Metaanálisis: efecto de las intervenciones para disminuir el nivel de estrés en padres de prematuros

Abstract

RESUMENIntroducción: el nacimiento prematuro de un bebé genera estrés en los padres, por el riesgo de aumento en la morbimortalidad que esto conlleva. Existen intervenciones que disminuyen el nivel de estrés en los padres beneficiando a su vez el neurodesarrollo del recién nacido. Objetivo: categorizar los principales componentes de los programas de intervención temprana y determinar el efecto de estas intervenciones en la disminución del nivel de estrés en padres de prematuros hospitalizados. Método: metaanálisis con 9 ensayos clínicos controlados, que cumplieron los criterios de rigurosidad metodológica. Resultados: las intervenciones aplicadas a los padres de prematuros hospitalizados mostraron efecto de intensidad media-baja sobre el nivel de estrés percibido (d=0,36 IC [-0.68, -0,05]). Sin embargo, las pruebas de heterogeneidad indican alta variabilidad inter-estudio (Q(df=8) = p-val: <0,00001), I2=85% ), explicada parcialmente por las características moderadoras codificadas para los estudios. Conclusiones: aunque las intervenciones mostraron efectos positivos en la disminución del nivel de estrés en los padres, se evidencia que la educación y el apoyo emocional en conjunto logran un mejor efecto. Las futuras investigaciones deben analizar aspectos como calidad de los estudios, intervenciones con apoyo emocional, edad de los padres y diversidad en los contextos de aplicación. PALABRAS CLAVEPadres; prematuro; estrés psicológico; intervención; metaanálisis; instrumentos; enfermería Neonatal (Fuente: DeCS, BIREME). The preterm birth of a baby stresses the parents, due to the risk of increased morbidity and mortality. Some interventions decrease parental stress levels while benefiting the neurodevelopment of the newborn. Objective: To categorize the main components of early intervention programs and to determine their effect in decreasing the stress levels of parents of hospitalized premature babies. Method: Meta-analysis with 9 controlled clinical trials that met the criteria of methodological rigor. Results: The interventions applied to parents of hospitalized premature babies showed a medium-low intensity effect on the perceived stress level (d=0.36 IC [-0.68, -0.05]). However, heterogeneity tests indicate high inter-study variability (Q(df=8) = p-val: <0.00001), I2=85% ), partially explained by the moderating coded features for the studies. Conclusions: Even though the interventions revealed positive effects in reducing parental stress levels, it is shown that education and emotional support achieve a better effect together. Future research should examine aspects such as the quality of studies, interventions with emotional support, parental age and diversity in application contexts.

Estresores parentales en Unidad de Cuidados Intensivos Pediátricos

“…The results obtained in this study could guide on the aspects to be improved in favor of less stress for parents, considering the local reality, with measures such as education and emotional support, which have shown positive effects in decreasing the level of parental stress 25,33 .…”

Preparação dos pais para a alta hospitalar da criança prematura: Análise de conceito

“…Os programas educacionais para a alta, podem reduzir o estresse percebido pelos pais. A educação e o apoio emocional fornecidos conjuntamente conseguem melhor efeito (39). Ingram e col. (40), descreveram no seu estudo qualitativo que os pais percebem que o programa educacional para o cuidado no lar, presta-lhes esperança, fortalecendo a sua importância no preparo emocional.…”

Effect of Reiki as a stress management technique for parents of hospitalized neonates

“…[9][10][11][12] Various nursing interventions for the management of parental stress in parents whose newborns are admitted to the NICU may have beneficial effects on their mental health, depending on the severity of the newborn's illness. [13][14][15] Reiki is a vibrational therapy that is generally applied by gentle touch and is credited with the ability to balance the biofield and strengthen the body's ability to heal itself; it is increasingly used as a complement to conventional medical care, both in and out of the hospital setting. 16 Integrated and complementary practices provide a possibility of improvement in the quality of life of individuals suffering from various diseases, among which Reiki stands out.…”