A Randomized Controlled Trial of Listening Visits for Mothers of Hospitalized Newborns

Abstract

BackgroundEmotional distress is frequently experienced by mothers whose newborns are hospitalized in a neonatal intensive care unit (NICU). Among these women, there is a critical need for emotional support conveniently delivered at the newborn’s point of care by a trusted and medically knowledgeable professional: a NICU nurse. One promising way to enhance in situ delivery of emotional care is to have a NICU nurse provide Listening Visits (LVs), a brief support intervention developed expressly for delivery by nurses to depressed postpartum women.ObjectivesThis trial assessed the feasibility of having NICU nurses deliver LVs to emotionally distressed mothers of hospitalized newborns and compared depression outcomes in a small sample of participants randomized to LVs or usual care (UC).MethodsIn this pilot randomized controlled trial, emotionally distressed mothers of hospitalized newborns were randomized to receive up to six LVs from a NICU nurse or UC from a NICU social worker. To assess change in depression symptoms, women were invited to complete the Inventory of Depression and Anxiety Symptoms–General Depression Scale at enrollment and 4 and 8 weeks post-enrollment.ResultsDepression symptoms declined over time for both groups, with no difference between the two groups. A post hoc analysis of reliable change found higher rates of improvement at the 4-week assessment among recipients of LVs than UC.DiscussionNICU nurses successfully implemented LVs during this trial. Depression symptom scores did not significantly differ in the two groups posttreatment or at follow-up. Nevertheless, post hoc analyses indicated comparatively higher rates of clinical improvement immediately after LVs, suggesting the intervention can reduce maternal depression early on when women are most distressed.

Compassionate Care

“…This multiple case study was a secondary analysis of qualitative data collected during the RCT of Listening Visits for depressed mothers of hospitalized infants (Segre et al, 2023). We used the RCT dataset to answer a different research question that had been examined in the primary study, a research strategy recommended by Beck (2019).…”

“…Although embedded design examines cases at more than one level, a holistic design focuses on cases' global nature and aims to understand phenomena in real-world situation, a colla borative partnership, and em powering the mother. Clinical trial evaluations of Listening Visits in the NICU setting found promising outcomes (Segre et al, 2013;Segre et al, 2022;Segre et al, 2023); and that NICU mothers value this approach (Segre et al, 2016).…”

“…Despite substantial empirical support for the effectiveness of Listening Visits ( McCabe et al, 2021), no prior studies have documented what women discuss during these sessions. The randomized controlled trial (RCT) evaluation of Listening Visits delivered by bedside nurses to depressed mothers in the NICU was the first study to record Listening Visit sessions (Segre et al, 2023). This secondary analysis of the transcribed recordings provides insight into what NICU mothers discuss in these sessions.…”

“…The infant's health continued to be a prominent focus, either concerns over deteriorating health or celebrations of improving health and parenting milestones, e.g., being able to hold the baby for (Percival et al, 2017); all key components of Listening Visits. Together, NICU mothers' positive views as well as empirical support for the effectiveness of Listening Visits ( McCabe et al, 2021) including in the NICU (Segre et al, 2013;Segre et al, 2022;Segre et al, 2023) justifies our new focus: refining and codifying Listening Visits to facilitate its integration into routine clinical care. Important decisions that need to be made include, but are not limited to, determining eligibility for Listening Visits (e.g., mothers vs. depressed mothers, mothers only vs. mothers and fathers, etc.…”

“…The essential elements of Listening Visits (Hanley, 2015) and the definition of compassionate care (Altimier, 2015) directly align: supportive listening, a genuine interest and understanding of the mother's situation, a collaborative partnership, and empowering the mother. Clinical trial evaluations of Listening Visits in the NICU setting found promising outcomes (Segre et al, 2013; Segre et al, 2022; Segre et al, 2023); and that NICU mothers value this approach (Segre et al, 2016).…”