Grunberg Victoria A, Presciutti Alex, Vranceanu Ana-Maria, Lerou Paul H
Center for Health Outcomes and Interdisciplinary Research, Mass General Brigham, Boston, MA; Harvard Medical School, Boston, MA; Division of Newborn Medicine, Mass General Brigham, Boston, MA.
Center for Health Outcomes and Interdisciplinary Research, Mass General Brigham, Boston, MA; Harvard Medical School, Boston, MA.
J Pediatr. 2025 Jan;276:114300. doi: 10.1016/j.jpeds.2024.114300. Epub 2024 Sep 13.
To identify factors that help explain associations between parent-staff interactions and: (1) parental depression, anxiety, and post-traumatic stress; and (2) parent-child bonding in the neonatal intensive care unit.
Our cross-sectional mixed methods survey investigated the ways in which parental-staff interactions relate to parental distress and parent-child bonding. Parents with babies in the neonatal intensive care unit (n = 165) completed validated measures and open-ended questions about their experiences with staff. Using a sequential explanatory approach, we examined: (1) whether and how parental self-efficacy and personal time mediated parent-staff interactions on distress and bonding; and (2) parental written accounts of experiences with staff.
Multiple mediation analyses revealed that parent-staff interactions exhibited an: (1) indirect effect on parental depression (b = -0.05, SE = 0.02, CI [-0.10, -0.01]), anxiety (b = -0.08, SE = 0.04, CI [-0.16, -0.02]), and parent-child bonding (b = -0.26, SE = 0.08, CI [-0.43, -0.11]) through parental self-efficacy; and (2) indirect effect on parental post-traumatic stress (b = -0.08, SE = 0.04, CI [-0.17, -0.00], completely standardized indirect effect = -0.06) through parental personal time. Thematic analyses revealed that emotional and instructional support from staff helped build parental self-efficacy. Trust with staff helped parents feel comfortable leaving the bedside and engage in basic needs (eg, eat, sleep).
Family-staff dynamics are the foundation for high quality family-centered care. Staff who empower parents to participate in care, engage in parenting tasks, and take care of themselves may reduce their distress and improve relationships among staff, parents, and babies.
确定有助于解释医护人员与家长互动和以下方面之间关联的因素：(1) 家长的抑郁、焦虑和创伤后应激；(2) 新生儿重症监护病房中的亲子关系。
我们的横断面混合方法调查研究了医护人员与家长互动与家长痛苦及亲子关系的关联方式。在新生儿重症监护病房有婴儿的家长（n = 165）完成了关于他们与医护人员经历的有效测量和开放式问题。采用顺序解释法，我们研究了：(1) 家长自我效能感和个人时间是否以及如何介导医护人员与家长互动对痛苦和亲子关系的影响；(2) 家长对与医护人员经历的书面描述。
多项中介分析显示，医护人员与家长互动呈现出：(1) 通过家长自我效能感对家长抑郁（b = -0.05，SE = 0.02，CI [-0.10, -0.01]）、焦虑（b = -0.08，SE = 0.04，CI [-0.16, -0.02]）和亲子关系（b = -0.26，SE = 0.08，CI [-0.43, -0.11]）的间接影响；(2) 通过家长个人时间对家长创伤后应激的间接影响（b = -0.08，SE = 0.04，CI [-0.17, -0.00]，完全标准化间接效应 = -0.06）。主题分析表明，医护人员的情感和指导支持有助于建立家长的自我效能感。与医护人员的信任有助于家长放心离开床边去满足基本需求（如吃饭、睡觉）。
家庭与医护人员的互动关系是高质量以家庭为中心护理的基础。使家长有能力参与护理、承担育儿任务并照顾好自己的医护人员，可能会减轻家长的痛苦，并改善医护人员、家长和婴儿之间的关系。
