Stress management interventions for parents having hospitalized newborns: an integrative literature review
Section: Reviews
How to quote
Hidalgo Mares B, Rivera Heredia ME, Ortega Jiménez MC. Intervenciones en el manejo de estrés para los padres con neonatos hospitalizados: revisión integrativa de la literatura. Rev. iberoam. Educ. investi. Enferm. 2020; 10(4):45-55.
Authors
1 Brenda Hidalgo Mares, 2 María Elena Rivera Heredia, 3 Mayra del Carmen Ortega Jiménez
Position
1 Estudiante de la Maestría en Ciencias de Enfermería. División de Ciencias de la Salud e Ingenierías (DCSI) del Campus Celaya-Salvatierra (CCS) de la Universidad de Guanajuato (UG). Celaya, Gto. México. 2 Doctora en Psicología. Adscrita a la Facultad de Psicología de la Universidad Michoacana de San Nicolás de Hidalgo. Morelia, Mich. México.3 Maestra en Ciencias de Enfermería. Adscrita al Departamento de Enfermería Clínica (DEC) de la DCSI del CCS de la UG. Enfermera Especialista en Cuidados Críticos.
Contact email: brenda.hidalgo20@outlook.com
Abstract
Introduction: the admission of a newborn to the neonatal intensive care unit (NICU) can be a stressful event for parents; neonatal disease, technological environment in the unit, and loss of the expected parental role are associated to parental stress.
Purpose: to assess the interventions implemented to address stress in parents having a NICU-admitted newborn from 2012 to the present.
Methods: an integrative literature review was performed based on several databases, including PubMed (NCBI), Science Direct and Google Scholar, and using the following descriptors: “nursing”, “parents”, “NICU”, “parental stress”, “intervention”, “newborn” and the Boolean operator AND. Both quantitative and qualitative papers, with full text available, in English, Spanish, or Portuguese, published from 2012 to 2019, were included.
Results: 20 articles were selected for analysis, with family-approach, nursing support, relaxation, and child massage interventions being recognized. In eleven articles, both parents were involved; whereas in eight and one only mothers or only fathers were involved, respectively. In most cases, the Parental Stress Scale: NICU was used to assess the effects of interventions to manage parental stress. The parent role dimension was found to be the one causing the highest level of stress.
Conclusions: inherent to nursing care in NICU is the support to parents when a child is admitted to a critical care unit, in order to help them managing parental stress caused by hospitalization.
Keywords:
parents; parental stress; neonatal intensive care unit; newbornnursing
Versión en Español
Título:
Artículo completo no disponible en este idioma / Full article is not available in this language
Bibliography
Bibliografía
1. Organización Mundial de la Salud (OMS). Casi 30 millones de recién nacidos enfermos y prematuros necesitan tratamiento cada año [internet]. Ginebra: OMS; 2019 [citado 8 sep 2020]. Disponible en: https://www.who.int/es/news-room/detail/13-12-2018-nearly-30-million-sick-and-premature-newborns-in-dire-need-of-treatment-every-year
2. Organización Mundial de la Salud (OMS). SURVIVE and THRIVE Transforming care for every small and sick newborn [internet]. Ginebra: OMS; 2018 [citado 8 sep 2020]. Disponible en: https://apps.who.int/iris/bitstream/handle/10665/276655/WHO-FWC-MCA-18.11-eng.pdf?ua=1
3. Govindaswamy P, Laing S, Waters D, Walker K, Spence K, Badawi N. Needs and stressors of parents of term and near-term infants in the NICU: A systematic review with best practice guidelines. Early Human Development. 2019; 139:104839. Doi: https://doi.org/10.1016/j.earlhumdev.2019.104839
4. Thomson-Salo F, Kuschel C, Kamlin O, Cuzzilla R. A fathers' group in NICU: Recognising and responding to paternal stress, utilising peer support. Journal of Neonatal Nursing. 2019; 23(6):294-8. Doi: https://doi.org/10.1016/j.jnn.2017.04.001
5. Browne J, Talmi A. Family-Based Intervention to Enhance Infant–Parent Relationships in the Neonatal Intensive Care Unit. Journal of Pediatric Psychology. 2005; 30(8):667-77. Doi: https://doi.org/10.1093/jpepsy/jsi053
6. Wraight CL, McCoy J, Meadow W. Beyond stress: Describing the experiences of families during neonatal intensive care. Acta Paediatr Int J Paediatr. 2015; 104(10):1012-7. Doi: https://doi.org/10.1111/apa.13071
