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


Autoři: Bente Silnes Tandberg aff001;  Renée Flacking aff004;  Trond Markestad aff003;  Hege Grundt aff005;  Atle Moen aff001
Působiště autorů: Department of Paediatric and Adolescent Medicine, Drammen Hospital, Vestre Viken Hospital Trust, Drammen, Norway aff001;  Lovisenberg Diaconal University College, Oslo, Norway aff002;  Department of Clinical Science, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway aff003;  School of Education, Health and Social Studies, Dalarna University, Falun, Sweden aff004;  Department of Paediatrics, Haukeland University Hospital, Bergen, Norway aff005;  Department of Neonatology, Oslo University Hospital, Oslo, Norway aff006
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
doi: 10.1371/journal.pone.0224488

Souhrn

Background

Studies of parents’ psychological well-being in single-family rooms in neonatal intensive care units have shown conflicting results.

Aims

To 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 design

Prospective survey design.

Subject

Parents (132) of 77 infants born at 28 0/7–32 0/7 weeks of gestation in the two units.

Outcome measures

Duration 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.

Results

Parents 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.

Conclusion

The 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.

Klíčová slova:

Anxiety – Depression – Emotions – Infants – Mothers – Neonatal care – Neonates – Psychological stress


Zdroje

1. Bergman NJ, Ludwig R, Westrup B, Welch M. Nurturescience versus neuroscience: A case for rethinking perinatal mother–infant behaviors and relationship. Birth defects research. 2019. https://doi.org/10.1002/bdr2.1529

2. Bergman NJ. Birth practices: Maternal‐neonate separation as a source of toxic stress. Birth defects research. 2019. doi: 10.1002/bdr2.1530

3. Provenzi L, Scotto di Minico G, Giusti L, Guida E, Müller M. Disentangling the dyadic dance: theoretical, methodological and outcomes systematic review of mother-infant dyadic processes. Frontiers in psychology. 2018;9:348. https://www.ncbi.nlm.nih.gov/pubmed/2961594729615947

4. Volpe JJ. Dysmaturation of Premature Brain: Importance, Cellular Mechanisms, and Potential Interventions. Pediatr Neurol. 2019;95:42–66. doi: 10.1016/j.pediatrneurol.2019.02.016 30975474

5. Montirosso R, Provenzi L. Implications of epigenetics and stress regulation on research and developmental care of preterm infants. J Obstet Gynecol Neonatal Nurs. 2015;44(2):174–82. doi: 10.1111/1552-6909.12559 25712710

6. Mooney-Leber SM, Brummelte S. Neonatal pain and reduced maternal care: Early-life stressors interacting to impact brain and behavioral development. Neuroscience. 2017;342:21–36. doi: 10.1016/j.neuroscience.2016.05.001 27167085

7. Westrup B. Family-centered developmentally supportive care. NeoReviews. 2014;15(8):e325–e35.

8. Roue JM, Kuhn P, Lopez Maestro M, Maastrup RA, Mitanchez D, Westrup B, et al. Eight principles for patient-centred and family-centred care for newborns in the neonatal intensive care unit. Arch Dis Child Fetal Neonatal Ed. 2017;102(4):F364–F8. doi: 10.1136/archdischild-2016-312180 28420745

9. Moen A, Hallberg B. EFCNI, European Standards of Care for Newborn Health: Core principles of NICU design to promote family-centred care 2018 https://newborn-health-standards.org/nicu-design-family-centred-care/.

10. Westrup B KPea. EFCNI, European Standards of Care for Newborn Health: Family access. 2018 https://newborn-health-standards.org/family-access/

11. UN. Convention on the Rights of the Child: United Nations Human Rights Office of the high Commissioner; 1989 https://www.ohchr.org/en/professionalinterest/pages/crc.aspx.

12. Raiskila S, Axelin A, Toome L, Caballero S, Tandberg BS, Montirosso R, et al. Parents’ presence and parent–infant closeness in 11 neonatal intensive care units in six European countries vary between and within the countries. Acta Paediatrica. 2017:n/a-n/a. http://dx.doi.org/10.1111/apa.13798

13. Pallas-Alonso CR, Losacco V, Maraschini A, Greisen G, Pierrat V, Warren I, et al. Parental involvement and kangaroo care in European neonatal intensive care units: a policy survey in eight countries. Pediatr Crit Care Med. 2012;13(5):568–77. doi: 10.1097/PCC.0b013e3182417959 22760425

14. O’Brien K, Robson K, Bracht M, Cruz M, Lui K, Alvaro R, et al. Effectiveness of Family Integrated Care in neonatal intensive care units on infant and parent outcomes: a multicentre, multinational, cluster-randomised controlled trial. Lancet Child Adolesc Health. 2018;2(4):245–54. https://doi.org/10.1016/S2352-4642(18)30039-30169298

