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Gómez-Rocha LD, Ospina-Romero AM. Promotion of self-efficacy in mothers with infants discharged from neonatal intensive care units. ENFERMERIA INTENSIVA 2024; 35:171-177. [PMID: 37980228 DOI: 10.1016/j.enfie.2023.10.001] [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: 02/02/2023] [Revised: 07/26/2023] [Accepted: 08/01/2023] [Indexed: 11/20/2023]
Abstract
INTRODUCTION The mothers of newborns who are discharged from a neonatal intensive care unit (NICU) experience stress and anxiety due to the specialized care their child requires at home, affecting their perception of maternal self-efficacy. OBJECTIVE To evaluate the effect of the nursing intervention called Hospital Discharge Plan (HDP) on the promotion of self-efficacy in mothers of newborns discharged from the NICU. METHOD Quantitative study, quasi-experimental design with pre-test/post-test in a single group, using the Parental Evaluation Scale applied to a convenience sample of 72 mothers of high-risk newborns from a NICU located in the city of Villavicencio (Colombia). The first measurement was taken between days 3 and 4 before discharge and at 15 days' post-discharge. Data processing was carried out using the statistical program SPSS, version 21. The intervention was based on the four concepts of self-efficacy by Barbara Resnick. RESULTS The perception of maternal self-efficacy before the intervention showed a median of 8.9 points (RI 7.6-9.5); after the intervention it showed a median of 9.6 points (RI of 10-8.7); a statistically significant p-value < 0.001 was obtained before and after the intervention with the Wilcoxon rank test. CONCLUSIONS Education and follow-up promoted the development of knowledge and skills in mothers for the care of high-risk newborns. This contributed to the experience of mastery and vicarious experience from the teaching-learning process and contact with the experience of other mothers, which contributes to the effective development of motherhood.
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Affiliation(s)
- L D Gómez-Rocha
- Facultad de Enfermería y Rehabilitación, Universidad de La Sabana, Chía, Colombia
| | - A M Ospina-Romero
- Facultad de Enfermería y Rehabilitación, Universidad de La Sabana, Chía, Colombia.
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Silveira RC, Valentini NC, O’Shea TM, Mendes EW, Froes G, Cauduro L, Panceri C, Fuentefria RN, Procianoy RS. Parent-Guided Developmental Intervention for Infants With Very Low Birth Weight: A Randomized Clinical Trial. JAMA Netw Open 2024; 7:e2421896. [PMID: 39018071 PMCID: PMC11255911 DOI: 10.1001/jamanetworkopen.2024.21896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 05/14/2024] [Indexed: 07/18/2024] Open
Abstract
Importance Early interventions improve neurodevelopmental outcomes after preterm birth, but few studies of early intervention have focused on preterm infants whose families reside in low- or middle-income countries (LMICs). Objective To evaluate whether parent-guided early intervention improves the neurodevelopmental outcomes of preterm infants in an LMIC. Design, Setting, and Participants This randomized clinical trial was performed at a high-risk obstetric referral hospital in Brazil, with outcome evaluations by examiners masked to randomization group. Eligibility criteria were (1) birth at the study hospital, (2) residence within 40 km of the birth hospital, and (3) gestational age of less than 32 weeks or birth weight of less than 1500 g. Of 138 enrolled infants, 19 died after randomization and 19 withdrew from the study; all other enrollees (50 per randomization group) were evaluated for the primary outcome. Data were collected from January 1, 2016, to May 31, 2022, and analyzed from June 10 to July 31, 2022. Interventions On postnatal day 7, infants were randomized to usual care, consisting of support for lactation, kangaroo care, and routine developmental therapies, or to a parent-guided enhanced developmental intervention, consisting of usual care plus infant massage and enhanced visual stimulation, auditory stimulation, social interactions, and support for motor development, instructed by developmental therapists. Main Outcomes and Measures The primary outcome was the Bayley Scales of Infant and Toddler Development-Third Edition score at 18 months of age adjusted for prematurity. Results Among the 100 infants included in the analysis, mean (SD) gestational age was 28.4 (2.2) weeks, and 57 (57%) were male. The mean (SD) gestational age for the intervention group was 28.3 (2.3) weeks; for the usual care group, 28.5 (2.2) weeks. Female infants accounted for 21 infants (42%) of the intervention group and 22 (44%) of the usual care group; male infants, 29 (58%) and 28 (56%), respectively. The enhanced developmental intervention group had higher cognitive scores at 18 months of corrected age (mean [SD], 101.8 [11.9] vs 97.3 [13.5]; mean difference, 4.5 [95% CI, 0.1-8.9]). Conclusions and Relevance In this randomized clinical trial of a parent-guided developmental intervention for early cognitive function of very preterm or very low birth weight infants implemented in an LMIC, the intervention improved very preterm infants' neurodevelopmental outcomes at 18 months of adjusted age. Parent-guided early intervention can improve neurodevelopmental outcome of very preterm infants born in LMICs. Trial Registration ClinicalTrials.gov Identifier: NCT02835612.
