Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island (Drs Sharp and Ward); Women's Medicine Collaborative, The Miriam Hospital, Providence, Rhode Island (Dr Sharp); Department of Psychology, East Carolina University, Greenville, North Carolina (Ms Huber and Dr Dolbier); and Center for Behavioral and Preventative Medicine, The Miriam Hospital, Providence, Rhode Island (Dr Ward).
J Perinat Neonatal Nurs. 2021;35(1):57-67. doi: 10.1097/JPN.0000000000000543.
This mixed-methods pilot study investigated maternal perceived stress specific to infant neonatal intensive care unit (NICU) hospitalization as a moderator of the relationship between traumatic childbirth appraisal and symptoms of posttraumatic stress disorder (PTSD). NICU mothers (N = 77) were recruited via social media 1 to 4 months postpartum for a cross-sectional survey about perinatal experiences. Measures included traumatic childbirth, PTSD Checklist for DSM-5, and Parental Stressor Scale (PSS): NICU. Quantitative results indicated that, only at high levels of stress, women who reported traumatic childbirth (68%) reported significantly higher PTSD symptoms [b = 18.00, standard error = 7.18, t = 2.51, P = .015, 95% confidence interval (3.65, 32.36)]. Qualitative analysis identified additional stressors: maternal emotional well-being, dissatisfaction with care, infant health problems, breastfeeding, and additional characteristics of the NICU environment. Results provide supportive evidence that NICU mothers are at high risk for childbirth-related trauma and PTSD. Perceived stress related to the NICU may be an important intervention target when developing trauma-informed patient care. In addition to the domains captured by the PSS: NICU, maternal emotional well-being, interpersonal relationships with NICU staff, and stress related to breastfeeding are additional areas for improvement in the family-centered NICU.
这项混合方法的初步研究调查了婴儿新生儿重症监护病房（NICU）住院期间特定于产妇的感知压力，作为创伤性分娩评估与创伤后应激障碍（PTSD）症状之间关系的调节因素。NICU 母亲（N=77）在产后 1 至 4 个月通过社交媒体招募，进行了一项关于围产期经历的横断面调查。研究采用的测量工具包括创伤性分娩、DSM-5 创伤后应激障碍清单和父母应激源量表（PSS）：NICU。定量结果表明，仅在高压力水平下，报告创伤性分娩（68%）的女性报告的 PTSD 症状明显更高[ b = 18.00，标准误差= 7.18， t = 2.51， P =.015，95%置信区间（3.65，32.36）]。定性分析确定了其他应激源：产妇的情绪健康、对护理的不满、婴儿的健康问题、母乳喂养以及 NICU 环境的其他特征。研究结果提供了有力的证据表明，NICU 母亲面临着与分娩相关的创伤和 PTSD 的高风险。与 NICU 相关的感知压力可能是开发以创伤为中心的患者护理时的一个重要干预目标。除了 PSS：NICU 所涵盖的领域外，产妇的情绪健康、与 NICU 工作人员的人际关系以及与母乳喂养相关的压力是家庭为中心的 NICU 中需要改进的其他领域。