15. Lester BM, Hawes K, Abar B, Sullivan M, Miller R, Bigsby R, et al. Single-family room care and neurobehavioral and medical outcomes in preterm infants. Pediatrics. 2014;134(4):754–60. doi: 10.1542/peds.2013-4252 25246623

16. Lester BM, Salisbury AL, Hawes K, Dansereau LM, Bigsby R, Laptook A, et al. 18-Month Follow-Up of Infants Cared for in a Single-Family Room Neonatal Intensive Care Unit. J Pediatr. 2016;177:84–9. doi: 10.1016/j.jpeds.2016.06.069 27470693

17. Vohr B, McGowan E, McKinley L, Tucker R, Keszler L, Alksninis B. Differential Effects of the Single-Family Room Neonatal Intensive Care Unit on 18- to 24-Month Bayley Scores of Preterm Infants. J Pediatr. 2017;185:42–8 e1. https://doi.org/10.1016/j.jpeds.2017.01.05628238479

18. Pineda RG, Stransky KE, Rogers C, Duncan MH, Smith GC, Neil J, et al. The single-patient room in the NICU: maternal and family effects. J Perinatol. 2012;32(7):545–51. doi: 10.1038/jp.2011.144 22031044

19. Domanico R, Davis DK, Coleman F, Davis BO Jr. Documenting the NICU design dilemma: parent and staff perceptions of open ward versus single family room units. J Perinatol. 2010;30(5):343–51. https://dx.doi.org/10.1038/jp.2009.19520072132

20. Pineda RG, Neil J, Dierker D, Smyser CD, Wallendorf M, Kidokoro H, et al. Alterations in brain structure and neurodevelopmental outcome in preterm infants hospitalized in different neonatal intensive care unit environments. J Pediatr. 2014;164(1):52–60 e2. https://doi.org/10.1016/j.jpeds.2013.08.04724139564

21. Raiskila S, Axelin A, Toome L, Caballero S, Tandberg BS, Montirosso R, et al. Parents’ presence and parent-infant closeness in 11 neonatal intensive care units in six European countries vary between and within the countries. Acta Paediatr. 2017;106(6):878–88. https://www.ncbi.nlm.nih.gov/pubmed/2823515228235152

22. Misund AR, Nerdrum P, Diseth TH. Mental health in women experiencing preterm birth. BMC Pregnancy Childbirth. 2014;14(1):263. doi: 10.1186/1471-2393-14-263 25107462

23. Prouhet PM, Gregory MR, Russell CL, Yaeger LH. Fathers’ Stress in the Neonatal Intensive Care Unit: A Systematic Review. Adv Neonatal Care. 2018;18(2):105–20. doi: 10.1097/ANC.0000000000000472 29595549

24. Tandberg BS, Froslie KF, Markestad T, Flacking R, Grundt H, Moen A. Single-family room design in the neonatal intensive care unit did not improve growth. Acta Paediatr. 2019;108(6):1028–35. doi: 10.1111/apa.14746 30729563

25. Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry. 1987;150(6):782–6. https://doi.org/10.1192/bjp.150.6.782

26. Eberhard-Gran M, Eskild A, Tambs K, Schei B, Opjordsmoen S. The Edinburgh Postnatal Depression Scale: validation in a Norwegian community sample. Nord J Psychiatry. 2001;55(2):113–7. https://doi.org/10.1080/0803948011768411802908

27. Eberhard‐Gran M, Eskild A, Tambs K, Opjordsmoen S, Ove Samuelsen S. Review of validation studies of the Edinburgh Postnatal Depression Scale. Acta Psychiatrica Scandinavica. 2001;104(4):243–9. https://doi.org/10.1111/j.1600-0447.2001.00187.x11722298

28. Rubertsson C, Börjesson K, Berglund A, Josefsson A, Sydsjö G. The Swedish validation of Edinburgh postnatal depression scale (EPDS) during pregnancy. Nordic journal of psychiatry. 2011;65(6):414–8. https://doi.org/10.3109/08039488.2011.59060621728782

29. Spielberger CD. Manual for the State-Trait Anxiety Inventory STAI (form Y)(" self-evaluation questionnaire"). 1983. https://doi.org/10.1002/9780470479216.corpsy0943

30. Marteau TM, Bekker HL. The development of a six‐item short‐form of the state scale of the Spielberger State—Trait Anxiety Inventory (STAI). British Journal of Clinical Psychology. 1992;31(3):301–6.