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Affiliation(s)
- Rita C. Silveira
- Neonatal Section, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Programa de Pós-Graduação em Saúde da Criança e Adolescente, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Nadia C. Valentini
- Programa de Pós-Graduação em Saúde da Criança e Adolescente, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - T. Michael O’Shea
- Department of Pediatrics, The University of North Carolina at Chapel Hill
| | - Eliane W. Mendes
- Neonatal Section, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Programa de Pós-Graduação em Saúde da Criança e Adolescente, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Graciela Froes
- Neonatal Section, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Lenir Cauduro
- Neonatal Section, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Carolina Panceri
- Neonatal Section, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Programa de Pós-Graduação em Saúde da Criança e Adolescente, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Rubia N. Fuentefria
- Neonatal Section, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Renato S. Procianoy
- Neonatal Section, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Programa de Pós-Graduação em Saúde da Criança e Adolescente, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Hopkins J, Merritt R. Strategies to Promote Success in Oral Feedings in Infants and Children with Intestinal Failure due to Short Bowel Syndrome. Gastroenterol Clin North Am 2024; 53:329-341. [PMID: 38719382 DOI: 10.1016/j.gtc.2024.01.008] [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] [Indexed: 05/25/2024]
Abstract
Infants and children with intestinal failure are at risk for pediatric feeding disorders, which challenge their oral feeding development. This article explores these challenges and offers several practical strategies that can be used by multidisciplinary care teams and at-home caregivers to help support the development of oral feeding in these children and eventually lead to their attaining enteral autonomy.
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Affiliation(s)
- Judy Hopkins
- Division of Occupational Therapy, Children's Hospital Los Angeles, Los Angeles, CA, USA.
| | - Russell Merritt
- Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital Los Angeles; Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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LaManna S, Hatfield B, McCann E. Considering the Influence of Social Determinants of Health on Parent Feeding Practices: A Case Example. Adv Neonatal Care 2024; 24:110-118. [PMID: 38241685 DOI: 10.1097/anc.0000000000001138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2024]
Abstract
BACKGROUND Social determinants of health (SDOH) are the nonmedical factors that influence health outcomes. SDOH can be grouped into 5 domains: economic stability, education access and quality, healthcare access and quality, neighborhood and built environment, and social and community context. SDOH impact people's health and quality of life but may also contribute to disparities in access to food, education, and healthcare. SDOH uniquely influence parent feeding practices in the neonatal intensive care unit (NICU) in a variety of ways, ranging from logistical considerations for parent visitation to cultural beliefs such as family perception of human milk feeding. EVIDENCE ACQUISITION A hypothetical case example of a preterm infant with a feeding disorder in the NICU is used to connect SDOH that influence prenatal health, parental lived experience, and postnatal medical care to maternal and infant outcomes with implications for feeding practices. Barriers and facilitators to successful feeding practices in the NICU and at discharge are considered for each SDOH domain. RESULTS This case example increases awareness of SDOH and how they influence parent feeding practices in the NICU, focusing on the intersection of SDOH, parent stress, and oral feeding outcomes. Examples were provided for how to support applying findings into practice. IMPLICATIONS FOR PRACTICE AND RESEARCH By being creating a culture of SDOH awareness, NICU staff can assist families in overcoming barriers by putting supports in place to increase equitable participation in developmentally supportive feeding practices during the NICU stay.
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Affiliation(s)
- Stefanie LaManna
- Author Affiliation: American Speech-Language-Hearing Association, Rockville, Maryland (Mss LaManna and Hatfield); and Independent Researcher, Voorhees, New Jersey (Ms McCann)
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Shah S, Dyess NF, Myers PJ. Devaluing babies: neonatal implications of proposed changes in pediatric residency training. J Perinatol 2023; 43:1455-1458. [PMID: 37532759 DOI: 10.1038/s41372-023-01739-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 07/06/2023] [Accepted: 07/20/2023] [Indexed: 08/04/2023]
Affiliation(s)
- Shetal Shah
- Division of Neonatology, Department of Pediatrics, Maria Fareri Children's Hospital, New York Medical College, Valhalla, NY, USA.
| | - Nicolle Fernández Dyess
- Division of Neonatology, Children's Hospital Colorado, Anschutz Medical Campus, University of Colorado School of Medicine, Aurora, CO, USA
| | - Patrick J Myers
- Division of Neonatology, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Franck LS, Gay CL, Hoffmann TJ, Kriz RM, Bisgaard R, Cormier DM, Joe P, Lothe B, Sun Y. Maternal mental health after infant discharge: a quasi-experimental clinical trial of family integrated care versus family-centered care for preterm infants in U.S. NICUs. BMC Pediatr 2023; 23:396. [PMID: 37563722 PMCID: PMC10413600 DOI: 10.1186/s12887-023-04211-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 07/25/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND Involvement in caregiving and tailored support services may reduce the risk of mental health symptoms for mothers after their preterm infant's neonatal intensive care unit (NICU) discharge. We aimed to compare Family-Centered Care (FCC) with mobile-enhanced Family-Integrated Care (mFICare) on post-discharge maternal mental health symptoms. METHOD This quasi-experimental study enrolled preterm infant (≤ 33 weeks)/parent dyads from three NICUs into sequential cohorts: FCC or mFICare. We analyzed post-discharge symptoms of perinatal post-traumatic stress disorder (PTSD) and depression using intention-to-treat and per protocol approaches. RESULTS 178 mothers (89 FCC; 89 mFICare) completed measures. We found no main effect of group assignment. We found an interaction between group and stress, indicating fewer PTSD and depression symptoms among mothers who had higher NICU-related stress and received mFICare, compared with mothers who had high stress and received FCC (PTSD: interaction β=-1.18, 95% CI: -2.10, -0.26; depression: interaction β=-0.76, 95% CI: -1.53, 0.006). Per protocol analyses of mFICare components suggested fewer PTSD and depression symptoms among mothers who had higher NICU stress scores and participated in clinical team rounds and/or group classes, compared with mothers who had high stress and did not participate in rounds or classes. CONCLUSION Overall, post-discharge maternal mental health symptoms did not differ between the mFICare and FCC groups. However, for mothers with high levels of stress during the NICU stay, mFICare was associated with fewer post-discharge PTSD and depression symptoms.
