | | | - Sarah Bourdon
- CHU Reims, Service de Pédopsychiatrie, Reims, France
| | | | - Julie Auer
- CHU Reims, Service de Pédopsychiatrie, Reims, France
| | - Anne-Catherine Rolland
- C2S, CHU Reims, Service de Pédopsychiatrie, Université Reims Champagne Ardenne, Reims, France
| | - Julien Eutrope
- C2S, CHU Reims, Service de Pédopsychiatrie, Université Reims Champagne Ardenne, Reims, France
| | - Marie Olivier
- C2S, Université Reims Champagne Ardenne, Reims, France
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Pineda R, Misikoff M, Ghahramani S, Smith J, Mathur A. Description and evidence on the supporting and enhancing neonatal intensive care unit sensory experiences (SENSE) program. Acta Paediatr 2024. [PMID: 38809111 DOI: 10.1111/apa.17293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 05/06/2024] [Accepted: 05/08/2024] [Indexed: 05/30/2024]
Abstract
AIM To describe the supporting and enhancing neonatal intensive care unit (NICU) sensory experiences (SENSE) program, associated research and opportunities for further study. METHODS A review of current materials on SENSE program implementation, publications related to SENSE development, and research on program implementation and patient outcomes was conducted to describe the SENSE program and its associated research. RESULTS The SENSE program combines structured, evidence-based, multisensory interventions with parent engagement in order to optimise outcomes in the complex NICU environment. Through a stepwise and scientific process, the SENSE program was developed to include specific doses and targeted timing (based on the infant's postmenstrual age, PMA) of evidence-based interventions such as massage, auditory exposure, rocking, holding and skin-to-skin care for parents to provide their infants each day of NICU hospitalisation. It is adapted in context of concurrent medical interventions, infant behavioural responses, as well as NICU culture. The program is feasible to implement, acceptable to staff, and related to infants receiving more developmentally appropriate sensory exposures. Adaptations related to NICU culture and parent involvement have been reported. Research has identified relationships of the SENSE program to improved parent confidence, neurobehaviour and feeding at term age as well as improved communication 1 year of age. CONCLUSION The literature related to the SENSE program is promising, but more research on efficacy and implementation is needed.
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Affiliation(s)
- Roberta Pineda
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
- Department of Pediatrics, Keck School of Medicine, Los Angeles, California, USA
- Gehr Family Center for Health Systems Science and Innovation, University of Southern California, Los Angeles, California, USA
- Program in Occupational Therapy, Washington University, St. Louis, Missouri, USA
| | - Maya Misikoff
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
| | - Sahar Ghahramani
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
| | - Joan Smith
- Department of Quality, Safety, and Practice Excellence, St. Louis Children's Hospital, St. Louis, Missouri, USA
| | - Amit Mathur
- Department of Pediatrics, St. Louis University, St. Louis, Missouri, USA
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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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Guittard C, Eutrope J, Caillies S, Loron G. Effect of tactile and/or kinesthetic stimulation therapy of preterm infants on their parents' anxiety and depressive symptoms: A systematic review. BMC Psychol 2024; 12:3. [PMID: 38167522 PMCID: PMC10759426 DOI: 10.1186/s40359-023-01510-x] [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: 05/22/2023] [Accepted: 12/26/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND In the case of preterm birth, the idealized postnatal period is replaced by an anxious and even traumatic experience for parents. Higher prevalence of parental anxiety, postnatal depression, and posttraumatic stress disorder has been observed in mothers of preterm infants up to 18 months after childbirth. There is increasing evidence that proprioceptive stimulation has a beneficial effect on preterms' short-term outcomes. Could this care also have an impact on parental anxiety and depressive symptoms? We reviewed recent publications on the impact on parents' anxiety and depressive symptoms of delivering tactile and/or kinesthetic stimulation to their premature newborn. METHODS We conducted a systematic review by searching the PubMed, PsycInfo, Scopus, ScienceDirect and Google Scholar databases for English-language publications from the past 10 years. We focused on the mothers or fathers of infants born preterm (before 37 weeks of gestation) who provided tactile and/or kinesthetic stimulation to their premature newborn in the neonatal intensive care unit. Relevant outcomes were the parents' anxiety, stress, depressive symptoms, and symptoms of posttraumatic stress disorder, assessed with reliable standardized inventories. RESULTS Eleven articles were included in the systematic review. Results suggested a beneficial effect of parents' early tactile and kinesthetic stimulation of their preterm infants. CONCLUSIONS These interventions may act as protective factors against the occurrence of anxiety and depressive symptoms in parents and deserve to be studied further in this population.
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Affiliation(s)
| | - Julien Eutrope
- Université de Reims Champagne-Ardenne, C2S, CHU Reims, service de psychiatrie de l'enfant et de l'adolescent, F-51100, Reims, France
| | | | - Gauthier Loron
- Université de Reims Champagne-Ardenne, CReSTIC, CHU Reims, service de médecine néonatale et de réanimation pédiatrique, F-51100, Reims, France
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Bouwmeester D, Anolda Naber FB, Heyman H, Hoffmann-Haringsma A, Lens A, Brunt TM. Follow-up care and support to parents of premature children: Multidisciplinary versus regular follow-up care. Child Care Health Dev 2024; 50:e13185. [PMID: 37842882 DOI: 10.1111/cch.13185] [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: 03/23/2023] [Revised: 08/04/2023] [Accepted: 10/01/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND Preterm care involves clinical measures almost exclusively aimed at keeping the preterm alive and ready for discharge from hospital. Children are then enrolled in clinical follow-up care after this stressful period, but mental or specialised care for parents and child is often not embedded in the routine of a neonatal hospital ward and the family is then dependent on institutions for mental health or child health clinics, that is, regular care that is regionally scattered. This study aimed to investigate experiences of parents with regular care and compare them with parents visiting a fixed, specialised, multidisciplinary institute, outside the hospital walls, for preterm follow-up care. METHODS A survey was conducted among 56 parents (regular follow-up care N = 26; multidisciplinary follow-up care N = 30) of children born prematurely. The survey consisted out of items like parents' experiences with follow-up care, like the organisation of care, supportive care, environmental support and experienced stress. RESULTS Parents receiving multidisciplinary follow-up care reported higher levels of satisfaction with organisation of care (F = 5.45; p = 0.023) and supportive care (F = 11.69; p = 0.001) than parents receiving regular follow-up care. Also, it was found that the extent of support from the social environment alleviated stress but only in parents receiving regular follow-up care (ß = -0.47; p = 0.016). CONCLUSIONS The current study findings indicate that experience with follow-up care is valued higher when receiving multidisciplinary care than regular care, and the degree in environmental support alleviates stress in parents receiving regular care.
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Affiliation(s)
- Daniëlle Bouwmeester
- Department of Psychology, Education and Child Studies, Erasmus University, Rotterdam, The Netherlands
| | | | | | | | - Annick Lens
- Department of Public Health, Municipality of Utrecht, Utrecht, The Netherlands
| | - Tibor Markus Brunt
- Het Kleine Heldenhuis, Rotterdam, The Netherlands
- Department of Psychiatry, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Kobus S, Diezel M, Dewan MV, Huening B, Dathe AK, Marschik PB, Felderhoff-Mueser U, Bruns N. Music therapy modulates mothers' perception of their preterm infants. Front Psychol 2023; 14:1231741. [PMID: 37928582 PMCID: PMC10620800 DOI: 10.3389/fpsyg.2023.1231741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 10/06/2023] [Indexed: 11/07/2023] Open
Abstract
Premature birth imposes considerable challenges on the preterm infant, but also challenges the mother, who may not yet be prepared for motherhood and encounter psychological stress during the post-partum period. This secondary analysis of a prospective randomized controlled trial (RCT) aimed to investigate how mothers perceive their preterm infants. We surveyed 33 mothers of preterm infants born before 32 weeks of gestation, who were participating in an RCT on music therapy. We employed the neonatal perception inventory (NPI), an instrument designed to assess the mother's perception and expectations regarding her infant immediately after birth. Infants were randomly assigned to either standard care (control group) or standard care plus music therapy (intervention group). Eighteen mothers from the intervention group participated in the survey (mean age 34.1 ± 4.6 years) and 15 mothers from the control group (mean age 29.6 ± 4.2 years). At the time of the infant's hospital discharge, mothers rated their expectations of how they felt a baby should behave (NPI I) and how they perceived their own infant (NPI II). The NPI score difference was calculated by subtracting the NPI II from the NPI I. Mean NPI I scores were comparable between both groups, but NPI II scores in the intervention group were better [18.0, 95% confidence interval (CI) 16.6-19.4] than in the control group (19.1, 95% CI 18.0-20.3). The relative probability of mothers rating their own baby as better than average was 1.94 (95% CI 1.00-3.79) for mothers whose infants received music therapy. These findings suggest that music therapy in the neonatal intensive care unit can positively influence mothers' perception of their hospitalized preterm infant.
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Affiliation(s)
- Susann Kobus
- Department of Paediatrics I, University Hospital, University of Duisburg-Essen, Essen, Germany
- Faculty of Medicine, Centre for Translational Neuro- and Behavioural Sciences (C-TNBS), University Duisburg-Essen, Essen, Germany
- Center of Artistic Therapy, University Medicine Essen, Essen, Germany
| | - Marlis Diezel
- Department of Paediatrics I, University Hospital, University of Duisburg-Essen, Essen, Germany
- Faculty of Medicine, Centre for Translational Neuro- and Behavioural Sciences (C-TNBS), University Duisburg-Essen, Essen, Germany
| | - Monia Vanessa Dewan
- Department of Paediatrics I, University Hospital, University of Duisburg-Essen, Essen, Germany
- Faculty of Medicine, Centre for Translational Neuro- and Behavioural Sciences (C-TNBS), University Duisburg-Essen, Essen, Germany
| | - Britta Huening
- Department of Paediatrics I, University Hospital, University of Duisburg-Essen, Essen, Germany
- Faculty of Medicine, Centre for Translational Neuro- and Behavioural Sciences (C-TNBS), University Duisburg-Essen, Essen, Germany
| | - Anne-Kathrin Dathe
- Department of Paediatrics I, University Hospital, University of Duisburg-Essen, Essen, Germany
- Faculty of Medicine, Centre for Translational Neuro- and Behavioural Sciences (C-TNBS), University Duisburg-Essen, Essen, Germany
- Department of Health and Nursing, Occupational Therapy, Ernst-Abbe-University of Applied Sciences, Jena, Germany
| | - Peter B. Marschik
- Child and Adolescent Psychiatry and Psychotherapy, Systemic Ethology and Developmental Science, University Medical Center Göttingen and Leibniz ScienceCampus Primate Cognition, Göttingen, Germany
- iDN - Interdisciplinary Developmental Neuroscience, Division of Phoniatrics, Medical University of Graz, Graz, Austria
- Center of Neurodevelopmental Disorders (KIND), Center for Psychiatry Research, Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
| | - Ursula Felderhoff-Mueser
- Department of Paediatrics I, University Hospital, University of Duisburg-Essen, Essen, Germany
- Faculty of Medicine, Centre for Translational Neuro- and Behavioural Sciences (C-TNBS), University Duisburg-Essen, Essen, Germany
| | - Nora Bruns
- Department of Paediatrics I, University Hospital, University of Duisburg-Essen, Essen, Germany
- Faculty of Medicine, Centre for Translational Neuro- and Behavioural Sciences (C-TNBS), University Duisburg-Essen, Essen, Germany
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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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Shaw RJ, Givrad S, Poe C, Loi EC, Hoge MK, Scala M. Neurodevelopmental, Mental Health, and Parenting Issues in Preterm Infants. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1565. [PMID: 37761526 PMCID: PMC10528009 DOI: 10.3390/children10091565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 09/09/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023]
Abstract
The World Health Organization in its recommendations for the care of preterm infants has drawn attention to the need to address issues related to family involvement and support, including education, counseling, discharge preparation, and peer support. A failure to address these issues may translate into poor outcomes that extend across the lifespan. In this paper, we review the often far-reaching impact of preterm birth on the health and wellbeing of the parents and highlight the ways in which psychological stress may have a negative long-term impact on the parent-child interaction, attachment, and the styles of parenting. This paper addresses the following topics: (1) neurodevelopmental outcomes in preterm infants, including cognitive, sensory, and motor difficulties, (2) long-term mental health issues in premature infants that include elevated rates of anxiety and depressive disorders, autism, and somatization, which may affect social relationships and quality of life, (3) adverse mental health outcomes for parents that include elevated rates of depression, anxiety, and symptoms of post-traumatic stress, as well as increased rates of substance abuse, and relationship strain, (4) negative impacts on the parent-infant relationship, potentially mediated by maternal sensitivity, parent child-interactions, and attachment, and (5) impact on the parenting behaviors, including patterns of overprotective parenting, and development of Vulnerable Child Syndrome. Greater awareness of these issues has led to the development of programs in neonatal mental health and developmental care with some data suggesting benefits in terms of shorter lengths of stay and decreased health care costs.
