Telehealth Listening Visits for emotionally distressed mothers of hospitalized newborns: Proof-of-concept

Abstract

ProblemNewborn admission to the neonatal intensive care unit (NICU) is stressful. Yet in clinical practice, at best, NICU mothers are screened for depression and if indicated, referred to a mental-health specialist. At worst, no action is taken. Listening Visits, an empirically supported nurse-delivered intervention addressing emotional distress, can be conveniently provided by a NICU nurse. Prompted by the need to minimize face-to-face contacts during the pandemic, the primary purpose of this small pilot trial was to assess the feasibility of having nurses provide Listening Visits to NICU mothers over Zoom. Secondarily, we assessed pre-to post-Listening Visits depression symptom scores as a preliminary evaluation of the effectiveness of this type of support.Materials and methodsNine NICU mothers with mildly to moderately severe depression symptoms received up to six Listening Visits sessions from a NICU nurse via Zoom. Participants completed the Inventory Depression and Anxiety Symptoms-General Depression scale (IDAS-GD) at study entry and 4- and 8-weeks post enrollment. They completed the Client Satisfaction Questionnaire (CSQ) at the 8-week assessment.ResultsUsing an intent-to-treat approach, the effect of time from the mixed model analysis of IDAS-GD was statistically significant (F(2,26) = 10.50, p < 0.001), indicating improvement in IDAS-GD scores from baseline to follow-up. The average CSQ score was high (M = 29.0, SD = 3.3), with 75% of participants rating the quality of help they received as “excellent”.DiscussionIn this pilot trial, we learned it is feasible to provide Listening Visits over Zoom, that this mode of delivery is associated with a significant decrease in depression symptom scores, and that women value this approach.Clinical trial registration[https://clinicaltrials.gov/], identifier [#201805961].

Improving Maternal Depression Screening in the Neonatal Intensive Care Unit

“…This RCT was halted because of the COVID-19 pandemic. To evaluate Listening Visits delivered by NICU nurses via zoom (Segre et al, 2022), a subsequent open-pilot trial enrolled women from February 2021 to May 2022. Procedures for both trials were approved by the University's institutional review board (IRB) and registered with a single Clinical Trials.gov.…”

Compassionate Care

“…The infant's health continued to be a prominent focus, either concerns over deteriorating health or celebrations of improving health and parenting milestones, e.g., being able to hold the baby for (Percival et al, 2017); all key components of Listening Visits. Together, NICU mothers' positive views as well as empirical support for the effectiveness of Listening Visits ( McCabe et al, 2021) including in the NICU (Segre et al, 2013;Segre et al, 2022;Segre et al, 2023) justifies our new focus: refining and codifying Listening Visits to facilitate its integration into routine clinical care. Important decisions that need to be made include, but are not limited to, determining eligibility for Listening Visits (e.g., mothers vs. depressed mothers, mothers only vs. mothers and fathers, etc.…”

“…Although embedded design examines cases at more than one level, a holistic design focuses on cases' global nature and aims to understand phenomena in real-world situation, a colla borative partnership, and em powering the mother. Clinical trial evaluations of Listening Visits in the NICU setting found promising outcomes (Segre et al, 2013;Segre et al, 2022;Segre et al, 2023); and that NICU mothers value this approach (Segre et al, 2016).…”

“…The essential elements of Listening Visits (Hanley, 2015) and the definition of compassionate care (Altimier, 2015) directly align: supportive listening, a genuine interest and understanding of the mother's situation, a collaborative partnership, and empowering the mother. Clinical trial evaluations of Listening Visits in the NICU setting found promising outcomes (Segre et al, 2013; Segre et al, 2022; Segre et al, 2023); and that NICU mothers value this approach (Segre et al, 2016).…”

Curso Online Sobre Escuta Empática Para Rastreio E Acompanhamento Da Depressão Pós-Parto

“…Essa intervenção foi concebida para cuidado de mulheres com sintomas de tristeza e ansiedade pós-parto (7) . Posteriormente, pesquisadoras norteamericanas adaptaram a intervenção de forma que pudesse ser implementada por enfermeiros (7,8) e promoveram junto a esses profissionais oficinas didáticas e atividade de simulação, a fim de desenvolver habilidades de empatia, colaboração, não diretividade e autonomia/apoio (9,10) . A intervenção citada ainda não foi desenvolvida nos países da América Central de do Sul, o que remonta a importância desse conhecimento aos enfermeiros que atuam nessa localidade.…”