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Affiliation(s)
- Linda S Franck
- Department of Family Health Care Nursing, University of California San Francisco (UCSF), 2 Koret Way, N411F, Box 0606, San Francisco, CA, 94143, USA.
| | - Caryl L Gay
- Department of Family Health Care Nursing, University of California San Francisco (UCSF), 2 Koret Way, N411F, Box 0606, San Francisco, CA, 94143, USA
| | - Thomas J Hoffmann
- Department of Epidemiology and Biostatistics, Office of Research, School of Nursing, UCSF, San Francisco, CA, USA
| | - Rebecca M Kriz
- Department of Family Health Care Nursing, University of California San Francisco (UCSF), 2 Koret Way, N411F, Box 0606, San Francisco, CA, 94143, USA
| | - Robin Bisgaard
- Intensive Care Nursery, UCSF Benioff Children's Hospital, San Francisco, CA, USA
| | - Diana M Cormier
- NICU and Pediatrics, Community Regional Medical Center, Fresno, CA, USA
| | - Priscilla Joe
- Division of Neonatology, UCSF Benioff Children's Hospital, Oakland, CA, USA
| | | | - Yao Sun
- Division of Neonatology, Department of Pediatrics, UCSF, San Francisco, CA, USA
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Haeusslein L, Gano D, Gay CL, Kriz RM, Bisgaard R, Vega M, Cormier DM, Joe P, Walker V, Kim JH, Lin C, Sun Y, Franck LS. Relationship between social support and post-discharge mental health symptoms in mothers of preterm infants. J Reprod Infant Psychol 2023; 41:260-274. [PMID: 34587850 PMCID: PMC8960471 DOI: 10.1080/02646838.2021.1984404] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 09/17/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Social support is associated with decreased symptoms of postpartum mood and anxiety disorders (PMAD) in mothers of healthy infants, but less is known about social support and PMADs in mothers with preterm infants. The purpose of this study was to examine the relationship between social support and symptoms of PMADs reported by mothers in the months following hospital discharge of their preterm infant. METHODS Mothers of infants less than 33 weeks gestational age were enrolled from neonatal intensive care units (NICU) at 6 sites. Mothers completed PMAD measures of depression, anxiety and post-traumatic stress approximately 3 months following their infant's discharge. Multivariable regression was used to evaluate relationships between social support and PMAD measures. RESULTS Of 129 mothers, 1 in 5 reported clinically significant PMAD symptoms of: depression (24%), anxiety (19%), and post-traumatic stress (20%). Social support was strongly inversely associated with all 3 PMADs. Social support explained between 21% and 26% of the variance in depression, anxiety and post-traumatic stress symptoms. CONCLUSION Increased social support may buffer PMAD symptoms in mothers of preterm infants after discharge. Research is needed to determine effective screening and interventions aimed at promoting social support for all parents during and following their infant's hospitalisation.