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Affiliation(s)
- Richard J. Shaw
- Division of Child and Adolescent Psychiatry and Child Development, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305, USA; (E.C.L.); (C.P.)
| | - Soudabeh Givrad
- Division of Child and Adolescent Psychiatry, Weill Cornell Medicine, 525 E 68th Street, New York, NY 10065, USA;
| | - Celeste Poe
- Division of Child and Adolescent Psychiatry and Child Development, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305, USA; (E.C.L.); (C.P.)
| | - Elizabeth C. Loi
- Division of Child and Adolescent Psychiatry and Child Development, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305, USA; (E.C.L.); (C.P.)
| | - Margaret K. Hoge
- Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA;
| | - Melissa Scala
- Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Palo Alto, CA 94304, USA;
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Orovou E, Eskitzis P, Mrvoljak-Theodoropoulou I, Tzitiridou-Chatzopoulou M, Arampatzi C, Rigas N, Palaska E, Dagla M, Iliadou M, Antoniou E. The Involvement of Neonatal Intensive Care Unit and Other Perinatal Factors in Postpartum PTSD After Cesarean Section. JOURNAL OF MOTHER AND CHILD 2023; 27:158-167. [PMID: 37920113 PMCID: PMC10623112 DOI: 10.34763/jmotherandchild.20232701.d-23-00056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 09/21/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND The experience of a neonate hospitalised in the Neonatal Intensive Care Unit (NICU) is an understandably traumatic experience for the parents, especially, for the mothers of neonates. This mental distress resulting from preterm birth and/or NICU hospitalisation can be understood as post-traumatic symptomatology, according to the Diagnostic and Statistical Manual-5 version. The aim of this study is to investigate the impact of the admission of a neonate to the NICU (from any reason) on the development of postpartum post-traumatic stress disorder (PTSD) in a sample of women after cesarean sections. MATERIAL AND METHODS A total of 469 women who gave birth with cesarean section from July 2019 to June 2020 participated in this study, from the original sample of 490 women who consented to participate. Data were obtained from the researcher's socio-demographic questionnaire, the past traumatic Life Events Checklist, the perinatal stressor Criterion A, and the Post-Traumatic Stress Checklist from the Diagnostic and Statistical Manual-5 version. RESULTS A percentage of 46.64% of sample experienced postpartum PTSD. Factors associated with PTSD were placenta previa type4, abruption, bleeding (β = .07, p = .049), premature contractions (β = .08, p = .039), heavy medical history or previous gynecological history and preeclampsia (β = .08, p = .034), abnormal heart rate, premature rupture of membrane, premature contractions, infections (β = .14, p = .004), life of child in danger (β = .12, p = .025), complications involving child (β = .15, p = .002), complications involving both (child and mother) (β = .12, p = .011), traumatic cesarean section (β = .041, p < .001) and prematurity (β = .12, p = .022). CONCLUSIONS Additional measures must be taken for mothers of children who have been admitted to the NICU with psychological support interventions and reassessment of their mental state.
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Affiliation(s)
- Eirini Orovou
- Department of Midwifery, University of West Attica, Egaleo, Greece
- Department of Midwifery, University of Western Macedonia, Keptse, Ptolemaida, Greece
| | - Panagiotis Eskitzis
- Department of Midwifery, University of Western Macedonia, Keptse, Ptolemaida, Greece
| | | | | | - Christiana Arampatzi
- Department of Midwifery, University of Western Macedonia, Keptse, Ptolemaida, Greece
| | - Nikolaos Rigas
- Department of Midwifery, University of West Attica, Egaleo, Greece
| | - Ermioni Palaska
- Department of Midwifery, University of West Attica, Egaleo, Greece
| | - Maria Dagla
- Department of Midwifery, University of West Attica, Egaleo, Greece
| | - Maria Iliadou
- Department of Midwifery, University of West Attica, Egaleo, Greece
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10
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Shaw RJ, Moreyra A, Simon S, Wharton E, Dowtin LL, Armer E, Goldman LW, Borkovi T, Neri E, Jo B, Hintz S, Van Meurs K, Horwitz SM. Group trauma focused cognitive behavior therapy for parents of premature infants compared to individual therapy intervention. Early Hum Dev 2023; 181:105773. [PMID: 37119727 PMCID: PMC10182567 DOI: 10.1016/j.earlhumdev.2023.105773] [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: 01/19/2023] [Revised: 03/28/2023] [Accepted: 04/07/2023] [Indexed: 05/01/2023]
Abstract
BACKGROUND The current study compares results of a group-based intervention developed to reduce symptoms of posttraumatic stress, depression, and anxiety in parents of premature infants with a prior study using an individual version of the treatment manual. METHODS 26 mothers of preterm infants (25-34 weeks' gestational age; >600 g) received 6 sessions of trauma-focused cognitive behavior therapy (CBT). Outcomes were compared with those of a previously published RCT, which tested an individual therapy based on the same model in a group of 62 mothers. Results were also compared across in-person and telehealth treatment. RESULTS From baseline to follow up, the individual intervention showed greater improvement in trauma symptoms assessed with the Davidson Trauma Scale (d = 0.48, p = 0.016), although both conditions showed clinically significant improvement. Similar patterns were found for maternal depression and anxiety. In-person treatment was found to be superior to telehealth treatment administered during the COVID-19 pandemic, although the difference was not significant. CONCLUSIONS Group-based trauma focused CBT is an effective treatment modality for parents of premature infants with symptoms of psychological distress but not as effective as individual therapy using the same treatment model.
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Affiliation(s)
- Richard J Shaw
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, United States of America.
| | - Angelica Moreyra
- Children's Hospital Los Angeles, 4650 Sunset Blvd, Los Angeles, CA, United States of America
| | - Stephanie Simon
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, United States of America
| | - Emily Wharton
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, United States of America
| | - LaTrice L Dowtin
- PlayfulLeigh Psyched, Silver Spring, MD, United States of America
| | - Erin Armer
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, United States of America
| | | | - Tonyanna Borkovi
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, United States of America
| | - Eric Neri
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, United States of America
| | - Booil Jo
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, United States of America
| | - Susan Hintz
- Department of Pediatrics, Stanford University School of Medicine, United States of America
| | - Krisa Van Meurs
- Department of Pediatrics, Stanford University School of Medicine, United States of America
| | - Sarah M Horwitz
- Department of Child and Adolescent Psychiatry, New York University Grossman School of Medicine, New York, NY, United States of America
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11
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The Use and Impact of Diaries in PICUs and Neonatal ICUs: A Scoping Review. Pediatr Crit Care Med 2023; 24:e84-e90. [PMID: 36521187 DOI: 10.1097/pcc.0000000000003122] [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: 12/23/2022]
Abstract
OBJECTIVE Several studies have investigated the impact of diaries in adult ICUs, which have been used as a tool to support recall and reduce post-traumatic stress disorder in patients and their families. We conducted a scoping review to determine the definition of ICU diaries, and the extent, range, and nature of research conducted on NICU and PICU diaries, describe their use and impact, as well as identify gaps in knowledge and areas for future research. DATA SOURCES The following databases were searched from inception to March 2022: Cumulated Index to Nursing and Allied Health Literature, Cochrane Library, Embase, PubMed, and American Psychological Association PsycINFO. Searches were also conducted in the following gray literature databases: Google Scholar, University of South Australia, and WorldCat. STUDY SELECTION All studies that discussed the use and impact of diaries or journals involving patients (<18 yr old) in PICUs and NICUs and/or their family members were included. DATA SYNTHESIS Sixteen studies were identified. Most studies defined diaries as daily entries written by nurses and/or family members regarding the patient's condition during their ICU admission. The majority reported that diaries were beneficial to children and their families as they helped to fill in memory gaps, provided a means to express their feelings, and served as effective health communication tools. Several gaps were identified: extent of the use of diaries as a means of communication, the significance of diaries as a coping mechanism for bereaved parents, and the impact of PICU diaries on the children, their families, and healthcare professionals. CONCLUSIONS There is a paucity of data on the use of NICU and PICU diaries. Nonetheless, the limited data revealed that NICU and PICU diaries were beneficial to children and their families. Our review demonstrated a heterogeneity in the terminology, content, use of photos, and the author/s of the NICU and PICU diaries. Further research is needed to investigate the impact of the use of NICU and PICU diaries on patient-reported outcomes.
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Ebersjö C, Berggren Broström E, Kull I, Lindholm Olinder A. Home Immunization with Palivizumab-A Randomized Pilot Study Describing Safety Aspects and Parents' Preferences. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020198. [PMID: 36832327 PMCID: PMC9955059 DOI: 10.3390/children10020198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 01/16/2023] [Accepted: 01/18/2023] [Indexed: 01/22/2023]
Abstract
Among prematurely born infants and newborns with chronic conditions, a respiratory syncytial virus (RSV) infection may cause (re-)admission and later respiratory complications. Therapeutic protection is possible with monthly injections of a specific monoclonal antibody, palivizumab, during RSV season. Standard care is giving up to five injections in clinic-based settings. Immunization at home could be an alternative to standard care for vulnerable infants to reduce the number of revisits and associated risk of RSV infection. The aim of this randomized pilot trial was to evaluate safety aspects and explore parents' preferences of home versus hospital immunization with palivizumab during one RSV season. Immediate adverse events (AEs) were observed and registered by a pediatric specialist nurse. Late-onset AEs were reported by parents. Parents' perceptions were collected through a questionnaire and analyzed using content analysis. The study population consisted of 43 infants in 38 families. No immediate AEs occurred. Three late-onset AEs were reported in two infants in the intervention group. Three categories emerged in the content analysis: (1) protect and watch over the infant, (2) optimal health and well-being for the whole family, and (3) avoid suffering for the infant. The study results show that home immunization with palivizumab is feasible if safety aspects are considered and that parental involvement in the choice of place for immunization after a neonatal intensive care experience can be important.
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Affiliation(s)
- Christina Ebersjö
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institute, 171 77 Stockholm, Sweden
- Sach’s Children and Youth Hospital, Södersjukhuset AB, 118 83 Stockholm, Sweden
- Correspondence:
| | - Eva Berggren Broström
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institute, 171 77 Stockholm, Sweden
| | - Inger Kull
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institute, 171 77 Stockholm, Sweden
- Sach’s Children and Youth Hospital, Södersjukhuset AB, 118 83 Stockholm, Sweden
| | - Anna Lindholm Olinder
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institute, 171 77 Stockholm, Sweden
- Sach’s Children and Youth Hospital, Södersjukhuset AB, 118 83 Stockholm, Sweden
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13
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Group Psychotherapy for Parents of Youth with Pediatric Acute-Onset Neuropsychiatric Syndrome. J Clin Psychol Med Settings 2022:10.1007/s10880-022-09926-0. [PMID: 36480109 DOI: 10.1007/s10880-022-09926-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2022] [Indexed: 12/13/2022]
Abstract
Parents of children with diagnoses of Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) and Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infections (PANDAS) may experience significant psychological distress related to their child's severe and relapsing illness and challenges with the traumatic nature of its treatment. No manualized or studied psychological interventions specifically for parents of youth with PANS have existed prior to this study. In this pilot study, we assessed the feasibility, satisfaction, and treatment fidelity of a brief 9-session group therapy intervention for parents based on principles of trauma-focused cognitive behavior therapy (CBT). We hypothesized that, if initially elevated, symptoms of depression, anxiety, and trauma would decrease and participants' utilization of positive coping mechanisms would increase post-intervention. We adapted an existing evidence-based group intervention developed for parents of children with premature infants to target sources of stress and coping in parents of children with PANS. Ten parents participated in the study. The 9-session intervention used a combination of techniques that included cognitive restructuring, coping skills, self-care, and a trauma narrative to address psychological stress, trust, grief, and unwanted emotions. Outcome measures included parental symptoms of anxiety, depression, and posttraumatic stress disorder (PTSD), as well as rating of parental satisfaction with the intervention. The treatment was feasible and deliverable with high fidelity. The intervention was rated as useful and satisfactory by parents (overall average usefulness of 4.54 and satisfaction of 4.71 out of 5.0). Elevated symptoms of PTSD and depression decreased with large effect sizes (Cohen's d = 1.42 and Cohen's d = 1.38, respectively). Participating parents demonstrated significantly more active coping and acceptance behaviors and stances. A brief 9-session group therapy intervention based on principles of trauma-focused CBT was found to be effective in reducing symptoms of psychological distress in parents of children with PANS.
