Early intervention program reduces stress in parents of preterms during childhood, a randomized controlled trial

Abstract

BackgroundIt is well documented that heightened levels of parenting stress have a negative influence on children’s socio-emotional and behavioral development. Parenting stress may therefore be regarded as an outcome variable in its own right. This study investigated whether a sensitizing intervention influences stress reported by parents of prematurely born children until the children were age nine.MethodsPreterm infants (N =146, birth weight <2,000 g) were randomized to intervention (N =72) with the Mother-Infant Transaction Program (MITP) or a preterm control group (N =74) that received standard hospital care. A term reference group comprised 75 healthy, full-term neonates. Parents reported on the Parenting Stress Index (PSI) when the children were 6 months, 1, 2, 3, 5, 7 years old and on the PSI-Short Form (PSI-SF) at age 9. Main outcomes were the mother’s and father’s reports of total, child and parent-related stress. Cross-sectional and longitudinal analyses were performed using linear mixed models (LMM), taking dependency in the data caused by twin pairs and repeated measures into account. Response rates were high across all follow-ups, and still reached 85% from mothers and 72% from fathers at 9 years.ResultsMothers in the intervention group reported better longitudinal development of child-related stress than mothers of preterm controls, as they perceived their children as being more adaptable and less moody throughout childhood until the age of seven. Less stress in the intervention group was revealed by cross-sectional analysis of maternal reports at all ages, while fathers reported similar differences at ages three and five. Parents in the intervention group reported stronger agreement on several stress scores on several occasions. Fathers with high interventional participation (mean 54%) reported significantly less stress at age nine than those who participated less. Both parents in the intervention group reported levels of stress similar to those experienced by the term reference group at all follow-ups, while differences between the preterm control and term reference groups increased.ConclusionsThis early intervention reduces stress among parents of prematurely born children to a level reported by parents of term-born children and enhances agreement between parents.Trial registrationClinical Trials Gov identifier NCT00222456, 05.09.2005.

Erfaringer fra lærings- og mestringskurs for foreldre til premature barn

“…Med sensitivering forstår man en større oppmerksomhet rundt premature barns signaler, hvordan de uttrykker seg og hvordan den voksne responderer (Slinning, Hansen, Moe og Smith 2010). Nyere norsk forskning rapporterer at tidlig intervensjon og foreldreveiledning reduserer stress hos foreldre til premature barn i tillegg til å bedre barnas skoleprestasjoner (Landsem et al 2014, Landsem et al 2015. Denne forskningen baserer seg på implementering av en strukturert foreldreopplaering, Prematurprosjektet 2000 (Tunby 2003).…”

“…Behovet kan også gjelde foreldre til barn født etter uke 30 (Rowe og Jones, 2010). Nyere forskning kan tyde på at foreldrekurs i den form som er beskrevet her ikke er tilstrekkelig for en optimal oppfølging av barna og familien (Landsem et al 2014, Landsem et al 2015og Nordhov et al2010). …”

Early intervention program for very low birth weight preterm infants and their parents: a study protocol

“…Any early intervention for high risk preterm infant must focus in the parents-infant relationship, environment and behavior attitudes in order to reduce stress among parents of prematurely born children and improves neurovelopment outcome their children during childhood [6]. So, our main hypotheses is that a continuous global early stimulation done by parents at home for very preterm infants is better than the traditional one, and it can be offered to many very preterm infants even in poor environments.…”

Os primeiros dias do filho prematuro em casa: discurso do sujeito coletivo

“…Para além do período de hospitalização, seu papel se amplia no domicílio. Como cuidador, interage de modo diferente com o filh , introduzindo novidades e desafio , contribuindo com o desenvolvimento cognitivo e empático da criança com os pais (10) . Pode estar envolvido de muitas formas com o bebê: brincando, cuidando, ensinando, provendo suporte financeiro, demonstrando afeto, compartilhando com a mãe atividades, responsabilidades e preocupações a respeito da criança (7) .…”