An integrative review of maternal distress during neonatal intensive care hospitalization
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REVIEW ARTICLE
An integrative review of maternal distress during neonatal intensive care hospitalization Morgan A. Staver 1
&
Tiffany A. Moore 1 & Kathleen M. Hanna 1
Received: 15 May 2020 / Accepted: 21 August 2020 # Springer-Verlag GmbH Austria, part of Springer Nature 2020
Abstract To synthesize literature addressing maternal distress and associated variables in response to infant hospitalization in the NICU. CINAHL, Medline, PubMed, PsychINFO, and Scopus were searched for studies addressing maternal distress during NICU hospitalization published between January 2009 and August 2019. The initial literature search yielded 862 articles. Articles were included for analysis if (a) they were peer-reviewed, (b) maternal distress was defined or measured, and (c) maternal distress occurred in the NICU. Ultimately, 33 articles were included for analysis. Distress symptoms were not consistently measured across the literature by one specific instrument. However, despite the variety of instruments, distress was prevalent in this population. Individual elements of maternal distress in the NICU include depression, anxiety, trauma, and post-traumatic stress symptoms. These elements often occur together and tend to follow a specific trajectory during hospitalization. This body of literature was inconsistent regarding the timing of distress measurement as well as the relationship between relevant associated variables (e.g., marital status or infant illness severity) and maternal distress. Additionally, researchers often excluded mothers of non-preterm infants and infants with congenital anomalies from investigation. Researchers and clinicians should carefully consider timing and instrumentation in their interpretations of maternal distress measurement during a NICU hospitalization. Future work should focus on developing a comprehensive, valid, and reliable screening tool for clinicians and researchers to use to identify maternal distress in the NICU. Additionally, future research should address gaps in the populations included in studies. Keywords Intensive care units . Neonatal . Mothers . Depression . Anxiety . Stress disorders . Post-traumatic
Women who give birth to an infant who requires admission to the neonatal intensive care unit (NICU) face an abnormal and often frightening birth experience. Unfortunately, infant hospitalization in the NICU is common; a comprehensive birth cohort study found that admissions to the NICU increased 23% between 2007 and 2012 (from 64.0 to 77.9 per 1000 live births; Harrison and Goodman 2015). A mother’s experience in the NICU is often characterized by worry, fear, trauma, and feeling out of control (Beck and Harrison 2017). Mothers in the NICU experience stress and distress at higher rates than mothers of healthy infants (Greene et al. 2015). Stress is a state of tension that occurs when a person appraises a situation as exceeding his or her coping strategies (Folkman et al. 1986). Stressful experiences can lead to distress in the * Morgan A. Staver [email protected] 1
Universit
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