Factors associated with parental stress in a Neonatal Intensive Care Unit

This is a cross-sectional study developed with 204 parents present in a Neonatal Intensive Care Unit in the state of Rio Grande do Sul. For data collection, we used an instrument to characterize participants and the Brazilian version of the Parental Stress Scale: Neonatal Intensive Care Unit. Data were analyzed using the Mann-Whitney and Kruskal-Wallis tests.

Results

The sociodemographic variables that were associated with higher levels of stress were sex, previous experience with neonatal unit, education and religion. And the clinical variables of newborns were hospitalization unit, respiratory and intravenous therapies and previous surgical procedure.

Conclusion

Female participants, who had no previous experience with a neonatal unit, with higher education and religion, had higher levels of stress, as well as those who had their children hospitalized in the high-risk unit, with respiratory support, use of two intravenous devices and with previous history of surgical procedure.

Stress, psychological; Parents; Infant, newborn; Infant, premature; Intensive care units, neonatal

Variables	PSS: NICU subscales
	Sights and sounds		Baby looks and behaves		Changes in parental role
	Mean	p-value	Mean	p-value	Mean	p-value
Sex*		0.00		0.01		0.00
Female	2.31		3.00		3.68
Male	1.94		2.54		3.11
Age group**		0.74		0.37		0.45
≤ 18 years old	2.20		2.44		3.56
19-25 years old	2.15		2.96		3.64
26-35 years old	2.23		2.83		3.40
> 35 years old	2.07		2.77		3.25
Marital status*		0.26		0.99		0.06
With a partner	2.15		2.82		3.40
Without a partner	2.33		2.82		3.93
Number of children**		0.69		0.62		0.15
One	2.21		2.82		3.59
Two	2.11		2.89		3.46
Three	2.06		2.61		2.95
Four or more	2.36		2.95		3.70
Another child hospitalized in NICU*		0.43		0.32		0.03
Yes	2.02		2.64		2.95
No	2.20		2.85		3.54
Education**		0.03		0.09		0.77
Incomplete elementary school	2.10^a		2.64		3.50
Complete elementary school/incomplete high school	1.99^b		2.69		3.39
Complete high school/incomplete higher education	2.28^c		3.07		3.56
Complete higher education	2.69^b		2.83		3.23
Religion*		0.11		0.01		0.92
Yes	2.23		2.93		3.47
No	1.99		2.49		3.46
Lives in the study setting city*		0.15		0.26		0.94
Yes	2.23		2.71		3.48
No	2.13		2.92		3.45
Socioeconomic stratum**		0.25		0.20		0.22
A	2.08		3.15		4.07
B1	2.56		3.03		3.47
B2	2.19		2.68		3.15
C1	1.98		2.74		3.47
C2	2.33		3.15		3.75
D-E	2.05		2.64		3.45

Variables	PSS: NICU subscales
	Sights and sounds		Baby looks and behaves		Changes in parental role
	Mean	p-value	Mean	p-value	Mean	p-value
Gestational age*		0.94		0.07		0.06
Premature	2.18		2.73		3.36
Full term	2.15		3.04		3.71
Birth weight*		0.47		0.65		0.26
< 2,500 g	2.21		2.80		3.39
≥ 2,500 g	2.11		2.87		3.58
Childbirth*		0.46		0.84		0.56
Vaginal	2.25		2.86		3.55
Caesarean section	2.15		2.82		3.44
Twin pregnancy*		1.00		0.67		0.63
Yes	2.27		2.94		3.38
No	2.16		2.81		3.47
Need for neonatal resuscitation*		0.59		0.29		0.35
Yes	2.19		2.74		3.38
No	2.15		2.91		3.57
Congenital malformation*		0.90		0.73		0.35
Yes	2.27		2.90		3.76
No	2.16		2.81		3.43

Variables	PSS: NICU subscales
	Sights and sounds		Baby looks and behaves		Changes in parental role
	Mean	p-value	Mean	p-value	Mean	p-value
Inpatient unit**		0.57		0.08		0.04
High risk	2.25		3.14		3.79^a
Intermediate care	2.09		2.66		3.40^b
Isolation	2.33		2.96		3.51^c
Kangaroo	2.16		2.67		3.04^a
Length of stay**		0.61		0.08		0.74
≤ 10 days	2.12		2.71		3.43
11-20 days	2.17		3.07		3.51
21-30 days	2.14		2.44		3.26
> 30 days	2.61		3.10		3.73
Respiratory therapy*		0.04		0.11		0.18
Yes	2.40		3.06		3.66
No	2.10		2.75		3.40
Type of respiratory therapy**		0.26		0.56		0.57
None	2.10		2.75		3.40
Nasal catheter	2.21		3.08		3.49
CPAP	2.48		3.00		4.04
Mechanical ventilation	2.41		3.03		3.62
In the incubator	3.16		3.58		3.66
Intravenous therapy*		0.12		0.24		0.41
Yes	2.26		2.90		3.53
No	2.06		2.72		3.37
Type of intravenous therapy**		0.15		0.06		0.02
None	2.06		2.72		3.37^b
Peripheral catheter	2.21		2.78		3.47^b
PICC	2.16		2.80		3.36^b
Umbilical catheter	2.50		2.62		4.00^a
Two intravenous devices	2.80		3.71		4.42^b
Nutritional therapy**		0.88		0.66		0.79
Absence of diet	2.50		3.50		4.57
Oral administration	2.15		2.81		3.44
Oral and probe administration	2.15		2.68		3.57
Probe administration	2.15		2.76		3.43
Parenteral administration	2.41		3.22		3.77
Enteral and parenteral administration	2.12		2.79		3.29
Phototherapy*		0.46		0.30		0.54
Yes	2.37		3.37		3.92
No	2.17		2.81		3.45
Previous surgical procedure*		0.03		0.01		0.28
Yes	2.64		3.50		3.80
No	2.12		2.75		3.43
Sedation*		0.05		0.07		0.64
Yes	2.78		3.49		3.75
No	2.14		2.79		3.45
Special coverage*		0.29		0.53		0.33
Yes	2.32		2.94		3.59
No	2.14		2.80		3.44
Bladder probe*		0.25		0.18		0.05
Yes	2.54		3.35		4.29
No	2.16		2.80		3.43

Escola Paulista de Enfermagem, Universidade Federal de São Paulo R. Napoleão de Barros, 754, 04024-002 São Paulo - SP/Brasil, Tel./Fax: (55 11) 5576 4430 - São Paulo - SP - Brazil
E-mail: actapaulista@unifesp.br

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[1] Corresponding author. Jaquiele Jaciára Kegler. E-mail: jake_kegler93@hotmail.com