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Parent psychological wellbeing in a single-family room versus an open bay neonatal intensive care unit.

ABSTRACT: BACKGROUND:Studies of parents' psychological well-being in single-family rooms in neonatal intensive care units have shown conflicting results. AIMS:To compare emotional distress in the form of depression, anxiety, stress and attachment scores among parents of very preterm infants cared for in a single-family rooms unit vs an open bay unit. STUDY DESIGN:Prospective survey design. SUBJECT:Parents (132) of 77 infants born at 28 0/7-32 0/7 weeks of gestation in the two units. OUTCOME MEASURES:Duration of parental presence was recorded. Scores for depression (The Edinburgh Postnatal Depression Scale), anxiety (The State-Trait-Anxiety Inventory, Short Form Y), stress (The Parent Stressor Scale: neonatal intensive care unit questionnaire and The Parenting Stress Index-short form) and attachment (Maternal Postnatal Attachment Scale) measured 14 days after delivery, at discharge, expected term date and four months post-term. RESULTS:Parents were present 21 hours/day in the single-family room unit vs 7 hours/day in the Open bay unit. Ninety-three percent of the fathers in the single-family rooms unit were present more than 12 hours per day during the first week. Mothers in the single-family rooms had a significantly lower depression score -1.9 (95% CI: -3.6, -0.1) points from birth to four months corrected age compared to mothers in the Open bay unit, and 14% vs 52% scored above a cut-off point considered being at high risk for depression (p<0.005). Both mothers and fathers in the single-family rooms reported significantly lower stress levels during hospitalization. There were no differences between the groups for anxiety, stress or attachment scores after discharge. CONCLUSION:The lower depression scores by the mothers and lower parental stress scores during hospitalization for both parents supports that single-family rooms care contribute to parents' psychological wellbeing.

SUBMITTER: Tandberg BS

PROVIDER: S-EPMC6830777 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Parent psychological wellbeing in a single-family room versus an open bay neonatal intensive care unit.

Tandberg Bente Silnes BS Flacking Renée R Markestad Trond T Grundt Hege H Moen Atle A

PloS one 20191105 11

<h4>Background</h4>Studies of parents' psychological well-being in single-family rooms in neonatal intensive care units have shown conflicting results.<h4>Aims</h4>To compare emotional distress in the form of depression, anxiety, stress and attachment scores among parents of very preterm infants cared for in a single-family rooms unit vs an open bay unit.<h4>Study design</h4>Prospective survey design.<h4>Subject</h4>Parents (132) of 77 infants born at 28 0/7-32 0/7 weeks of gestation in the two ...[more]

PMID: 31689307

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Project description:Abstract Preterm birth is a risk factor for early experience of pain. Despite advances in neonatal care, evidence‐based knowledge of the importance of adequate pain management and strong international guidelines for assessment and treatment of neonatal pain, only 10% of sick term and preterm infants were assessed for pain and stress on a daily basis. The aim of this quality improvement (QI) project is evaluation of implemented guidelines for pain assessment and management, and increased parental involvement in a Norwegian single‐family room NICU. Method: The different steps of the project entailed translation of the English version of COMFORTneo, development and implementation of guidelines with flowcharts for pain management, and pain assessment certification of the interprofessional staff. Part two of the project is supervision of the interprofessional staff in parental involvement in stress‐ and painful procedures. Our study showed that one year after implementation, 88.8% of the COMFORTneo assessments were performed according to the pain management guidelines. The staff used the flowcharts to assess, treat and reassess pain and stress. There was a high interrater reliability with linearly weighted Cohen's kappa values ranging from 0.81 to 0.95, with a median of 0.90. In addition, our study showed increased parental involvement in procedures, from 50.3% before to 82.3% after the quality improvement project. The success of this quality improvement project is explained by systematic use of flowcharts and implemented guidelines for pain management, interprofessional collaboration, and cultural change agents. Theoretical lectures and practical bedside supervision to interprofessional staff increased parental involvement in stress‐ and painful procedures. The aim of this quality improvement (QI) project is evaluation of implemented guidelines for pain assessment and management and increased parental involvement in a Norwegian single‐family room (SFR) NICU. The main steps were translation and implementation of the COMFORTneo scale and development of flowcharts and pain management guidelines. The study showed high compliance to guidelines, high COMFORTneo assessment inter‐rater reliability, and increased parental involvement in procedures.

Dataset Information

Parent psychological wellbeing in a single-family room versus an open bay neonatal intensive care unit.

Publications

Parent psychological wellbeing in a single-family room versus an open bay neonatal intensive care unit.

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