Reducing parental stress in the neonatal Intensive Care Unit through a parental empowerment program

Abstract

Overview of Topic: The experience of parents of new-borns who are hospitalized in the Neonatal Intensive Care Unit (NICU) is known to be very stressful, which in turn affects the parent-infant attachment (Obeidat, Bond & Callister, 2009). Therefore, it is important to identify ways in which parental stress can be reduced. Family-centred care (FCC) has been established as an ideal approach used in the NICU and the FCC intervention; Creating Opportunities for Parent Empowerment (COPE) program has been linked to reduced parental stress. The COPE program is an educational-behavioural intervention, aiming to empower parents to care for their new-born by providing the necessary information (Melynk et al., 2006). Research Question: Does the Creating Opportunities for Parent Empowerment program decrease parental stress experienced in the Neonatal Intensive Care Unit? PICO elements: The population (P) of parents of hospitalized neonates in the NICU were studied. The Creating Opportunities for Parent Empowerment program was the intervention (I) tested, compared (C) to standard care. Reduction in parental stress was the outcome (O) desired. Inclusion and Exclusion Criteria: This criteria was based on the PICO elements and their characteristics that affected the search, such as a date limit according to when intervention was developed. Only quantitative research was included as the outcome was a quantitative measure. Outcome of Search: A total of 729 studies were retrieved from the search, from which 4 Randomised Controlled Trials (RCTs) and 1 Systematic Review were selected as the key studies. Methods of Appraisal: The Critical Appraisal Skills Programme (CASP) tool was used for the RCTs and the AMSTAR checklist for the Systematic Review. Main results: Two sets of results from the RCTs resulted in no statistical significance, whilst the other 3 RCTs and Meta-Analysis from the Systematic Review showed significantly lower maternal stress in the intervention group after Phase II of the COPE program. Main conclusions: The COPE program can greatly decrease maternal stress experienced in the NICU but the same cannot be confirmed for paternal stress. Implications and Recommendations: Further research is to be done on the effect of COPE on paternal stress. The COPE program is a potential intervention to be included in the standard of care in the local NICU and in the syllabi of nursing and midwifery studies.