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  • Original Article
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Emotional distress in mothers of preterm hospitalized infants: a feasibility trial of nurse-delivered treatment

Abstract

Objective:

Mothers of preterm infants in a hospital neonatal intensive care unit (NICU) are at risk for clinically significant depression and anxiety, but for these women their own treatment is likely a secondary priority. This study evaluated the feasibility, acceptability and effectiveness of an evidence-based, nurse-delivered, on-site depression treatment: listening visits (LVs).

Study Design:

Therapeutic LVs were delivered on site to 23 distressed mothers of NICU infants. The intervention was conducted by a neonatal nurse practitioner and the outcome was examined in an open-trial, pre-post evaluation.

Result:

A part-time nurse practitioner delivered six LVs to each participant within a 1-month time frame. LVs were associated with significantly improved mood and well-being in mothers. The majority of eligible women took advantage of LVs and felt satisfied with their care.

Conclusion:

This open trial provides ‘proof-of-concept’, with results that warrant further evaluation in a multisite randomized controlled trial.

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References

  1. Brandon DH, Tully KP, Silva SG, Malcolm WF, Murtha AP, Turner BS et al. Emotional respones of mothers of late-preterm and term infants. J Obstet Gynecol Neonatal Nurs 2011; 40: 719–731.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Singer LT, Salvator A, Guo S, Collin M, Lilien L, Baley J . Maternal psychological distress and parenting stress after the birth of a very low-birth-weight infant. J Am Med Assoc 1999; 281: 799–805.

    Article  CAS  Google Scholar 

  3. Vigod SN, Villegas L, Dennis C-L, Ross LE . Prevalence and risk factors for postpartum depression among women with preterm and low-birth-weight infants: a systematic review. Int J Obstet Gynecol 2010; 117: 540–550.

    CAS  Google Scholar 

  4. Lefkowitz DS, Baxt C, Evans J . Prevalence and correlates of posttraumatic stress and postpartum depression in parents of infants in the Neonatal Intensive Care Unit (NICU). J Clin Psychol Med Settings 2010; 17: 230–237.

    Article  PubMed  Google Scholar 

  5. Druss B, Pincus H . Suicidal ideation and suicide attempts in general medical illness. Arch Intern Med 2000; 160: 1522–1526.

    Article  CAS  PubMed  Google Scholar 

  6. Lindahl V, Pearson JL, Colpe L . Prevalence of suicidality during pregnancy and the postpartum. Arch Womens Ment Health 2005; 8: 77–87.

    Article  CAS  PubMed  Google Scholar 

  7. Rogers CE, Kidokoro H, Wallendorf M, Inder TE . Identifying mothers of very preterm infants at-risk for postpartum depression and anxiety before discharge. J Perinatol 2012; 33: 171–176.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Melnyk BM, Feinstein NF, Alpert-Gillis L, Fairbanks E, Crean HF, Sinkin RA et al. Reducing premature infants' length of stay and improving parents'; mental health outcomes with the Creating Opportunities for Parent Empowerment (COPE) Neonatal Intensive Care Unit Program: A randomized controlled trial. Pediatrics 2006; e1414–e1427.

  9. Price CP . Point of care testing. Br Med J 2001; 322: 1285–1288.

    Article  CAS  Google Scholar 

  10. Davis L, Edwards H, Mohay H, Wollin J . The impact of very premature birth on the psychological health of mothers. Early Hum Dev 2003; 73: 61–70.

    Article  PubMed  Google Scholar 

  11. Holden JM, Sagovsky R, Cox JM . Counselling in a general practice setting: controlled study of health visitor intervention in treatment of postnatal depression. Br Med J 1989; 298: 223–226.

    Article  CAS  Google Scholar 

  12. Cooper PJ, Murray L, Wilson A, Romaniuk H . Controlled trial of the short-and long-term effect of psychological treatment of post-partum depression. I. Impact on maternal mood. Br J Psychiatry 2003; 182: 412–419.

    Article  PubMed  Google Scholar 

  13. Morrell CJ, Slade P, Warner R, Paley G, Dixon S, Walters SJ et al. Clinical effectiveness of health visitor training in psychologically informed approaches for depression in postnatal women: pragmatic cluster randomised trial in primary care. Br Med J 2009; 338: a3045.

    Article  Google Scholar 

  14. Wickberg B, Hwang CP . Counselling of postnatal depression: A controlled study on a population based Swedish sample. J Affect Disord 1996; 39: 209–216.

    Article  CAS  PubMed  Google Scholar 

  15. National Collaborating Center for Mental Health. Antenatal and Postnatal Mental Health: Clinical Management and Service Guidance. National Institute for Health and Clinical Excellence. British Psychological Society: Leicester, UK, 2007.

  16. Segre LS, Stasik SM, O'Hara MW, Arndt S . Listening visits: an evaluation of the effectiveness and acceptability of a home-based depression treatment. Psychother Res 2010; 20: 712–721.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Rounsaville BJ, Carroll KM, Onken LS . A stage model of behavioral therapies research: Getting started and moving on from stage I. Clin Psychol Sci Practice 2001; 8: 133–142.

