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Korean J Child Health Nurs. 2000 Jun;6(2):224-239. Korean. Original Article.
Kim TI .
Department of Nursing, Taejon University, Korea.
Abstract

This descriptive study was conducted to understand the contents and degree of parental stress level in the NICU patients, and to give a baseline data in developing nursing intervention program. Subjects were the 62 mother of hospitalized newborn in NICU of 1 University Hospital in Taejon City from May 1st, 1999 to November 30th, 1999, who agreed to take part in this study. The instrument used in this study were Parental Stressor Scales : NICU(PSS:NICU) developed by Miles et al. and validated by 3 NICU practitioners and 3 child health nursing faculties. The questionnaire has 4 dimensions and 45 items; sight and sounds of NICU(5 items), babies' appearance and behavior(19 items), parental role alteration and relationship with their baby(10 items), communication with health team(11 items). The questionnaire asks parents to rate each item on a five-point Likert type scale that ranges from "not stressful" (1) to "extremely stressful"(5). Total scores representing overall stress from the NICU environment are calculated by summing response to each item. A high score indicates high stress. A subscale score is calculated by summing the responses to each item in the subscale. Cronbach's alpha coefficients were .93. The data was analyzed as average, Frequency, Standard deviation, t-test, ANOVA, Pearson correlation coefficient by use of SPSS/PC+ . The results of this study is summarized as follows ; 1. The total perceived stress level score of mothers was slightly high(3.6 +/- .7). The highest scored dimension was 'appearance and behavior of the baby' (3.9 +/- 1.5), and next were 'relationship with their baby and parental role change' (3.5 +/- 1.4), 'communication with health team' (3.4 +/- .9), 'sight and sounds of NICU' (3.2 +/- .8). 2. Two variables were statistically significant with PSS:NICU total scale ; mother's perceived severity of the baby's condition (r=.482, P=.002) and mother's religious attendance(t=2.83, P=.01). The more the mother perceive their baby's condition severe, the higher the total stress score. There were high stress score noted in the mother of no religious attendance. 3. Four variables were statistically significant with NICU environment subscale ; mother's educational background(F=3.45, P=.04), religious attendance(t=2.28, P=.04), sex of the baby(t=2.83, P=.01) and NICU patients' hospital day(r=.359, P=.004). That is mother with high educational background and girl baby were high NICU environment subscale score. 4. Four variables were statistically significant with appearance and behavior of the baby subscale ; when first saw baby(F=3.52, P=.04), incubator care(t=2.83, P=.01), mother's perceived severity of the baby's condition(r=.303, P=.017), number of NICU visit(r=.441, P=.002). That is, seeing the baby first in the NICU and recieved incubator care was very stressful. Also, the more the mother perceive their baby's condition severe and more NICU visit, the higher the appearance and behavior of the baby subscale stress score. 5. Four variables were statistically significant with relationship with their baby and parental role change subscale ; when first saw baby(F=3.37, P=.04), sex of the baby(t=2.36, P=.03), incubator care(t=5.60, P=.00), mother's perceived severity of the baby's condition(r=.401, P=.001). That is, seeing the baby first in the NICU and girl baby was very stressful. Also, the more the mother perceive their baby's condition severe, the higher the relationship with their baby and parental role change subscale stress score. 6. Three variables were statistically significant with communication with health team subscale ; mother's educational background (F=3.63, P=.04), incubator care(t=4.24, P=.00), gestational age(r=-.394, P=.047), and birth weight(r=-.460, P=.004). That is, mother with high educational background and receiving incubator care were high communication with health team subscale score. Also, the shorter the gestational age and smaller the baby's birth weight, the higher the communication with health team subscale score. In conclusion, information about physical environment of NICU, the mother's perceived severity of baby's illness state, maternal role change related variables and the knowledge of characteristics of NICU patients must be included in nursing intervention program of mother's of NICU patients in reducing the maternal stress and anxiety level.

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