Department of Psychiatry, Center for Health Outcomes and Interdisciplinary Research, Massachusetts General Hospital, Harvard Medical School, Boston, MB, USA.
Division of Newborn Medicine, MassGeneral for Children, Harvard Medical School, Boston, MA, USA.
Eur J Pediatr. 2022 Sep;181(9):3545-3548. doi: 10.1007/s00431-022-04553-1. Epub 2022 Jul 8.
The neonatal intensive care unit (NICU) is a high-acuity, stressful unit for both parents and staff. Up to 50% of mothers and partners experience emotional distress (i.e., depression, anxiety, or posttraumatic stress) during NICU hospitalization and 30-60% continue to experience distress after discharge. Similarly, up to 50% of NICU staff report burnout and emotional distress. Although healthcare providers have developed interdisciplinary guidelines to enhance psychosocial resources for parents and staff, standardized psychosocial services are lacking. The purpose of this short communication is to describe: (1) the need for psychosocial interventions for NICU parents and staff; (2) existent psychosocial programs and their gaps and limitations; and (3) future directions for psychosocial care in NICU settings. We reviewed the current literature and propose a new conceptual model to inform psychosocial interventions for the NICU. We argue that brief, evidence-based, resiliency, and relationship-based programs are needed to enhance parent and staff outcomes and, ultimately, child development and the NICU unit culture.
Given the lack of standardized psychosocial care, new interventions for NICU families and staff are needed more than ever. Resiliency, relationship-based interventions that leverage multidisciplinary support may be an innovative way to enhance NICU outcomes and care.
• 40-50% of parents in the NICU report elevated emotional distress and 30-50% of staff report burnout. • Psychosocial interventions for parents and staff are needed, yet lacking.
• Interventions that focus on resiliency and relationships may improve the culture of the NICU. • New multidisciplinary collaborations and approaches are needed to improve implementation.
新生儿重症监护病房(NICU)对父母和工作人员来说都是一个高度紧张的环境。在 NICU 住院期间,多达 50%的母亲和伴侣会经历情绪困扰(即抑郁、焦虑或创伤后应激),而 30-60%的人在出院后仍会继续感到困扰。同样,多达 50%的 NICU 工作人员报告 burnout 和情绪困扰。尽管医疗保健提供者已经制定了跨学科指南,以增强父母和工作人员的社会心理资源,但标准化的社会心理服务仍然缺乏。本简短交流的目的是描述:(1)NICU 父母和工作人员需要社会心理干预;(2)现有的社会心理项目及其差距和局限性;以及(3)NICU 环境中社会心理护理的未来方向。我们回顾了当前的文献,并提出了一个新的概念模型,为 NICU 的社会心理干预提供信息。我们认为,需要简短、基于证据的、恢复力和基于关系的项目,以提高父母和工作人员的结果,并最终促进儿童发展和 NICU 单位文化。
鉴于缺乏标准化的社会心理护理,现在比以往任何时候都更需要为 NICU 家庭和工作人员提供新的干预措施。利用多学科支持的恢复力、基于关系的干预措施可能是增强 NICU 结果和护理的一种创新方式。
• 40-50%的 NICU 父母报告情绪困扰升高,30-50%的工作人员报告 burnout。• 需要针对父母和工作人员的社会心理干预,但缺乏此类干预。
• 关注恢复力和关系的干预措施可能会改善 NICU 的文化。• 需要新的多学科合作和方法来改善实施。