Yenidoğan Yoğun Bakım Ünitesine Kabulün İlk Haftasında Algılanan Ebeveyn Stres Düzeyleri ve Aile Merkezli Bakım Nasıl Değişir: Tanımlayıcı Bir Takip Çalışması
Yıl 2025,
Cilt: 41 Sayı: 2, 317 - 326, 22.08.2025
Güzide Üğücü
,
Rana Yiğit
Öz
YYBÜ'ye kabulün ilk haftasında algılanan ebeveyn stres düzeyleri ve aile merkezli bakım nasıl değişir: Tanımlayıcı bir takip çalışması
Öz
Amaç: Bu araştırma, yenidoğan yoğun bakım ünitesine (YYBÜ) bebeği yatan ebeveynlerin stres düzeyleri ve aile merkezli bakım algılarını değerlendirmeyi amaçlamıştır.
Yöntem: Bu tanımlayıcı takip çalışması, bebekleri doğumdan hemen sonra üniteye kabul edilen ve en az yedi gün kalması beklenen 62 ebeveynin katılımı ile III. Düzey YYBÜ’de Kasım 2017-Mayıs 2018 tarihlerinde yürütülmüştür. Verilerin toplanmasında; T1 (yatışın 2. günü) ve T2'de (yatışın 7. günü) YYBÜ Ebeveyn Stres Ölçeği (PSS: NICU), Aile Merkezli Bakım Ölçeği-Tutarlılık (FCCS-Consistency) ve Ebeveyn-Bebek Bilgi Formundan yararlanılmıştır. Analiz için tanımlayıcı istatistikler ve tekrarlanan ölçümler t-testleri kullanılmıştır.
Bulgular: Ebeveynlerin T1 ve T2'deki PSS: NICU ve FCCS-Consistency puan ortalamalarında istatistiksel olarak anlamlı farklılıklar bulunmuştur (p<0,05). T1'deki en yüksek stres kaynağı "görüntü ve sesler" iken, T2'de ise "bebeğin davranışı ve görünümü" olarak değişmiştir (p<0,05).
Sonuç: Bu araştırma, üniteye kabulün ikinci gününde ve ilk haftanın sonunda ebeveynlerin stres düzeylerinde farklılıklar olduğunu ortaya koymuştur. T2'de ebeveyn stres düzeyleri azalmış ve algılanan bakımın aile merkezli yaklaşımla tutarlı olması artmıştır. Standart ölçüm zamanlarının ve araçların oluşturulması, ebeveyn stres düzeylerinin ve algılanan FCC'nin karşılaştırılabilirliğini kolaylaştıracaktır. Kurumlar, rutin bakımın FCC modeliyle tutarlılığını değerlendirmek için kontrol listeleri ve kalite göstergeleri geliştirebilirler.
Anahtar Kelimeler: Hemşirelik bakımı, ebeveyn stresi, aile merkezli bakım, yenidoğan yoğun bakım ünitesi
Etik Beyan
An approval from the noninvasive clinical trials ethics committee (Mersin University, 19/10/2017-2017/299) was obtained
Destekleyen Kurum
No external funding.
Teşekkür
We are grateful to Professor Gülhan TEMEL (Department of Biostatistics, Faculty of Medicine, Mersin University) for supervision support to statistical analysis and all parents who participated to study.
Kaynakça
-
Acunaş, B., Uslu, S., & Yağmur Baş, A. (2018). Turkish Neonatal Society guideline for the follow-up of high-risk newborn infants. Turk Pediatri Ars, 53(Suppl 1), 180–195. https://doi.org/10.5152/TurkPediatriArs.2018.01817
-
Adama, E. A., Adua, E., Bayes, S., & Mörelius, E. (2022). Support needs of parents in neonatal intensive care unit: An integrative review. Journal of Clinical Nursing, 31(5-6), 532-547.