    Article  Google Scholar 

  18. Bulachek GM, Butcher HK, Dochterman JM, Wagner CM (eds). Listening Visits Sixth edn. Elsevier: St Louis, 2013.

    Google Scholar 

  19. Cox J, Holden J . Perinatal Mental Health: A Guide to The Edinburgh Postnatal Depression Scale (EPDS). Gaskell: London, 2003.

    Google Scholar 

  20. Myers ER, Aubuchon-Endsley N, Bastian LA, Gierisch JM, Kemper AR, Swamy GK et al Efficacy and Safety of Screening for Postpartum Depression. Comparative Effectiveness Review 106. Agency for Healthcare Research and Quality: Rockville, MD, USA, 2013.

    Google Scholar 

  21. Beck AT, Epstein N, Brown G, Steer RA . An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 1988; 56: 893–897.

    Article  CAS  PubMed  Google Scholar 

  22. Endicott J, Nee J, Harrison W, Blumenthal R . Quality of life enjoyment and satisfaction questionnaire: A new measure. Psychopharmacol Bull 1993; 29: 321–326.

    CAS  PubMed  Google Scholar 

  23. Larsen DL, Attkisson CC, Hargreaves WA, Nguyen TD . Assessment of client/patient satisfaction: development of a general scale. Eval Program Plann 1979; 2: 197–207.

    Article  CAS  PubMed  Google Scholar 

  24. Raudenbush SW, Bryk AS (eds). Hierarchical Linear Models: Applications and Data Analysis Methods 2nd edn. Sage: Thousand Oaks, CA, USA, 2002.

    Google Scholar 

  25. Cohen J . A power primer. Psychol Bull 1992; 112: 155–159.

    Article  CAS  PubMed  Google Scholar 

  26. Jacobson NS, Truax P . Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. J Consult Clin Psychol 1991; 59: 12–19.

    Article  CAS  PubMed  Google Scholar 

  27. Matthey S . Calculating clinically significant change in postnatal depression studies using the Edinburgh Postnatal Depression Scale. J Affect Disord 2004; 78: 269–272.

    Article  PubMed  Google Scholar 

  28. Swartz HA, Zuckoff A, Frank E, Spielvogle HN, Shear MK, Fleming MAD et al. An open-label trial of enhanced brief Interpersonal Psychotherapy in depressed mothers whose children are receiving psychiatric treatment. Depress Anxiety 2006; 23: 398–404.

    Article  PubMed  Google Scholar 

  29. Marcus SM, Flynn HA, Blow FC, Barry KL . Depressive symptoms among pregnant women screened in obstetrics settings. J Womens Health 2003; 12: 373–380.

    Article  Google Scholar 

  30. Conner JM, Nelson EC . Neonatal intensive care: satisfaction measured from a parent's perspective. Pediatrics 1999; 103: 336–349.

    CAS  PubMed  Google Scholar 

  31. Segre LS, O'Hara MW, Arndt S, Beck CT . Postpartum depression, Part 1: Do nurses think they should offer both screening and counseling? Am J Maternal Child Nurs 2010; 35: 220–225.

    Article  Google Scholar 

  32. Haaga DAF . Introduction to the special section on stepped care models in psychotherapy. J Consult Clin Psychol 2000; 68: 547–548.

    Article  CAS  PubMed  Google Scholar 

  33. Miles MS, Holditch-Davis D, Schwartz TA, Scher M . Depressive symptoms in mothers of prematurely born infants. J Dev Behav Pediatr 2007; 28: 36–44.

    Article  PubMed  Google Scholar 

  34. Thompson RJ, Oehler JM, Catlett AT, Johndrow DA . Maternal psychological adjustment to the birth of an infant weighing 1,500 grams or less. Infant Behav Dev 1993; 16: 471–485.

    Article  Google Scholar 

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Acknowledgements

Funding for this research was provided by the Social Science Funding Program, Vice President for Research Office of the University of Iowa. During the period of the conduct of this research, Lisa S. Segre, PhD, was supported by an NIMH K-23 Award grant MH075964. We acknowledge the assistance of NICU nursing staff (Jennifer Nieman (MSN, NNP-BC) and Jade Kalmes (MSN, NNP-BC)), social work staff (Ruth Truhlar (MSW), Tara Clark (MSW) and the NICU social work team), Stephan Arndt (PhD) for statistical consultation, James Marchman, PhD (Member of Data and safety Monitoring Board) Diana Colgan (PhD), the College of Nursing editor, and importantly, the mothers who participated in this research.

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Correspondence to L S Segre.

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Segre, L., Chuffo-Siewert, R., Brock, R. et al. Emotional distress in mothers of preterm hospitalized infants: a feasibility trial of nurse-delivered treatment. J Perinatol 33, 924–928 (2013). https://doi.org/10.1038/jp.2013.93

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