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Affiliation(s)
- Laurel Haeusslein
- Department of Family Health Care Nursing, University of California, San Francisco, San Francisco, California, USA
| | - Dawn Gano
- Department of Neurology and Pediatrics, UCSF
| | - Caryl L. Gay
- Department of Family Health Care Nursing, University of California, San Francisco, San Francisco, California, USA
| | - Rebecca M. Kriz
- Department of Family Health Care Nursing, University of California, San Francisco, San Francisco, California, USA
| | - Robin Bisgaard
- Intensive Care Nursery, UCSF Benioff Children’s Hospital, San Francisco
| | - Myrna Vega
- Intensive Care Nursery, UCSF Benioff Children’s Hospital, San Francisco
| | | | - Priscilla Joe
- Division of Neonatology, UCSF Benioff Children’s Hospital, Oakland
| | - Valencia Walker
- Department of Pediatrics, Division of Neonatology, The Ohio State University College of Medicine, Columbus, Ohio
| | - Jae H. Kim
- Division of Neonatology, Perinatal Institute, Cincinnati Children’s Hospital Medical Center
| | - Carol Lin
- Division of Neonatology, Kaiser Permanente Santa Clara
| | - Yao Sun
- Division of Neonatology, UCSF Benioff Children’s Hospital, San Francisco
| | - Linda S. Franck
- Department of Family Health Care Nursing, University of California, San Francisco, San Francisco, California, USA
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Orovou E, Eskitzis P, Mrvoljak-Theodoropoulou I, Tzitiridou-Hatzopoulou M, Dagla M, Arampatzi C, Iliadou M, Antoniou E. The Relation between Neonatal Intensive Care Units and Postpartum Post-Traumatic Stress Disorder after Cesarean Section. Healthcare (Basel) 2023; 11:1877. [PMID: 37444711 DOI: 10.3390/healthcare11131877] [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: 05/28/2023] [Revised: 06/20/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND The experience of a neonate hospitalized in the NICU is an understandably traumatic experience for parents, especially for the mothers of neonates. This mental distress resulting from preterm birth and/or NICU hospitalization can be understood as post-traumatic symptomatology, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5 version). The aim of this study is to investigate the impact of the admission of a neonate to the NICU (forany reason) on the development of postpartum PTSD in a sample of women after cesarean section. METHODS A total of 469 women who gave birth with cesarean section from July 2019 to June 2020 participated in this study out of the original sample of 490 women who consented to participate. Data were obtained from the researcher's socio-demographic questionnaire and the post-traumatic stress checklist (PCL-5) from the Diagnostic and Statistical Manual of Mental Disorders DCM-5 version. RESULTS In total,11.7% of the sample experienced postpartum PTSD. There is a strong relationship between the inclusion of a neonate to the NICU due to perinatal stress, breathing difficulties, infections, and IUGR with postpartum PTSD (37.7%) in relation to the perinatal stress Criterion A (fear for the life of the neonate), the first criterion of postpartum PTSD. CONCLUSIONS Additional measures must be taken for mothers of children who have been admitted to the neonatal intensive care unit with psychological support interventions and a reassessment of their mental state.
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Affiliation(s)
- Eirini Orovou
- Department of Midwifery, University of West Attica, Agioy Spyridonos 28, 12243 Egaleo, Greece
- Department of Midwifery, University of Western Macedonia, Keptse, 50200 Ptolemaida, Greece
| | - Panagiotis Eskitzis
- Department of Midwifery, University of Western Macedonia, Keptse, 50200 Ptolemaida, Greece
| | | | | | - Maria Dagla
- Department of Midwifery, University of West Attica, Agioy Spyridonos 28, 12243 Egaleo, Greece
| | - Christiana Arampatzi
- Department of Midwifery, University of Western Macedonia, Keptse, 50200 Ptolemaida, Greece
| | - Maria Iliadou
- Department of Midwifery, University of West Attica, Agioy Spyridonos 28, 12243 Egaleo, Greece
| | - Evangelia Antoniou
- Department of Midwifery, University of West Attica, Agioy Spyridonos 28, 12243 Egaleo, Greece
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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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Legge N, Popat H, Fitzgerald D. Examining the impact of premature birth on parental mental health and family functioning in the years following hospital discharge: A review. J Neonatal Perinatal Med 2023:NPM221107. [PMID: 37182844 DOI: 10.3233/npm-221107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
BACKGROUND This review provides an update of the current research related to the impact of extreme and very premature birth on parental mental health and family functioning following discharge from hospital. METHODS Full-text peer reviewed articles in English, describing parents' and families' health and wellbeing after the discharge from hospital of their baby using validated questionnaires, were evaluated. Results of included studies are presented in a summarized format. Embase, Medline and PsycINFO databases were accessed in January 2021. RESULTS 38 studies were included. Nine manuscripts reported on parental mental health and 13 on stress, which are a concern after the birth of a premature infant, especially in the first year. Depression, anxiety, and stress are known to measure higher compared to parents of infants born at term. Over several years, these measures of mental health decrease significantly. Four reported on quality of life for parents of premature infants, which is reduced immediately after discharge, but then improves over time. The impact of premature birth on the family functioning was described in ten included studies and was described to have positive and negative consequences. CONCLUSION The negative impact of the premature birth and hospital journey on parental mental health lessens significantly with time.