-
Al Maghaireh, D. F., Abdullah, K. L., Chong, M. C., Chua, Y. P., & Al Kawafha, M. M. (2017). Stress, anxiety, depression and sleep disturbance among Jordanian mothers and fathers of infants admitted to neonatal intensive care unit: a preliminary study. Journal of Pediatric Nursing, 36, 132–140. https://doi.org/10.1016/j.pedn.2017.06.007
-
Alkozei, A., McMahon, E., & Lahav, A. (2014). Stress levels and depressive symptoms in NICU mothers in the early postpartum period. The Journal of Maternal-Fetal & Neonatal Medicine, 27(17), 1738–1743. https://doi.org/10.3109/14767058.2014.942626
-
Altıparmak, D., & Taş-Arslan, F. (2016). Aile Merkezli Bakım Ölçeği’nin Türkçe geçerlik ve güvenirlik çalışması. [The Adaptation of Family Centred Care Scale to Turkish a Validity and Reliability Study]. Journal of Pediatric Research, 3(2), 97–103. https://doi.org/10.4274/jpr.60566
-
Baía, I., Amorim, M., Silva, S., Kelly-Irving, M., de Freitas, C., & Alves, E. (2016). Parenting very preterm infants and stress in Neonatal Intensive Care Units. Early Human Development, 101, 3–9. https://doi.org/10.1016/j.earlhumdev.2016.04.001
-
Bernardo, J., Rent, S., Arias-Shah, A., Hoge, M. K., & Shaw, R. J. (2021). Parental stress and mental health symptoms in the NICU: Recognition and interventions. Neoreviews, 22(8), e496-e505.
-
Brunson, E., Thierry, A., Ligier, F., Vulliez-Coady, L., Novo, A., Rolland, A. C., & Eutrope, J. (2021). Prevalence and predictive factors of maternal trauma through 18 months after premature birth: A longitudinal, observational and descriptive study. PLoS One, 16(2), e0246758.
-
Caporali, C., Pisoni, C., Gasparini, L., Ballante, E., Zecca, M., Orcesi, S., & Provenzi, L. (2020). A global perspective on parental stress in the neonatal intensive care unit: A meta-analytic study. Journal of Perinatology, 40(12), 1739-1752.
-
Curley, M. A. Q., Hunsberger, M., & Harris, S. K. (2013). Psychometric evaluation of the family-centered care scale for pediatric acute care nursing. Nursing Research, 62(3), 160–168. https://doi.org/10.1097/nnr.0b013e318286d64b
-
Dimitroff, S. J., Kardan, O., Necka, E. A., Decety, J., Berman, M. G., & Norman, G. J. (2017). Physiological dynamics of stress contagion. Scientific Reports, 7(1). https://doi.org/10.1038/s41598-017-05811-1
-
Gómez-Cantarino, S., García-Valdivieso, I., Moncunill-Martínez, E., Yáñez-Araque, B., & Ugarte Gurrutxaga, M. I. (2020). Developing a family-centered care model in the neonatal intensive care unit (NICU): A new vision to manage healthcare. International Journal of Environmental Research and Public Health, 17(19), 7197.
-
Govindaswamy, P., Laing, S., Waters, D., Walker, K., Spence, K., & Badawi, N. (2019). Needs and stressors of parents of term and near-term infants in the NICU: A systematic review with best practice guidelines. Early Human Development, 104839. https://doi.org/10.1016/j.earlhumdev.2019.104839
-
Gustafson, K. W., LaBrecque, M. A., Graham, D. A., Tella, N. M., & Curley, M. A. Q. (2016). Effect of parent presence during multidisciplinary rounds on NICU-related parental stress. Journal of Obstetric, Gynecologic & Neonatal Nursing, 45(5), 661–670. https://doi.org/10.1016/j.jogn.2016.04.012
-
Heidarzadeh, M., Heidari, H., Ahmadi, A., Solati, K., & Sadeghi, N. (2023). Evaluation of parental stress in neonatal intensive care unit in Iran: A national study. BMC Nursing, 22(1), 41.
-
Lazzerini, M., do Amaral Gomez, D. B. C., Azzimonti, G., Bua, J., Neto, W. B., Brasili, L., ... & Mariani, I. (2024). Parental stress, depression, anxiety and participation to care in neonatal intensive care units: Results of a prospective study in Italy, Brazil and Tanzania. BMJ Paediatrics Open, 8(Suppl 2), e002539.
