Stress and distress in parents of neonates admitted to the neonatal intensive care unit for cardiac surgery

Diffin, Janet; Spence, Kenneth W.; Naranian, T.; Badawi, Nadia; Johnston, Linda

doi:10.1016/j.earlhumdev.2016.08.002

Cited by 38 publications

(33 citation statements)

References 48 publications

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“…These stressors include separation from parents and family, unfamiliar environment, investigations and treatments, and loss of self‐determination. However, having a child hospitalised is also stressful for parents and families (Commodari, ; Diffin, Spence, Naranian, Badawi, & Johnston, ; Power & Franck, ). Parents' sleep, when accommodated at the hospital during the child's admission, can be challenging, and parents' disrupted sleep over a long time is experienced as a burden, is stressful and reduces their quality of life (Doering & Durfor, ).…”

Section: Introductionmentioning

confidence: 99%

A systematic integrative review of parents' experience and perception of sleep when they stay overnight in the hospital together with their sick children

Løyland

Angelhoff

Kristjánsdóttir

et al. 2019

Journal of Clinical Nursing

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Aims and objectives To elucidate knowledge available on parents' experience and perception of sleep when they stay overnight in hospital together with their sick children. Background In Nordic countries, children are entitled to have at least one parent with them during hospitalisation. Parents' sleep, when accommodated at the hospital during the child's admission, may be a challenge. Design A systematic literature search was conducted in EMBASE, MEDLINE and PsycINFO; period is restricted from 1 January 2007 to 1 April 2019. Studies included were those in which parents were accommodated in hospital with their child, 0–18 years of age, for at least one night. Original peer‐reviewed scientific research papers conducting qualitative, quantitative or mixed designs were included. Systematic reviews were not included. This systematic integrative review was registered in PROSPERO and performed according to the PRISMA guidelines. All authors participated in study selection, data extraction and quality assessment of the literature. Results Fifteen studies were included, and they varied in terms of origin, aims, design, methods used and sample size. Three overall main themes appeared: sleep quality, factors affecting sleep and consequences of sleep loss. Combined psychological factors were found to affect parents' sleep, as well as isolated psychological factors, for example, stress, anxiety, worries and difficult thoughts. Environmental and social factors were also identified, for example, privacy and caring for family. Conclusion Study of this subject is still in its exploratory phase. There is a need for the development of theory of substance in the clarification of the meaning of sleep among parents during difficult times such as children's hospitalisation. Relevance to clinical practice Understanding risk factors associated with sleep and sleep deprivation in parents staying overnight in the hospital with their sick child is important, since lack of sleep may lead to serious stress‐related outcomes for the parents.

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Section: Introductionmentioning

confidence: 99%

A systematic integrative review of parents' experience and perception of sleep when they stay overnight in the hospital together with their sick children

Løyland

Angelhoff

Kristjánsdóttir

et al. 2019

Journal of Clinical Nursing

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“…Over the past decade, survival rates in surgical neonatal units in Australia have risen above 95% . As survival increases and major neurodevelopmental consequences, such as cerebral palsy, decrease, health professionals are turning their attention to psychosocial consequences such as parental depression and attachment disorders . Parents of hospitalised newborns face many challenges, giving rise to a variety of needs, and it has been shown that parents of preterm newborns and infants requiring neonatal surgery for complex congenital cardiac anomalies experience significant stress.…”

