Sociodemographic risk factors, parental stress and social support in the neonatal intensive care unit

Abstract

ObjectiveInvestigate relationships among neonatal intensive care unit (NICU) parent demographics, reported stress and social support.DesignCross-sectional observation.SettingTertiary referral NICU in Mid-Atlantic USA.PatientsParents (n=300) in the Giving Parents Support trial at enrolment.MeasuresPsychometric scales measured general stress, parental stress, NICU stress and social support. Demographic variables included education level, health insurance type, race, relationship status, age and gender. Length of stay was used to control for illness severity. Associations and potential modifying effects were evaluated using linear regression.ResultsHaving less than a college degree (b=−2.52, SE=0.91) and female parent gender (b=−3.42, SE=1.47) were associated with lower parental stress scores. Older age in years was associated with higher parental stress scores (b=0.21, SE=0.07) but lower NICU stress scores (b=−0.01, SE=0.01). Greater social support scores were associated with lower scores of general (b=−2.76, SE=0.39) and parental stress (b=−1.71, SE=0.47). Less than a college degree (b=−0.26, SE=0.11), Medicaid insurance (b=−0.43, SE=0.11) and black race (b=−0.56, SE=0.12) were associated with decreased social support scores. Level of social support modified the relationship between education and parental stress, with higher social support decreasing education-based differences in parental stress scores (p=0.049).ConclusionSociodemographic risk factors may not infer stress or risk in the anticipated direction. Practice and future research should focus on identifying and supporting NICU families at high risk for stress and low support.Trial registration numberNCT02643472.

Parental stress and depression in the NICU: an analysis of psychosocial evaluations, infant factors, and stress-related salivary biomarkers

“…Elsewhere, Black and Hispanic mothers of NICU infants have been reported to experience more hospital and home life stressors 43, 44 . Also of note, recent studies have suggested that mothers who reside in lower-income homes and neighborhoods, respectively, report lower anxiety and postpartum traumatic symptoms 22, 24 .…”

“…In addition to parental distress related to an infant's clinical course and the NICU environment, other extrinsic factors may contribute negatively to parents' overall emotional health, such as travel distance from home to the NICU, stressful home situations, and parental pre-existing psychosocial stress [22][23][24] .…”

Does Educational Status Influence Parents’ Response to Bad News in the NICU?

“…So, we dealt with highly burdened parents but to a lesser extent than reported by Soghier et al [32], who found levels of depression in NICU parents by up to 45%, possibly due to the different survey tools. Younge et al [31] also found differences in stress scores among parents with different educational levels in NICUs, which may be due to the larger sample and a broader range of stress-related parameters that were collected. The detected differences only appeared in relation to parental and NICU-elicited stress parameters but not in the PSS-10.…”

“…Therefore, socioeconomic status seems to play an important role in NICUs whereat an infant s health risks generally increase with the lower educational status of the parents [3,[25][26][27][28][29][30]. Additionally, factors such as parents level of education, their age, and social support have been found to influence the level of stress experienced in NICUs [31,32]. Nevertheless, to our knowledge, no surveys have been conducted to investigate the influence of educational level on stress, well-being, and trust in physicians in NICUs in relation to BBN (Box 1).…”