Howe Tsu-Hsin, Sheu Ching-Fan, Wang Tien-Ni, Hsu Yung-Wen
Department of Occupational Therapy, Steinhardt School of Culture, Education and Human Development, New York University, New York, NY 10012, United States.
Institute of Education, National Cheng Kung University, Tainan, Taiwan.
Res Dev Disabil. 2014 Jul;35(7):1748-56. doi: 10.1016/j.ridd.2014.02.015. Epub 2014 Mar 19.
Taking care of a premature infant adds an extra burden to already stressed parents. Previous studies have shown that parental stress occurs during the initial hospitalization. However, there is little information on parental stress over time, and the few existing results are conflicting. In addition, many studies have focused on maternal stress but there is little information about a father's long-term adaptation to stress. The purpose of this study was to examine the degree and type of parenting stress in the families of very low birth weight (VLBW) preterm infants over the first two years of life. We compared parenting stress in families with preterm infants with control families, while also comparing the stress in mothers to that in fathers. Furthermore, we explored the relationship between parenting stress in the preterm group with identified factors that included the infant's age, medical complications, and parents' perceived feeding issues after they had been discharged from the hospital. This was an exploratory study with a cross sectional design. Participants included a total of 505 mothers from Tainan, Taiwan; 297 with preterm children (239 mothers, 58 fathers) and 208 with full-term children (181 mothers, 27 fathers). Assessments including the Parenting Stress Index, Neonatal Medical Index and Behavior-based Feeding Questionnaire were used to measure parental distress, infants' medical complications and parents' perceived feeding issues, respectively. Results of the study, though not statistically significant, indicated the presence of increased parenting stress in parents of preterm infants as compared to parents of full-term infants. 13.1% of mothers with preterm infants demonstrated total stress levels that warranted clinical intervention. We also found that mothers of preterm infants presented different parenting stress patterns than fathers of preterm infants. Fathers of preterm infants tended to have overall higher stress scores than mothers. On the other hand, mothers of preterm infants tended to report more health related difficulties, more depression, higher social isolation and role restriction, and less support from their spouses, than reported by fathers. Moreover, as time went on, parents with preterm infants continued to experience greater parenting stress than those with full-term infants. Understanding the experiences of parents with preterm children is important for health care providers while interviewing parents for information regarding their children and designing intervention programs to improve children's outcomes.
照顾早产儿给本就压力重重的父母增添了额外负担。先前的研究表明，父母压力在婴儿初次住院期间就会出现。然而，关于父母压力随时间变化的情况，相关信息很少，而且现有的少数研究结果相互矛盾。此外，许多研究聚焦于母亲的压力，但关于父亲对压力的长期适应情况，相关信息甚少。本研究的目的是调查极低出生体重（VLBW）早产儿家庭在婴儿出生后的头两年中育儿压力的程度和类型。我们将早产儿家庭的育儿压力与对照组家庭进行比较，同时也比较母亲和父亲的压力。此外，我们探讨了早产儿组的育儿压力与一些已确定因素之间的关系，这些因素包括婴儿的年龄、医疗并发症以及父母在孩子出院后察觉到的喂养问题。这是一项采用横断面设计的探索性研究。参与者共有来自中国台湾台南的505位母亲；其中297位母亲的孩子为早产儿（239位母亲，58位父亲），208位母亲的孩子为足月儿（181位母亲，27位父亲）。评估工具包括育儿压力指数、新生儿医学指数和基于行为的喂养问卷，分别用于测量父母的苦恼、婴儿的医疗并发症以及父母察觉到的喂养问题。研究结果虽无统计学意义，但表明与足月儿父母相比，早产儿父母的育儿压力有所增加。13.1%的早产儿母亲表现出的总体压力水平需要临床干预。我们还发现，早产儿母亲呈现出与早产儿父亲不同的育儿压力模式。早产儿父亲的总体压力得分往往高于母亲。另一方面，与父亲相比，早产儿母亲往往报告更多与健康相关的困难、更多的抑郁情绪、更高的社交隔离感和角色限制，以及来自配偶的支持更少。此外，随着时间的推移，早产儿父母持续承受着比足月儿父母更大的育儿压力。对于医疗保健人员来说，在询问父母有关其孩子的信息以及设计改善孩子预后的干预项目时，了解早产儿父母的经历非常重要。