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14
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Di Chiara M, Laccetta G, Gangi S, De Santis B, Spiriti C, Attenni M, Bertolaso L, Boscarino G, De Nardo MC, Ciambra G, Parisi P, Terrin G. Risk factors and preventive strategies for post-traumatic stress disorder in neonatal intensive care unit. Front Psychol 2022; 13:1003566. [PMID: 36438350 PMCID: PMC9683535 DOI: 10.3389/fpsyg.2022.1003566] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 10/20/2022] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND Preterm birth and admission to the neonatal intensive care unit (NICU) could induce post-traumatic stress disorder (PTSD). PTSD is an important factor to focus on, as it is associated with parental mental health difficulties and with changes in caregiving quality such as increased intrusiveness, reduced sensitivity, and increased attachment insecurity for the child. AIMS We aimed to study the main risk factors, in the early life of newborns, and preventive measures for PTSD in parents of neonates hospitalized in the NICU. METHODS We included parents of preterm newborns, consecutively admitted to the NICU of the University La Sapienza of Rome. The presence of PTSD following preterm birth and NICU admission was assessed using the Clinician-administered PTSD scale (CAPS) at enrollment and at 28-30 days following NICU admission or the moment of discharge. We also evaluated the Family Environment Scale which measures the social environment of all types of families; the Parental Stressor Scale which measures parental anxiety and stress; the Spielberger State-Trait Anxiety Inventory consisting of two parts measuring the State (response to present situation) and Trait (pre-disposition to be anxious) anxieties separately, and the Beck Depression Inventory Second Edition assessing depressive symptoms. RESULTS We found, in a multivariate analysis, that the gestational age of newborns admitted to NICU significantly (β = 2.678; p = 0.040) influences the occurrence of PTSD. We found that the cases showed significantly (β = 2.443; p = 0.020) more pathological Parental Stressor Scale sights and sounds scores compared to controls. The early Kangaroo-Care (KC) significantly (β = -2.619; p = 0.015) reduces the occurrence of PTSD. CONCLUSION Post-traumatic stress disorder in parents of preterm newborns is a pathological condition that should be properly managed, in the very first days after birth. The NICU environment represents a main risk factor for PTSD, whereas KC has been demonstrated to have a protective role in the occurrence of PTSD.
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Affiliation(s)
- Maria Di Chiara
- Department of Maternal and Child Health, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Gianluigi Laccetta
- Department of Maternal and Child Health, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Sara Gangi
- Department of Maternal and Child Health, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Benedetta De Santis
- Department of Maternal and Child Health, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Caterina Spiriti
- Department of Maternal and Child Health, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Martina Attenni
- Department of Maternal and Child Health, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Laura Bertolaso
- Department of Maternal and Child Health, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Giovanni Boscarino
- Department of Maternal and Child Health, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Maria Chiara De Nardo
- Department of Maternal and Child Health, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Gianluca Ciambra
- Department of Maternal and Child Health, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Pasquale Parisi
- Department of Neuroscience, Mental Health and Sense Organs (NESMOS), Faculty of Medicine and Psychology, Sant’Andrea University Hospital, Sapienza University of Rome, Rome, Italy
| | - Gianluca Terrin
- Department of Maternal and Child Health, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
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15
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Moulds ML, Bisby MA, Black MJ, Jones K, Harrison V, Hirsch CR, Newby JM. Repetitive negative thinking in the perinatal period and its relationship with anxiety and depression. J Affect Disord 2022; 311:446-462. [PMID: 35597469 DOI: 10.1016/j.jad.2022.05.070] [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: 03/24/2022] [Revised: 05/04/2022] [Accepted: 05/13/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Rumination and worry represent two types of repetitive negative thinking (RNT), and their predictive and maintaining roles are well-established in depression and anxiety, respectively. Furthermore, there is an emerging literature on the link between RNT and psychological wellbeing in the perinatal period. METHODS We conducted a scoping review of studies that have investigated the relationship between RNT and perinatal depression and anxiety. We identified 87 papers eligible for inclusion in the review; they included cross-sectional and longitudinal studies, as well as treatment evaluations (pilot trials and randomised controlled trials). RESULTS Cross-sectional studies provided evidence of an association between RNT (i.e., rumination and worry) and depression and anxiety, in both pregnancy and postpartum. Longitudinal findings were mixed. Whilst antenatal worry consistently predicted subsequent depression and anxiety (both later in pregnancy and postpartum), rumination did not consistently predict depression. However, there was some evidence that rumination interacted with other processes to predict later psychopathology. Three randomised controlled trials evaluated whether psychological treatments reduce RNT in the perinatal period, only one of which included a clinical sample. LIMITATIONS No experimental investigations were eligible for inclusion in the review. CONCLUSIONS Further studies are needed to further our understanding of the nature and role of RNT in pregnancy and postpartum, and its consequences for maternal mental health. These include (but are not limited to) experimental investigations, studies with large clinical samples, and RCTs evaluating the effectiveness of psychological interventions targeting RNT to prevent and treat perinatal depression and anxiety.
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Affiliation(s)
| | - Madelyne A Bisby
- eCentreClinic, School of Psychological Sciences, Macquarie University, Australia
| | - Melissa J Black
- School of Psychology, UNSW Sydney, Australia; Black Dog Institute, UNSW Sydney, Australia
| | - Katie Jones
- School of Health, Wellbeing and Social Care, The Open University, UK
| | | | - Colette R Hirsch
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; South London and Maudsley NHS Foundation Trust, UK
| | - Jill M Newby
- School of Psychology, UNSW Sydney, Australia; Black Dog Institute, UNSW Sydney, Australia
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16
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Leikas S, Lahti-Pulkkinen M, Räikkönen K. Facet-level changes in mothers’ neuroticism and extraversion from early pregnancy to 6 months post-partum. EUROPEAN JOURNAL OF PERSONALITY 2022. [DOI: 10.1177/08902070221098908] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Becoming a parent could be expected to affect personality development, but the existing results on parenthood-personality change connection are mixed. The present study investigated 2445 primi- and multiparous mothers’ facet- and domain-level changes in Neuroticism and Extraversion from early pregnancy to 6 months post-partum, using latent difference score models. The results showed that Excitability and the affective facets of Neuroticism decreased, and the Neuroticism facets Impulsivity and Self-Consciousness increased during the follow-up. Furthermore, mother-perceived child difficult temperament attenuated desirable personality change and amplified the increases in Impulsivity. The results suggested that considering facet-level changes in personality development across significant life events is informative, and that mother-perceived child temperament may represent an important moderator of short-term personality change across the transition to parenthood.
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Affiliation(s)
- Sointu Leikas
- Swedish School of Social Science, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Marius Lahti-Pulkkinen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Katri Räikkönen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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17
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Catholic Perspective on Decision-Making for Critically Ill Newborns and Infants. CHILDREN 2022; 9:children9020207. [PMID: 35204927 PMCID: PMC8870660 DOI: 10.3390/children9020207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/01/2022] [Accepted: 02/02/2022] [Indexed: 11/17/2022]
Abstract
In this paper, we discuss the foundational values informing the Catholic perspective on decision-making for critically ill newborns and infants, particularly focusing on the prudent use of medical technologies. Although the Church has consistently affirmed the general good of advances in scientific research and medicine, the technocratic paradigm of medicine may, particularly in cases with severely ill infants, lead to decision-making conflicts and breakdowns in communication between parents and providers. By exploring two paradigm cases, we offer specific practices in which providers can engage to connect with parents and avoid common technologically mediated decision-making conflicts. By focusing on the inherent relationality of all human persons, regardless of debility, and the Christian hope in the life to come, we can make decisions in the midst of the technocratic paradigm without succumbing to it.
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18
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Dickinson C, Vangaveti V, Browne A. Psychological impact of neonatal intensive care unit admissions on parents: A regional perspective. Aust J Rural Health 2022; 30:373-384. [PMID: 35112425 DOI: 10.1111/ajr.12841] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 12/22/2021] [Accepted: 12/31/2021] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE This study aimed to report the prevalence of adverse psychological symptoms and health behaviours of parents who had a baby admitted to a regional neonatal intensive care unit to spotlight mental health care in these unique settings. DESIGN This was a prospective, prevalence-based study using quantitative data. SETTING The study was conducted at the Townsville University Hospital, Queensland. PARTICIPANTS Participants comprised 114 parents of 79 infants enrolled in the study (mothers = 69 and fathers = 45). MAIN OUTCOME MEASURES Trauma, depression, anxiety, stress, alcohol and drug use, prior mental health history and bonding experience were assessed by standardised self-report questionnaires and a structured diagnostic interview within 2 weeks and at 3 months post-admission to neonatal intensive care unit. RESULTS Clinically significant acute trauma symptoms (16% of mothers only), depression (22% mothers; 4% of fathers), anxiety (27% mothers; 11% fathers) and stress (24% mothers; 13% fathers) were reported within the first 2 weeks after their baby was admitted to the neonatal intensive care unit. Notably, 18% of parents reported engaging in harmful alcohol use behaviour within 2 weeks post-birth; 29% of fathers continued to report risky drinking at 3 months. At 3 months, 21%, 8% and 6% of mothers met diagnostic criteria for generalised anxiety disorder, major depressive disorder and post-traumatic stress disorder, respectively. CONCLUSION Screening for psychological distress and alcohol use of parents of neonatal intensive care unit babies can ensure that support services are made available post-discharge to optimise family function and development of the preterm infant.
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Affiliation(s)
- Corrine Dickinson
- Queensland Children's Hospital, Children's Health Queensland, South Brisbane, QLD, Australia
| | - Venkat Vangaveti
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia
| | - Allyson Browne
- Medical School, University of Western Australia, Perth, WA, Australia
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19
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Stuebe AM, Tucker C, Ferrari RM, McClain E, Jonsson-Funk M, Pate V, Bryant K, Charles N, Verbiest S. Perinatal morbidity and health utilization among mothers of medically fragile infants. J Perinatol 2022; 42:169-176. [PMID: 34376790 PMCID: PMC8858647 DOI: 10.1038/s41372-021-01171-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 06/29/2021] [Accepted: 07/14/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To determine the burden of perinatal morbidity among mothers of medically fragile infants. STUDY DESIGN We conducted a retrospective cohort study of 6849 mothers who delivered liveborn infants at a quaternary care hospital during a two-year period. We compared mothers of well babies with mothers of infants admitted to the Neonatal Intensive Care Unit (NICU), and we used logistic regression to model predictors of postpartum acute care utilization among NICU mothers. RESULTS Rates of obstetric morbidity were highest for mothers of infants staying ≥72 h in the NICU; 54.2% underwent cesarean birth, 7.5% experienced severe maternal morbidity, and 6.6% required a blood transfusion. Factors independently associated with postpartum acute care use included gestational age <28 weeks, ever smoking, non-Hispanic Black race, temperature >38 °C and receiving psychiatric medication during the birth hospitalization. CONCLUSION Focused support for mothers of NICU infants has the potential to reduce maternal morbidity and improve health.
