Assessment of stress among parents of neonates admitted in the neonatal intensive care unit of a tertiary care hospital in Eastern India

Parent experiences of the esophageal atresia journey during the early post-natal period: results from a support group perspective

Surgically repaired esophageal atresia (EA) is associated with chronic esophageal and respiratory morbidity that require ongoing management. The care of chronically ill children can exert considerable stress on parents, thereby potentially affecting their mental well-being. In response to this, disease-specific support groups have emerged with the aim to bring together individuals facing similar challenges, facilitating the exchange of experiences within a nurturing environment, and providing essential emotional support. In the context of this international collaborative study, we investigated the role played by EA-specific support groups in promoting the emotional well-being of EA families. An anonymous online survey was distributed through a network comprising 12 international EA support groups affiliated with the Federation of Esophageal Atresia and Tracheoesophageal Fistula (EAT) during May and August of 2022. In the study, 96 parents from 23 different countries completed the survey. Fifty-six percent indicated a lack of interaction with other EA families during the initial diagnosis, with 91% expressing the belief that such contact would have been beneficial. Participants exhibited a unanimous recognition of the critical role played by disease-specific support groups in navigating the emotional journey associated with EA.Conclusion: The findings of this global survey align with existing literature, reaffirming the beneficial impact of disease-specific support groups tailored for EA patients and their families on their emotional well-being. These groups provide a valuable platform for the exchange of personal experiences and narratives, delivering advantages to both those who share their stories and those who receive this valuable information.

Stress and stressors experienced by the parents of high-risk neonates admitted in neonatal intensive care unit: Systematic review and meta-analysis evidence available from India

The aim of the systematic review and meta-analysis is to determine the stress and stressors experienced by the parents of high-risk neonates admitted to the neonatal intensive care unit (NICU) in India. We included both quantitative and qualitative studies. The Joanna Briggs Institute Critical Appraisal Checklist and Critical Appraisal Skill Programme checklist were used to assess the quality of included studies. A systematic search was conducted in PubMed, EMBASE, SCOPUS, EBSCOhost, Web of Science, ProQuest, Microsoft Academic, DOAJ, Indian Citation Index, and J-Gate to identify relevant studies. Additionally, online hand searching was performed on Indian websites of relevant institutions, women and child health departments, repositories, registries, and paediatric journals. Twelve of the 21 quantitative studies found that maternal stress was higher than fathers due to the separation from their babies and the medical condition of the neonate. One qualitative study reported that financial burden, alterations in the parenting role, and concern over domestic issues are significant causes of fathers' stress. A meta-analysis of the included studies assessed the prevalence of maternal, paternal, and parental stress and reported that mothers experienced higher stress levels than fathers across all subscales. The most typical stressors for parents were changes in neonatal looks, behaviour, and altered parental roles. Beyond the immediate NICU care and interactions, other triggering factors of stress among parents must be considered to design multicomponent interventions in a local (Indian) context. Moreover, parental psychological support and regular counselling can be incorporated into the standard neonatal intensive care policy.

Prevalence of anxiety, depression, and stress among parents of neonates admitted to neonatal intensive care unit: a systematic review and meta-analysis

BACKGROUND

Neonatal intensive care unit (NICU) admission causes significant distress that can hinder the successful transition into parenthood, child-parent relations, and child development.

PURPOSE

This systematic review and meta-analysis aimed to understand parental psychological phenomena. Here we assessed the emotional response of parents of newborns during NICU admission.

METHODS

Two authors independently searched the PubMed, Cumulative Index to Nursing and Allied Health Literature, Embase, Clinical Key, and Google Scholar databases for studies published between January 01, 2004, and December 31, 2021. The review followed Cochrane collaboration guidelines and the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) statement. The quality of the included studies was assessed using the modified Newcastle-Ottawa Scale. Stata software (version 16) was used to compute the results.

RESULTS

This review comprised 6,822 parents (5,083 mothers, 1,788 fathers; age range, 18-37 years) of NICU patients. The gestational ages and neonatal weights were 25.5-42 weeks and 750-2,920 g, respectively. The pooled prevalence of anxiety was higher among mothers (effect size [ES], 0.51; 95% confidence interval [CI], 0.41-0.61; and heterogeneity [I2]=97.1%; P<0.001) than among fathers (ES, 0.26; 95% CI, 0.11-0.42; I2=96.6%; P<0.001). Further, the pooled prevalence of depression was higher among mothers (ES, 0.31; 95% CI, 0.24-0.38; I2=91.5%; P<0.001) than among fathers (ES, 0.12; 95% CI, 0.03-0.22; I2=85.6%; P<0.001). Similarly, the pooled prevalence of stress was higher among mothers (ES, 0.41; 95% CI, 0.31-0.51; I2= 93.9%; P<0.001) than among fathers (ES, 0.22; 95% CI, 0.09-0.34; I2=85.2%; P<0.001).

