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

Abstract

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.

Neonatal medical trainee doctors' perceptions and parents' self‐reported needs and stressors in a surgical neonatal intensive care unit: An individualised approach

“…A previous study has reported infant pain management as a priority concern for fathers in an SNICU. 4,13 It may be that the doctors were either confident that pain management strategies were in place or that doctors' underestimate parents' stress. 14 This underestimation extended to understanding that parents want to feel free to choose to stay or leave during painful procedures.…”

“…Research consistently shows that NICU professionals focus more than parents on NICU environmental sights and sounds, often at the cost of overlooking parents' emotional needs. 4,6,29 Educating all health professionals about these approaches to parent and infant care as part of their SNICU orientation is important to support changes in their role and practices.…”

“…Detailed methods of this multidimensional study and psychometric properties of these tools have been reported elsewhere. 4,10 Doctors and parents completed demographic information and the questionnaires between 48 and 72 h of the infant's NICU admission and requested to return these in a sealed envelope to the PI. This timeframe was chosen because this is when the baby is most likely to have surgery and both parents be present in the SNICU.…”

“…Due to the decreasing mortality in the NICU, the focus is now on quality care, family experiences and quality survival. This includes supporting parents through this stressful time, particularly given the potential for long‐term adverse consequences following NICU admission 3–5 …”

“…This includes supporting parents through this stressful time, particularly given the potential for long-term adverse consequences following NICU admission. [3][4][5] There are no published studies focusing on doctors' perceptions of parents' needs or stressors in the NICU, although doctors were included in two studies that compared health-care professionals' and parents' perceptionsone looking at NICU practices 6 and the other at parental support. 7 However, neither compared doctor and parent perceptions or discerned findings regarding surgery.…”