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Affiliation(s)
- Nele Legge
- Department of Neonatal Intensive Care, Liverpool Hospital, Liverpool, Australia
- Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Health Sciences, University of Sydney, Australia
| | - H Popat
- Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Health Sciences, University of Sydney, Australia
- The Children's Hospital at Westmead, Westmead, Australia
| | - D Fitzgerald
- Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Health Sciences, University of Sydney, Australia
- The Children's Hospital at Westmead, Westmead, Australia
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Mukabana B, Makworo D, Mwenda CS. Prevalence of post-traumatic stress disorder and associated predictors among mothers of preterm infants in Western Kenya: a cross-sectional study. Pan Afr Med J 2023; 44:194. [PMID: 37484590 PMCID: PMC10362683 DOI: 10.11604/pamj.2023.44.194.37849] [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: 10/19/2022] [Accepted: 04/02/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction mothers of preterm infants are exposed to stress leading to post-traumatic stress disorder (PTSD). Preterm births have increased lately with World Health Organization (WHO) reporting an estimated prevalence of up to 5-18% and Kenya reporting a prevalence of 18.3%. The current study sought to determine the prevalence of PTSD and its associated predictors among mothers with preterm infants. Methods this was a hospital-based cross-sectional study among 182 mothers with preterm babies admitted in neonatal care units (NCUs) of two referral hospitals. A simple random sampling technique was used to select participants and data was collected using a semi-structured pretested questionnaire and an Impact of events scale-revised (IES-R). Analysis was done using STATA 15 and a significance level set at P≤ 0.05 and 95% confidence interval. Results the majority of the respondents 67 (36.8%) were aged between 18-22 years and only 34 (18.7%) were above 34 years. Most of the respondents had attained secondary and tertiary level education at 86 (47.3%) and 51 (28.0%) respectively. Prevalence of PTSD was 78.6% at a confidence interval of 95% CI: 0.72-0.84. Mothers who had a previous preterm birth were 0.09 less likely to develop PTSD {AOR=0.09, 95% CI: 0.01-0.80, p=0.023} while those who underwent cesarean section were 11.1 times more likely to develop PTSD {AOR=11.1, 95% CI:1.1-114.8, p=0.043}. Conclusion the prevalence of PTSD was 78.6%. Although mothers of preterm infants experience stress, the associated predictors included; cesarean section birth, having had a preterm birth before and staying in fair housing conditions.
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Affiliation(s)
- Beatrice Mukabana
- School of Nursing, Midwifery and Paramedical Sciences, Masinde Muliro University of Science and Technology (MMUST), Kakamega, Kenya
| | - Drusilla Makworo
- School of Nursing, Jomo Kenyatta University of Agriculture and Technology (JKUAT), Juja, Kenya
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Garg D, Chaudhury S, Saldanha D, Kumar S. Stress, postpartum depression, and anxiety in mothers of neonates admitted in the NICU: A cross-sectional hospital-based study. Ind Psychiatry J 2023; 32:48-58. [PMID: 37274566 PMCID: PMC10236660 DOI: 10.4103/ipj.ipj_93_22] [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: 05/31/2021] [Revised: 06/04/2022] [Accepted: 06/06/2022] [Indexed: 12/14/2022] Open
Abstract
Background Mothers of neonates admitted to a neonatal intensive care unit (NICU) experience heightened distress, anxiety, depression, and trauma symptoms. Despite their prevalence, these conditions are generally neither recognized nor treated due to the constraints of time and concerns about the social acceptability of screening. Aim To study stress, postpartum depression, and anxiety in mothers of neonates admitted to the NICU. Materials and Methods One hundred forty consecutive mothers having preterm and low birth weight neonates in the NICU were taken for the study as cases and an equal number of mothers of full-term neonates matched for age and socioeconomic status (SES), were recruited as controls with their informed consent. Subjects were assessed with the Acute Stress Disorder Scale (ASDS), Post-Traumatic Stress Disorder (PTSD) Symptom Scale (PSS), Edinburgh Postnatal Depression Scale (EPDS), and Perinatal Anxiety Screening Scale (PASS). Results Mothers of preterm neonates in NICU had significantly higher scores on the ASDS, PSS, EPDS, and PASS compared to controls. There was a significant association of ASDS and PSS scores with younger age, higher education, middle SES, joint family, urban residence, unplanned pregnancy, and male child. There was a significant association of the EPDS scores with lower SES, low education, unemployment, and male child. There was a significant association of the PASS scores with younger age, lower SES, and cesarean section. Conclusion Mothers of preterm neonates admitted to the NICU compared to controls have significantly higher levels of stress, anxiety, and depression.
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Affiliation(s)
- Dikshita Garg
- Department of Psychiatry, Dr D Y Patil Medical College, Dr D Y Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India
| | - Suprakash Chaudhury
- Department of Psychiatry, Dr D Y Patil Medical College, Dr D Y Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India
| | - Daniel Saldanha
- Department of Psychiatry, Dr D Y Patil Medical College, Dr D Y Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India
| | - Santosh Kumar
- Department of Psychiatry, Indira Gandhi Institute of Medical Sciences (IGIMS), Sheikhpura, Patna, Bihar, India
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13
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Abstract
Significant racial and ethnic disparities exist in birth outcomes and complications related to prematurity. However, little is known about racial and ethnic variations in health outcomes after premature infants are discharged from the neonatal intensive care unit (NICU). We propose a novel, equity-focused conceptual model to guide future evaluations of post-discharge outcomes that centers on a multi-dimensional, comprehensive view of health, which we call thriving. We then apply this model to existing literature on post-discharge inequities, revealing a need for rigorous analysis of drivers and strength-based, longitudinal outcomes.
