Department of Pediatrics, Division of Neonatology & Developmental Biology, University of California-Los Angeles (UCLA), Los Angeles, CA, USA.
Keck School of Medicine of University of Southern California, Los Angeles, CA, USA.
J Perinatol. 2019 Mar;39(3):375-386. doi: 10.1038/s41372-018-0310-9. Epub 2019 Jan 18.
To classify NICU interventions for parental distress and quantify their effectiveness.
We systematically reviewed controlled studies published before 2017 measuring NICU parental distress, defined broad intervention categories, and used random-effects meta-analysis to quantify treatment effectiveness.
Among 1643 unique records, 58 eligible trials predominantly studied mothers of preterm infants. Interventions tested in 22 randomized trials decreased parental distress (p < 0.001) and demonstrated improvement beyond 6 months (p < 0.005). In subgroup analyses, complementary/alternative medicine and family-centered instruction interventions each decreased distress symptoms (p < 0.01), with fathers and mothers improving to similar extents. Most psychotherapy studies decreased distress individually but did not qualify for meta-analysis as a group.
NICU interventions modestly reduced parental distress. We identified family-centered instruction as a target for implementation and complementary/alternative medicine as a target for further study. Investigators must develop psychosocial interventions that serve NICU parents at large, including fathers and parents of full-term infants.
对新生儿重症监护病房（NICU）中父母痛苦干预措施进行分类，并量化其效果。
我们系统性地回顾了 2017 年以前发表的、针对 NICU 父母痛苦的对照研究，定义了广泛的干预类别，并使用随机效应荟萃分析量化了治疗效果。
在 1643 条独特的记录中，有 58 项符合条件的试验主要研究了早产儿母亲。22 项随机试验中测试的干预措施降低了父母的痛苦（p<0.001），并在 6 个月后显示出改善（p<0.005）。在亚组分析中，补充/替代医学和以家庭为中心的指导干预都降低了痛苦症状（p<0.01），父亲和母亲的改善程度相似。大多数心理治疗研究单独降低了痛苦，但作为一个整体不符合荟萃分析的条件。
NICU 干预措施适度减轻了父母的痛苦。我们确定以家庭为中心的指导是实施的目标，补充/替代医学是进一步研究的目标。研究人员必须开发针对广大 NICU 父母的心理社会干预措施，包括父亲和足月婴儿的父母。
