Departments of Anesthesia.
Psychology, University of Calgary.
Clin J Pain. 2018 Oct;34(10):936-943. doi: 10.1097/AJP.0000000000000620.
The birth of a preterm infant and witnessing ones' infant in pain is remembered by parents as being one of the most stressful aspects of the neonatal intensive care unit (NICU). Elevated posttraumatic stress symptoms (PTSS) are highly prevalent among mothers of preterm infants, however, little is known about mothers' memories of invasive procedures in the NICU and how these memories may contribute to the development of PTSS. We examined the relationships between number of invasive procedures, mothers' memories of these procedures, and their PTSS at discharge from the NICU.
Participants included 36 mothers of infants born below 37 weeks gestational age recruited from a tertiary-level NICU. Medical chart review was performed between birth and discharge from the NICU. At discharge, a research nurse conducted a structured memory interview with the mothers to assess their memories of their infants' invasive procedures. Mothers also completed a self-report measure of PTSS (Posttraumatic Stress Disorder Checklist for the DSM-5).
Mothers of infants exposed to greater numbers of invasive procedures had more elevated PTSS at discharge (R=0.37). Moreover, mothers who recalled having greater anxiety about their infant's invasive procedures had greater symptoms of reexperiencing (R=0.34) and avoidance (R=0.28) at discharge from the NICU.
Greater neonatal exposure to invasive procedures and mothers' recall of these procedures were related to mothers' posttraumatic stress symptomatology at discharge. Invasive procedures in the NICU represent an important target area for neonatal intervention to reduce maternal distress and improve outcomes.
早产儿的诞生和目睹婴儿的痛苦被父母视为新生儿重症监护病房（NICU）中最具压力的方面之一。早产儿母亲的创伤后应激症状（PTSS）发生率很高，然而，人们对母亲在 NICU 中对侵入性程序的记忆以及这些记忆如何导致 PTSS 的发展知之甚少。我们研究了侵入性程序的数量、母亲对这些程序的记忆与她们从 NICU 出院时的 PTSS 之间的关系。
参与者包括从三级 NICU 招募的 36 名胎龄低于 37 周的婴儿的母亲。在 NICU 出生和出院期间进行了病历回顾。在出院时，研究护士对母亲进行了结构化记忆访谈，以评估她们对婴儿侵入性程序的记忆。母亲还完成了创伤后应激障碍检查表第五版（DSM-5）的自我报告 PTSS 测量。
接受更多侵入性程序的婴儿的母亲在出院时的 PTSS 更高（R=0.37）。此外，回忆起对婴儿的侵入性程序感到更焦虑的母亲在出院时表现出更强烈的再体验（R=0.34）和回避（R=0.28）症状。
新生儿接受更多的侵入性程序和母亲对这些程序的回忆与母亲出院时的创伤后应激症状有关。NICU 中的侵入性程序代表了新生儿干预的一个重要目标领域，可以减轻母亲的痛苦并改善结果。
