Development of Program Standards for Psychosocial Support of Parents of Infants Admitted to a Neonatal Intensive Care Unit: A National Interdisciplinary Consensus Model

Hall, Sue; Hynan, Michael T.; Phillips, Raylene; Press, Janet; Kenner, Carole; Ryan, Donna J.

doi:10.1053/j.nainr.2015.01.007

Cited by 22 publications

(14 citation statements)

References 33 publications

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“…Assel et al (2002) concluded that parental stress, even at low levels, has been shown to disturb the relationships of parents with their healthy infants. This finding is consistent with what other researchers documented on stress being one of the most common barriers to effective parenting and yet one of the most important predictors of the developmental outcome of the infant (Umasankar and Sathiadas, 2016;Hall et al, 2015;Hildingsson and Thomas, 2014;Shaw et al, 2006). In addition, the distress that these parents experience has been noted to influence their parenting behaviour (Lefkowitz et al, 2010) and can affect the long-term relationship with their children and their ability to take care of them.…”

Section: Duration Of Stay In Nicu (Days)supporting

confidence: 91%

Perception of stressors by mothers with babies admitted to the Neonatal Intensive Care Unit in Women and New Born Hospital, Lusaka, Zambia

Masumo¹,

Mwape²,

Katowa-Mukwato³

et al. 2019

Int. J. Nurs. Midwifery

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Admission of a new born to the Neonatal Intensive Care Unit (NICU) is a stressful and unexpected event to most parents. This quantitative study aimed at identifying factors that contribute to stress in mothers nursing babies in the NICU at the Women and New Born Hospital in Zambia. A cross sectional study was conducted among 280 mothers who were randomly selected over a three-month period. Stress levels were assessed using Parental Stressor Scale: Neonatal Intensive Care Unit (PSS: NICU) questionnaire. Informed consent was obtained from the mothers for the study. Inclusion criteria for the study were mothers of admitted neonates and their neonates who had to remain in the NICU for at least 24 h. Stata software version 13 was used to analyse data Chi square test to determine association between stress and maternal and infant characteristics. Kruskal wallis test was used to determine association between subscales of the PSS: NICU tool and interquartile and median were calculated since the data was not normally distributed. Results revealed that participants were more stressed by alteration of the parental role and the appearance and behaviour of their neonate. All participants rated admission of the neonate as being stressful. Maternal characteristics that were associated with stress included education level and duration of stay in Kruskal-Wallis test showed a statistical difference between the stress subscales with alteration of parental role being the most stressful subscale. Mothers have different stress levels with most of them experiencing moderate and extreme stress; appropriate counselling targeted towards specific stressors identified is required. The limitation of this study is that it did not monitor levels of stress at different times of admission Future research should monitor how maternal stress changes throughout the neonate's NICU stay. This information can be used to design effective support programme to help mothers adopt coping strategies during their infant's hospitalization.

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Section: Duration Of Stay In Nicu (Days)supporting

confidence: 91%

Perception of stressors by mothers with babies admitted to the Neonatal Intensive Care Unit in Women and New Born Hospital, Lusaka, Zambia

Masumo¹,

Mwape²,

Katowa-Mukwato³

et al. 2019

Int. J. Nurs. Midwifery

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“…Thus, the need for large prospective RCTs remains. Third, as recent studies highlight gaps in service provision for mothers with psychopathology (72,97), investigation of NICU discharge planning that incorporates referral to community-based mental health programs is desperately needed for mothers with perinatal mental health disorders.…”

Section: Directions For Future Researchmentioning

confidence: 99%

“…For a small service to implement family-focused care within an adult hospital, it requires overcoming numerous barriers that may not be encountered in pediatric hospitals. Thus, some NICUs implement all components family-care while others offer isolated components or are at varying stages of implementation (21,97,99). In addition, there are no standardized recommendations for providing psychosocial support in the NICU, underscoring the importance of embedding evidence-based guidelines for psychiatric and trauma-focused care (97).…”