7. Tandberg BS, Sandtrø HP, Vårdal M, Rønnestad A. Parents of preterm evaluation of stress and nursing support. J Neonatal Nurs. 2013; 19(6):317-26. Doi: https://doi.org/10.1016/j.jnn.2013.01.008
8. Gustafson KW, LaBrecque MA, Graham DA, Tella NM, Curley MAQ. Effect of Parent Presence During Multidisciplinary Rounds on NICU-Related Parental Stress. JOGNN-J Obstet Gynecol Neonatal Nurs. 2016; 45(5):661-70. Doi: http://dx.doi.org/10.1016/j.jogn.2016.04.012
9. Pérez Padilla J, Menéndez Álvarez-Dardet S. Un análisis tipológico del estrés parental en familias en riesgo psicosocial. Salud Ment. [internet] 2014 [citado 8 sep]; 37(1):27. Disponible en: http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0185-33252014000100004
10. Caruso A, Mikulic IM. Anuario de investigaciones El estrés en padres de bebés prematuros internados en la Unidad de Cuidados Intensivos Neonatales: traducción y adaptación de la escala Parental Stressor Scale: Neonatal. Anu Investig. [internet] 2012 [citado 8 sep 2020]; 19:19-26. Disponible en: http://www.scielo.org.ar/scielo.php?script=sci_abstract&pid=S1851-16862012000200004&lng=pt
11. Ramezani T, Hadian Shirazi Z, Sabet Sarvestani R, Moattari M. Family-Centered Care in Neonatal Intensive Care Unit: A Concept Analysis. IJCBNM. [internet] 2014 [citado 8 sep 2020]; 2(4):268-78. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4201206/
12. Sgandurra G, Beani E, Inguaggiato E, Lorentzen J, Nielsen JB, Cioni G. Effects on parental stress of early home-based caretoy intervention in low-risk preterm infants. BMC Pediatr 2014; 14:268. Doi: https://doi.org/10.1186/1471-2431-14-268
13. Gabis L, Hacham-Pilosof K, Yosef O, Rabinovitz G, Leshem G, Shilon-Hadass A, et al. The Influence of a Multisensory Intervention for Preterm Infants Provided by Parents, on Developmental Abilities and on Parental Stress Levels. Journal of Child Neurology. 2014; 30(7):896-903. Doi: https://doi.org/10.1177/0883073814549242
14. Cano-Giménez E, Sánchez-Luna M. Providing parents with individualised support in a neonatal intensive care unit reduced stress, anxiety and depression. Acta Paediatr Int J Paediatr. 2015; 104(7):e300-5. Doi: https://doi.org/10.1111/apa.12984
15. Matricardi S, Agostino R, Fedeli C, Montirosso R. Mothers are not fathers: Differences between parents in the reduction of stress levels after a parental intervention in a NICU. Acta Paediatr Int J Paediatr. 2013; 102(1):8-14. Doi: https://doi.org/10.1111/apa.12058
16. Ong SL, Abdullah KL, Danaee M, Soh KL, Soh KG, Lee DSK, et al. The effectiveness of a structured nursing intervention program on maternal stress and ability among mothers of premature infants in a neonatal intensive care unit. J Clin Nurs. 2019; 28(3-4):641-9. Doi: https://doi.org/10.1111/jocn.14659
17. Villamizar-Carvajal B, Vargas-Porras C, García-Corzo JR. Decrease of premature mothers’ stress levels in the intensive care unit. Enferm Intensiva. 2018; 29(3):113-20. Doi: https://doi.org/10.1016/j.enfie.2017.12.003
18. Kadivar M, Seyedfatemi N, Akbari N, Haghani H, Fayaz M. Evaluation of the effect of narrative writing on the stress sources of the parents of preterm neonates admitted to the NICU. J Matern Neonatal Med. 2017; 30(13):1616-20. Doi: https://doi.org/10.1080/14767058.2016.1219995
19. Fotiou C, Vlastarakos P V, Bakoula C, Papagaroufalis K, Bakoyannis G, Darviri C, et al. Parental stress management using relaxation techniques in a neonatal intensive care unit: A randomised controlled trial. Intensive Crit Care Nurs. 2016; 32:20-8. Doi: http://dx.doi.org/10.1016/j.iccn.2015.08.006
20. Chertok IRA, McCrone S, Parker D, Leslie N. Review of interventions to reduce stress among mothers of infants in the NICU. Adv Neonatal Care. 2014; 14(1):30-7. Doi: https://doi.org/10.1097/ANC.0000000000000044
21. Villamizar-Carvajal B, Vargas-Porras C, Gómez-Ortega OR. Meta-analysis: Effect of interventions to reduce the stress level of parents of premature babies. Aquichan. 2016; 16(3):276-95. Doi: http://dx.doi.org/10.5294/aqui.2016.16.3.2
22. Miles MS, Funk SG, Carlson J. Parent stressor scale: Neonatal intensive care. Nursing Research. [internet] 1993 [citado 8 sep 2020]; 42:148-52. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/8506163
23. Miles MS. Support for parents during child hospitalization. A J Nurs.2003; 103:62-4.
24. Miles MS & Brunssen S. Psychometric properties of the parental stressor scale: infant hospitalization. Advances in Neonatal Care. 2003; 3(4):189-96.
