Parent psychological wellbeing in a single-family room versus an open bay neonatal intensive care unit

Abstract

BackgroundStudies of parents’ psychological well-being in single-family rooms in neonatal intensive care units have shown conflicting results.AimsTo compare emotional distress in the form of depression, anxiety, stress and attachment scores among parents of very preterm infants cared for in a single-family rooms unit vs an open bay unit.Study designProspective survey design.SubjectParents (132) of 77 infants born at 28 0/7–32 0/7 weeks of gestation in the two units.Outcome measuresDuration of parental presence was recorded. Scores for depression (The Edinburgh Postnatal Depression Scale), anxiety (The State–Trait–Anxiety Inventory, Short Form Y), stress (The Parent Stressor Scale: neonatal intensive care unit questionnaire and The Parenting Stress Index—short form) and attachment (Maternal Postnatal Attachment Scale) measured 14 days after delivery, at discharge, expected term date and four months post-term.ResultsParents were present 21 hours/day in the single-family room unit vs 7 hours/day in the Open bay unit. Ninety-three percent of the fathers in the single-family rooms unit were present more than 12 hours per day during the first week. Mothers in the single-family rooms had a significantly lower depression score -1.9 (95% CI: -3.6, -0.1) points from birth to four months corrected age compared to mothers in the Open bay unit, and 14% vs 52% scored above a cut-off point considered being at high risk for depression (p<0.005). Both mothers and fathers in the single-family rooms reported significantly lower stress levels during hospitalization. There were no differences between the groups for anxiety, stress or attachment scores after discharge.ConclusionThe lower depression scores by the mothers and lower parental stress scores during hospitalization for both parents supports that single-family rooms care contribute to parents’ psychological wellbeing.

Hospitalising preterm infants in single family rooms versus open bay units: A systematic review and meta-analysis of impact on parents

“…In one study (assessing state and trait anxiety), mothers in SFRs had higher trait anxiety, but experienced lower state anxiety than mothers in OBUs [32]. After discharge, parent anxiety did not differ between admission to either of two environments (n = 136, SMD-0¢17, 95%CI-0¢51;0¢17, p = 0¢316, I 2 =0%) [18,21]. Up to 29% of parents had depressive symptomatology upon discharge.…”

“…Two to four months after infant discharge, no differences in stress was found (Table 3, Supplemental Figure 5), all studies were at serious RoB and all infants were >32 weeks of GA [18,26,30]. No difference was noted analysing only infants admitted straight after birth to SFRs (Supplemental Table 4) [18,21,30].…”

“…Up to 29% of parents had depressive symptomatology upon discharge. Heterogeneity between studies was high (I 2 =87%, Table 3, Supplemental Figure 4) [18,21,29,32]. In sensitivity analyses of RoB, heterogeneity decreased (I 2 =0%), and no statistically significant difference in parent depression upon discharge was noted (n = 297, SMD-0¢10, 95%CI-0¢33;0¢14, p = 0¢42, Supplemental Table 4) [18,29].…”

“…Including all studies that measured parental stress at discharge, statistical heterogeneity was high (I 2 =79%, n = 909 parents, Table 3, Supplemental Figure 2) and no meta-analysis was performed [18,21,28,29,32,33]. Heterogeneity decreased when accounting for RoB (including only studies with low risk of confounding, I 2 =63%, Supplemental Table 4) [18,28,29,33], but not for GA [21,28,32] or start of SFR care at admission [18,21,28,32] (88% and 83%, respectively). One study specifically influenced heterogeneity, as it reported higher levels of stress on the parental role alteration subscale but not on all aspects of NICU-related parental stress [32].…”

Study protocol: parents as pain management in Swedish neonatal care – SWEpap, a multi-center randomized controlled trial

“…Therefore, infants need an emotionally available and stable parent who responds adequately to the infant's distress signals and who is able to soothe, regulate and share the infant's states [1]. In the Nordic countries today, the concept of family-centered care (FCC) is considered best practice in the care of the newborn [2,3]. Since the 1990s, FCC has been and still is, part of an ongoing paradigm shift where family involvement in the infant's care and the parent-infant relationship are of central importance, a cornerstone in current neonatal and pediatric health care [4,5].…”