CONCLUSION

NICU admission is more stressful for mothers than fathers and can affect mental health and quality of life. Mothers reported a higher pooled prevalence of stress, anxiety, and depression than fathers, possibly attributable to their feelings about birthing a sick child.

The Stress Levels of Premature Infants' Parents and Related Factors in NICU

Introduction

Parental stress related to their infants' hospitalization is a significant concern that affects both parents and their infants. Fathers' experiences tend to be understudied compared to mothers. Further research on fathers' stress levels is necessary. While parental stress has been correlated with infant health severity, the specific causes and risk factors contributing to heightened stress levels in parents of neonatal intensive care unit (NICU) infants are not yet fully understood and require further investigation.

Objective

This study aimed to examine the stress levels experienced by parents of premature infants in the NICU and to explore the factors associated with parental stress in this specific context.

Methods

A cross-sectional observational design was used to accomplish this study, which was carried out on 743 parents from nine different NICUs located in governmental hospitals across various locations in Egypt. We used characteristics of parents and premature infants, and Parent Stress Scale was used for data collection.

Results

A majority of parents reported experiencing high stress in the following domains: sight and sound (80.3%), infants' appearance (69%), and the parent-infant relationship (81.4%). Additionally, about three-quarters (73.6%) of parents experienced high stress overall, with a mean score of 167.56 (21.3).

Conclusion

About three-quarters of the parents experienced high overall stress levels. Also, factors that were found to affect parents' stress levels included premature infants connected to mechanical ventilators, previous neonatal death, parents living far from hospitals, infants delivered through cesarean section, insufficient income, and prolonged hospitalization beyond 5 days.

The predictive roles of parental stress and intolerance of uncertainty on psychological well-being of parents with a newborn in neonatal intensive care unit: a hierarchical linear regression analysis

BACKGROUND

Hospitalization of newborns in neonatal intensive care units (NICU) exposes parents to considerable stress. This study aimed to determine the predictive role of parental stress and intolerance of uncertainty on the psychological well-being of parents with a newborn in NICU using hierarchical linear regression analysis.

METHODS

This cross-sectional study included 130 parents of newborns hospitalized in the NICU. Data were collected using Parental Stress Scale, Intolerance of Uncertainty Scale, and Psychological Wellbeing Scale. The data were analyzed in SPSS v.26 using hierarchical linear regression analysis.

RESULTS

The mean scores of the parents' psychological well-being, parental stress, and intolerance of uncertainty were 79.08 (SD = 11.70), 63.06 (SD = 26.71), and 75.38 (SD = 19.40), respectively. The result of the hierarchical linear regression analysis revealed that, in step 1, academic education had a significant proportion of the variance of parents' psychological well-being (β = 0.26, P = 0.005). In step 2, it was shown that academic education (β=-0.25, P = 0.006) and parental stress (β=-0.25, P = 0.006) had a significant proportion of the variance of parents' psychological well-being. According to step 2, education levels, parental stress, and intolerance of uncertainty explained 22% of the changes in parents' psychological well-being.

CONCLUSION

There was a significant association between the parents' psychological well-being and education levels, intolerance of uncertainty, and parental stress. Academic education and parental stress were the predictors of parents' psychological well-being. Based on these findings, early detection of parents' education and stress are important for their psychological well-being.

The effect of the supportive care program based on Bandura's self-efficacy on stress and participation of the mothers of the neonates admitted to neonatal intensive care unit

BACKGROUND

Maternal stress can affect both the neonate and the mother and deter them from participating in the care of preterm neonates. The purpose of the study was to determine the effect of the supportive care program (SCP) based on Bandura's self-efficacy on stress and participation of mothers of neonates admitted to the neonatal intensive care unit.

MATERIALS AND METHODS

This quasi-experimental study was performed in 2020 on 90 mothers of premature infants admitted to the NICU of Hajar Hospital in Shahrekord, Iran. First, the control group and then the experimental group were selected and a training package based on Bandura's self-efficacy theory was implemented for the intervention group. The research instruments in this study were the Heidari mothers stress questionnaire and Melnyk mother's participation questionnaire which was completed before and after the intervention. The analysis was performed based on SPSS (version 24) and Chi-square, independent t-test, and paired tests.