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Affiliation(s)
- Daria C Murosko
- Division of Neonatology, Children's Hospital of Philadelphia, Philadelphia PA.
| | - Michelle-Marie Peña
- Division of Neonatology, Children's Hospital of Philadelphia, Philadelphia PA; Department of Pediatrics, Division of Neonatology, Emory University School of Medicine and Children's Healthcare of Atlanta
| | - Scott A Lorch
- Division of Neonatology, Children's Hospital of Philadelphia, Philadelphia PA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Leonard Davis Institute of Health Economics, University of Pennsylvania; Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA
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14
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Thivierge E, Luu TM, Bourque CJ, Duquette LA, Pearce R, Jaworski M, Barrington KJ, Synnes A, Janvier A. Guilt and Regret Experienced by Parents of Children Born Extremely Preterm. J Pediatr 2022:S0022-3476(22)01019-8. [PMID: 36463935 DOI: 10.1016/j.jpeds.2022.10.042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 10/17/2022] [Accepted: 10/21/2022] [Indexed: 12/03/2022]
Abstract
OBJECTIVES To explore decisional regret of parents of babies born extremely preterm and analyze neonatal, pediatric, and parental factors associated with regret. STUDY DESIGN Parents of infants born <29 weeks of gestational age, aged between 18 months and 7 years, attending neonatal follow-up were enrolled. Hospital records were reviewed to examine morbidities and conversations with parents about levels of care. Parents were asked the following question: "Knowing what you know now, is there anything you would have done differently?" Mixed methods were used to analyze responses. RESULTS In total, 248 parents (98% participation) answered, and 54% reported they did not have regret. Of those who reported regret (n = 113), 3 themes were most frequently invoked: 35% experienced guilt, thinking they were responsible for the preterm birth; 28% experienced regret about self-care decisions; and 20% regretted decisions related to their parental role, generally wishing they knew sooner how to get involved. None reported regret about life-and-death decisions made at birth or in the neonatal intensive care unit. Impairment at follow-up, gestational age, and decisions about levels/reorientation of care were not associated with regret. More mothers reported feeling guilt about the preterm birth (compared with fathers); parents of children with severe lesions on ultrasonography of the head were less likely to report regret. CONCLUSIONS Approximately one-half of the parents of infants born extremely preterm had regrets regarding their neonatal intensive care unit stay. Causes of regret and guilt should be addressed and minimized.
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Affiliation(s)
- Emilie Thivierge
- Department of Pediatrics, Centre Hospitalier Universitaire (CHU) Sainte-Justine, Université de Montréal, Montréal, Canada
| | - Thuy Mai Luu
- Department of Pediatrics, Centre Hospitalier Universitaire (CHU) Sainte-Justine, Université de Montréal, Montréal, Canada; CHU Sainte-Justine Research Center, Montréal, Canada
| | - Claude Julie Bourque
- CHU Sainte-Justine Research Center, Montréal, Canada; Unité d'éthique clinique, CHU Sainte-Justine, Montréal, Canada; Centre d'excellence en éthique clinique, CHU Sainte-Justine, Montréal, Canada
| | | | - Rebecca Pearce
- Canadian Premature Baby Foundation, Montréal, Quebec, Canada
| | - Magdalena Jaworski
- Department of Pediatrics, Centre Hospitalier Universitaire (CHU) Sainte-Justine, Université de Montréal, Montréal, Canada; Unité d'éthique clinique, CHU Sainte-Justine, Montréal, Canada
| | - Keith J Barrington
- Department of Pediatrics, Centre Hospitalier Universitaire (CHU) Sainte-Justine, Université de Montréal, Montréal, Canada; CHU Sainte-Justine Research Center, Montréal, Canada
| | - Anne Synnes
- Department of Pediatrics, BC Women's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Annie Janvier
- Department of Pediatrics, Centre Hospitalier Universitaire (CHU) Sainte-Justine, Université de Montréal, Montréal, Canada; CHU Sainte-Justine Research Center, Montréal, Canada; Centre d'excellence en éthique clinique, CHU Sainte-Justine, Montréal, Canada; Bureau de l'éthique Clinique, Université de Montréal, Montréal, Canada; Unité de soins palliatifs, CHU Sainte-Justine, Montréal, Canada.
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15
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deRegnier RA. Disparities in Neurodevelopmental Services Between Children with Congenital Heart Disease and Children Born Very Preterm. J Pediatr 2022; 250:9-10. [PMID: 35944712 DOI: 10.1016/j.jpeds.2022.07.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 07/29/2022] [Indexed: 11/15/2022]
Affiliation(s)
- Raye-Ann deRegnier
- Neonatology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.
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16
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Smiley Y, Silberholz E, Bekele E, Brodie N. Caregiver stress and social determinants of health in key populations: immigrant parents, parents of children with medical complexity, and adolescent parents. Curr Opin Pediatr 2022; 34:521-530. [PMID: 35993274 DOI: 10.1097/mop.0000000000001163] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW To examine the five domains of social determinants of health - economic stability, education access, healthcare access and quality, neighborhood and built environment, and social and community context - and how these relate to caregiver stress in under-resourced populations. RECENT FINDINGS Socioeconomic and family factors are increasingly understood as drivers of child health. Caregiver stress can impact family stability and child wellbeing. Immigrant parents, caregivers of children with medical complexity, and adolescent parents experience stressors due to the unique needs of their families. These groups of parents and caregivers also face various challenges identified as social determinants of health. Interventions to mitigate these challenges can promote resilience, care coordination, and community-based supports. SUMMARY Current research describes caregiver stress in key populations, how caregiver stress affects children, and approaches to minimize and mitigate these effects. Pediatric providers can implement best practices to support families who are navigating stress due to caregiving and social determinants of health.
