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Maternal Stress and Mental Health Prior to Their Technology-Dependent Infant's Discharge Home From the NICU

Toly, Valerie Boebel PhD, RN, CPNP; Blanchette, Julia E. PhD(c), RN, CDE; Liu, Wei MS; Sattar, Abdus PhD; Musil, Carol M. PhD, RN, FAAN; Bieda, Amy PhD, RN, APRN, PNP-BC, NNP-BC; Em, Sarah BSN

The Journal of Perinatal & Neonatal Nursing: April/June 2019 - Volume 33 - Issue 2 - p 149–159
doi: 10.1097/JPN.0000000000000409
Feature Articles: Continuing Education

Mothers of infants in the neonatal intensive care unit (NICU) face stressors including turbulent emotions from their pregnancy/unexpected preterm delivery and their infant's unpredictable health status. The study purpose was to examine the psychological state of mothers prior to the discharge of their technology-dependent infants (eg, feeding tubes, supplemental oxygen) from the NICU to home. The study sample consisted of mothers (N = 19) of infants dependent on medical technology being discharged from a large Midwest NICU. A descriptive, correlational design using convenience sampling was employed to recruit mothers to examine associations of infant and maternal factors, resourcefulness, and stress with psychological state (depressive symptoms, posttraumatic stress symptoms). Forty-two percent of mothers were at high risk for clinical depression, with 37% in the clinical range for posttraumatic stress disorder. Increased maternal depressive symptoms were significantly associated with the increased frequency and perceived difficulty of their stress and posttraumatic stress symptoms. Increased posttraumatic stress symptoms were significantly associated solely with elevated depressive symptoms. This study identified factors associated with the mothers' increased psychological distress, providing beginning evidence for future interventions to employ prior to their technology-dependent infant's NICU discharge.

Frances Payne Bolton School of Nursing (Drs Toly, Musil, and Bieda and Mss Blanchette and Em), and Department of Epidemiology and Biostatistics, School of Medicine (Dr Sattar), Case Western Reserve University, Cleveland, Ohio; and Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio (Ms Liu).

Corresponding Author: Valerie Boebel Toly, PhD, RN, CPNP, Frances Payne Bolton School of Nursing, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH 44106 (

This study was supported by funding from Sigma Theta Tau International, Doris Bloch Research Award.

Disclosure: The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

Each author has indicated that he or she has met the journal's requirements for Authorship.

Submitted for publication: November 22, 2018; accepted for publication: February 19, 2019.

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