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Published Online First: 17 July 2008. doi:10.1136/adc.2007.135921
Archives of Disease in Childhood - Fetal and Neonatal Edition 2009;94:F98-F104
Copyright © 2009 BMJ Publishing Group Ltd & Royal College of Paediatrics and Child Health.

ORIGINAL ARTICLES

Psychological stress of parents of preterm infants enrolled in an early discharge programme from the neonatal intensive care unit: a prospective randomised trial

P Sáenz1, M Cerdá1, J L Díaz2, P Yi2, M Gorba1, N Boronat1, P Barreto2, M Vento1

1 Servicio de Neonatología, Hospital Universitario Materno Infantil La Fe, Valencia, Spain
2 Departamento de Psicología de la Personalidad, Facultad de Psicología, Universidad de Valencia, Valencia, Spain

Máximo Vento, Neonatal Research Unit, Servicio de Neonatología, Hospital Universitario Materno Infantil La Fe, Avenida de Campanar, 21: E46009 Valencia, Spain; maximo.vento{at}uv.es

Background: Psychological stress of parents of preterm infants is aggravated by prolonged hospitalisation. Early discharge programmes (EDPs) have been implemented to alleviate this situation.

Objective: To evaluate parental psychological stress in an EDP for the first 3 months after neonatal intensive care unit (NICU) discharge.

Design/methods: Prospective randomised trial comparing parents of preterm infants assigned to EDP (n = 72) or standard discharge programme (SDP) (standard discharge) (n = 68). At discharge, parents were evaluated using the Hospital Anxiety and Depression Scale (HAD), and the Likert Scale for well-being every 10 days for 3 months. Parental narrative of Worrying and Helping issues was assessed using a semi-structured interview.

Results: Length of stay was greater in the SDP group (p<0.01). HAD showed no differences in anxiety, but SDP mothers scored higher in depression (p<0.05). Altogether, parents reported a worrisome emotional condition (EDP 87.2%; SDP 80%), which decreased at the end of the study (EDP 45.2%; SDP 34.5%). Their baby’s physical well-being was the most relevant issue in the narrative for Worrying and Helping issues at discharge (EDP 69.2%; SDP 67.5%); however, it decreased at the end of the study (EDP 22.6%; SDP 24.1%). At discharge, the paediatrician’s support was more for the SDP group. No differences on the Well-Being Scale were found, but the EDP group always scored better.

Conclusions: Vulnerability of parents enrolled in an EDP did not increase after hospital discharge. Physical well-being of the baby was the most important issue for both groups. EDP parents requested less paediatric support and scored higher in the Well-being verbatim.

Trial registration number: Registered at the Clinical Trial Government Protocol Registration System no NCT00569608 [ClinicalTrials.gov] .


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