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Affiliation(s)
- Alison M. Stuebe
- School of Medicine, University of North Carolina at Chapel Hill,Gillings School of Global Public Health, University of North Carolina at Chapel Hill
| | - Christine Tucker
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill
| | - Renée M. Ferrari
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill
| | - Erin McClain
- School of Medicine, University of North Carolina at Chapel Hill
| | - Michele Jonsson-Funk
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill
| | - Virginia Pate
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill
| | | | - Nkechi Charles
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill
| | - Sarah Verbiest
- School of Medicine, University of North Carolina at Chapel Hill,School of Social Work, University of North Carolina at Chapel Hill
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20
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Choi HS, Lee KE, Shin Y. Effects of an emotional regulation program on maladaptive cognitive emotion regulation, stress, anxiety, and postpartum depression among South Korean mothers of premature infants in the neonatal intensive care unit. CHILD HEALTH NURSING RESEARCH 2022; 27:24-33. [PMID: 35004494 PMCID: PMC8650872 DOI: 10.4094/chnr.2021.27.1.24] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/16/2020] [Accepted: 11/17/2020] [Indexed: 11/13/2022] Open
Abstract
Purpose This study aimed to evaluate the effects of a rational emotive behavior therapy (REBT)-based emotional regulation program for mothers of premature infants in the neonatal intensive care unit (NICU). Methods The study utilized a nonequivalent control group pretest-posttest design. Seventeen mothers were recruited for the experimental group and 21 mothers for the control group. Data were collected from July 9, 2018, to Oct 12, 2018 from mothers of premature infants in the NICU regarding parental stress, state anxiety, depression, and maladaptive cognitive emotion regulation. The experimental group received eight sessions of the REBT-based emotional regulation program for 3-4 weeks, and the control group only received standard nursing care. Results Significant differences were found between the two groups in maladaptive cognitive emotion regulation (Z=−3.88, p<.001), stress (Z=−2.76, p=.006), state anxiety (Z=−3.72, p<.001), and postpartum depression(Z=−2.62, p=.009) after the intervention in the experimental group. Conclusion The REBT-based emotional regulation program for mothers of premature infants was effective for reducing maladaptive cognitive emotion regulation, stress, anxiety, and postpartum depression. Therefore, it may be necessary to provide an REBT-based emotional regulation program for mothers of premature infants in the NICU in clinical practice.
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Affiliation(s)
- Hyo Sin Choi
- Assistant Professor, Department of Nursing, Daegu Health College, Daegu, Korea
| | - Kyung Eun Lee
- Assistant Professor, Department of Nursing, Keimyung College University, Daegu, Korea
| | - Yeonghee Shin
- Professor, College of Nursing, Keimyung University, Daegu, Korea
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21
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Feudtner C, Nye RT, Boyden JY, Schwartz KE, Korn ER, Dewitt AG, Waldman AT, Schwartz LA, Shen YA, Manocchia M, Xiao R, Lord BT, Hill DL. Association Between Children With Life-Threatening Conditions and Their Parents' and Siblings' Mental and Physical Health. JAMA Netw Open 2021; 4:e2137250. [PMID: 34928360 PMCID: PMC8689391 DOI: 10.1001/jamanetworkopen.2021.37250] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
IMPORTANCE Despite concerns regarding the potential deleterious physical and mental health outcomes among family members of a child with a life-threatening condition (LTC), few studies have examined empirical measures of health outcomes among these family members. OBJECTIVES To examine whether mothers, fathers, sisters, and brothers of children with 1 of 4 types of pediatric LTCs have higher rates of health care encounters, diagnoses, and prescriptions compared with families of children without these conditions. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study included US families with commercial insurance coverage from a single carrier. Children who had 1 of 4 LTCs (substantial prematurity, critical congenital heart disease, cancer, or a condition resulting in severe neurologic impairment) were identified by a diagnosis in their insurance claim data between July 1, 2015, and June 30, 2016. Each case child and their family was matched with up to 4 control children and their families based on the age of the case and control children. Data were analyzed between August 2020 and March 2021. EXPOSURES Having a child or sibling with substantial prematurity, critical congenital heart disease, cancer, or a condition resulting in severe and progressive neurologic impairment. MAIN OUTCOMES Rates of occurrence of health care encounters, physical and mental health diagnoses, and physical and mental health medication prescriptions, identified from insurance claims data, were compared between case and control families using a multivariable negative binomial regression model. The statistical analysis adjusted for observed differences between case and control families and accounted for clustering at the family level. RESULTS The study included 25 528 children (6909 case children [27.1%] and 18 619 control children [72.9%]; median age, 6.0 years [IQR, 1-13 years]; 13 294 [52.1%] male), 43 357 parents (11 586 case parents [26.7%] and 31 771 control parents [73.3%]; mean [SD] age, 40.4 [8.1] years; 22 318 [51.5%] female), and 25 706 siblings (7664 case siblings [29.8%] and 18 042 control siblings [70.2%]; mean [SD] age, 12.1 [6.5] years; 13 114 [51.0%] male). Overall, case mothers had higher rates of the composite outcome of health care encounters, diagnoses, and prescriptions compared with control mothers (incident rate ratio [IRR], 1.61; 95% CI, 1.54-1.68), as did case fathers compared with control fathers (IRR, 1.55; 95% CI, 1.46-1.64). Sisters of children with LTCs had higher rates of the composite outcome compared with sisters of children without LTCs (IRR, 1.68; 95% CI, 1.55-1.82), as did brothers of children with LTCs compared with brothers of children without LTCs (IRR, 1.70; 95% CI, 1.56-1.85). CONCLUSIONS AND RELEVANCE In this cohort study, mothers, fathers, sisters, and brothers who had a child or sibling with 1 of 4 types of LTCs had higher rates of health care encounters, diagnoses, and medication prescriptions compared with families who did not have a child with that condition. The findings suggest that family members of children with LTCs may experience poorer mental and physical health outcomes. Interventions for parents and siblings of children with LTCs that aim to safeguard their mental and physical well-being appear to be warranted.
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Affiliation(s)
- Chris Feudtner
- Justin Michael Ingerman Center for Palliative Care, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- Division of General Pediatrics, Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | - Russell T. Nye
- Justin Michael Ingerman Center for Palliative Care, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Jackelyn Y. Boyden
- Justin Michael Ingerman Center for Palliative Care, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Katherine E. Schwartz
- Division of Neonatology, Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | - Emilie R. Korn
- Division of General Pediatrics, Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | - Aaron G. Dewitt
- Division of Cardiology, Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | - Amy T. Waldman
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | - Lisa A. Schwartz
- Division of Oncology, Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | | | - Michael Manocchia
- Cigna, Bloomfield, Connecticut
- Department of Sociology, University of North Florida, Jacksonville
| | - Rui Xiao
- Division of General Pediatrics, Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | | | - Douglas L. Hill
- Justin Michael Ingerman Center for Palliative Care, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
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22
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Twohig A, Murphy JF, McCarthy A, Segurado R, Underdown A, Smyke A, McNicholas F, Molloy EJ. The preterm infant-parent programme for attachment-PIPPA Study: a randomised controlled trial. Pediatr Res 2021; 90:617-624. [PMID: 33432155 DOI: 10.1038/s41390-020-01262-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 08/24/2020] [Accepted: 10/20/2020] [Indexed: 01/29/2023]
Abstract
BACKGROUND There is increasing recognition of adverse mental health consequences of preterm birth and the impact on social-emotional development. However, the quality of the developing parent-infant relationship may be protective, with enhanced maternal sensitivity to infants' cues associated with improved outcomes. METHODS Eighty mothers and their preterm infants born <32 weeks gestation were randomised to intervention and standard care groups. Intervention comprised reflective interview, observation of infant cues and video interaction guidance (VIG). The primary outcome, maternal sensitivity during play, was measured by the Child Adult Relationship Evaluation-Index. Secondary outcomes were infant social-emotional problems measured by the Ages and Stages Questionnaire-Social-Emotional version. RESULTS There was no statistically significant difference between the intervention and standard care groups in maternal sensitivity during play at 9 months corrected age (CA). In the secondary outcome analysis at 12 months CA, infants in the intervention group had fewer self-regulation problems than infants whose mothers received standard care. Per-protocol analysis revealed that infants whose mothers completed VIG had significantly fewer communication problems. CONCLUSIONS This early attachment-focussed intervention integrating VIG for mothers and their preterm infants did not enhance maternal sensitivity; however, there were effects on infant social-emotional problems at 12 months CA. IMPACT Preterm birth can adversely affect infant and parent mental health and the quality of the parent-infant relationship. Early intervention to support parent-infant interaction can have positive effects on infant social-emotional development. There was no statistically significant difference in maternal sensitivity during play at 9 months CA. However, there were fewer infant self-regulation and communication problems reported by mothers at 12 months CA following intervention. Further evaluations of attachment-focussed interventions in the neonatal intensive care unit are needed.
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Affiliation(s)
- Aoife Twohig
- Department of Paediatrics, The National Maternity Hospital, Dublin, Ireland. .,Perinatal Mental Health, The National Maternity Hospital, Dublin, Ireland. .,National Children's Research Centre, Children's Health Ireland, Crumlin, Dublin, Ireland. .,Child Psychiatry, Children's Health Ireland, Crumlin, Dublin, Ireland. .,School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland.
| | - John F Murphy
- Department of Paediatrics, The National Maternity Hospital, Dublin, Ireland
| | - Anthony McCarthy
- Perinatal Mental Health, The National Maternity Hospital, Dublin, Ireland.,School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland
| | | | - Angela Underdown
- Formerly Warwick Medical School, University of Warwick, Coventry, UK
| | - Anna Smyke
- Section of Child and Adolescent Psychiatry, School of Medicine, Tulane University, New Orleans, LA, USA
| | - Fiona McNicholas
- Child Psychiatry, Children's Health Ireland, Crumlin, Dublin, Ireland.,School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland
| | - Eleanor J Molloy
- National Children's Research Centre, Children's Health Ireland, Crumlin, Dublin, Ireland.,Department of Neonatology, Children's Health Ireland, Crumlin, Dublin, Ireland.,Department of Paediatrics, Coombe Women and Infants' University Hospital, Dublin, Ireland.,Department of Paediatrics, Children's Health Ireland, Tallaght, Dublin, Ireland.,Dublin School of Medicine, Trinity College Dublin, Dublin, Ireland
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23
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Cristóbal-Cañadas D, Bonillo-Perales A, Casado-Belmonte MDP, Galera-Martínez R, Parrón-Carreño T. Mapping the Field in Stress, Anxiety, and Postpartum Depression in Mothers of Preterm Infants in Neonatal Intensive Care. CHILDREN-BASEL 2021; 8:children8090730. [PMID: 34572162 PMCID: PMC8468620 DOI: 10.3390/children8090730] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 08/18/2021] [Accepted: 08/23/2021] [Indexed: 01/10/2023]
Abstract
Objective: The main aim of this study was to describe and conduct a bibliometric analysis of the state of research on stress, anxiety, and postpartum depression in mothers of preterm infants in the Neonatal Intensive Care Unit. Background: Women affected by premature births are particularly exposed to mental health difficulties in the postpartum period. The desire to comprehend and the growing interest in research on stress, anxiety, and postpartum depression in mothers of preterm infants in neonatal intensive care have led to a substantial rise in the number of documents in this field over the last years. Thus, it makes it vital to regularly review the state of knowledge on this phenomenon in order to identify progress and constraints, to stimulate reflection, and to encourage progress in future research. Method: This study examined 366 articles published in the Scopus database (1976–2020). Keyword analysis was also used to identify hot research trends to be developed in future studies. This study complies with the PRISMA-Scr guidelines for quality improvement research in the EQUATOR network. Results: Our results reveal that research in this field is in a period of high production and allows this flourishing body of work to be organized into different periods, highlighting the most important themes. In such a way, our research enriches the lively field by presenting a comprehensive understanding of the field. Discussion: The key contribution of this study is the development of a conceptual map of research on stress, anxiety, and postpartum depression in mothers of preterm infants in neonatal intensive care units.
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Affiliation(s)
| | - Antonio Bonillo-Perales
- Pediatric Department, Torrecárdenas University Hospital, 04009 Almería, Spain; (A.B.-P.); (R.G.-M.)
| | | | - Rafael Galera-Martínez
- Pediatric Department, Torrecárdenas University Hospital, 04009 Almería, Spain; (A.B.-P.); (R.G.-M.)
| | - Tesifón Parrón-Carreño
- Department of Nursing, Physiotherapy and Medicine, University of Almería, 04120 Almería, Spain;
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Abstract
Diagnosis of a fetal anomaly in pregnancy increases the risk for perinatal mental health difficulties, including anxiety, depression, and traumatic stress among expectant parents. Common emotional challenges include uncertainty about the diagnosis/prognosis, anticipated neonatal course, fears of fetal or neonatal demise, loss of a typical, uncomplicated pregnancy and postpartum course, and disruption of family roles due to medical care-related activities and restrictions. Psychologists in multidisciplinary fetal care centers are uniquely positioned to assess mental health risks and address the needs of expectant parents. Psychologists bring additional expertise in screening and assessment, clinical interventions to promote coping and symptom reduction while preparing for birth and a complicated neonatal course, consultation and effective communication, and programmatic development. This review paper provides an overview of the challenges and behavioral health risks for expectant parents carrying a fetus with a birth defect and the unique role psychologists play to support patients and families within fetal care settings.