-
Matricardi, S., Agostino, R., Fedeli, C., & Montirosso, R. (2012). Mothers are not fathers: Differences between parents in the reduction of stress levels after a parental intervention in a NICU. Acta Paediatrica, 102(1), 8–14. https://doi.org/10.1111/apa.12058
-
Meier, P. P., Johnson, T. J., Patel, A. L., & Rossman, B. (2017). Evidence-based methods that promote human milk feeding of preterm infants. Clinics in Perinatology, 44(1), 1–22. https://doi.org/10.1016/j.clp.2016.11.005
-
Miles, M. S., Funk, S. G., & Carlson, J. (1993). Parental Stressor Scale: Neonatal intensive care unit. Nursing Research, 42(3), 148–152. https://doi.org/10.1097/00006199-199305000-00005
-
Montirosso, R., Fedeli, C., Del Prete, A., Calciolari, G., & Borgatti, R. (2014). Maternal stress and depressive symptoms associated with quality of developmental care in 25 Italian Neonatal Intensive Care Units: A cross sectional observational study. International Journal of Nursing Studies, 51(7), 994–1002. https://doi.org/10.1016/j.ijnurstu.2013.11.001
-
O’Brien, K., Robson, K., Bracht, M., Cruz, M., Lui, K., Alvaro, R., … Ng, E. (2018). Effectiveness of family integrated care in neonatal intensive care units on infant and parent outcomes: A multicentre, multinational, cluster-randomised controlled trial. The Lancet Child & Adolescent Health, 2(4), 245–254. https://doi.org/10.1016/s2352-4642(18)30039-7
-
Palma, I, E., Von Wussow K, F., Morales B, I., Cifuentes R, J., & Ambiado T, S. (2017). Estrés en padres de recién nacidos hospitalizados en una unidad de paciente crítico neonatal. Revista Chilena de Pediatría, 88(3), 332–339. https://doi.org/10.4067/s0370-41062017000300004
-
Raiskila, S., Lehtonen, L., Tandberg, B. S., Normann, E., Ewald, U., Caballero, S., & Axelin, A. (2016). Parent and nurse perceptions on the quality of family-centered care in 11 European NICUs. Australian Critical Care, 29(4), 201–209. https://doi.org/10.1016/j.aucc.2016.09.003
-
Soghier, L. M., Kritikos, K. I., Carty, C. L., Glass, P., Tuchman, L. K., Streisand, R., & Fratantoni, K. R. (2020). Parental depression symptoms at neonatal intensive care unit discharge and associated risk factors. The Journal of Pediatrics, 1–7. https://doi.org/10.1016/j.jpeds.2020.07.040
-
Soni, R., & Tscherning, C. (2021). Family-centred and developmental care on the neonatal unit. Paediatrics and Child Health, 31(1), 18-23.
-
Turan, T., & Başbakkal, Z. (2006). Study on validity and reliability of a Turkish version of the Parental Stress Scale: Neonatal Intensive Care Unit. Journal of Hacettepe University School of Nursing, 32–42. https://dergipark.org.tr/en/download/article-file/88580
-
Turan, T., Başbakkal, Z., & Özbek, Ş. (2008). Effect of nursing interventions on stressors of parents of premature infant in neonatal intensive care unit. Journal of Clinical Nursing, 17, 2856–2866. https://doi.org/10.1111/j.1365-2702.2008.02307.x
-
Turner, M., Chur-Hansen, A., Winefield, H., & Stanners, M. (2015). The assessment of parental stress and support in the neonatal intensive care unit using the Parent Stress Scale – Neonatal Intensive Care Unit. Women and Birth, 28(3), 252–258. https://doi.org/10.1016/j.wombi.2015.04.001
-
Üğücü, G. (2018). Yenidoğan yoğun bakım ünitesinde verilen standart hemşirelik bakımının ebeveyn stres düzeyi ve aile merkezli bakım algısına etkisi. (Yükseklisans Tezi). Mersin Üniversitesi Sağlık Bilimleri Enstitüsü, Mersin.
-
Üğücü, G., Çelebioğlu, A., & İşbir, G. G. (2024). Yenidoğan yoğun bakım ünitesindeki prematüre bebeğin nörogelişiminin desteklenmesi: İyileştirici çevrenin oluşturulması. Adnan Menderes Üniversitesi Sağlık Bilimleri Fakültesi Dergisi, 8(2), 192-208.
