Stress and distress in parents of neonates admitted to the neonatal intensive care unit for cardiac surgery

•Parental role alteration was the most stressful aspect of the NICU for parents of infants admitted for cardiac surgery.•Scores for anxiety and depression were highest during the NICU stay and were associated with NICU related stress and coping style.•Interventions which help minimise stress associated with the NICU and support task-focused coping are therefore recommended.

BackgroundParents of infants admitted to the Neonatal Intensive Care Unit (NICU) are at risk of psychological distress and NICU-related stress. However, parents of infants admitted to NICU for cardiac surgery are an under-researched population.AimsIdentify levels of NICU-related stress, and levels of psychological distress, reported by parents of infants admitted to the NICU for cardiac surgery.Study designObservational study.Subjects69 parents of infants admitted to the NICU for cardiac surgery (cardiac group) and 142 parents of healthy infants (control group).Outcome measuresQuestionnaire packs provided to parents prior to discharge (time-point 1), and at six and 12 months corrected age included: Hospital Anxiety and Depression Scale, Coping Inventory for Stressful Situations, and Family Support Scale. The Parental Stressor Scale:NICU was administered to the cardiac group at time-point 1.ResultsThe cardiac group reported (i) that parental role alteration was the most stressful aspect of the NICU and (ii) higher scores for anxiety and depression than the control group at all three time-points, with the highest levels reported during the NICU stay. Correlation analyses indicated (i) stress associated with the sights and sounds of the NICU, and the appearance and behaviour of the infant in the NICU, had a significant positive association with anxiety and depression, and (ii) a significant negative relationship between anxiety and task-focused coping.ConclusionsAn individualised parent-targeted intervention aimed at reducing stress associated with the NICU and enhancing task-focused coping style may help to reduce levels of anxiety and depression within this group of parents.