Center for Perinatal Research, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio.
College of Nursing, The Ohio State University, Columbus, Ohio.
J Nurs Manag. 2019 Mar;27(2):442-449. doi: 10.1111/jonm.12679. Epub 2018 Sep 20.
This pilot study explored how maternal stress experienced in the neonatal intensive care unit (NICU) is affected by the individual nursing structure and the network that provides care to extremely preterm infants.
Mothers experience high stress when their extremely preterm infants are hospitalized in the NICU. This often translates into maladaptive parenting behaviours that negatively affect the long-term cognitive, social, and emotional development of the infant. Efforts to identify modifiable sources of maternal stress in the NICU could lead to improvement in maternal engagement and, ultimately, long-term neurodevelopmental outcomes.
Time- and date-stamped nursing shift data were extracted from the medical record and transformed into five structural nursing metrics with resultant nurse data networks. These were then analysed for associations with maternal stress outcomes on the Parental Stressor Scale (PSS: NICU).
Infants experienced highly variable nursing care and networks of nurses throughout their hospitalization. This variability is associated with the PSS: NICU (a) Sights and Sounds and (b) Altered Parental Role subscales.
Nursing structure and the resultant caregiving network have an impact on maternal stress.
Changing the pattern of nurse staffing may be a modifiable intervention target for reducing maternal stress in the NICU.
本初步研究旨在探讨新生儿重症监护病房（NICU）中产妇经历的应激如何受到个体护理结构和为极早产儿提供护理的网络的影响。
当极早产儿住院于 NICU 时，母亲会经历高度应激。这通常会导致适应不良的育儿行为，从而对婴儿的长期认知、社会和情感发展产生负面影响。努力识别 NICU 中可改变的产妇应激源可能会改善产妇的参与度，并最终改善长期神经发育结局。
从病历中提取带有时间戳的护理班次数据，并将其转化为五个结构护理指标，以及相应的护士数据网络。然后分析这些指标与父母应激量表（PSS：NICU）中产妇应激结果的关联。
婴儿在整个住院期间经历了高度可变的护理和护士网络。这种变异性与 PSS：NICU 的（a）视觉和听觉以及（b）父母角色改变亚量表相关。
护理结构和由此产生的护理网络对产妇应激有影响。
改变护士配置模式可能是减少 NICU 中产妇应激的可改变干预目标。