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confidence: 99%

Needs of parents in a surgical neonatal intensive care unit

Govindaswamy

Laing

Waters

et al. 2018

J Paediatrics Child Health

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Aim While there is evidence of parental needs in the neonatal intensive care unit (NICU), parents of newborns admitted for general surgery are an under‐researched population. This study aimed to identify needs in parents of newborns admitted to the NICU for general surgery and whether health‐care professionals meet these needs. Methods This was a prospective cohort study of 111 parents (57% mothers) of newborns admitted to a surgical NICU for general surgery in Australia from January 2014 to September 2015. Parents completed the Neonatal Family Needs Inventory (NFNI), comprising 56 items in five subscales (Support, Comfort, Information, Proximity, Assurance) at admission and discharge, as well as the Social Desirability Scale (SDS). Data were analysed using parametric and non‐parametric techniques. Results At both admission and discharge, parents rated Assurance (M = 3.8, standard deviation (SD) = 0.24) needs as the most important, followed by Proximity (M = 3.6, SD = 0.32) and Information (M = 3.5, SD = 0.38). Mothers rated Assurance significantly more important than fathers (P < 0.02). Overall, parents' most important needs were having questions answered honestly (M = 3.96, SD = 0.19), seeing their infant frequently and knowing about the medical treatment (both M = 3.95, SD = 0.23). The 10 most important needs were met for more than 96% of parents, with no evidence of response bias. Conclusions Reassurance is a priority need for parents in the surgical NICU. Mothers' and fathers' needs may be best met by practices based on family‐centred, individualised care principles.

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“…Parents are not expected to rate the stressfulness of any non‐experienced items. The tool is widely used with psychometric properties evaluated and reliability demonstrated in the Australian context . The internal consistency of the PSS: NICU has also been shown to be acceptable ( α > 0.70) .…”

Section: Methodsmentioning

confidence: 99%

“…For many parents, their infant's admission to neonatal intensive care unit (NICU) may lead to fear, shock, stress, anxiety and feelings of helplessness . In addition to having a sick newborn, the need for surgery soon after birth can present many unseen and stressful challenges to parents . These stressors could affect parents coping ability and infant–parent bonding leading to attachment problems …”

mentioning

confidence: 99%

“…While there is extensive evidence demonstrating stress in parents of preterm and low‐birthweight infants in NICU, less is known about stress in parents of newborns undergoing general surgery . Several studies reporting high levels of stress in parents of preterm and term infants admitted to NICU for medical and/or surgical management do not distinguish findings for parents whose infants required surgery . While there are many commonalities across NICU environments, there are also some sights, sounds and challenges that are specific to surgical units and that confront parents whose infants have major congenital anomalies requiring newborn surgery.…”

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confidence: 99%

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Stressors of parents of infants undergoing neonatal surgery for major non‐cardiac congenital anomalies in a surgical neonatal intensive care unit

Govindaswamy

Laing

Waters

et al. 2019

J Paediatrics Child Health

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Aim: As more babies survive major neonatal surgery, the quality of life of the whole family is a major focus of health care. While there is evidence suggesting that parents of babies admitted to neonatal intensive care units (NICUs) experience high levels of stress, little is known about stressors in parents whose infants also require neonatal surgery. This study identified fathers' and mothers' stressors in a surgical NICU. Methods: Parents of infants admitted for general surgery to the NICU at a tertiary children's hospital from February 2014 to September 2015 were eligible for enrolment. Parents completed the Parental Stressor Scale: NICU to measure levels of stress related to three subscales: sights and sounds, infant appearance and parental role alteration, using a 5-point Likert scale. Results: Data for 111 parents (57% mothers) showed parental role alteration as the greatest stressor for parents (M = 2.98, standard deviation (SD) = 0.89), particularly for mothers, followed by infant appearance (M = 2.84, SD = 0.95). Both fathers and mothers rated feeling helpless (M = 4.1, SD = 1.0), unable to protect their baby (M = 4.1, SD = 0.9) and seeing their baby in pain (M = 3.9, SD = 1.2) the most common, most stressful experiences and highest contributors to overall stress in the surgical NICU environment. Conclusion: Parental role alteration is the greatest stressor for parents in the surgical NICU. Reducing stress for parents of infants undergoing neonatal surgery requires management of the infant's pain and strategies to support parents in their role in the NICU.

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Stress and distress in parents of neonates admitted to the neonatal intensive care unit for cardiac surgery

Cited by 38 publications

References 48 publications

A systematic integrative review of parents' experience and perception of sleep when they stay overnight in the hospital together with their sick children

A systematic integrative review of parents' experience and perception of sleep when they stay overnight in the hospital together with their sick children

Needs of parents in a surgical neonatal intensive care unit

Stressors of parents of infants undergoing neonatal surgery for major non‐cardiac congenital anomalies in a surgical neonatal intensive care unit

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