Academic journal article Family Relations

Parental Anxiety Following Discharge from Hospital of Their Very Low Birth Weight Infants

Academic journal article Family Relations

Parental Anxiety Following Discharge from Hospital of Their Very Low Birth Weight Infants

Article excerpt

Parental Anxiety Following Discharge From Hospital of Their Very Low Birth Weight Infants*

The uncertainty regarding the future well-being of very low birth weight infants is a source of considerable anxiety for parents, even after discharge from the hospital. We identify factors related to postdischarge anxiety levels of parents of 65 infants. Infant's weight relative to gestational age; the presence of central nervous system complications; informational support; and a warm, caring attitude by hospital staff explained 35% of the variance in mothers' anxiety levels. Father's age, infant's gender, perception of the infant as problematic, and the availability of child care support explained 33% of the variance in fathers' anxiety levels. Practice implications, including both identification of high-risk groups and interventions aimed at bringing about change in specific factors, are discussed.

Key Words: anxiety, infants, low birth weight, parents, preterm

he birth of a child represents an important life event for families; the birth of a very low birth weight (VLBW) infant is particularly stressful. Parents often are affected by the unexpected nature of the birth, feel guilty and helpless, and express disappointment and concern for their ability to fulfill parental roles (Miles, Funk & Kasper, 1992; Pederson, Bento, Chance, Evans & Fox, 1987). The neonatal intensive care unit (NICU) itself also is a source of stress, with its sophisticated equipment, intrusive procedures, exposure to other sick infants and their parents, and on-going interactions with health care professionals. Of particular concern to most parents is the condition and prognosis of the infant-fears for the child's survival, health, and appearance (Hughes, McCollum & Sheftel, 1994; Miles et al.). A definitive prognosis regarding the child's normal development typically cannot be provided at the time of discharge (Palta, Sadeh-Badawi, Evans, & Weinstein, 2000).

The current study focuses on anxiety as an outcome of this stress and uncertainty. We assumed that anxiety is an undesirable emotional state, particularly if it persists over time or reaches high levels (Siefert, Thompson, Ten Bensel, & Hunt, 1983; Singer et al., 1999). Given the growing body of evidence indicating the importance of parents' psychological status for the long-term well-being of children (e.g., Black, Heyman, & Slep, 2001; Egami, Ford, Greenfield, & Crum, 1996), it is important to understand which parents are at particular risk for high levels of anxiety.

As an outcome or me stress process, anxiety levels can De affected by various factors (Taylor & Aspinwall, 1993). Key among them are the objective nature of the stressor, the individual's appraisal of that stress, and the availability of personal and social coping resources (Lazarus & Folkman, 1984; Moos & Schaefer, 1993; Pearlin & Schooler, 1978). Among the social resources of key interest are the social support received from the informal social network and formal service providers (Ben-Sira, 1984). The current study examines these factors in relation to levels of anxiety among parents following the discharge of their VLBW infants from an NICU in Israel.

Literature Review

Advances in neonatal intensive care have led to increased survival rates of VLBW infants. However, these children remain at risk for a range of difficulties, such as delayed growth, developmental problems, attention deficit disorders, hyperactivity, language delay, and learning disabilities (e.g., Cronin, Shapiro, Casiro, & Cheang, 1995; Hack, Taylor, Klein, & Mercuri-Minich, 2000). Infants born prematurely also use more chronic and acute care resources than those born at full-term (Bar-Oz, Netzer, & Arad, 1995; Slonim, Patel, Ruttimann, & Pollack, 2000). Follow-up studies in various countries of VLBW infants 1-2 years of age show that between 8% and 15% have severe limitations, and another 12-23% have mild limitations (Coccia, Pezzani, Moro, & Minoli, 1992; Wang, Wang, Huang, & Lin, 1998). …

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