31. Bekker HL, Legare F, Stacey D, O’Connor A, Lemyre L. Is anxiety a suitable measure of decision aid effectiveness: a systematic review? Patient Education and Counseling. 2003;50(3):255–62. doi: 10.1016/s0738-3991(03)00045-4 12900095

32. Tluczek A, Henriques JB, Brown RL. Support for the reliability and validity of a six-item state anxiety scale derived from the State-Trait Anxiety Inventory. Journal of nursing measurement. 2009;17(1):19. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2776769/ 19902657

33. Miles MS, Funk SG, Carlson J. Parental Stressor Scale: neonatal intensive care unit. Nurs Res. 1993;42(3):148–52. http://dx.doi.org/10.1097/00006199-199305000-00005 8506163

34. Miles MS, Holditch-Davis D, Schwartz TA, Scher M. Depressive symptoms in mothers of prematurely born infants. Journal of Developmental & Behavioral Pediatrics. 2007;28(1):36–44. doi: 10.1097/01.DBP.0000257517.52459.7a 17353730

35. Franck LS, Cox S, Allen A, Winter I. Measuring neonatal intensive care unit-related parental stress. J Adv Nurs. 2005;49(6):608–15. doi: 10.1111/j.1365-2648.2004.03336.x 15737221

36. Månsson C, Jakobsson U, Lundqvist P. Translation and psychometric evaluation of a Swedish version of the parental stressor scale PSS: NICU. Scandinavian journal of caring sciences. 2016;30(1):193–201. https://doi.org/10.1111/scs.1221725918977

37. Abidin RR. Parenting Stress Index: Manual, Administration Booklet,[and] Research Update. 1983.

38. Abidin RR, Flens JR, Austin WG. Parenting Stress Index. Forensic uses of clinical assessment instruments. 1995:297–328.

39. Kornør H, & Martinussen, M. PSI: Parenting Stress Index, 3. versjon. I H. Kornør (red.), PsykTestBARN. Hentet fra http://www.psyktest.no/PSI.63155.cms. 2011.

40. Condon JT, Corkindale CJ. The assessment of parent-to-infant attachment: Development of a self-report questionnaire instrument. Journal of Reproductive and Infant Psychology. 1998;16(1):57–76. doi: 10.1080/02646839808404558

41. Feeley N, Waitzer E, Sherrard K, Boisvert L, Zelkowitz P. Fathers’ perceptions of the barriers and facilitators to their involvement with their newborn hospitalised in the neonatal intensive care unit. J Clin Nurs. 2013;22(3–4):521–30. doi: 10.1111/j.1365-2702.2012.04231.x 23186388

42. McMahon GE, Spencer-Smith MM, Pace CC, Spittle AJ, Stedall P, Richardson K, et al. Influence of Fathers’ Early Parenting on the Development of Children Born Very Preterm and Full Term. The Journal of pediatrics. 2019;205:195–201. doi: 10.1016/j.jpeds.2018.09.073 30448013

43. Sabnis A, Fojo S, Nayak SS, Lopez E, Tarn DM, Zeltzer L. Reducing parental trauma and stress in neonatal intensive care: systematic review and meta-analysis of hospital interventions. J Perinatol. 2019;39(3):375–86. doi: 10.1038/s41372-018-0310-9 30659239

44. Shields L, Zhou H, Pratt J, Taylor M, Hunter J, Pascoe E. Family-centred care for hospitalised children aged 0–12 years. Cochrane Database Syst Rev. 2012;10:CD004811. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD004811.pub3

45. Belsky J, de Haan M. Annual Research Review: Parenting and children’s brain development: the end of the beginning. Journal of Child Psychology and Psychiatry. 2011;52(4):409–28. doi: 10.1111/j.1469-7610.2010.02281.x

46. Ludington-Hoe SM. Skin-to-Skin Contact: A Comforting Place With Comfort Food. MCN Am J Matern Child Nurs. 2015;40(6):359–66; quiz E23–4. https://www.ncbi.nlm.nih.gov/pubmed/2628094726280947

47. Provenzi L, Broso S, Montirosso R. Do mothers sound good? A systematic review of the effects of maternal voice exposure on preterm infants’ development. Neuroscience & Biobehavioral Reviews. 2018;88:42–50. doi: 10.1016/j.neubiorev.2018.03.009

48. Filippa M, Lordier L, De Almeida JS, Monaci MG, Darque A, Grandjean D, et al. Early vocal contact and music in the NICU: new insights into preventive interventions. Pediatric research. 2019:1. doi: 10.1038/s41390-019-0521-6

49. Pineda RG, Neil J, Dierker D, Smyser CD, Wallendorf M, Kidokoro H, et al. Alterations in brain structure and neurodevelopmental outcome in preterm infants hospitalized in different neonatal intensive care unit environments. The Journal of pediatrics. 2014;164(1):52–60. e2. https://www.ncbi.nlm.nih.gov/pubmed/2413956424139564