-
World Health Organization (WHO). (2022). WHO recommendations for care of the preterm or low-birth-weight infant. Retrieved from https://apps.who.int/iris/bitstream/handle/10665/363697/9789240058262-eng.pdf
-
Yiğit, R., & Üğücü, G. (2019). Yüksek riskli yenidoğan ve bakımının tarihsel gelişimi: Dünya ve Türkiye. Adnan Menderes Üniversitesi Sağlık Bilimleri Fakültesi Dergisi, 3(3), 200-211.
How Perceived Parental Stress Levels and Family-Centered Care Change During The First Week of Admission to The Neonatal Intensive Care Unit: A Descriptive Follow-Up Study
Yıl 2025,
Cilt: 41 Sayı: 2, 317 - 326, 22.08.2025
Güzide Üğücü
,
Rana Yiğit
Öz
How perceived parental stress levels and family-centered care change during the first week of admission to the NICU: A descriptive follow-up study
Abstract
Objective: This study aimed to evaluate the evolving dynamics of perceived parental stress levels and family-centered care (FCC) during the initial week of infant admission to the Neonatal Intensive Care Unit (NICU).
Methods: Conducted in a Level III NICU from November 2017 to May 2018, this descriptive follow-up study involved 62 parents whose infants were admitted to the unit immediately after birth and were expected to remain for at least seven days. Data collection at T1 (2nd day of admission) and T2 (7th day of admission) utilized the Parental Stress Scale: NICU (PSS: NICU), Family-Centered Care Scale-Consistency (FCCS-Consistency), and Parent-Infant Information Form. Descriptive statistics and repeated measures t-tests were employed for analysis.
Results: Statistically significant differences were found in the mean scores of parents’ PSS: NICU and FCCS-Consistency at T1 and T2 (p<0.05). The highest source of stress was “sights and sounds” at T1 and shifted to “infant behavior and appearance” at T2 (p<0.05).
Conclusion: This study revealed differences in parental stress levels on the second day of admission to the unit and at the end of the first week. Stress levels decreased and perceived FCCS-Consistency scores increased at T2. The creation of standardized time points and instruments would enhance the comparability of parental stress levels and perceived FCC. Organizations can develop checklists and quality indicators to assess the consistency of routine care with the FCC model.
Keywords: Nursing care, parental stress, family-centered care, NICU
Etik Beyan
An approval from the noninvasive clinical trials ethics committee (Mersin University, 19/10/2017-2017/299) was obtained
Destekleyen Kurum
No external funding.
Teşekkür
We are grateful to Professor Gülhan TEMEL (Department of Biostatistics, Faculty of Medicine, Mersin University) for supervision support to statistical analysis and all parents who participated to study.
Kaynakça
-
Acunaş, B., Uslu, S., & Yağmur Baş, A. (2018). Turkish Neonatal Society guideline for the follow-up of high-risk newborn infants. Turk Pediatri Ars, 53(Suppl 1), 180–195. https://doi.org/10.5152/TurkPediatriArs.2018.01817
-
Adama, E. A., Adua, E., Bayes, S., & Mörelius, E. (2022). Support needs of parents in neonatal intensive care unit: An integrative review. Journal of Clinical Nursing, 31(5-6), 532-547.
-
Al Maghaireh, D. F., Abdullah, K. L., Chong, M. C., Chua, Y. P., & Al Kawafha, M. M. (2017). Stress, anxiety, depression and sleep disturbance among Jordanian mothers and fathers of infants admitted to neonatal intensive care unit: a preliminary study. Journal of Pediatric Nursing, 36, 132–140. https://doi.org/10.1016/j.pedn.2017.06.007
-
Alkozei, A., McMahon, E., & Lahav, A. (2014). Stress levels and depressive symptoms in NICU mothers in the early postpartum period. The Journal of Maternal-Fetal & Neonatal Medicine, 27(17), 1738–1743. https://doi.org/10.3109/14767058.2014.942626
-
Altıparmak, D., & Taş-Arslan, F. (2016). Aile Merkezli Bakım Ölçeği’nin Türkçe geçerlik ve güvenirlik çalışması. [The Adaptation of Family Centred Care Scale to Turkish a Validity and Reliability Study]. Journal of Pediatric Research, 3(2), 97–103. https://doi.org/10.4274/jpr.60566
-
Baía, I., Amorim, M., Silva, S., Kelly-Irving, M., de Freitas, C., & Alves, E. (2016). Parenting very preterm infants and stress in Neonatal Intensive Care Units. Early Human Development, 101, 3–9. https://doi.org/10.1016/j.earlhumdev.2016.04.001
-
Bernardo, J., Rent, S., Arias-Shah, A., Hoge, M. K., & Shaw, R. J. (2021). Parental stress and mental health symptoms in the NICU: Recognition and interventions. Neoreviews, 22(8), e496-e505.