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25
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Orovou E, Theodoropoulou IM, Antoniou E. Psychometric properties of the Post Traumatic Stress Disorder Checklist for DSM-5 (PCL-5) in Greek women after cesarean section. PLoS One 2021; 16:e0255689. [PMID: 34388199 PMCID: PMC8363016 DOI: 10.1371/journal.pone.0255689] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 07/21/2021] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to examine psychometric properties of the revised Posttraumatic Stress Checklist (PCL-5) for Diagnostic and Statistical Manual- 5th Edition (DSM-5) in Greek postpartum women after Cesarean Section(CS) (emergency-elective).So far, there was no study in Greece assessing psychometric properties of the PCL-5 in women after CS. The participating women (N = 469), who gave birth with emergency and elective CS at the Greek University Hospital of Larisa, have consented to participate in two phases of the survey and completed self-report questionnaires, the 2nd day after CS and at the 6th week after CS. Measures used in this study were the PCL-5 for DSM-5, the Life Events Checklist (LEC-5), Criteria B, C, D, E, and Criterion A, specifically designed for detection of posttraumatic stress disorder (PTSD) symptoms in postpartum period. To evaluate the internal reliability of the PCL-5 two different indices of internal consistency were calculated, i.e., Cronbach's alpha (.97) and Guttman'ssplit-half (.95), demonstrating high reliability level. The data were positively skewed, suggesting that the reported levels of PTSD among our participants were low. Factor analyses demonstrated acceptable construct validity; a comparison of thePCL-5 with the other measures of the same concept showed a good convergent validity of the scale. Overall, all the results suggest that the four-factor PCL-5 seemed to work adequately for the Greek sample of women after CS.
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Affiliation(s)
- Eirini Orovou
- Department of Midwifery, University of West Attica, Aigaleo, Greece
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26
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Bieleninik Ł, Lutkiewicz K, Cieślak M, Preis-Orlikowska J, Bidzan M. Associations of Maternal-Infant Bonding with Maternal Mental Health, Infant's Characteristics and Socio-Demographical Variables in the Early Postpartum Period: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8517. [PMID: 34444265 PMCID: PMC8392040 DOI: 10.3390/ijerph18168517] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/06/2021] [Accepted: 08/09/2021] [Indexed: 01/25/2023]
Abstract
(1) Background: There is a continuing discussion concerning the impact of preterm birth on Maternal-Infant bonding with inconsistent results. The large burden of preterm births calls for research to evaluate the impact of it on material psychological outcome in the early postpartum period. Thus, the aim of this study was to evaluate the relationship between maternal postpartum bonding with maternal mental health, socio-demographical factors, and child's characteristics. (2) Methods: A cross-sectional study design was used. In total, 72 women (a mean age of 31.44 years old) of preterm infants (mean gestational age = 33.54; range 24-36) filled out socio-demographic questionnaires, Postpartum Bonding Questionnaire (PBQ), Edinburgh Postpartum Depression Scale (EPDS), Postpartum Depression Screening Scale (PDSS), Generalized Anxiety Disorder Assessment (GAD-7), and Parental Stress Scale (PSS) 1-3 days post-delivery; (3) Results: The results analyses have shown positive correlations between the overall result of maternal postpartum bonding with stress (p < 0.01), maternal educational level (p < 0.01), maternal age (p < 0.05) and the number of children (p < 0.01). However, there were no significant relationships between other investigated variables. The results of linear regression have revelated the important role of the overall scores in experience of stress among mothers (explaining 49% of the variability). The mediating role of maternal stress on maternal postpartum bonding was not found. That relationship of maternal postpartum bonding and maternal stress was not moderated through socio-demographic variables. (4) Conclusions: In this study mothers of prematurely born children had a good level of Maternal-Infant bonding. Maternal stress was found to be a predictor of maternal postpartum bonding among the tested variables. Surprisingly, the study results did not show significant relationships between maternal postpartum bonding and maternal mental health (depression and anxiety).
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Affiliation(s)
- Łucja Bieleninik
- Department of Clinical and Health Psychology, Faculty of Social Sciences, Institute of Psychology, University of Gdańsk, 80-309 Gdańsk, Poland; (K.L.); (M.B.)
- GAMUT—The Grieg Academy Music Therapy Research Centre, NORCE Norwegian Research Centre, 5838 Bergen, Norway
| | - Karolina Lutkiewicz
- Department of Clinical and Health Psychology, Faculty of Social Sciences, Institute of Psychology, University of Gdańsk, 80-309 Gdańsk, Poland; (K.L.); (M.B.)
| | - Mariusz Cieślak
- Faculty of Educational Sciences, Institute of Psychology, University of Lodz, 91-433 Lodz, Poland;
| | - Joanna Preis-Orlikowska
- Division of Obstetrics, Division of Neonatology, Department of Perinatology, Faculty of Medicine, Medical University of Gdańsk, 80-214 Gdańsk, Poland;
| | - Mariola Bidzan
- Department of Clinical and Health Psychology, Faculty of Social Sciences, Institute of Psychology, University of Gdańsk, 80-309 Gdańsk, Poland; (K.L.); (M.B.)
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McKelvey LM, Lewis KN, Beavers J, Casey PH, Irby C, Goudie A. Home Visiting for NICU Graduates: Impacts of Following Baby Back Home. Pediatrics 2021; 148:peds.2020-029397. [PMID: 34083358 DOI: 10.1542/peds.2020-029397] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/12/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The Following Baby Back Home (FBBH) home visiting program supports families of high-risk low birth weight preterm infants after discharge from a hospital NICU. This study compares the health care use, immunization, and infant mortality rate of low birth weight preterm infants enrolled in FBBH with similar infants not in the program. METHODS From January 2013 to December 2017, 498 children enrolled in FBBH were identified in Arkansas vital statistics records and the Arkansas All-Payer Claims Database. Infants in FBBH were matched with children in a control group on the basis of demographics and medical conditions of the infant. Generalized linear mixed models with double propensity-score adjustment were used to estimate program effects. RESULTS In the first year after discharge and compared with a propensity-score matched cohort of control infants, those enrolled in FBBH were significantly more likely to have higher numbers of medical appointments and more compliant immunization history. The odds of dying in the first year of life for control infants was 4.4 times (95% confidence interval: 1.2-20.7) higher than those managed in the program. CONCLUSIONS A goal of the FBBH home visiting program is to work with parents to educate and support them as they care for their medically fragile infants. We conclude that education and support was instrumental in the infant health care use and outcome differences we observed during the first year of life.
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Affiliation(s)
| | - Kanna N Lewis
- Departments of Family and Preventive Medicine.,Arkansas Center for Health Improvement, Little Rock, Arkansas
| | | | | | | | - Anthony Goudie
- Department of Health Policy and Management, College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas.,Arkansas Center for Health Improvement, Little Rock, Arkansas
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28
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Gateau K, Song A, Vanderbilt DL, Gong C, Friedlich P, Kipke M, Lakshmanan A. Maternal post-traumatic stress and depression symptoms and outcomes after NICU discharge in a low-income sample: a cross-sectional study. BMC Pregnancy Childbirth 2021; 21:48. [PMID: 33435907 PMCID: PMC7802207 DOI: 10.1186/s12884-020-03536-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 12/30/2020] [Indexed: 01/02/2023] Open
Abstract
Background Having a preterm newborn and the experience of staying in the neonatal intensive care unit (NICU) has the potential to impact a mother’s mental health and overall quality of life. However, currently there are few studies that have examined the association of acute post-traumatic stress (PTS) and depression symptoms and infant and maternal outcomes in low-income populations. Design/ methods In a cross-sectional study, we examined adjusted associations between positive screens for PTS and depression using the Perinatal Post-traumatic stress Questionnaire (PPQ) and the Patient Health-Questionnaire 2 (PHQ-2) with outcomes using unconditional logistic and linear regression models. Results One hundred sixty-nine parents answered the questionnaire with 150 complete responses. The majority of our sample was Hispanic (68%), non-English speaking (67%) and reported an annual income of <$20,000 (58%). 33% of the participants had a positive PPQ screen and 34% a positive PHQ-2 screen. After adjusting for confounders, we identified that a positive PHQ-2 depression score was associated with a negative unit (95% CI) change on the infant’s Vineland Adaptive Behavior Scales, second edition of − 9.08 (− 15.6, − 2.6) (p < 0.01). There were no significant associations between maternal stress and depression scores and infant Bayley Scales of Infant Development III scores or re-hospitalizations or emergency room visits. However, positive PPQ and screening score were associated with a negative unit (95% CI) unit change on the maternal Multicultural Quality of Life Index score of − 8.1 (− 12, − 3.9)(p < 0.01) and − 7.7 (− 12, − 3) (p = 0.01) respectively. Conclusions More than one-third of the mothers in this sample screened positively for PTS and depression symptoms. Screening scores positive for stress and depression symptoms were associated with a negative change in some infant development scores and maternal quality of life scores. Thoughtful screening programs for maternal stress and depression symptoms should be instituted. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-020-03536-0.
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Affiliation(s)
- Kameelah Gateau
- Division of Neonatology, LAC+USC Medical Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.,Fetal and Neonatal Medicine Institute, Division of Neonatal Medicine, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, 4650 Sunset Boulevard, MS #31, Los Angeles, CA, 90027, USA
| | - Ashley Song
- Fetal and Neonatal Medicine Institute, Division of Neonatal Medicine, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, 4650 Sunset Boulevard, MS #31, Los Angeles, CA, 90027, USA.,Department of Preventive Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Douglas L Vanderbilt
- Section of Developmental-Behavioral Pediatrics, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Cynthia Gong
- Fetal and Neonatal Medicine Institute, Division of Neonatal Medicine, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, 4650 Sunset Boulevard, MS #31, Los Angeles, CA, 90027, USA.,Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, CA, USA
| | - Philippe Friedlich
- Fetal and Neonatal Medicine Institute, Division of Neonatal Medicine, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, 4650 Sunset Boulevard, MS #31, Los Angeles, CA, 90027, USA
| | - Michele Kipke
- Division of Research on Children, Youth and Families, Children's Hospital, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Ashwini Lakshmanan
- Fetal and Neonatal Medicine Institute, Division of Neonatal Medicine, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, 4650 Sunset Boulevard, MS #31, Los Angeles, CA, 90027, USA. .,Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, CA, USA. .,Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
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29
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Salmani N, Beigy S, Khodayarian M. The effect of home visit on anxiety of mothers with preterm infant discharged from neonatal intensive care unit. J Clin Neonatol 2021. [DOI: 10.4103/jcn.jcn_156_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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30
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Baraldi E, Allodi MW, Smedler AC, Westrup B, Löwing K, Ådén U. Parents' Experiences of the First Year at Home with an Infant Born Extremely Preterm with and without Post-Discharge Intervention: Ambivalence, Loneliness, and Relationship Impact. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E9326. [PMID: 33322234 PMCID: PMC7764273 DOI: 10.3390/ijerph17249326] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/04/2020] [Accepted: 12/11/2020] [Indexed: 12/29/2022]
Abstract
With increasing survival rates of children born extremely preterm (EPT), before gestational week 28, the post-discharge life of these families has gained significant research interest. Quantitative studies of parental experiences post-discharge have previously reported elevated levels depressive symptoms, posttraumatic stress-disorder and anxiety among the parents. The current investigation aims to qualitatively explore the situation for parents of children born EPT in Sweden during the first year at home. Semi-structured interviews were performed with 17 parents of 14 children born EPT; eight parents were from an early intervention group and nine parents from a group that received treatment as usual, with extended follow-up procedures. Three main themes were identified using a thematic analytic approach: child-related concerns, the inner state of the parent, and changed family dynamics. Parents in the intervention group also expressed themes related to the intervention, as a sense of security and knowledgeable interventionists. The results are discussed in relation to different concepts of health, parent-child interaction and attachment, and models of the recovery processes. In conclusion, parents describe the first year at home as a time of prolonged parental worries for the child as well as concerns regarding the parent's own emotional state.
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Affiliation(s)
- Erika Baraldi
- Department of Special Education, Stockholm University, 106 91 Stockholm, Sweden;
| | - Mara Westling Allodi
- Department of Special Education, Stockholm University, 106 91 Stockholm, Sweden;
| | | | - Björn Westrup
- Department of Women’s and Children’s Health, Karolinska Institutet, 171 77 Stockholm, Sweden; (B.W.); (K.L.); (U.Å.)
| | - Kristina Löwing
- Department of Women’s and Children’s Health, Karolinska Institutet, 171 77 Stockholm, Sweden; (B.W.); (K.L.); (U.Å.)
- Karolinska University Hospital Functional Area Occupational Therapy and Physiotherapy, Allied Health Professionals Function, 171 76 Stockholm, Sweden
| | - Ulrika Ådén
- Department of Women’s and Children’s Health, Karolinska Institutet, 171 77 Stockholm, Sweden; (B.W.); (K.L.); (U.Å.)