RESULTS

The results indicated that the demographic variables of mothers and neonatal characteristics of the two groups did not have significant differences except for the history of abortion and infertility in mothers and the weight of preterm neonates (P < 0.05). Mothers in the experimental group had less stress (t (88) = 29.50, P < 0.001) and more participation than the control group (t (88) = -27.18, P < 0.001) after the intervention.

CONCLUSIONS

Using self-efficacy-based SCP for maternal education besides routine education could positively affect the reduction of stress and the increase of maternal participation in caring for preterm neonates during hospitalization. Thus, using this supportive program is suggested for mothers with preterm neonates admitted to NICU.

Evaluation of parental stress in neonatal intensive care unit in Iran: a national study

BACKGROUND

More attention is paid to the survival and treatment of the sick infant in the neonatal intensive care unit (NICU) and parental stress is not considered. The purpose of this study was to determine samples of the level of parental stress in the NICU.

METHOD

This study is a descriptive-analytical study in which Parental Stress and General Health were used in an analytical national survey in Iran. The research sample consists of 2456 parents of infants admitted to NICU. The sampling method was multi-stage random. We used 11- item parental stress questionnaire and 28-item general health questionnaire for the data collection.

RESULT

Baloch ethnicity with an average of 11.52 had the highest level of stress. The mean stress score of mothers was higher than fathers. The mean score of all dimensions of physical symptoms, anxiety, social functioning, depression, and total mental health score in mothers was higher than fathers. There was a statistically significant difference in the length of hospitalization in terms of different levels of parental stress scores (p < 0.002). Lack of decisive response to parents was one of the most stressful issues (8.1%).

CONCLUSION

Our result shows mothers' stress was higher than fathers. So that health policymakers should pay attention to stress risk factors to provide appropriate interventions according stress risk factors Future studies should design appropriate interventions to reduce parental stress, especially in high-risk mothers.

Psychosocial Difficulties Experienced By Parents Of Babies Treated In A Neonatal Intensive Care Unit During The Coronavirus Pandemic

AIM

This study had two objectives: (1) to investigate the psychosocial difficulties experienced by parents of babies treated in a neonatal intensive care unit during the coronavirus pandemic and (2) to determine parent-infant attachment.

MATERIALS AND METHODS

This study adopted phenomenology, a qualitative research design in order to answer the research questions design. The sample consisted of 20 parents of babies treated in the neonatal intensive care unit (NICU) of a City Hospital in Turkey between July and August 2021. Participation was voluntary. Data were collected using a sociodemographic characteristics questionnaire and a semi-structured qualitative interview form. Each participant was interviewed face to face. Each interview was recorded and transcribed. The data were analyzed using content analysis.

RESULTS

Participants had a mean age of 32.2 ± 3.61 years and at least secondary school degrees. Babies were admitted to the NICU for congenital anomalies (n = 3) or preterm birth (n = 7). Participants experienced anxiety, worry, and loneliness and produced less milk because they could not see and touch their babies. Their greatest source of support was their spouses.

CONCLUSION

Parents of babies treated in the NICU during the COVID-19 pandemic experience anxiety, sadness, unhappiness, and loneliness. The preventive measures against the pandemic affect parents psychosocially. Healthcare professionals should plan and implement care practices and establish effective communication with parents to identify their physiological, psychological, and social needs and help them produce breastmilk and bond with their babies.

Factors affecting stress levels in parents of surgical neonates: A prospective observational study

BACKGROUND

There is a paucity of research focusing on the stress levels in parents of newborns undergoing surgery. Resource challenged systems have to deal with overcrowding, a shortage of workforce along with demographic and socioeconomic issues like delayed presentations and out of pocket expenses. The primary objective of this study was to understand the factors associated with stress in the parents of these congenitally malformed neonates.

METHODOLOGY

This was a prospective cohort study, which was conducted in a neonatal surgical ICU of a tertiary care teaching hospital. Factors affecting stress levels in parents of surgical neonates were studied in 100 participants. A multi-dimensional questionnaire - The PSS: NICU score was utilized in the study. The parents were interviewed on Day 3-5 after surgery.

RESULT

59% of the respondents were fathers. The majority of the parents were in the age bracket of 24 to 35 years. The mean scores for the subscales sights and sounds, looks and behavior and alteration in the parental role were 3.24±0.8, 3.52±0.63, 3.55±0.8 and 2.8 ± 0.9 respectively. The highest level of stress was found in the domains of alteration of parental role and infant appearance and behavior. Comparisons showed significantly higher maternal scores in all the domains. Overall stress scores were highest for abdominal wall defects.

CONCLUSION

Parents of neonates undergoing surgery suffer from significant stress levels and appropriate counseling targeted towards specific stressors is required to allay this important parental issue.