Symptoms of depression in parents after discharge from NICU associated with family‐centred care

Axelin, Anna; Feeley, Nancy; Cambell‐Yeo, Marsha; Tandberg, Bente Silnes; Szczapa, Tomasz; Wielenga, Joke M.; Weis, Janne; Bošnjak, Anita Pavičić; Jónsdóttir, Rakel; George, Kendall; Blomqvist, Ylva Thernström; Bohlin, Kajsa; Lehtonen, Liisa

doi:10.1111/jan.15128

Cited by 24 publications

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“… 20 , 21 Such care practices have been shown to be associated with lower levels of depressive symptoms in parents of preterm infants. 22 Second, the intervention increased maternal presence by 41% and skin‐to‐skin contact by 38% when we compared pre‐ and post‐intervention groups in nine Finnish neonatal units. 23 Skin‐to‐skin contact, in turn, has been shown to have a small protective effect on postnatal depression symptoms among the mothers of preterm infants, probably through oxytocin production stimulation and attachment promotion.…”

Section: Discussionmentioning

confidence: 99%

“…First, the Close Collaboration with Parents intervention has been shown to improve units’ family‐centred care practices by, for example promoting a mutual partnership between staff and parents, the involvement of parents in the care of the infant and decision‐making related to care and the provision of emotional support to parents 20,21 . Such care practices have been shown to be associated with lower levels of depressive symptoms in parents of preterm infants 22 . Second, the intervention increased maternal presence by 41% and skin‐to‐skin contact by 38% when we compared pre‐ and post‐intervention groups in nine Finnish neonatal units 23 .…”

Section: Discussionmentioning

confidence: 99%

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Fewer maternal depression symptoms after the Close Collaboration with Parents intervention: Two‐year follow‐up

et al. 2022

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Several parenting interventions, which have been delivered during neonatal intensive care, have shown promising results, especially in decreasing postnatal depression symptoms among the mothers of preterm infants. 1 These findings are vital, as the elevated risk of postnatal depression continues to be a significant issue among the parents of preterm infants. A recent review reported that the proportion of mothers of preterm infants exceeding the cut-off for clinical PPD varied from 6.6% to 42.9% suggesting that preterm delivery

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Fewer maternal depression symptoms after the Close Collaboration with Parents intervention: Two‐year follow‐up

et al. 2022

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“…Depressive symptoms among the parents of preterm infants varied between the units despite using the same methods, cut-offs, and age points. Depressive symptoms associated with the quality of family-centered care reported by the parents ( Axelin et al, 2021 ). This variation suggests that there are care practices which are more successful in supporting the parents’ psychological well-being than others.…”

Section: Discussionmentioning

confidence: 99%

“…This study question was one of the two main aims of the 2nd International Closeness Survey. The other aim was to study the association between the quality of family-centered care in the units and later parental depression ( Axelin et al, 2021 ). STROBE guidelines were followed in reporting the study.…”

Section: Methodsmentioning

confidence: 99%

Parent–infant closeness after preterm birth and depressive symptoms: A longitudinal study

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BackgroundPreterm birth increases the risk for postpartum depression in both mothers and fathers, calling for strategies to alleviate and prevent depressive symptoms in parents of preterm infants. The aim of this study was to assess the association between early parent-infant closeness and later depressive symptoms among parents of preterm infants. We hypothesized that longer duration of closeness associate with fewer depressive symptoms in both parents.MethodsThis prospective cohort study included 23 neonatal intensive care units (NICUs) from 15 countries in 2018 to 2020. Each unit recruited families with preterm infants aiming to 30 families. The total duration of parents’ presence in the NICU, and separately parent-infant skin-to-skin contact and holding, were measured using a Closeness Diary up to 14 days. The Edinburgh Postnatal Depression Scale (EPDS) was used at discharge and at 4 months corrected age of the infant.ResultsThe study included 684 mothers and 574 fathers. The median presence was 469 min (Q1 258 and Q3 1,087) per 24 h for the mothers and 259 min (Q1 100 and Q3 540) for the fathers; mean EPDS scores were 9.2 (SD 5.0) and 6.3 (SD 4.4) at discharge and 6.6 (4.7) and 4.3 (4.2) at 4 months, respectively. Parents’ presence and depressive symptoms varied greatly between the units. Parents’ presence as the total measure, or skin-to-skin contact and holding separately, did not associate with depressive symptoms in either mothers or fathers at either time point (adjusted).ConclusionNo association was found between the duration of parent-infant closeness in the neonatal unit and parents’ depressive symptoms. The beneficial effects of family-centered care on parents’ depression seem to be mediated by other elements than parent-infant physical closeness. More research is needed to identify the critical elements which are needed to alleviate parents’ depression after NICU stay.