- Karolinska University Hospital Neonatal Unit, 171 76 Stockholm, Sweden
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Mind-Mindedness and Parenting Stress: A Cross-Sectional Study in a Cohort of Mothers of 3-Month-Old Full-Term and Preterm Infants. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217735. [PMID: 33105872 PMCID: PMC7660160 DOI: 10.3390/ijerph17217735] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 10/17/2020] [Accepted: 10/19/2020] [Indexed: 12/11/2022]
Abstract
The preterm birth of a child is a sudden event that can disturb the overall family system and its functioning. Many studies have been conducted with the aim of exploring how and the degree to which this event affects the early mother–infant dyadic relationship and maternal well-being, with often mixed findings. The present study investigates the combined effect of preterm birth and parenting stress on mind-mindedness, a parenting dimension that captures how parents represent and treat their children as separate individuals with their own mental states and activities. A hundred and ten mothers and their three-month-old infants (preterm = 54; full-term = 56) participated in the study. Mind-mindedness was assessed by coding mothers’ comments about infant’s mental states during dyadic face-to-face interaction. Parenting stress was evaluated with the Parenting Stress Index Short Form questionnaire. Mothers of preterm infants reported similar levels of appropriate and non-attuned mind-related comments to mothers of full-term infants. The reported parenting stress levels were also comparable. Interestingly, only mothers of preterm infants who reported higher stress in parenting showed more non-attuned comments during the interaction. The results underline the need to address preterm birth as a complex event, going beyond group differences and considering its interplay with other risk or protective factors in shaping children’s and parents’ adjustments and well-being.
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Blanc J, Rességuier N, Lorthe E, Goffinet F, Sentilhes L, Auquier P, Tosello B, d'Ercole C. Association between extremely preterm caesarean delivery and maternal depressive and anxious symptoms: a national population-based cohort study. BJOG 2020; 128:594-602. [PMID: 32931138 DOI: 10.1111/1471-0528.16499] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To evaluate whether caesarean delivery before 26 weeks of gestation was associated with symptoms of depression and anxiety in mothers in comparison with deliveries between 26 and 34 weeks. DESIGN Prospective national population-based EPIPAGE-2 cohort study. SETTING 268 neonatology departments in France, March to December 2011. POPULATION Mothers who delivered between 22 and 34 weeks and whose self-reported symptoms of depression (Center for Epidemiologic Studies Depression Scale: CES-D) and anxiety (State-Trait Anxiety Inventory: STAI) were assessed at the moment of neonatal discharge. METHODS The association of caesarean delivery before 26 weeks with severe symptoms of depression (CES-D ≥16) and anxiety (STAI ≥45) was assessed by weighted and design-based log-linear regression model. MAIN OUTCOME MEASURES Severe symptoms of depression and anxiety in mothers of preterm infants. RESULTS Among the 2270 women completing CES-D and STAI questionnaires at the time of neonatal discharge, severe symptoms of depression occurred in 25 (65.8%) women having a caesarean before 26 weeks versus in 748 (50.6%) women having a caesarean after 26 weeks. Caesarean delivery before 26 weeks was associated with severe symptoms of depression compared with caesarean delivery after 26 weeks (adjusted relative risk [aRR] 1.42, 95% CI 1.12-1.81) adjusted to neonatal birthweight and severe neonatal morbidity among other factors. There was no evidence of an association between mode of delivery and symptoms of anxiety. CONCLUSIONS Mothers having a caesarean delivery before 26 weeks' gestation are at high risk of symptoms of depression and may benefit from specific preventive care. TWEETABLE ABSTRACT Mothers having caesarean delivery before 26 weeks' gestation are at high risk of symptoms of depression.
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Affiliation(s)
- J Blanc
- Department of Obstetrics and Gynaecology, APHM, Nord Hospital, Marseille, France.,EA3279, CEReSS, Health Service Research and Quality of Life Centre, Aix-Marseille University, Marseille, France
| | - N Rességuier
- EA3279, CEReSS, Health Service Research and Quality of Life Centre, Aix-Marseille University, Marseille, France
| | - E Lorthe
- INSERM, INRA, Epidemiology and Statistics Research Centre/CRESS, Université de Paris, Paris, France.,EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal
| | - F Goffinet
- INSERM, INRA, Epidemiology and Statistics Research Centre/CRESS, Université de Paris, Paris, France.,Maternité Port-Royal, AP-HP, AP-HP Centre-Université de Paris, Paris, France
| | - L Sentilhes
- Department of Obstetrics and Gynaecology, Bordeaux University Hospital, Bordeaux, France
| | - P Auquier
- EA3279, CEReSS, Health Service Research and Quality of Life Centre, Aix-Marseille University, Marseille, France
| | - B Tosello
- Department of Neonatology, Assistance Publique des Hôpitaux de Marseille, North Hospital, France.,CNRS, EFS, ADES, Aix-Marseille University, Marseille, France
| | - C d'Ercole
- Department of Obstetrics and Gynaecology, APHM, Nord Hospital, Marseille, France.,EA3279, CEReSS, Health Service Research and Quality of Life Centre, Aix-Marseille University, Marseille, France
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Posttraumatic Stress Symptoms in Mothers and Fathers of Very Preterm Infants Over the First 2 Years. J Dev Behav Pediatr 2020; 41:612-618. [PMID: 32576786 DOI: 10.1097/dbp.0000000000000828] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Mothers and fathers of infants born very preterm (VPT) are at increased risk for posttraumatic stress symptoms (PTSSs), such as reexperiencing the event, persistent avoidance, or increased reactivity within the early months, compared with parents of term-born infants. This study aimed to assess PTSSs in mothers and fathers of VPT infants over the first 2 years of life, including changes over time and relationship with medical and social risk. METHOD A longitudinal, prospective, cohort study of PTSSs in parents of VPT infants. PTSS was assessed at term equivalent age (TEA) and 12 and 24 months using the Posttraumatic Stress Disorder Checklist Specific Version. Participants were 105 parents of 131 infants born at <30 weeks' gestational age with PTSS data at least once (92 mothers and/or 75 fathers). RESULTS At TEA and 12 and 24 months, elevated PTSSs were reported by 36%, 22%, and 18% of mothers and 35%, 25%, and 19% of fathers, respectively. The mean symptom scores and rates of elevated PTSSs declined over time: mean (95% confidence interval) change in PTSS score per year = -1.52 (-2.33 to -0.72, p < 0.001). There was little evidence for difference in these patterns for mothers or fathers (interaction p = 0.46 [total score] and 0.71 [elevated category]) or that medical and social risk were associated with PTSSs over time. CONCLUSION Although the rates of parents experiencing clinically elevated symptoms declined over time, it is concerning that one-fifth of mothers and fathers reported elevated PTSSs at 24 months. Further research is needed to identify factors associated with increased risk and resilience for PTSSs after VPT birth in mothers and fathers to provide effective and appropriate support.
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Suttora C, Salerni N, Selvagno E, Porro M, Gangi S, Squarza C, Gardon L, Picciolini O. Mind-mindedness and parenting stress in mothers of preterm and full-term infants: The moderating role of perceived social support. Infant Ment Health J 2020; 42:35-46. [PMID: 32965688 DOI: 10.1002/imhj.21891] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The goal of this study was to examine the effects of preterm birth and maternal childbirth-related posttraumatic stress and parenting stress on maternal mind-mindedness (MM). The study also investigated the effects of perceived social support on parenting stress and MM. Sixty-five preterm (N = 32) and full-term (N = 33) mother-infant dyads were observed at 6 months. Measures of maternal MM were obtained from observations of mother-infant interaction. Mothers also provided ratings of their posttraumatic stress disorder (PTSD) symptoms, parenting stress, and perceived social support via an online survey. Experiencing a preterm birth did not affect mothers' use of mental state descriptors during mother-infant interaction. Neither childbirth-related posttraumatic stress nor parenting stress directly affected maternal ability to comment on the child's mental states appropriately. However, at medium and high levels of perceived social support, a negative association between parenting stress and MM was observed. Maternal perception of being emotionally supported by significant others promoted MM in mothers showing low or mild levels of parenting stress, but not in mothers experiencing high stress in parenting their infants. Results suggest that a proclivity to MM might be affected by the interaction between parenting stress and social support, rather than by childbirth-related variables, such as prematurity.
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Affiliation(s)
- Chiara Suttora
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Nicoletta Salerni
- Department of Psychology, University of Milano-Bicocca, Milano, Italy
| | - Elena Selvagno
- Department of Psychology, University of Milano-Bicocca, Milano, Italy
| | - Matteo Porro
- Servizio di Follow-up del neonato a rischio evolutivo, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.,UO Medicina Fisica e Riabilitativa Pediatrica, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Silvana Gangi
- Servizio di Follow-up del neonato a rischio evolutivo, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.,UO di Neonatologia e Terapia Intensiva neonatale, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Chiara Squarza
- Servizio di Follow-up del neonato a rischio evolutivo, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Laura Gardon
- Servizio di Follow-up del neonato a rischio evolutivo, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Odoardo Picciolini
- Servizio di Follow-up del neonato a rischio evolutivo, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.,UO Medicina Fisica e Riabilitativa Pediatrica, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
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Park E, Meyer RML, Gold JI. The Role of Medical Specialization on Posttraumatic Symptoms in Pediatric Nurses. J Pediatr Nurs 2020; 53:22-28. [PMID: 32339973 DOI: 10.1016/j.pedn.2020.03.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 03/31/2020] [Accepted: 03/31/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE Comparison of medical specialization of repeated exposure to secondary trauma and Post-Traumatic Stress Disorder (PTSD) symptoms in pediatric nurses was examined. DESIGN AND METHODS The PTSD Checklist-Civilian Version (PCL-C) was administered to 182 nurses over their first year on the job at a pediatric hospital (three time-points: baseline, 3 month follow-up, and 1 year follow-up). Demographic characteristics (age groups, gender, education, and race) and previous healthcare experience on whether nurses met criteria for no, partial, or full PTSD across all three time-points was examined. Differences in unit assignment on total PTSD symptoms and symptoms of each criterion of PTSD (re-experiencing, avoidance, and arousal) were also examined. RESULTS No significant differences of both demographic characteristics and previous healthcare experience were found on these PTSD categories. However, both ICU and Hematology/Oncology units were more at risk for developing partial and full PTSD, respectively compared to other units. Nurses in the rehabilitation units had significantly higher re-experiencing, avoidance, and arousal symptoms than those assigned to medical/surgical and intensive care units. CONCLUSIONS Results demonstrate a need for hospitals to assess why nurses from certain units are reporting more PTSD symptoms and screen for PTSD symptoms and other mental health concerns throughout their career. PRACTICE IMPLICATIONS Being aware of which units may be more at-risk should inform unit-specific prevention and intervention programs to decrease negative outcomes, including burnout, compassion fatigue, and job dissatisfaction.
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Affiliation(s)
- Elizabeth Park
- The Saban Research Institute at Children's Hospital Los Angeles, Department of Anesthesiology Critical Care Medicine, University Center of Excellence in Developmental Disabilities, United States of America
| | - Rika M L Meyer
- California State University, Northridge, Department of Child and Adolescent Development, United States of America
| | - Jeffrey I Gold
- The Saban Research Institute at Children's Hospital Los Angeles, Department of Anesthesiology Critical Care Medicine, University Center of Excellence in Developmental Disabilities, United States of America; Keck School of Medicine, Departments of Anesthesiology, Pediatrics, and Psychiatry & Behavioral Sciences, University of Southern California, United States of America.
