Psychological health of family caregivers of children admitted at birth to a NICU and healthy children: a population-based cross-sectional survey

Anne F Klassen,Shoo K Lee,Parminder Raina,Sarka Lisonkova

doi:10.1186/1471-2431-4-24

Abstract

BackgroundThere is little information in the research literature on how parents of children who spend time in a neonatal intensive care unit (NICU) adapt psychologically to the demands of caregiving beyond the initial hospitalization period. Our aim was to compare parents of NICU children with parents of healthy full-term children, looking specifically at the relationship between parental psychosocial health and child characteristics, as well as the relationship between important predictor variables and psychosocial health.MethodsA cross-sectional survey was sent to parents as their child turned 3 1/2 years of age. The setting was the province of British Columbia, Canada. The sample included all babies admitted to tertiary level neonatal intensive care units (NICU) at birth over a 16-month period, and a consecutive sample of healthy babies. The main outcome was the SF-36 mental component summary (MCS) score. Predictor variables included caregiver gender; caregiver age; marital status; parental education; annual household income; child health status; child behavior; birth-related risk factors; caregiver strain; and family function.ResultsPsychosocial health of NICU parents did not differ from parents of healthy children. Child health status and behavior for NICU and healthy children were strongly related to MCS score in bivariate analysis. In the pooled multivariate model, parental age, low family function, high caregiver strain, and child's internalizing and externalizing behavioral symptoms were independently associated with lower psychosocial health. In addition, female gender was associated with lower psychosocial health in the NICU group, whereas lower education and child's problem with quality of life indicated lower psychosocial health in the healthy baby group.ConclusionsOverall, parental gender, family functioning and caregiver strain played influential roles in parental psychosocial health.

Highlights

There is little information in the research literature on how parents of children who spend time in a neonatal intensive care unit (NICU) adapt psychologically to the demands of caregiving beyond the initial hospitalization period
Our list of babies was matched with provincial mortality records to exclude any babies that had died after discharge from the NICU and thereby prevent questionnaires being sent to bereaved parents
Psychosocial health comparing NICU and healthy children The unadjusted mean mental component summary (MCS) score for parents of NICU children did not differ from parents of healthy children (48.2 versus 48.8; p = .305)

Summary

Introduction

There is little information in the research literature on how parents of children who spend time in a neonatal intensive care unit (NICU) adapt psychologically to the demands of caregiving beyond the initial hospitalization period. Neonatal intensive care is associated with a range of longterm health problems such as cerebral palsy, mental retardation, deafness, blindness and milder but more common problems such as learning disabilities and behavioral problems [1,2,3,4,5,6,7,8,9,10,11,12,13] These problems create challenges for the parent responsible for the day-to-day provision of care to their child at home, the impact of caregiving on the health of parents of children discharged from neonatal intensive care units (NICUs) remains an under-explored research topic. The authors report that early differences between the groups at one month and two years were no longer apparent by the age of three, parenting stress remained high throughout

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