50. Matthey S. Calculating clinically significant change in postnatal depression studies using the Edinburgh Postnatal Depression Scale. Journal of affective disorders. 2004;78(3):269–72. doi: 10.1016/S0165-0327(02)00313-0 15013253

51. Prouhet PM, Gregory MR, Russell CL, Yaeger LH. Fathers’ stress in the neonatal intensive care unit: A systematic review. Advances in Neonatal Care. 2018;18(2):105–20. https://www.ncbi.nlm.nih.gov/pubmed/2959554929595549

52. Provenzi L, Santoro E. The lived experience of fathers of preterm infants in the Neonatal Intensive Care Unit: a systematic review of qualitative studies. J Clin Nurs. 2015;24(13–14):1784–94. https://www.ncbi.nlm.nih.gov/pubmed/2585051825850518

53. Fisher D, Khashu M, Adama EA, Feeley N, Garfield CF, Ireland J, et al. Fathers in neonatal units: Improving infant health by supporting the baby-father bond and mother-father coparenting. Journal of Neonatal Nursing. 2018;24(6):306–12. doi: 10.1016/j.jnn.2018.08.007

54. Aagaard H, Hall EO. Mothers’ experiences of having a preterm infant in the neonatal care unit: a meta-synthesis. Journal of pediatric nursing. 2008;23(3):e26–e36. doi: 10.1016/j.pedn.2007.02.003 18492543

55. Lean RE, Rogers CE, Paul RA, Gerstein ED. NICU Hospitalization: Long-Term Implications on Parenting and Child Behaviors. Curr Treat Options Pediatr. 2018;4(1):49–69. doi: 10.1007/s40746-018-0112-5 29881666

56. Schappin R, Wijnroks L, Uniken Venema MM, Jongmans MJ. Rethinking stress in parents of preterm infants: a meta-analysis. PLoS One. 2013;8(2):e54992. https://doi.org/10.1371/journal.pone.005499223405105

57. Tandberg BS, Froslie KF, Flacking R, Grundt H, Lehtonen L, Moen A. Parent-Infant Closeness, Parents’ Participation, and Nursing Support in Single-Family Room and Open Bay NICUs. J Perinat Neonatal Nurs. 2018;32(4):E22–E32. doi: 10.1097/JPN.0000000000000359 30358674

58. Flacking R, Thomson G, Axelin A. Pathways to emotional closeness in neonatal units—a cross-national qualitative study. BMC Pregnancy Childbirth. 2016;16(1):170. doi: 10.1186/s12884-016-0955-3

59. Flacking R, Thomson G, Ekenberg L, Lowegren L, Wallin L. Influence of NICU co-care facilities and skin-to-skin contact on maternal stress in mothers of preterm infants. Sex Reprod Healthc. 2013;4(3):107–12. doi: 10.1016/j.srhc.2013.06.002 24041731

60. Als H. A synactive model of neonatal behavioral organization. Physical & Occupational Therapy in Pediatrics. 1986;6(3–4):3–53.

61. Pineda R, Bender J, Hall B, Shabosky L, Annecca A, Smith J. Parent participation in the neonatal intensive care unit: Predictors and relationships to neurobehavior and developmental outcomes. Early Hum Dev. 2018;117:32–8. doi: 10.1016/j.earlhumdev.2017.12.008 29275070

62. Lyngstad LT, Tandberg BS, Storm H, Ekeberg BL, Moen A. Does skin-to-skin contact reduce stress during diaper change in preterm infants? Early Hum Dev. 2014;90(4):169–72. http://dx.doi.org/10.1016/j.earlhumdev.2014.01.01124548816

63. Philpott-Robinson K, Lane SJ, Korostenski L, Lane AE. The impact of the Neonatal Intensive Care Unit on sensory and developmental outcomes in infants born preterm: A scoping review. British journal of occupational therapy. 2017;80(8):459–69. doi: 10.1177/0308022617709761

64. Puthussery S, Chutiyami M, Tseng PC, Kilby L, Kapadia J. Effectiveness of early intervention programs for parents of preterm infants: a meta-review of systematic reviews. BMC Pediatr. 2018;18(1):223. https://doi.org/10.1186/s12887-018-1205-929986683

65. Pineda R, Guth R, Herring A, Reynolds L, Oberle S, Smith J. Enhancing sensory experiences for very preterm infants in the NICU: an integrative review. Journal of Perinatology. 2016;37(4):323. doi: 10.1038/jp.2016.179 27763631


Článek vyšel v časopise

PLOS One


2019 Číslo 11