Kathryn J Malin1, Teresa S Johnson2, Sarah McAndrew3, Jacqueline Westerdahl2, Jonathan Leuthner3, Joanne Lagatta3. 1. The University of Wisconsin Milwaukee, Milwaukee, WI, United States of America; NICU, Children's Hospital of Wisconsin, Milwaukee, WI, United States of America. Electronic address: kmalin@uwm.edu. 2. The University of Wisconsin Milwaukee, Milwaukee, WI, United States of America. 3. Neonatology, Medical College of Wisconsin, Milwaukee, WI, United States of America.
Abstract
BACKGROUND: Risk factors for perinatal posttraumatic stress disorder (PTSD) among parents of an infant in the NICU have varied in previous literature. The relationships between perception of illness severity and objective measures of illness severity with PTSD are not well understood. AIMS: To determine if PTSD among parents after an infant NICU discharge can be predicted by 1) objective measures of infant illness severity or 2) perceptions of infant illness severity. STUDY DESIGN: A prospective, observational study. SUBJECTS: Parent/infant dyads who were in the NICU for ≥14 days. OUTCOME MEASURES: Objective measures of illness severity were obtained from the electronic health record. Perceptions of illness were measured by the response to the question, "How sick is your child/patient?" on a 5-point Likert scale. The Perinatal Post-Traumatic Stress Disorder Questionnaire (PPQ) was completed by parents three months after discharge. RESULTS: One hundred ninety-four dyads participated in the study, 86% of parents completed follow up screening. 25% of parents screened positive for PTSD. Parents perceived infants to be sick more often than hospital caregivers. In bivariate analysis many objective measures of illness severity were associated with PTSD. Parent perceptions of illness were also associated with PTSD after adjusting for objective measures of illness (OR 3.2, 95% CI 1.1-6.1, p = 0.008). CONCLUSIONS: PTSD in parents after NICU discharge is multifactorial. Objective illness risk factors can be used to screen parents at risk. Hospital caregivers should strive to understand parents' perception of illness and improve communication to potentially decrease PTSD after discharge.
BACKGROUND: Risk factors for perinatal posttraumatic stress disorder (PTSD) among parents of an infant in the NICU have varied in previous literature. The relationships between perception of illness severity and objective measures of illness severity with PTSD are not well understood. AIMS: To determine if PTSD among parents after an infant NICU discharge can be predicted by 1) objective measures of infant illness severity or 2) perceptions of infant illness severity. STUDY DESIGN: A prospective, observational study. SUBJECTS: Parent/infant dyads who were in the NICU for ≥14 days. OUTCOME MEASURES: Objective measures of illness severity were obtained from the electronic health record. Perceptions of illness were measured by the response to the question, "How sick is your child/patient?" on a 5-point Likert scale. The Perinatal Post-Traumatic Stress Disorder Questionnaire (PPQ) was completed by parents three months after discharge. RESULTS: One hundred ninety-four dyads participated in the study, 86% of parents completed follow up screening. 25% of parents screened positive for PTSD. Parents perceived infants to be sick more often than hospital caregivers. In bivariate analysis many objective measures of illness severity were associated with PTSD. Parent perceptions of illness were also associated with PTSD after adjusting for objective measures of illness (OR 3.2, 95% CI 1.1-6.1, p = 0.008). CONCLUSIONS:PTSD in parents after NICU discharge is multifactorial. Objective illness risk factors can be used to screen parents at risk. Hospital caregivers should strive to understand parents' perception of illness and improve communication to potentially decrease PTSD after discharge.
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