Maternal Anxiety and Attitudes to Universal Neonatal Hearing Screening

Abstract

Neonatal hearing screening of all babies within the maternity unit is now feasible using transient evoked otoacoustic emission (TEOAE) recording. However, in many maternity units in the United Kingdom, the majority of babies are discharged within the first 48 hours. During the first two days of life, there is a higher proportion of babies in whom emissions cannot be recorded. A universal TEOAE hearing screen has been implemented in Whipps Cross Hospital. As 70% of the babies are discharged from the maternity unit before they are 48 hours old, a two stage screen was implemented, with failure at the initial TEOAE test being followed by a retest after 4-6 weeks. The maternal anxiety caused by this model was investigated in 288 mothers enrolled for the initial TEOAE test. Generally, anxiety was low and attitudes towards the screen were positive. Ninety-seven per cent of mothers considered the screen to be worthwhile at the initial test with 15% feeling it had caused some anxiety but less than 1% being very worried. The mothers who had some anxieties were not dissatisfied with the screen, and within this group there was no increase in the proportion of babies who had failed the initial test. At the retest, two of 57 mothers (3.5%) considered they were very worried, but there was no significant deterioration in attitude towards the screen. Spielberger's State-Trait Anxiety Inventory revealed no significant difference in the anxiety state of the retest group when compared with a control group whose babies had not received a neonatal hearing test. The results of the initial test and the retest did not influence the anxiety state of the mothers. Ways of minimizing anxiety caused to a minority of mothers whilst maintaining positive attitudes to the screen are discussed.

Newborn screening for congenital heart defects: a systematic review and cost-effectiveness analysis

“…398 Anxiety during the screening process or experience of a false positive result does not decrease a parent's willingness to undertake screening of subsequent children. 357,358,363,368,369,373,375 However, lower support for screening is shown by parents who have experienced delay between screening and final diagnosis on a previous occasion, 385 who do not feel they were fully informed about the screening process 370,374 or whose children have been found to have a minor problems for which no intervention is needed. 358 Screening is less likely to be declined when it is offered in person or as an adjunct to routine care.…”

“…355 Increased anxiety within a newborn screening programme has also been related to being given too little information about the screening process, rather than about test results, 356 and mothers report that separation from their baby during a screening test is the trigger for their anxiety. 357 In a study of newborn hearing screening, the critical anxiety points in the screening pathway were identified as the repeat screening test, when anxiety increased significantly, and receiving a definite answer as to whether the child was affected or not, when anxiety subsided. 358 This reduction of anxiety on confirming a diagnosis has also been found elsewhere.…”

Rapid testing for group B streptococcus during labour: a test accuracy study with evaluation of acceptability and cost-effectiveness

“…Satisfaction with information provided on GBS, the study and treatment (10 items 116 This was developed for similar populations and has been widely used in screening studies. 117 ii. Illness perceptions in the baby -illness perceptions of the identity, severity, chronicity and controllability of GBS infection were measured using an adapted version of the Brief Revised Illness Perceptions Questionnaire 118 (8 items).…”

Maternal anxiety following newborn hearing screening: the moderating role of knowledge

“…[8][9][10][11] The aim of the present study was to describe the emotional impact upon mothers of receiving a referral for diagnostic testing following newborn hearing screening. On the basis of increased testing and the different implications of different results, it was predicted that anxiety would increase linearly with the number of tests needed.…”