An integrative review of maternal distress during neonatal intensive care hospitalization

Staver, Morgan A.; Moore, Tiffany A.; Hanna, Kathleen M.

doi:10.1007/s00737-020-01063-7

Cited by 27 publications

(10 citation statements)

References 56 publications

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“…Last, note that Staver et al had previously concluded that NICU environment is one of the variables associated with parent moral distress in the context of neonatal intensive care (Staver et al, 2021) [43].…”

Section: Nicu Environment -Related Parent Moral Distressmentioning

confidence: 99%

Parent Moral Distress From The Perspectives of Mothers With An Infant Previously Hospitalized in The NICU

Voultsos

Deligianni

Tsamadou

2022

Preprint

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BackgroundGiven that having an infant in the NICU is a morally stressful event for parents and preterm birth rates are increasing worldwide, parent moral distress is a matter of public health. While moral distress in the clinical context is already a widely explored phenomenon, the parent moral distress still remains a largely under-explored complex phenomenon. Methods This is a prospective qualitative study using semi-structured interviews of seventeen parents (mothers) who previously had an infant in the NICU. The study conducted between February 2021 and August 2021. A thematic analysis of the data was performed. Results While parents with infants in the NICU initially needed for having their decisions respected by physicians, they ultimately shew a tolerant attitude towards benevolent medical paternalism. However, many physician-related factors (i.e. uncertainty, discrepancy of opinion, operational behavior, lack of communicative or empathetic behavior, previous malpractice) facilitate parent moral distress. The important role of the family pediatrician in creating parent moral distress is highlighted. The same holds for family/social environment – related factors. Furthermore, the role of parent’s internal factors (especially spiritual/existential core values or beliefs) as well as the role of NICU environment-related factors (such as the image of a long-suffering infant, preventing mothers from providing their own milk for their infants and having a skin-to-skin contact with them) in creating parent moral distress are highlighted. Moral residue no more than mild was found. Moreover, parent moral schisma is emerged as a conceptually distinct from moral distress phenomenon. Last, the findings of this study confirm the relational account of parental moral distress offered by Mooney-Doyle and Ulrich. ConclusionsWhile many findings of the present study are in line with previous studies, our data analysis revealed findings which are little recognized in the available literature. Parents showed tolerant attitudes towards benevolent medical paternalism. No more than mild moral residue has been found. The most relevant categories of variables associated with parent moral distress were a) physician-related (various factors), b) parent-related, c) parent’s context (family or broader social)-related, and d) NICU environment-related. Furthermore, parent moral distress and parent moral schisma are conceptualized as conceptually distinct albeit strictly related or overlapping phenomena. The findings of this study support the relational account of parent moral distress.

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Section: Nicu Environment -Related Parent Moral Distressmentioning

confidence: 99%

Parent Moral Distress From The Perspectives of Mothers With An Infant Previously Hospitalized in The NICU

Voultsos

Deligianni

Tsamadou

2022

Preprint

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“…Faced with a sick newborn in such an unfamiliar, fast-paced clinical environment, it is not surprising that parents experience emotional distress. Two systematic reviews confirm that depression, anxiety, trauma, and posttraumatic symptoms are prevalent in mothers of NICU newborns (Roque et al, 2017; Staver et al, 2021). Researchers have consistently found a higher rate of depression in mothers of hospitalized newborns compared to mothers whose newborns were not hospitalized (Farr et al, 2022; Vigod et al, 2010).…”