-
Brunson, E., Thierry, A., Ligier, F., Vulliez-Coady, L., Novo, A., Rolland, A. C., & Eutrope, J. (2021). Prevalence and predictive factors of maternal trauma through 18 months after premature birth: A longitudinal, observational and descriptive study. PLoS One, 16(2), e0246758.
-
Caporali, C., Pisoni, C., Gasparini, L., Ballante, E., Zecca, M., Orcesi, S., & Provenzi, L. (2020). A global perspective on parental stress in the neonatal intensive care unit: A meta-analytic study. Journal of Perinatology, 40(12), 1739-1752.
-
Curley, M. A. Q., Hunsberger, M., & Harris, S. K. (2013). Psychometric evaluation of the family-centered care scale for pediatric acute care nursing. Nursing Research, 62(3), 160–168. https://doi.org/10.1097/nnr.0b013e318286d64b
-
Dimitroff, S. J., Kardan, O., Necka, E. A., Decety, J., Berman, M. G., & Norman, G. J. (2017). Physiological dynamics of stress contagion. Scientific Reports, 7(1). https://doi.org/10.1038/s41598-017-05811-1
-
Gómez-Cantarino, S., García-Valdivieso, I., Moncunill-Martínez, E., Yáñez-Araque, B., & Ugarte Gurrutxaga, M. I. (2020). Developing a family-centered care model in the neonatal intensive care unit (NICU): A new vision to manage healthcare. International Journal of Environmental Research and Public Health, 17(19), 7197.
-
Govindaswamy, P., Laing, S., Waters, D., Walker, K., Spence, K., & Badawi, N. (2019). Needs and stressors of parents of term and near-term infants in the NICU: A systematic review with best practice guidelines. Early Human Development, 104839. https://doi.org/10.1016/j.earlhumdev.2019.104839
-
Gustafson, K. W., LaBrecque, M. A., Graham, D. A., Tella, N. M., & Curley, M. A. Q. (2016). Effect of parent presence during multidisciplinary rounds on NICU-related parental stress. Journal of Obstetric, Gynecologic & Neonatal Nursing, 45(5), 661–670. https://doi.org/10.1016/j.jogn.2016.04.012
-
Heidarzadeh, M., Heidari, H., Ahmadi, A., Solati, K., & Sadeghi, N. (2023). Evaluation of parental stress in neonatal intensive care unit in Iran: A national study. BMC Nursing, 22(1), 41.
-
Lazzerini, M., do Amaral Gomez, D. B. C., Azzimonti, G., Bua, J., Neto, W. B., Brasili, L., ... & Mariani, I. (2024). Parental stress, depression, anxiety and participation to care in neonatal intensive care units: Results of a prospective study in Italy, Brazil and Tanzania. BMJ Paediatrics Open, 8(Suppl 2), e002539.
