Stress
and Coping Strategies
among Mothers’ of Neonates, admitted in Neonatal Intensive Care Unit
Dr. Valliammal
Shanmugam1, Dr. Ramachandra2
1Lecturer, College of
Nursing, National Institute of Mental Health and Neurosciences (NIMHANS),
Institute of National Importance (INI), Hosur Road, Bengaluru-560 029, Karnataka.
2Additional Professor,
Department of Nursing, National Institute of Mental Health and Neurosciences
(NIMHANS), Institute of National Importance (INI), Hosur
Road, Bengaluru-560 029, Karnataka.
*Corresponding Author
Email: valliammal.shanmugam@gmail.com
ABSTRACT:
Aim: To assess the level
of stress and coping strategies of mothers of neonates admitted in Neonatal
Intensive Care Unit at Government Hospital, Bengaluru.
Objective:
To
correlate the level of stress and coping strategies among mothers of neonates
and to determine the association between stress and coping with demographic
variables.
Methodology: Descriptive design
was employed by using a simple random sampling technique. Data collected from
100 mothers were analyzed using descriptive and inferential statistics.
Results: Among 100 mothers
34% had mild stress, 28% had moderate stress and 38% had severe stress.
Regarding coping mechanism adapted by the mothers 25% of them had poor coping
50% of them had moderate coping and 25% of them good coping. There was a
significant correlation between stress and the coping strategies at P< 0.05
level. No significant association between the stress and coping strategies with
demographic variables.
KEYWORDS: Stress, Coping Strategies, Mothers, Neonates,
Neonatal Intensive Care Unit (NICU).
INTRODUCTION:
In India 30 -40% of newborns weigh less than
2.5 kgs at birth. Nearly 80% of the neonatal deaths
and 50% of infant deaths occur among low birth weight neonates. Having a child
admitted to neonatal Intensive Care Unit, parents lose their ability to help or
to comfort their newborn in a meaningful way and find themselves that they
experience interruption in their family roles1. On entering the NICU
the mothers see their little ones surrounded by sophisticated monitors with
varying sounds and find themselves to be helpless in such situations to care
for their newborns. Under such conditions mothers perceive fear of death,
uncertain outcome, emotional turmoil, financial constraints, role changes which
are sources of anxiety.
This made the researchers to assess the
stress and coping strategies of mothers’ of neonates admitted in Neonatal
Intensive Care Unit with the objectives to assess and correlate the stress and
coping strategies of mothers’ and to determine the association between stress
and the coping strategies of mothers2.
MATERIAL
AND METHODS:
A descriptive research design was used. 100
mothers of neonates admitted in the NICU in a Government hospital, Bengaluru were selected by using a simple random sampling
method. A self administered structured questionnaire was used to collect the
data which consisted of three parts. Part I consisted of demographic data. Part
II consisted of 40 questions with three point Likert
scale on different domains of stress such as physical, physiological,
emotional, cognitive, socio economic, communication with staff and parental
role alteration. Part III consisted of 40 questions three point Likert scale related to physical, cognitive, emotional,
spiritual, social coping and divisional activity. The constructed tools were
validated by the experts from the medical and nursing departments of child
health and the suggestions were incorporated in the tool. The reliability of co
efficient of correlation of stress questionnaire was found to be 0.91 and
coping strategies was found to be 0.93. Permission was obtained by the concerned
authorities of the hospital to conduct the study and informed consent was
obtained from the mothers to take part in the study. Descriptive statistics
such as frequency, percentage, mean, standard deviation and inferential
statistics (chi-square test) were used to analyze the study findings.
Categorization of stress level and coping
strategies are placed in Table 1 and 2. And the statistical evaluation of these
is indicated in Table 3.
