Family Reactions During Infants' Hospitalization in the Neonatal Intensive Care Unit

ABSTRACT

The purpose of this investigation is to assess family stress, coping, perceptions of their infant, and alterations in mood that may result from the hospitalization of their critically ill newborn infant. Eligible patients were those infants hospitalized in the Special Care Nursery (SCN) at Christiana Care Health Services, who were born up to 31 weeks' gestational age. Twenty-seven families (mothers and/or fathers) completed four questionnaires at 2-week intervals during the course of their premature infants' hospitalization. Data were primarily evaluated by using analysis of variance (ANOVA)/multivariate analysis of variance (MANOVA). A score for neonatal acute physiology (SNAP) was obtained in each infant to assess the effect of the severity of neonatal illness on the questionnaire variables. Families with high stress scores on the Parental Stressor Scale had different coping strategies than those with less stress scores. A high level of maternal depressive symptomatology was associated with altered methods of coping, general stress, and perception of infant health. There was no relationship between the SNAP score on the overall level of stress families. Families who completed more than two questionnaires differed from those who only completed two or less questionnaires, although the sample size was too small to assess longitudinal changes in this study population. Level of stress and depressive symptoms are two major influences of how families cope with the current hospitalization of a premature infant. The degree of neonatal illness is not a major contributor to the parents' coping ability. Healthcare providers need to understand these dynamics when supporting families during the hospitalization of their premature infant.

KEYWORDS

Premature infant - family coping - stress

REFERENCES

• 1 Coffman S, Levitt M J, Deets C. Personal and professional support for mothers of NICU and healthy newborns.  J Obstet Gynecol Neonatal Nurs . 1995;  20 406-415
• 2 Hill Y W. Children in intensive care: can nurse-parent partnership enable the child and family to cope more effectively?.  Intensive Crit Care Nurs . 1996;  12 155-160
• 3 Jeffcoate J A, Humphrey M E, Lloyd J K. Role perception and response to stress in fathers and mothers following pre-term delivery.  Soc Sci Med . 1979;  13 139-145
• 4 Halm M A, Titler M G, Kleiber C. Behavioral responses of family members during critical illness.  Clin Nurs Res . 1993;  2 414-437
• 5 Chartier L, Coutu-Wakilczyk G C. Families in ICU: their needs and anxiety level.  Intensive Care . 1989;  5 11-18
• 6 Epps S. Effects of infant chronic illness and prematurity on parent stress, anxiety, and health locus of control. Poster presentation, Association for the Advancement of Behavior Therapy, November 1992, Boston, MA
• 7 Epps S. Parenting stress and health locus of control associated with infant prematurity. Family Issues in Pediatric Psychology: The Fourth Florida Conference on Child Health Psychology, April, 1993, Gainesville, FL
• 8 Miles M S, Carson J, Funk S G. Sources of support reported by mothers and fathers of infants hospitalized in a neonatal intensive care unit.  Neonatal Network . 1996;  15 45-52
• 9 Miles M S, Funk S G, Carlson J. Parental Stressor Scale: neonatal intensive care unit.  Nurs Res . 1993;  42 148-152
• 10 Miles M S, Funk S G, Kasper M A. The stress response of mothers and fathers of preterm infants.  Res Nurs Health . 1992;  15 261-269
• 11 Spielbereger C D, Goruch R L, Lushene R E. Manual for the State-Trait Anxiety Inventory.  Palo Alto, CA: C.P.P., Inc. 1983
• 12 Philichi L M. Family adaptation during a pediatric intensive care hospitalization.  J Pediat Nurs . 1989;  4 268-276
• 13 Aldwin C, Revenson T. Does coping help?.  <~>A reexamination of the relation between coping and mental health. J Personality Soc Psychol . 1987;  53 337-348
• 14 Schlump-Urquhart S R. Families experiencing a traumatic accident: implications and nursing management.  AACN . 1990;  1 522-535
• 15 Crnic K A, Greenberg M T, Ragozin A S. Effects of stress and social support on mothers and premature and full-term infants.  Child Dev . 1983;  54 209-217
• 16 Kleiber C, Halm M, Titler M. Emotional responses of family members during a critical care hospitalization.  Am J Crit Care . 1994;  3 70-76
• 17 Singer L, Salvator A, Guo S. Maternal psychological distress and parenting stress after the birth of a very low-birth-weight infant.  JAMA . 1999;  281 799-805
• 18 Koller P A. Family needs and coping strategies during illness crisis.  AACN Clin Issues Crit Care Nurs . 1991;  2 338-345
• 19 Lazarus R S, Folkman S. Stress, appraisal, and coping.  New York: Springer 1984
• 20 Meyers E, Coll C, Seifer R. Psychological distress in mothers of preterm infants.  J Dev Behav Pediatr . 1995;  16 412-417
• 21 Hansen M, Young D A, Carden F E. Psychological evaluation and support in the pediatric intensive care unit.  Pediatr Ann . 1986;  15 60-69
• 22 Lynn-McHale D, Bellinger A. Need satisfaction levels of family members of critical care patients and accuracy of nurses' perceptions.  Heart Lung . 1988;  17 447-453
• 23 Weissman M, Sholomskas D, Pottenger M, Prusoff B. Assessing depressive symptoms in five psychiatric populations: a validation study.  Am J Epidemiol . 1977;  106 203-214
• 24 Richardson D K, Gray J E, McCormick M C. Score for neonatal acute physiology: a physiologic severity index for neonatal intensive care.  Pediatrics . 1993;  91 617-623