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“…Admission to a NICU is often acute, and parents have little opportunity to shape expectations about the care for their infants. Still, they often face critical decisions and can experience stress during their admission ( 11 – 13 ). Standardized assessment of the experiences of parents in the care of their infants in the NICU is not formally assessed, which could potentially provide data for improving clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Validation of the Chinese Empowerment of Parents in the Intensive Care (EMPATHIC-30) Questionnaire Among Parents in Neonatal Intensive Care Units: A Prospective Cross-Sectional Study

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BackgroundThere are no specific validated questionnaires assessing satisfaction of family-centered care experienced by parents of infants hospitalized in Chinese Neonatal Intensive Care Units (NICU).AimTo adapt and test the reliability and validity of the Chinese version of the EMPATHIC-30 questionnaire in NICU settings.MethodsA prospective, cross-sectional design was adopted. The EMPATHIC-30 questionnaires were completed by parents of infants admitted to one of the four NICUs at Hunan Children's Hospital, China, between November 2018 and 2019. Inclusion criteria were parents whose infants were admitted to the NICU for at least 5 days. Exclusion criteria were parents whose children were discharged within 5 days after admission or whose infants died in the NICU. Reliability was tested with Cronbach's alpha. The congruent validity was tested using Spearman's Rank correlation analysis, and the non-differential validity was tested using Cohen's d.ResultsParents of 619 infants discharged from the NICUs completed and returned the questionnaire. Most infants were male (n = 337, 54.4%) and infants' length of stay was a median of 21 days (IQR = 14–37). Mostly, mothers completed the questionnaire (n = 523, 84.5%). The Cronbach's alpha values of the five individual domains were between 0.67 and 0.95, and the alpha of the total questionnaire was.90, providing an adequate internal consistency. Congruent validity was measured by correlating the five domains with four standard satisfaction scales, documenting a weak correlation (rs −0.025–0.327). Non-differential validity showed some significant effect size between four binary variables (mechanical ventilation, unplanned admission, admission after surgery, length of stay) four of the five domains.ConclusionThe Chinese version of EMPATHIC-30 questionnaire showed acceptable psychometric properties. This instrument might be considered a suitable instrument to measure parent satisfaction among Chinese parents whose infants are admitted to an NICU. Measuring parent satisfaction with this instrument might contribute to improving family-centered care initiatives in NICUs with Chinese parents.

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Symptoms of depression in parents after discharge from NICU associated with family‐centred care

Abstract: Aims:The aim of this study was to examine the potential association of family-centred care as perceived by parents during a NICU stay with parents' depressive symptoms at discharge and at 4 months corrected for infant age.

Cited by 24 publications

References 50 publications

Fewer maternal depression symptoms after the Close Collaboration with Parents intervention: Two‐year follow‐up

Fewer maternal depression symptoms after the Close Collaboration with Parents intervention: Two‐year follow‐up

Parent–infant closeness after preterm birth and depressive symptoms: A longitudinal study

Validation of the Chinese Empowerment of Parents in the Intensive Care (EMPATHIC-30) Questionnaire Among Parents in Neonatal Intensive Care Units: A Prospective Cross-Sectional Study

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