Table 1:
Categorization of stress levels of mothers’ of Neonates Admitted in Neonatal
Intensive Care Unit. N=100
|
S.no |
Stress scale |
Number |
Min. Score |
Max. score |
Mean score |
Mean Percentage |
Standard Deviation |
|
1 |
Physical |
6 |
7 |
16 |
10.27 |
13.05 |
1.69 |
|
2 |
Physiological |
8 |
10 |
18 |
14.62 |
18.58 |
1.48 |
|
3 |
Emotional |
7 |
10 |
17 |
14.05 |
17.85 |
1.87 |
|
4 |
Cognitive |
5 |
8 |
14 |
11.32 |
14.38 |
1.12 |
|
5 |
Communication with staff |
6 |
8 |
15 |
11.52 |
14.64 |
1.55 |
|
6 |
Parental role alteration |
4 |
6 |
11 |
8.95 |
11.37 |
1.30 |
|
7 |
Socio economic |
4 |
4 |
11 |
7.95 |
10.10 |
1.36 |
|
Total |
40 |
68 |
89 |
78.68 |
100 |
4.41 |
|
Table 2: Categorization
of coping strategies of mothers’ of Neonates Admitted in Neonatal Intensive
Care Unit. N=100
|
S.no |
Coping scale |
Number |
Min. Score |
Max. score |
Mean score |
Mean Percentage |
Standard Deviation |
|
1 |
Physical |
6 |
7 |
13 |
9.25 |
13.20 |
1.41 |
|
2 |
Cognitive |
8 |
11 |
19 |
14.77 |
21.08 |
1.74 |
|
3 |
Emotional |
6 |
8 |
17 |
10.95 |
15.63 |
1.55 |
|
4 |
Spiritual |
6 |
7 |
16 |
10.04 |
14.33 |
1.53 |
|
5 |
Social |
7 |
9 |
16 |
13.34 |
19.04 |
1.33 |
|
6 |
Diversion activity |
7 |
8 |
15 |
11.70 |
16.70 |
1.50 |
|
Total |
40 |
61 |
90 |
70.05 |
100 |
4.21 |
|
Table 3:
Categorization of coping strategies of mothers’ of Neonates Admitted in
Neonatal Intensive Care Unit. N=100
|
S.no |
Variables |
Mean ± S.D |
Correlation
coefficient |
t -vaule |
|
1 |
Stress |
78.68 ± 4.41 |
0.238* |
0.05 ( p< 0.05) SIGNIFICANT |
|
2 |
Coping Strategies |
70.05 ± 4.21 |
|
RESULTS:
Data relating to stress (Table 1) show that
the mothers who admitted their neonates in NICU had high stress in
physiological domain (mean 18.58% and SD 1.48) and low stress in socio economic
domain (mean 10.10% and SD 1.36). Good cognitive coping (mean 21.08% and SD
1.74) and poor physical coping (13.20% and SD1.41) observed in mothers whose
neonates were admitted in NICU (Table 2). There was significant correlation (r
= 0.238) between the stress and coping strategies of mothers at P< 0.05
level (Table 3).
DISCUSSION:
Among 100 mothers, 38% had severe stress, 28%
had moderate stress and the remaining mothers had mild stress. The results of
the present study were supported by the earlier study on how parents perceived
severity of their infants’ illness3. Coping mechanism adapted by the
mothers, 25% of them had good coping 50% of them had moderate coping and 25% of
them poor coping. The results supported the study and indicates that health
care providers especially nurses could have a
major role in reducing distress of mothers by maintaining ongoing communication
with mothers and providing competent care for the neonates in NICU4.
The present study findings show that there was no significant association
between the stress and copping strategies of the mothers with selected
demographic variables. A study conducted on Kangaroo mother care and maternal
stress in NICU show that there have been no significant differences between
groups on any of the demographic variables5. There is a significant
relationship between stress and coping strategies at 0.05 levels. It is evident
that when the stress is high the mother significantly relates to coping. The
results of the present study were similar regarding all baseline variables
which is presented in the study findings of Kangaroo care versus tradition care
of newborns <
2000 grams6.
CONCLUSION:
Mothers often experiences high levels of
stress, when the neonate’s health status is unstable and admitted in NICU.
Nurse should develop proper understanding about the mother’s stressful
situation to provide a holistic care to the neonates and mothers. Nurses should
also work out for educational programmes such as
stress management for mothers who admit their neonates in NICU to help them
gain adequate knowledge and coping strategies.
REFERENCES:
1.
Intosh BT, Sharma S and Dev H. Stress coping,
psychological Distress and maternal reactions to NICU Hospitalization. Journal
Health Equity. 21 (2); 2014:34-37
2.
Seidman, RY and Hash J. Parent stress and
coping in NICU and PICU. Journal of Pediatric Nursing. 112 (3); 2012:23-26
3.
Shields Peo, D and Pinelli. Variables associated with parental stress in NICU.
Neonatal Network. 18 (3); 2010: 34-36
4.
Davis M, Holdich C and Miks S. Mothers shoes about their experiences in the NICU.
Neonatal Network.16 (2); 2007:11-16
5.
Engle M and Shaw R. Kangaroo care, well baby care and
maternal stress in NICU. International Journal of Nursing Education. 21 (1); 2009:
32-36
6.
Charpac N, Nathalie J and Juan J. Kangaroo
mother versus traditional care for newborns infants. Journal of Pediatrics. 14 (2);
2011: 41 – 44
Received on 13.02.2015 Modified on 10.03.2015
Accepted on
20.03.2015 © A&V Publication all
right reserved
Asian
J. Nur. Edu. and Research 5(3): July-
Sept.2015; Page 363-365
DOI: 10.5958/2349-2996.2015.00073.7