Living in Limbo: Factors Associated with Parental Stress across Admission in the Neonatal Intensive Care Unit

Abstract

The hospitalisation of a premature or critically-ill infant to the Neonatal Intensive Care Unit (NICU) is often a highly stressful and unexpected crisis for parents. Although this event is known to cause stress in mothers and fathers, little is known about the components of the hospitalisation that parents perceive as major sources of stress, specifically at admission and at discharge. This study investigated mothers’ and fathers’ unique experiences of stress and perceived stressors during their baby’s admission and discharge in the Special Care Baby Unit (SCBU) within NICU. Predictors of parental stress at admission and characteristics associated with worsened stress at discharge were also investigated in relation to parents’ satisfaction with hospital information, perceptions of their baby’s condition and perceived relationship quality. An observational design was used to assess 64 mothers and 20 fathers of 68 babies admitted to National Women’s NICU in Auckland City Hospital. Mothers and fathers independently completed questionnaires and interviews shortly following their baby’s admission to the unit and before their baby’s discharge. The results indicated that maternal and paternal stress levels declined from admission to discharge, with no significant differences according to sex. Parents who perceived greater personal control and understood their baby’s condition reported less stress at discharge. Parents who were satisfied with the information they received in SCBU believed the treatment would be effective and understood their baby’s condition at admission. Conversely, parents who were satisfied with information also considered that their baby’s condition would last a short time and perceived their infants as less sick. Parents’ relationship quality declined across the hospitalisation. It appears that mothers and fathers demonstrate similar stress levels during the hospitalisation, although are stressed by different factors. Although many parents’ stress reduces, some parents remain at risk of being highly stressed by discharge. Personal control, illness coherence and information satisfaction appear to have an important impact on parental stress. Furthermore, parenting concerns and the infant’s appearance are the most common sources of stress at admission. This data provides valuable insights into mothers’ and fathers’ experiences of the SCBU hospitalisation that may inform interventions and care practices in NICU.