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Dickinson C, Whittingham K, Sheffield J, Wotherspoon J, Boyd RN. Efficacy of interventions to improve psychological adjustment for parents of infants with or at risk of neurodevelopmental disability: A systematic review. Infant Ment Health J 2020; 41:697-722. [DOI: 10.1002/imhj.21871] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Corrine Dickinson
- Faculty of Medicine Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre The University of Queensland South Brisbane Australia
- Queensland Children's Hospital Children's Health Queensland South Brisbane Australia
| | - Koa Whittingham
- Faculty of Medicine Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre The University of Queensland South Brisbane Australia
| | - Jeanie Sheffield
- The School of Psychology The University of Queensland Brisbane Australia
| | - Jane Wotherspoon
- Faculty of Medicine Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre The University of Queensland South Brisbane Australia
| | - Roslyn N Boyd
- Faculty of Medicine Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre The University of Queensland South Brisbane Australia
- Queensland Children's Hospital Children's Health Queensland South Brisbane Australia
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Levinson M, Parvez B, Aboudi D, Shah S. Impact of maternal stressors and neonatal clinical factors on post-partum depression screening scores. J Matern Fetal Neonatal Med 2020; 35:1328-1336. [PMID: 32316772 DOI: 10.1080/14767058.2020.1754394] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: Higher rates of postpartum depression (PPD) are reported in mothers of neonatal intensive care unit (NICU) hospitalized infants. The relationship of neonatal clinical risk factors and self-reported maternal stress levels to positive PPD screening is not well characterized.Objective: To determine the feasibility of postpartum depression screening in a regional perinatal center, and assess the association of NICU-specific comorbidities and maternal stress levels with PPD screening scores.Design/Methods: Prospective study of mothers of NICU-hospitalized infants conducted between 21and 30 days of their infant's life. Mothers completed the Edinburgh Postpartum Depression scale (EPDS) and the Parental Stressor Scale: NICU (PSS: NICU) in the environmental, infant behavior and parental domains. Total EPDS scores and positive PPD screening were correlated with NICU comorbidities, demographic factors and PSS: NICU scores.Results: The incidence of positive PPD screening was 19% (25/135). In bivariate analysis, positive PPD screen was associated with exclusive breastfeeding (67% vs, 35%, p < .05) and maternal age <35 years (32% vs. 12%, p < .05). No observed differences in maternal and infant demographic factors or neonatal comorbidities were seen in mothers with positive PPD screening. Mean PPD screening scores were higher in infants with intraventricular hemorrhage of any grade and necrotizing enterocolitis. In adjusted analysis, overall and domain-specific PSS: NICU scores were associated with positive PPD screening.Conclusion: Cumulatively and within each PSS: NICU domain, parental stress correlated with positive PPD screening but was unrelated to NICU comorbidities. Reducing modifiable factors which exacerbate parental stress may impact the incidence of positive PPD screening among NICU mothers.
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Affiliation(s)
- Michelle Levinson
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, New York Medical College, Maria Fareri Children's Hospital, Valhalla, NY, USA
| | - Boriana Parvez
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, New York Medical College, Maria Fareri Children's Hospital, Valhalla, NY, USA
| | - David Aboudi
- New York City Department of Health and Mental Hygiene, Division of Mental Health Statistics, New York, NY, USA
| | - Shetal Shah
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, New York Medical College, Maria Fareri Children's Hospital, Valhalla, NY, USA
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Correlation between Kind of Cesarean Section and Posttraumatic Stress Disorder in Greek Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051592. [PMID: 32121561 PMCID: PMC7084417 DOI: 10.3390/ijerph17051592] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 02/20/2020] [Accepted: 02/27/2020] [Indexed: 11/22/2022]
Abstract
A birth experience with cesarean section (CS) can be a cause of the development of post-traumatic stress disorder after a cesarean (PTSD-AC) or profile PTSD, for a percentage of women. So far, there is no data on the frequency of PTSD-AC in Greece and this syndrome is often associated with other mental disorders of the postpartum period. The purpose of this research is to associate the kind of CS with PTSD-AC for Greek mothers and the combination of factors that make them less resistant to trauma. A sample of ahundred and sixty-six mothers who gave birth with emergency cesarean section (EMCS) and elective cesarean section (ELCS) at a Greek University hospital have consented to participate in the two phases of the survey, in the 2nd day postpartum and a follow-up in the 6th week postpartum. Medical/demographic data and a life events checklist (LEC-5) with Criterion A and post-traumatic stress checklist (PCL-5) were used to diagnose PTSD and PTSD Profile. Out of166 mothers enrolled, 160 replied to the follow-up (96.4%), ELCS 97 (97%) and EMCS 63 (95%). Twenty (31.7%) EMCS had PTSD and nine (14.3%) had Profile. One (1%) ELCS had PTSD and 4 (4.1%) had Profile. This survey shows a high prevalence rate of PTSD after EMCS with additional risk factors of preterm labor, inclusion in the Neonatal Intensive Care Unit (NICU), a lack of breastfeeding, and a lack of support from the partner.
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Lotterman JH, Lorenz JM, Bonanno GA. You Can't Take Your Baby Home Yet: A Longitudinal Study of Psychological Symptoms in Mothers of Infants Hospitalized in the NICU. J Clin Psychol Med Settings 2020; 26:116-122. [PMID: 29789995 DOI: 10.1007/s10880-018-9570-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Evidence suggests that mothers of infants hospitalized in the Neonatal Intensive Care Unit (NICU) experience elevated rates of psychological symptoms. However, previous studies of this population have been mainly cross-sectional and have focused on very preterm infants. Although moderate- to late-preterm infants generally thrive, the possible psychological toll on their mothers has not yet been sufficiently examined. In the current study, we used a longitudinal design to investigate whether mothers of moderate- to late-preterm infants experience elevated rates of psychological symptoms during the infant's hospitalization in the NICU and 6 months later. Results indicated that these mothers did show elevated depression, anxiety, and PTSD symptoms, and that symptom levels were similar in mothers of moderate- versus late-preterm infants. Mothers of moderate- to late-preterm infants hospitalized in the NICU appeared to experience these symptoms steadily over a 6-month period after giving birth. These findings suggest a need for greater support for these mothers while in the NICU.
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Affiliation(s)
- Jenny H Lotterman
- Teachers College, Columbia University, 525 West 120th Street, Box 102, New York, NY, 10027, USA.
| | - John M Lorenz
- Department of Pediatrics, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - George A Bonanno
- Teachers College, Columbia University, 525 West 120th Street, Box 102, New York, NY, 10027, USA
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Baraldi E, Allodi MW, Löwing K, Smedler AC, Westrup B, Ådén U. Stockholm preterm interaction-based intervention (SPIBI) - study protocol for an RCT of a 12-month parallel-group post-discharge program for extremely preterm infants and their parents. BMC Pediatr 2020; 20:49. [PMID: 32007087 PMCID: PMC6995087 DOI: 10.1186/s12887-020-1934-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 01/16/2020] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Improved neonatal care has resulted in increased survival rates among infants born after only 22 gestational weeks, but extremely preterm children still have an increased risk of neurodevelopmental delays, learning disabilities and reduced cognitive capacity, particularly executive function deficits. Parent-child interaction and parental mental health are associated with infant development, regardless of preterm birth. There is a need for further early interventions directed towards extremely preterm (EPT) children as well as their parents. The purpose of this paper is to describe the Stockholm Preterm Interaction-Based Intervention (SPIBI), the arrangements of the SPIBI trial and the chosen outcome measurements. METHODS The SPIBI is a randomized clinical trial that includes EPT infants and their parents upon discharge from four neonatal units in Stockholm, Sweden. Inclusion criteria are EPT infants soon to be discharged from a neonatal intensive care unit (NICU), with parents speaking Swedish or English. Both groups receive three initial visits at the neonatal unit before discharge during the recruitment process, with a strengths-based and development-supportive approach. The intervention group receives ten home visits and two telephone calls during the first year from a trained interventionist from a multi-professional team. The SPIBI intervention is a strengths-based early intervention programme focusing on parental sensitivity to infant cues, enhancing positive parent-child interaction, improving self-regulating skills and supporting the infant's next small developmental step through a scaffolding process and parent-infant co-regulation. The control group receives standard follow-up and care plus extended assessment. The outcomes of interest are parent-child interaction, child development, parental mental health and preschool teacher evaluation of child participation, with assessments at 3, 12, 24 and 36 months corrected age (CA). The primary outcome is emotional availability at 12 months CA. DISCUSSION If the SPIBI shows positive results, it could be considered for clinical implementation for child-support, ethical and health-economic purposes. Regardless of the outcome, the trial will provide valuable information about extremely preterm children and their parents during infancy and toddlerhood after regional hospital care in Sweden. TRIAL REGISTRATION The study was registered in ClinicalTrials.gov in October 2018 (NCT03714633).
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Affiliation(s)
- Erika Baraldi
- Department of Special Education, Specialpedagogiska institutionen Stockholms universitet, Stockholm University, Frescati Hagväg 10, 106 91 Stockholm, Sweden
| | - Mara Westling Allodi
- Department of Special Education, Specialpedagogiska institutionen Stockholms universitet, Stockholm University, Frescati Hagväg 10, 106 91 Stockholm, Sweden
| | - Kristina Löwing
- Department of Women’s and Children’s Health, Institutionen för kvinnors och barns hälsa, Karolinska Institutet, Karolinska Institutet, 171 77 Stockholm, Sweden
- Functional Area Occupational Therapy & Physiotherapy, Allied Health Professionals Function, Karolinska University Hospital, 171 76 Stockholm, Sweden
| | - Ann-Charlotte Smedler
- Department of Psychology, Psykologiska institutionen Stockholms universitet, Stockholm University, Frescati Hagväg 8, 106 91 Stockholm, Sweden
| | - Björn Westrup
- Department of Women’s and Children’s Health, Institutionen för kvinnors och barns hälsa, Karolinska Institutet, Karolinska Institutet, 171 77 Stockholm, Sweden
- Neonatology unit, Karolinska University Hospital, 171 76 Stockholm, Sweden
| | - Ulrika Ådén
- Department of Women’s and Children’s Health, Institutionen för kvinnors och barns hälsa, Karolinska Institutet, Karolinska Institutet, 171 77 Stockholm, Sweden
- Neonatology unit, Karolinska University Hospital, 171 76 Stockholm, Sweden
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Schecter R, Pham T, Hua A, Spinazzola R, Sonnenklar J, Li D, Papaioannou H, Milanaik R. Prevalence and Longevity of PTSD Symptoms Among Parents of NICU Infants Analyzed Across Gestational Age Categories. Clin Pediatr (Phila) 2020; 59:163-169. [PMID: 31833404 DOI: 10.1177/0009922819892046] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective. This study aims to investigate whether posttraumatic stress disorder (PTSD) symptoms exist >1 year after neonatal intensive care unit (NICU) experience and whether PTSD symptomatology differs across parents of infants of different gestational age categories. Methods. A survey was given to parents at routine NICU follow-up visits. Parents completed the PTSD CheckList-Civilian (PCL-C), a standardized scale comprising 17 key symptoms of PTSD. Parents also rated how traumatic their birth experience, first day in the NICU, and first week in the NICU were from "Not Traumatic at All" to "Most Traumatic." Fisher's exact test was used to compare PCL-C responses across gestational age categories (Extremely Preterm, Very Preterm, Moderate to Late preterm, and Full Term). Results. Eighty parents participated. In total, 15% of parents had "Moderate to High Severity" PTSD symptoms. There were no statistical differences in PTSD prevalence between parents of children <1 year old and parents of children >1 year old (P = .51). There was also no statistical difference in prevalence of "Moderate to High Severity" level of PTSD symptoms across gestational age (P = .16). Overall, 38% of parents rated at least one experience as "Most traumatic." Conclusion. A high percentage of parents who had a recent NICU experience and parents who had a NICU experience more than a year ago demonstrated PTSD symptoms. In light of these results, many parents of NICU graduates-both mothers and fathers-would benefit from access to long-term counseling services.
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Affiliation(s)
- Rachel Schecter
- Steven and Alexandra Cohen Children's Medical Center of New York, Lake Success, NY, USA
| | - Tammy Pham
- Steven and Alexandra Cohen Children's Medical Center of New York, Lake Success, NY, USA
| | - Alexandra Hua
- Steven and Alexandra Cohen Children's Medical Center of New York, Lake Success, NY, USA
| | - Regina Spinazzola
- Steven and Alexandra Cohen Children's Medical Center of New York, Lake Success, NY, USA
| | - Jill Sonnenklar
- Steven and Alexandra Cohen Children's Medical Center of New York, Lake Success, NY, USA
| | - Diana Li
- Steven and Alexandra Cohen Children's Medical Center of New York, Lake Success, NY, USA
| | - Helen Papaioannou
- Steven and Alexandra Cohen Children's Medical Center of New York, Lake Success, NY, USA
| | - Ruth Milanaik
- Steven and Alexandra Cohen Children's Medical Center of New York, Lake Success, NY, USA
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Brunton G, Webbe J, Oliver S, Gale C. Adding value to core outcome set development using multimethod systematic reviews. Res Synth Methods 2020; 11:248-259. [PMID: 31834675 DOI: 10.1002/jrsm.1391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 11/25/2019] [Accepted: 12/04/2019] [Indexed: 11/10/2022]
Abstract
Trials evaluating the same interventions rarely measure or report identical outcomes. This limits the possibility of aggregating effect sizes across studies to generate high-quality evidence through systematic reviews and meta-analyses. To address this problem, core outcome sets (COS) establish agreed sets of outcomes to be used in all future trials. When developing COS, potential outcome domains are identified by systematically reviewing the outcomes of trials, and increasingly, through primary qualitative research exploring the experiences of key stakeholders, with relevant outcome domains subsequently determined through transdisciplinary consensus development. However, the primary qualitative component can be time consuming with unclear impact. We aimed to examine the potential added value of a qualitative systematic review alongside a quantitative systematic review of trial outcomes to inform COS development in neonatal care using case analysis methods. We compared the methods and findings of a scoping review of neonatal trial outcomes and a scoping review of qualitative research on parents', patients', and professional caregivers' perspectives of neonatal care. Together, these identified a wider range and greater depth of health and social outcome domains, some unique to each review, which were incorporated into the subsequent Delphi process and informed the final set of core outcome domains. Qualitative scoping reviews of participant perspectives research, used in conjunction with quantitative scoping reviews of trials, could identify more outcome domains for consideration and could provide greater depth of understanding to inform stakeholder group discussion in COS development. This is an innovation in the application of research synthesis methods.
