Identification of Internal and External Stressors in Parents of Newborns in Intensive Care

Abstract

The purpose of this study was to identify parents' self-reported stressors as they experience their baby's course in the neonatal intensive care unit (NICU). Miles, Funk & Carlson (1993) Parental Stressor Scale: Neonatal Intensive Care Unit was used to survey 119 parents of neonatal infants, born at 24 weeks to full term, in the 28-bed level 3 NICU of a mid-Atlantic, Magnet-designated acute care hospital with 665 licensed beds. The newly developed Grosik, Snyder, Cleary and Tidwell NICU External Stressors and Stress Reduction Scale (2006), a 5-point Likert scale, was also used. Intrapersonal and interpersonal stressors were categorized as internal (occurring within the NICU) and extrapersonal (occurring outside the NICU) as external stressors. The findings were used to develop a new practice in the NICU to help reduce parental stressors.

Maternal Coping with Baby Hospitalization at a Neonatal Intensive Care Unit

“…The stress is influenced by birth variables, by the baby's immaturity and physical fragility (Grosik et al, 2013), and by the NICU that has equipment noises, a stressful routine, and a lot of movement by health professionals and other babies' parents (Alkozei, McMahon, & Lahav, 2014). Such factors can interfere in the formation of affective bonds within the mother-child dyad (Evans, Whittingham, & Boyd, 2012;Forcada-Guex et al, 2011;Spinelli et al, 2016).…”

“…The mother's perception of hospitalization is negative, and feelings of guilt, insecurity, fear and sadness are common (Barr, 2015;Sipos et al, 2013) because of the hospital's stressful routine, the painful and invasive procedures to which her baby is subject, and a temporary absence from her home and her other children that requires the transfer of responsibility for their care to another family member (Grosik, Snyder, Cleary, Breckenridge, & Tidwell, 2013). Thus, mothers need to share their experience and feelings with someone in this context (Coppola, Cassibba, Bosco, & Papagna, 2013).…”

In Whose Best Interests? Critiquing the “Family-as-Unit” Myth in Pediatric Ethics

“…There are new sounds-beeping monitors, infants in distress, and the constant (albeit brief) encounters with the large clinical team (attending physician, medical fellow and resident, nurses, consulting specialists, palliative care experts, social workers, chaplains, and ethicist). Parents are often unprepared, overwhelmed, shocked, and may experience hopelessness and despair [5]. In one study, some of the highest reported stressors identified by parents included "feeling helpless about how to help my baby during this time"; "seeing my baby stop breathing"; and noticing that "my baby seems to be in pain" [5].…”

“…Parents are often unprepared, overwhelmed, shocked, and may experience hopelessness and despair [5]. In one study, some of the highest reported stressors identified by parents included "feeling helpless about how to help my baby during this time"; "seeing my baby stop breathing"; and noticing that "my baby seems to be in pain" [5]. The subjective experience of parents may be likened to an "emotional roller-coaster" [6].…”

“…Initially, Mrs. Rusin was a patient, undergoing emergency surgery; she later became separated from her child at a crucial moment. 5 Mr. and Mrs. Rusin also were separated during their first 2 days following the delivery of Konstantin; Mr. Rusin may have felt significant stress by making critical decisions in his wife's absence, and Mrs. Rusin probably felt to some extent abandoned and sequestered from her family. Several days later, Mr. and Mrs. Rusin were told that their child was not improving clinically.…”