-
Matricardi, S., Agostino, R., Fedeli, C., & Montirosso, R. (2012). Mothers are not fathers: Differences between parents in the reduction of stress levels after a parental intervention in a NICU. Acta Paediatrica, 102(1), 8–14. https://doi.org/10.1111/apa.12058
-
Meier, P. P., Johnson, T. J., Patel, A. L., & Rossman, B. (2017). Evidence-based methods that promote human milk feeding of preterm infants. Clinics in Perinatology, 44(1), 1–22. https://doi.org/10.1016/j.clp.2016.11.005
-
Miles, M. S., Funk, S. G., & Carlson, J. (1993). Parental Stressor Scale: Neonatal intensive care unit. Nursing Research, 42(3), 148–152. https://doi.org/10.1097/00006199-199305000-00005
-
Montirosso, R., Fedeli, C., Del Prete, A., Calciolari, G., & Borgatti, R. (2014). Maternal stress and depressive symptoms associated with quality of developmental care in 25 Italian Neonatal Intensive Care Units: A cross sectional observational study. International Journal of Nursing Studies, 51(7), 994–1002. https://doi.org/10.1016/j.ijnurstu.2013.11.001
-
O’Brien, K., Robson, K., Bracht, M., Cruz, M., Lui, K., Alvaro, R., … Ng, E. (2018). Effectiveness of family integrated care in neonatal intensive care units on infant and parent outcomes: A multicentre, multinational, cluster-randomised controlled trial. The Lancet Child & Adolescent Health, 2(4), 245–254. https://doi.org/10.1016/s2352-4642(18)30039-7
-
Palma, I, E., Von Wussow K, F., Morales B, I., Cifuentes R, J., & Ambiado T, S. (2017). Estrés en padres de recién nacidos hospitalizados en una unidad de paciente crítico neonatal. Revista Chilena de Pediatría, 88(3), 332–339. https://doi.org/10.4067/s0370-41062017000300004
-
Raiskila, S., Lehtonen, L., Tandberg, B. S., Normann, E., Ewald, U., Caballero, S., & Axelin, A. (2016). Parent and nurse perceptions on the quality of family-centered care in 11 European NICUs. Australian Critical Care, 29(4), 201–209. https://doi.org/10.1016/j.aucc.2016.09.003
-
Soghier, L. M., Kritikos, K. I., Carty, C. L., Glass, P., Tuchman, L. K., Streisand, R., & Fratantoni, K. R. (2020). Parental depression symptoms at neonatal intensive care unit discharge and associated risk factors. The Journal of Pediatrics, 1–7. https://doi.org/10.1016/j.jpeds.2020.07.040
-
Soni, R., & Tscherning, C. (2021). Family-centred and developmental care on the neonatal unit. Paediatrics and Child Health, 31(1), 18-23.
-
Turan, T., & Başbakkal, Z. (2006). Study on validity and reliability of a Turkish version of the Parental Stress Scale: Neonatal Intensive Care Unit. Journal of Hacettepe University School of Nursing, 32–42. https://dergipark.org.tr/en/download/article-file/88580
-
Turan, T., Başbakkal, Z., & Özbek, Ş. (2008). Effect of nursing interventions on stressors of parents of premature infant in neonatal intensive care unit. Journal of Clinical Nursing, 17, 2856–2866. https://doi.org/10.1111/j.1365-2702.2008.02307.x
-
Turner, M., Chur-Hansen, A., Winefield, H., & Stanners, M. (2015). The assessment of parental stress and support in the neonatal intensive care unit using the Parent Stress Scale – Neonatal Intensive Care Unit. Women and Birth, 28(3), 252–258. https://doi.org/10.1016/j.wombi.2015.04.001
-
Üğücü, G. (2018). Yenidoğan yoğun bakım ünitesinde verilen standart hemşirelik bakımının ebeveyn stres düzeyi ve aile merkezli bakım algısına etkisi. (Yükseklisans Tezi). Mersin Üniversitesi Sağlık Bilimleri Enstitüsü, Mersin.
-
Üğücü, G., Çelebioğlu, A., & İşbir, G. G. (2024). Yenidoğan yoğun bakım ünitesindeki prematüre bebeğin nörogelişiminin desteklenmesi: İyileştirici çevrenin oluşturulması. Adnan Menderes Üniversitesi Sağlık Bilimleri Fakültesi Dergisi, 8(2), 192-208.
-
World Health Organization (WHO). (2022). WHO recommendations for care of the preterm or low-birth-weight infant. Retrieved from https://apps.who.int/iris/bitstream/handle/10665/363697/9789240058262-eng.pdf
-
Yiğit, R., & Üğücü, G. (2019). Yüksek riskli yenidoğan ve bakımının tarihsel gelişimi: Dünya ve Türkiye. Adnan Menderes Üniversitesi Sağlık Bilimleri Fakültesi Dergisi, 3(3), 200-211.