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Affiliation(s)
- Ginny Brunton
- Faculty of Health Sciences, OntarioTech University, Oshawa, Ontario, Canada.,Evidence for Policy and Practice Information and Coordinating (EPPI-) Centre, UCL Institute of Education, University College London, London, UK
| | - James Webbe
- Neonatal Medicine, School of Public Health, Faculty of Medicine, Chelsea and Westminster Hospital Campus, Imperial College London, London, UK
| | - Sandy Oliver
- Evidence for Policy and Practice Information and Coordinating (EPPI-) Centre, UCL Institute of Education, University College London, London, UK.,Africa Centre for Evidence, Faculty of the Humanities, University of Johannesburg, Johannesburg, South Africa
| | - Chris Gale
- Neonatal Medicine, School of Public Health, Faculty of Medicine, Chelsea and Westminster Hospital Campus, Imperial College London, London, UK
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Aftyka A, Rosa W, Taczała J. Self-rated health in mothers of children hospitalised for severe illnesses and mothers of healthy children: cross-sectional study. Scand J Caring Sci 2019; 34:698-709. [PMID: 31657048 DOI: 10.1111/scs.12774] [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: 02/14/2019] [Revised: 09/12/2019] [Accepted: 09/15/2019] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Self-rated health (SRH) is a recognised tool for predicting morbidity and mortality. AIM The aim of the study was to investigate and compare SRH in a group of mothers of hospitalised children and mothers of healthy children and to indicate the variables associated with poor SRH in both groups. METHODS We conducted questionnaire-based cross-sectional research in a group of 184 women. Half of the respondents (n = 92) were the mothers of children hospitalised for a severe illnesses (Group H). The control group (n = 92) comprised mothers of healthy children (Group C). Self-Rated Health (SRH), Numerical Rating Scale (NRS), Hospital Anxiety and Depression Scale (HADS), Impact of Event Scale-Revised (IES-R) and Interpersonal Support Evaluation List (ISEL-40 v. GP) were used. In order to facilitate critical appraisal and interpretation of results, STROBE recommendations were used. RESULTS The prevalence of poor SRH was greater in mothers of children hospitalised for a severe illness than in those of healthy children (35 and 19%, respectively). In both groups, the risk of poor SRH was statistically significantly higher in those mothers who for the past 7 days reported at least moderate pain and in mothers who manifested anxiety symptoms. In both groups, the prevalence of poor SRH was statistically significantly lower if the respondents' children were in good health. The risk of poor SRH was associated with poor financial status in group H and with depression and at least moderate pain for the past 7 days in group C. RELEVANCE TO CLINICAL PRACTICE In order to provide mothers of severely ill children with high-quality health care including preventive measures, it is recommended that their health is assessed by healthcare professionals.
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Affiliation(s)
- Anna Aftyka
- Department of Anaesthesiological and Intensive Care Nursing, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
| | - Wojciech Rosa
- Department of Applied Mathematics, Faculty of Technology Fundamentals, Lublin University of Technology, Lublin, Poland
| | - Jolanta Taczała
- Department of Rehabilitation and Physiotherapy, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
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Memories of Infant Pain in the Neonatal Intensive Care Unit Influence Posttraumatic Stress Symptoms in Mothers of Infants Born Preterm. Clin J Pain 2019; 34:936-943. [PMID: 29698249 DOI: 10.1097/ajp.0000000000000620] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVES The birth of a preterm infant and witnessing ones' infant in pain is remembered by parents as being one of the most stressful aspects of the neonatal intensive care unit (NICU). Elevated posttraumatic stress symptoms (PTSS) are highly prevalent among mothers of preterm infants, however, little is known about mothers' memories of invasive procedures in the NICU and how these memories may contribute to the development of PTSS. We examined the relationships between number of invasive procedures, mothers' memories of these procedures, and their PTSS at discharge from the NICU. MATERIALS AND METHODS Participants included 36 mothers of infants born below 37 weeks gestational age recruited from a tertiary-level NICU. Medical chart review was performed between birth and discharge from the NICU. At discharge, a research nurse conducted a structured memory interview with the mothers to assess their memories of their infants' invasive procedures. Mothers also completed a self-report measure of PTSS (Posttraumatic Stress Disorder Checklist for the DSM-5). RESULTS Mothers of infants exposed to greater numbers of invasive procedures had more elevated PTSS at discharge (R=0.37). Moreover, mothers who recalled having greater anxiety about their infant's invasive procedures had greater symptoms of reexperiencing (R=0.34) and avoidance (R=0.28) at discharge from the NICU. DISCUSSION Greater neonatal exposure to invasive procedures and mothers' recall of these procedures were related to mothers' posttraumatic stress symptomatology at discharge. Invasive procedures in the NICU represent an important target area for neonatal intervention to reduce maternal distress and improve outcomes.
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Andrushchenko NV, Muhamedrahimov RJ, Kryukov EY, Iova AS, Arintsina IA, Anikina VO, Poteshkina OV, Solodunova MY, Chernego DI. [Mothers' emotional states and characteristics of early interaction with their prematurely born babies]. Zh Nevrol Psikhiatr Im S S Korsakova 2019; 119:148-153. [PMID: 31317904 DOI: 10.17116/jnevro2019119051148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Advanced technologies of neonatal reanimation and intensive care have led to the increase in the number of children with the extremely low and low birth weight. These children constitute a risk group often having severe development complications and disabilities. This article provides a review of the existing research literature on emotional states of mothers of prematurely born infants' and characteristics of their early interaction. The data on the influence of the mother's emotional state on her interaction with her prematurely born infant and its impact on the child's long-term development are presented. The authors present directions of studying development of prematurely born infants, which are not fully reflected in the literature, regarding infants with structural intracranial changes (intraventricular hemorrhages) and associated hydrocephalus and posthemorrhagic hydrocephaly. New targets of practical work have been developed to improve the family-centered interdisciplinary support for children at infancy and early age.
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Affiliation(s)
- N V Andrushchenko
- Saint Petersburg State University, St. Petersburg, Russia; Mechnikov North-Western State Medical University, St.-Petersburg, Russia
| | | | - E Yu Kryukov
- Mechnikov North-Western State Medical University, St.-Petersburg, Russia
| | - A S Iova
- Mechnikov North-Western State Medical University, St.-Petersburg, Russia
| | - I A Arintsina
- Saint Petersburg State University, St. Petersburg, Russia
| | - V O Anikina
- Saint Petersburg State University, St. Petersburg, Russia
| | - O V Poteshkina
- Mechnikov North-Western State Medical University, St.-Petersburg, Russia
| | | | - D I Chernego
- Saint Petersburg State University, St. Petersburg, Russia
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47
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Waddell N, Karatzias T. The relationship between interpersonal trauma and substance misuse in pregnancy. ACTA ACUST UNITED AC 2019. [DOI: 10.12968/bjom.2019.27.9.578] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BackgroundThere is a strong body of evidence supporting associations between interpersonal trauma (IPT) and substance use; however, this tends to focus on associations between childhood trauma and substance use in non-pregnant populations. Neonatal and obstetric outcomes are poorer among pregnant women with problematic substance use, yet few studies have explored IPT as a possible mechanism underlying their use of substances.AimTo explore the literature regarding the relationship between IPT and substance misuse among pregnant women.MethodA systematic search of relevant databases was conducted and a narrative review of the literature was undertaken. Titles, abstracts and full articles were screened against inclusion criteria. Data were extracted and quality assessed.FindingsA total of 15 studies were identified that suggested associations between negative life events and substance misuse in pregnant women/new mothers.ConclusionsAlthough a link between IPT and substance misuse is suggested, this review has highlighted a number of important gaps in the literature that warrant further investigation. These include a paucity of UK-based studies, and a lack of research that fully explores possible associations between IPT and substance use in pregnant women. Moreover, research to date has employed quantitative methodology.
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Affiliation(s)
- Naomi Waddell
- Midwifery Lecturer/Researcher, School of Health and Social Care, Edinburgh Napier University
| | - Thanos Karatzias
- Professor and Director of Research, School of Health and Social Care, Edinburgh Napier University
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Klawetter S, Neu M, Roybal KL, Greenfield JC, Scott J, Hwang S. Mothering in the NICU: A qualitative exploration of maternal engagement. SOCIAL WORK IN HEALTH CARE 2019; 58:746-763. [PMID: 31219407 PMCID: PMC10027385 DOI: 10.1080/00981389.2019.1629152] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 05/21/2019] [Accepted: 05/31/2019] [Indexed: 06/09/2023]
Abstract
Research suggests maternal engagement in the neonatal intensive care unit (NICU) may positively impact maternal and infant health outcomes. However, the U.S. has lower rates of maternal engagement in the NICU compared to other developed countries. This qualitative study reflects a transdisciplinary research partnership between social work, nursing, and neonatology. Qualitative inquiry explores maternal experiences in the NICU from the perspectives of mothers of preterm infants hospitalized in 2 U.S. NICUs. Results support an ecological systems framework to understanding barriers and facilitators to maternal engagement in the NICU and the utilization of a trauma-informed health care approach in NICU settings.
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Affiliation(s)
| | - Madalynn Neu
- College of Nursing, University of Colorado, Aurora, CO, USA
| | | | | | - Jessica Scott
- Department of Pediatrics/Neonatology, University of Colorado, Aurora, CO, USA
| | - Sunah Hwang
- Department of Pediatrics/Neonatology, University of Colorado and Children’s Hospital Colorado, Aurora, CO, USA
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Gondwe KW, Brandon D, Yang Q, Malcom WF, Small MJ, Holditch-Davis D. Emotional distress in mothers of early-preterm infants, late-preterm infants, and full-term infants in Malawi. Nurs Outlook 2019; 68:94-103. [PMID: 31375345 DOI: 10.1016/j.outlook.2019.05.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 05/19/2019] [Accepted: 05/28/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Mothers of preterm infants, early or late, report more distress than mothers of full-term infants. Malawi has the highest preterm birth rate in the world, but nothing is known about the relation of preterm birth to maternal mental health. PURPOSE To compare emotional distress among mothers of early-preterm, late-preterm, and full-term infants. METHODS We recruited 28 mothers of early-preterm, 29 mothers of late-preterm, and 28 mothers of full-term infants. Emotional distress was assessed 24-72 hr following birth. One-way ANOVA and regression analysis were used to compare the three groups. FINDINGS Mothers of early-preterm infants reported more distress symptoms than mothers of full-term infants, and scores of mothers of late-preterm infants fell between the other two groups. Having a support person present was associated with lower symptoms and caesarean birth was associated with more symptoms. DISCUSSION Promoting maternal mental health is important following preterm birth and health care providers need to support mothers.
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Affiliation(s)
- Kaboni Whitney Gondwe
- University of Wisconsin, Milwaukee, Milwaukee, WI; School of Nursing, Duke University, Durham, NC.
| | | | - Qing Yang
- School of Nursing, Duke University, Durham, NC
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Hunt H, Abbott R, Boddy K, Whear R, Wakely L, Bethel A, Morris C, Prosser S, Collinson A, Kurinczuk J, Thompson-Coon J. “They’ve walked the walk”: A systematic review of quantitative and qualitative evidence for parent-to-parent support for parents of babies in neonatal care. ACTA ACUST UNITED AC 2019. [DOI: 10.1016/j.jnn.2019.03.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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