Department of Neonatology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, No 136, Zhongshan Er Road, Yuzhong District, Chongqing City, 400014, China.
Department of Pediatrics, the Peoples's Hospital of Wenshan Prefecture, Yunnan, China.
BMC Public Health. 2024 Sep 11;24(1):2476. doi: 10.1186/s12889-024-19969-7.
This study aims to evaluate the impact of a home-based, post-discharge early intervention (EI) program on reducing parental stress levels in families with preterm infants born between 28 and 31 weeks gestational age.
A randomized controlled trial was conducted, with families randomly allocated to either the EI or standard care (SC) group. A term reference group was also recruited for comparison. The Parental Stress Index-Short Form was used to assess parental stress levels, yielding a total stress score and three subdomain scores. Assessment was performed at baseline, at the 60-day mark of the study, and when the infants reached six corrected months of age. Parents in the reference group were assessed only at six months of corrected age for infants. The intervention comprised three sections: intellectual, physical, and social training, which was administered to the infants in the EI group immediately after discharge and to those in the SC group after 60 days of enrollment.
Seventy-three families were enrolled in this study, with 37 allocated to the EI group, and 36 to the SC group. Prior to intervention, higher stress levels were reported by mothers in both groups than fathers, with no difference observed between the EI and SC groups. Re-assessment performed at 60 days of the study showed that mothers and fathers in the EI group had significantly lower total stress score than those in the SC group (82.00 ± 5.64 vs. 94.26 ± 7.99, p < 0.001; 80.74 ± 7.14 vs. 89.94 ± 9.17, p < 0.001, respectively), which was predominantly due to the lower scores in parental distress and parental-child dysfunction interaction subdomains in the EI group (both had p < 0.001). Mothers in the EI group exhibited a more pronounced reduction in total stress score after intervention when compared to fathers (13.15 ± 4.68 vs. 8.26 ± 4.03, p < 0.001). At six months of infant age, the total stress score and subdomain scores of parents in the EI and SC groups were similar, but significantly higher than those of the reference group.
The home-based, post-discharge EI program demonstrated significant effectiveness in reducing parental stress levels among the parents of very preterm infants.
This study was registered in the Chinese Clinical Trial Registry (registration number: CTR1900028330). Registration date: December 19, 2019.
本研究旨在评估家庭为基础的出院后早期干预（EI）方案对降低 28 至 31 周龄早产儿家庭父母压力水平的影响。
采用随机对照试验设计，将家庭随机分配到 EI 组或标准护理（SC）组。还招募了一个足月参考组进行比较。使用父母压力指数-短式量表（Parental Stress Index-Short Form）评估父母压力水平，得出总压力评分和三个子域评分。在研究开始时、第 60 天和婴儿矫正 6 个月时进行评估。参考组的父母仅在婴儿矫正 6 个月时进行评估。干预包括智力、身体和社会训练三个部分，在 EI 组的婴儿出院后立即进行，在 SC 组的婴儿入组 60 天后进行。
本研究共纳入 73 个家庭，其中 37 个家庭分配到 EI 组，36 个家庭分配到 SC 组。干预前，母亲的压力水平高于父亲，EI 组和 SC 组之间没有差异。研究进行至第 60 天时的再次评估显示，EI 组的母亲和父亲的总压力评分显著低于 SC 组（82.00±5.64 比 94.26±7.99，p<0.001；80.74±7.14 比 89.94±9.17，p<0.001），这主要归因于 EI 组在父母困扰和父母-儿童功能障碍交互子域的评分较低（均 p<0.001）。干预后，EI 组的母亲比父亲的总压力评分下降更为明显（13.15±4.68 比 8.26±4.03，p<0.001）。在婴儿 6 个月时，EI 和 SC 组父母的总压力评分和子域评分与参考组相似，但显著高于参考组。
家庭为基础的出院后 EI 方案在降低极早产儿父母的压力水平方面具有显著效果。
本研究在中国临床试验注册中心（注册号： CTR1900028330）注册。注册日期：2019 年 12 月 19 日。
