Fatores associados ao estresse parental em unidade de terapia intensiva neonatal

Abstract

During the gestational period, parents project images, dreams and expectations about the child to be born. When a premature birth occurs and/or with other complications, the idealized figure of the "perfect newborn” (NB) is abandoned and parents need to face a new reality. Risky newborns commonly require hospitalization in the Neonatal Intensive Care Unit (NICU), which is extremely distressing and stressful for the mother, father and baby triad, because the rituals that should take place at the beginning of the child's life are broken. It is noteworthy that, from the hospitalization of a baby in NICU, the parents experience feelings of frustration, guilt, fear, in the face of the unknown and uncertainties regarding the child’s recovery. Therefore, the driving question of this study was: what are the factors associated with parental stress in a neonatal intensive care unit? This is a cross-sectional research, with a quantitative approach, the population consisted of fathers and mothers of newborns hospitalized in neonatal intensive care unit. The data collection occurred in two philanthropic hospitals in the south of the country. The questionnaires used were Parental Stress Scale: Neonatal Intensive Care Unit (PSS: NICU) and Perception of Family Centered Care – Parents Brazilian version (PCCF-P Brazilian version), both validated and translated into Brazilian Portuguese, in addition to an instrument for participants’ characterization, obstetric and newborns’ data, produced by the authors. The qualitative variables were presented by absolute and relative frequencies. Simple crosses of qualitative variables were performed and, to verify the association between them, the "Odds Ratio" (OR) measure and its confidence interval were used. The analysis was performed in statistica software 9.1, and the findings with p value ≤ 0.05 being considered as significant. The quantitative variables were presented by mean (± standard deviation), median, minimum and maximum. A total of 129 volunteers participated and it was found that 79.8% of them had parental stress. Through the description of the PSS: NICU instrument, a lower mean stress was observed in the domain "Sounds and images", followed by "Appearance and behavior of the baby" and, with higher score, the category "Changes in the role of father/mother". There was a significant association between ‘participants’ gender’ and ‘newborns’ clinical complications during the hospitalization period in the NICU with parental stress. A statistically significant difference was observed between the "stress” and "stress-free" groups in the variable "length of hospital stay until the moment of data collection", in the domains "respect", "collaboration" and in the total sum of the PCCF-P scale. Therefore, it is concluded that there is relevance in deepening the knowledge about the factors associated with parental stress in a neonatal intensive care unit, in order to implement strategies with the objective of minimizing these aggravating factors and improving the emotional health of parents, the relationship of parents with the medical team and with their baby and, as a result, improving the child’s development.