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Affiliation(s)
- Yael Smiley
- Division of General and Community Pediatrics, Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
| | - Elizabeth Silberholz
- Division of General Pediatrics, Boston Children's Hospital; Harvard Medical School, Boston, Massachusetts, USA
| | - ElShadey Bekele
- Division of General and Community Pediatrics, Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
| | - Nicola Brodie
- Division of General and Community Pediatrics, Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
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17
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Malouf R, Harrison S, Burton HA, Gale C, Stein A, Franck LS, Alderdice F. Prevalence of anxiety and post-traumatic stress (PTS) among the parents of babies admitted to neonatal units: A systematic review and meta-analysis. EClinicalMedicine 2022; 43:101233. [PMID: 34993425 PMCID: PMC8713115 DOI: 10.1016/j.eclinm.2021.101233] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 11/09/2021] [Accepted: 11/26/2021] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Parents of babies admitted to neonatal units (NNU) are exposed to a range of potentially distressing experiences, which can lead to mental health symptoms such as increased anxiety and post-traumatic stress (PTS). This review aimed to describe how anxiety and PTS are defined and assessed, and to estimate anxiety and PTS prevalence among parents of babies admitted to NNU. METHOD Medline, Embase, PsychoINFO, Cumulative Index to Nursing and Allied Health literature were searched to identify studies published prior to April 14, 2021. Included studies were assessed using Hoy risk of bias tool. A random-effects model was used to estimate pooled prevalence with 95% CIs. Potential sources of variation were investigated using subgroup analyses and meta-regression. The review is registered with PROSPERO (CRD42020162935). FINDINGS Fifty six studies involving 6,036 parents met the review criteria; 21 studies assessed anxiety, 35 assessed PTS, and 8 assessed both. The pooled prevalence of anxiety was 41.9% (95%CI:30.9, 53.0) and the pooled prevalence of PTS was 39.9% (95%CI:30.8, 48.9) among parents up to one month after the birth. Anxiety prevalence decreased to 26.3% (95%CI:10.1, 42.5) and PTS prevalence to 24.5% (95%CI:17.4, 31.6) between one month and one year after birth. More than one year after birth PTS prevalence remained high 27.1% (95%CI:20.7, 33.6). Data on anxiety at this time point were limited. There was high heterogeneity between studies and some evidence from subgroup and meta-regression analyses that study characteristics contributed to the variation in prevalence estimates. INTERPRETATION The prevalence of anxiety and PTS was high among parents of babies admitted to NNU. The rates declined over time, although they remained higher than population prevalence estimates for women in the perinatal period. Implementing routine screening would enable early diagnosis and effective intervention. FUNDING This research is funded by the National Institute for Health Research (NIHR) Policy Research Programme, conducted through the Policy Research Unit in Maternal and Neonatal Health and Care, PR-PRU-1217-21202. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.
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Affiliation(s)
- Reem Malouf
- Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - Sian Harrison
- Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - Hollie A.L Burton
- Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - Chris Gale
- Neonatal Medicine, School of Public Health, Faculty of Medicine, Imperial College London, Chelsea and Westminster campus, 369 Fulham Road, London, SW10 9NH
| | - Alan Stein
- Department of Psychiatry, Medical Sciences Division, University of Oxford, Oxford, UK
- Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa Honorary Professor, African Health Research Institute, KwaZulu, Natal
| | - Linda S. Franck
- Department of Family Health Care Nursing, School of Nursing, University of California San Francisco, 2 Koret Way, San Francisco, CA 94143, USA
| | - Fiona Alderdice
- Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
- School of Nursing and Midwifery, Queens University Belfast, Belfast, UK
- Corresponding author:-Fiona Alderdice, Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, Oxford OX3 7LF
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18
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Franck LS, Shellhaas RA, Lemmon ME, Sturza J, Barnes M, Brogi T, Hill E, Moline K, Soul JS, Chang T, Wusthoff CJ, Chu CJ, Massey SL, Abend NS, Thomas C, Rogers EE, McCulloch CE, Glass HC. Parent Mental Health and Family Coping over Two Years after the Birth of a Child with Acute Neonatal Seizures. CHILDREN 2021; 9:children9010002. [PMID: 35053627 PMCID: PMC8774381 DOI: 10.3390/children9010002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/08/2021] [Accepted: 12/09/2021] [Indexed: 11/16/2022]
Abstract
Little is known about parent and family well-being after acute neonatal seizures. In thus study, we aimed to characterize parent mental health and family coping over the first two years after their child’s neonatal seizures. Parents of 303 children with acute neonatal seizures from nine pediatric hospitals completed surveys at discharge and 12-, 18- and 24-months corrected age. Outcomes included parental anxiety, depression, quality of life, impact on the family, post-traumatic stress and post-traumatic growth. We used linear mixed effect regression models and multivariate analysis to examine relationships among predictors and outcomes. At the two-year timepoint, parents reported clinically significant anxiety (31.5%), depression (11.7%) and post-traumatic stress (23.7%). Parents reported moderately high quality of life and positive personal change over time despite ongoing challenges to family coping. Families of children with longer neonatal hospitalization, functional impairment, post-neonatal epilepsy, receiving developmental support services and families of color reported poorer parental mental health and family coping. Parents of color were more likely to report symptoms of post-traumatic stress and positive personal change. Clinicians caring for children with neonatal seizures should be aware of lasting risks to parent mental health and family coping. Universal screening would enable timely referral for support services to mitigate further risk to family well-being and child development.