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confidence: 94%

A Randomized Controlled Trial of Listening Visits for Mothers of Hospitalized Newborns

et al. 2023

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BackgroundEmotional distress is frequently experienced by mothers whose newborns are hospitalized in a neonatal intensive care unit (NICU). Among these women, there is a critical need for emotional support conveniently delivered at the newborn’s point of care by a trusted and medically knowledgeable professional: a NICU nurse. One promising way to enhance in situ delivery of emotional care is to have a NICU nurse provide Listening Visits (LVs), a brief support intervention developed expressly for delivery by nurses to depressed postpartum women.ObjectivesThis trial assessed the feasibility of having NICU nurses deliver LVs to emotionally distressed mothers of hospitalized newborns and compared depression outcomes in a small sample of participants randomized to LVs or usual care (UC).MethodsIn this pilot randomized controlled trial, emotionally distressed mothers of hospitalized newborns were randomized to receive up to six LVs from a NICU nurse or UC from a NICU social worker. To assess change in depression symptoms, women were invited to complete the Inventory of Depression and Anxiety Symptoms–General Depression Scale at enrollment and 4 and 8 weeks post-enrollment.ResultsDepression symptoms declined over time for both groups, with no difference between the two groups. A post hoc analysis of reliable change found higher rates of improvement at the 4-week assessment among recipients of LVs than UC.DiscussionNICU nurses successfully implemented LVs during this trial. Depression symptom scores did not significantly differ in the two groups posttreatment or at follow-up. Nevertheless, post hoc analyses indicated comparatively higher rates of clinical improvement immediately after LVs, suggesting the intervention can reduce maternal depression early on when women are most distressed.

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“…Исследования показывают тенденцию к усилению родительского дистресса в случае, если новорожденный нуждается в неонатальной помощи. В качестве реакций матерей и отцов на госпитализацию ребенка выявляют снижение фона настроения, повышение тревожности, симптомы посттравматического стрессового расстройства (ПТСР) (Roque et al, 2017;Lotterman et al, 2019;Staver et al, 2021). В то же время подчеркивается, что картина дистресса у каждого родителя уникальна, а его уровень может варьировать от низкого до высокого при одних и тех же перинатальных проблемах (Bernardo et al, 2021;Staver et al, 2021).…”

Section: Introductionunclassified

Analysis of the results of application of the rational-emotive behaviour therapy for mothers of newborns with hypoxic affection of the central nervous system

Mamaychuk¹,

Milanich²

2022

Vestnik SPbSU. Psychology

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Parents of hospitalized newborns tend to experience more severe psychological distress. Rel- evant to this is the impact on the specific irrational beliefs of mothers for the purpose of improving adaptation to the life situation. It is necessary to study the possibilities of cognitive- behavioral methods of intervention in working with this client category. The objective of this work is to study the dynamics of distress indicators in mothers of newborns with hypoxic affection of the central nervous system (CNS) in the process of the program developed on the basis of rational-emotive behaviour therapy (REBT). The study included 98 mothers of newborns with hypoxic affection of CNS. Based on the results of a semi-structured inter- view, 80 mothers were identified with a dysfunctional type of response to a life situation. The intervention group (N=50) received 8 REBT sessions for three weeks. The main target for psychotherapy was irrational beliefs, which underlie negative emotions and non-constructive ways coping with stress caused by hospitalization and facing information on the condition and developmental prognosis of a newborn. The control group (N=30) received one consul- tation session. To assess the dynamics of distress indicators, the Integrative Anxiety Test and Zung Self-Rating Depression Scale were used before and after the program in the intervention group and with an interval of three weeks in the control group. In the intervention group, the indicators of depression, situational anxiety, emotional discomfort and the phobic component of anxiety decreased. In the control group, the indicators of situational anxiety and asthenic component of anxiety decreased. In comparison with the control group, the mothers in the intervention group showed more significant positive changes. The programs developed on the basis of REBT have moderate efficacy in reduction of the distress in mothers of newborns with hypoxic affection of CNS.

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An integrative review of maternal distress during neonatal intensive care hospitalization

Cited by 27 publications

References 56 publications

Parent Moral Distress From The Perspectives of Mothers With An Infant Previously Hospitalized in The NICU

Parent Moral Distress From The Perspectives of Mothers With An Infant Previously Hospitalized in The NICU

A Randomized Controlled Trial of Listening Visits for Mothers of Hospitalized Newborns

Analysis of the results of application of the rational-emotive behaviour therapy for mothers of newborns with hypoxic affection of the central nervous system

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