25. Busse M, Stromgren K, Thorngate L, Thomas K. Parents’ Responses to Stress. Crit Care Nurse. 2013; 33(4):52-60. Doi: https://doi.org/10.4037/ccn2013715
26. Mercer RT. Becoming a mother versus maternal role attainment. J Nurs Scholarsh. 2004; 36(3):226-32. Doi: https://doi.org/10.1111/j.1547-5069.2004.04042.x
27. Mianaei SJ, Karahroudy FA, Rassouli M, Tafreshi MZ. The effect of Creating Opportunities for Parent Empowerment program on maternal stress, anxiety, and participation in NICU wards in Iran. Iran J Nurs Midwifery Res. 2014; 19(1):94-100. Disponible en: https://pubmed.ncbi.nlm.nih.gov/24554967/
28. Enke C, Oliva y Hausmann A, Miedaner F, Roth B, Woopen C. Communicating with parents in neonatal intensive care units: The impact on parental stress. Patient Educ Couns. 2017; 100(4):710-9. Doi: http://dx.doi.org/10.1016/j.pec.2016.11.017
29. O’Brien K, Bracht M, Macdonell K. A pilot cohort analytic study of Family Integrated Care in a Canadian neonatal intensive care unit. BMC Pregnancy Childbirth. 2013; 13 Suppl 1(Suppl 1):1-8. Doi: https://doi.org/10.1186/1471-2393-13-S1-S12
30. Balbino FS, Balieiro MMFG, Mandetta MA. Avaliação da percepção do cuidado centrado na família e do estresse parental em unidade neonata. Rev Lat Am Enfermagem. 2016; 24:e2753. Doi: http://dx.doi.org/10.1590/1518-8345.0710.2753
31. Abdeyazdan Z, Shahkolahi Z, Mehrabi T, Hajiheidari M. A family support intervention to reduce stress among parents of preterm infants in neonatal intensive care unit. Iran J Nurs Midwifery Res. [internet] 2014 [citado 8 sep 2020]; 19(4):349-53. Disponible en: https://pubmed.ncbi.nlm.nih.gov/25183973/
32. Shahkolahi Z, Abdeyazdan Z, Mehrabi T, Hajiheidari M. Supporting fathers of premature infants hospitalized in Neonatal Intensive Care Unit (NICU). Iran J Crit Care Nurs [internet] 2014 [citado 8 sep 2020]; 7(1):31-40. Disponible en: http://jccnursing.com/article-1-275-fa.pdf
33. O'Brien K, Robson K, Bracht M, Cruz M, Lui K, Alvaro R, et al. Effectiveness of Family Integrated Care in neonatal intensive care units on infant and parent outcomes: a multicentre, multinational, cluster-randomised controlled trial. The Lancet Child & Adolescent Health. 2018; 2(4):245-54. Doi: https://doi.org/10.1016/S2352-4642(18)30039-7
34. Weis J, Zoffmann V, Greisen G, Egerod I. The effect of person-centred communication on parental stress in a NICU: A randomized clinical trial. Acta Paediatr Int J Paediatr. 2013; 102(12):1130-6. Doi: https://doi.org/10.1111/apa.12404
35. Weis J, Zoffmann V, Egerod I. Enhancing person-centred communication in NICU: A comparative thematic analysis. Nurs Crit Care. 2015; 20(6):287-98. Doi: https://doi.org/10.1111/nicc.12062
36. Howland LC, Jallo N, Connelly CD, Pickler RH. Feasibility of a Relaxation Guided Imagery Intervention to Reduce Maternal Stress in the NICU. JOGNN-J Obstet Gynecol Neonatal Nurs. 2017; 46(4):532-43. Doi: http://dx.doi.org/10.1016/j.jogn.2017.03.004
37. Samra HA, Dutcher J, McGrath JM, Foster M, Klein L, Djira G, et al. Effect of Skin-to-Skin Holding on Stress in Mothers of Late-Preterm Infants: A Randomized Controlled Trial. Adv Neonatal Care. 2015; 15(5):354-64. Doi: 10.1097/ANC.0000000000000223
38. Shaw RJ, John NS, Lilo EA, Jo B, Benitz W, Stevenson DK, et al. Prevention of traumatic stress in mothers with preterm infants: A randomized controlled trial. Pediatrics. 2013; 132(4):886-94. Doi: https://doi.org/10.1542/peds.2013-1331
39. Beheshtipour N, Baharlu SM, Montaseri S, Razavinezhad Ardakani SM. The Effect of the Educational Program on Iranian Premature Infants’ Parental Stress in a Neonatal Intensive Care Unit: A Double-Blind Randomized Controlled Trial. IJCBNM. [internet] 2014 [citado 8 sep 2020]; 2(4):240-50. Disponible en: https://ijcbnm.sums.ac.ir/article_40682.html
40. Secretaría de Gobernación, Diario oficial de la federación. NORMA Oficial Mexicana NOM-007-SSA2-2016, Para la atención de la mujer durante el embarazo, parto y puerperio, y de la persona recién nacida [internet] [citado 8 sep 2020]. Disponible en: http://www.dof.gob.mx/nota_detalle.php?codigo=5432289&fecha=07%2F04%2F2016
41. Schappin R, Wijnroks L, Uniken Venema M, Jongmans M. Rethinking Stress in Parents of Preterm Infants: A Meta-Analysis. PLoS ONE. 2013; 8(2):e54992. Doi: https://doi.org/10.1371/journal.pone.0054992