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Affiliation(s)
- Linda S. Franck
- Department of Family Health Care Nursing, University of California San Francisco, San Francisco, CA 94143, USA;
- Correspondence:
| | - Renée A. Shellhaas
- Department of Pediatrics, University of Michigan, Ann Arbor, MI 48109, USA; (R.A.S.); (J.S.); (E.H.)
| | - Monica E. Lemmon
- Departments of Pediatrics and Population Health Sciences, Duke University School of Medicine, Durham, NC 27710, USA;
| | - Julie Sturza
- Department of Pediatrics, University of Michigan, Ann Arbor, MI 48109, USA; (R.A.S.); (J.S.); (E.H.)
| | | | - Trisha Brogi
- Department of Family Health Care Nursing, University of California San Francisco, San Francisco, CA 94143, USA;
| | - Elizabeth Hill
- Department of Pediatrics, University of Michigan, Ann Arbor, MI 48109, USA; (R.A.S.); (J.S.); (E.H.)
| | | | - Janet S. Soul
- Department of Neurology, Boston Children’s Hospital, Boston, MA 02115, USA;
- Harvard Medical School, Boston, MA 02115, USA;
| | - Taeun Chang
- Department of Neurology, Children’s National Hospital, Washington, DC 20010, USA;
- Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC 20052, USA
| | - Courtney J. Wusthoff
- Departments of Neurology and Pediatrics, Stanford University, Palo Alto, CA 94304, USA;
| | - Catherine J. Chu
- Harvard Medical School, Boston, MA 02115, USA;
- Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Shavonne L. Massey
- Departments of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA; (S.L.M.); (N.S.A.)
- Departments of Neurology and Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Nicholas S. Abend
- Departments of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA; (S.L.M.); (N.S.A.)
- Departments of Neurology and Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Cameron Thomas
- Division of Neurology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA;
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
| | - Elizabeth E. Rogers
- Department of Pediatrics, UCSF Benioff Children’s Hospital, University of California San Francisco, San Francisco, CA 94143, USA;
| | - Charles E. McCulloch
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA 94143, USA;
| | - Hannah C. Glass
- Departments of Neurology, Pediatrics, Epidemiology and Biostatistics, Weill Institute for Neuroscience, UCSF Benioff Children’s Hospital, University of California San Francisco, San Francisco, CA 94143, USA;
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19
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Vance AJ, Malin KJ, Chen B, Shuman CJ, Moore TA. Impacts of Neonatal Hospitalization on Families during the 2019 Coronavirus Pandemic. Am J Perinatol 2021; 38:1201-1208. [PMID: 34225372 DOI: 10.1055/s-0041-1731649] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVE Limited data are available regarding family and financial well-being among parents whose infants were hospitalized during the 2019 coronavirus (COVID-19) pandemic. The study objective was to evaluate the family and financial well-being of parents whose infants were hospitalized in the neonatal intensive care unit (NICU) during COVID-19. STUDY DESIGN Parents were recruited for this online, cross-sectional survey via support groups on social media. Data collection was completed between May 18, 2020 and July 31, 2020. The final sample consisted of 178 parents, who had an infant hospitalized in an NICU between February 1, 2020 and July 31, 2020. The primary outcomes were impact on family life and financial stability, as measured by the Impact on Family scale, an instrument that evaluates changes to family life as a result of infant or childhood illness. RESULTS Of the 178 parent respondents, 173 (97%) were mothers, 107 (59.4%) were non-Hispanic White, and 127 (69.5%) of the infants were born prematurely. Parents reported significant family impact and greater financial difficulty. Extremely premature infants, lower household income, parent mental health, and lower parental confidence were predictive of greater impacts on family life. CONCLUSION Parents reported significant family and financial impacts during their infant's hospitalization amid COVID-19. Further studies are needed to guide clinical practice and inform family-supportive resources that can mitigate consequences to family well-being. KEY POINTS · Impact of infant hospitalization in the context of COVID-19 is largely unknown.. · In a cohort of NICU parents during COVID-19, they reported changes to family life and finances.. · Greater impacts were reported by parents with lower income, confidence, and very premature infants..
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Affiliation(s)
- Ashlee J Vance
- National Clinician Scholars Program, University of Michigan, School of Nursing, Ann Arbor, Michigan
| | - Kathryn J Malin
- College of Nursing, Marquette University, Milwaukee, Wisconsin
| | - Bingxin Chen
- School of Nursing, University of Michigan, Ann Arbor, Michigan
| | | | - Tiffany A Moore
- College of Nursing, University of Nebraska Medical Center, Omaha, Nebraska
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