Section: Remaining Clinical Considerationsmentioning

confidence: 99%

NICU Hospitalization: Long-Term Implications on Parenting and Child Behaviors

Lean

Rogers

Paul

et al. 2018

Curr Treat Options Peds

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Opinion statement Purpose of review Parents of infants admitted to the Neonatal Intensive Care Unit (NICU) experience psychological distress, loss of the parenting role, and disruptions to parent-infant bonding. The inclusion of evidence-based practices to address these challenges in the NICU has largely been based upon short-term improvements in parent and infant functioning. However, less is known regarding the extent to which family-based interventions may also be associated with longer-term parenting behaviors and children’s neurobehavioral outcomes. Recent findings Comprehensive family-based NICU interventions demonstrate consistent links with later parental mental wellbeing, sensitive parenting behaviors, and children’s cognitive and socioemotional development. Dyadic co-regulation activities implemented inconsistently and/or in isolation to other components of NICU interventions show mixed associations with outcomes, highlighting the need for multifaceted wrap-around care. Further research is needed to delineate associations between NICU interventions and children’s neurological and language development, with follow-up beyond very early childhood in larger samples. Summary Long-term associations may reflect the stability of early parental responses to NICU interventions and the extent to which parents continue to implement mental health and sensitive parenting techniques in the home. However, the transition of parental psychiatric care from hospital to community-based services upon NICU discharge remains a pertinent need for high-risk families. Remaining issues also concern the extent to which NICU interventions incorporate sociodemographic differences across families, and whether interventions are generalizable or feasible across hospitals. Despite variation across interventions and NICUs; supporting, educating, and partnering with parents is crucial to strengthen longer-term family functioning and alter the developmental trajectories of high-risk infants.

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“…Common stressors that parents experience while having an infant in the NICU include anxiety about their infant’s well-being, struggling to meet the demands of parenting other children, loss of parenting role to NICU medical team, transportation barriers, and financial strain [ 13 , 14 , 15 ]. Due to the impact of these stressors and subsequent maternal adjustment on both maternal and infant health, NICU experiences are becoming critical area of study.…”

Section: Introductionmentioning

confidence: 99%

The Neonatal Intensive Care Unit: Environmental Stressors and Supports

Williams

Patel

Stausmire

et al. 2018

IJERPH

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The relationship between maternal mental health and infant development has been established in the literature. The Neonatal Intensive Care Unit (NICU) is a particularly challenging environment for new mothers as several natural processes are disrupted. The objective of this study is to elucidate protective factors and environmental deficits associated with the NICU. The experiences of forty-six (n = 46) mothers of infants admitted to a Level III NICU in the Midwestern United States, who responded to a related open-ended question, were analyzed thematically. Five themes related to the NICU environment emerged as being either stressful or helpful: (1) amount and quality of communication with medical staff, (2) bedside manner of medical staff, (3) feeling alienated from infant’s care, (4) support from other NICU mothers and families, and (5) NICU Physical Environment and Regulations. There is a need for medical staff training on awareness, communication, empathy, and other behaviors that might improve maternal (and parental) experiences in the NICU. The physical environment, including rules and regulations of the NICU, should be reexamined with family comfort in mind in addition to the clinical care of the infant.

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Development of Program Standards for Psychosocial Support of Parents of Infants Admitted to a Neonatal Intensive Care Unit: A National Interdisciplinary Consensus Model

Cited by 22 publications

References 33 publications

Perception of stressors by mothers with babies admitted to the Neonatal Intensive Care Unit in Women and New Born Hospital, Lusaka, Zambia

Perception of stressors by mothers with babies admitted to the Neonatal Intensive Care Unit in Women and New Born Hospital, Lusaka, Zambia

NICU Hospitalization: Long-Term Implications on Parenting and Child Behaviors

The Neonatal Intensive Care Unit: Environmental Stressors and Supports

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