Sociodemographic risk factors, parental stress and social support in the neonatal intensive care unit

Abstract

Objective: Investigate relationships among neonatal intensive care unit (NICU) parent demographics, reported stress and social support.

Design: Cross-sectional observation.

Setting: Tertiary referral NICU in Mid-Atlantic USA.

Patients: Parents (n=300) in the Giving Parents Support trial at enrolment.

Measures: Psychometric scales measured general stress, parental stress, NICU stress and social support. Demographic variables included education level, health insurance type, race, relationship status, age and gender. Length of stay was used to control for illness severity. Associations and potential modifying effects were evaluated using linear regression.

Results: Having less than a college degree (b=-2.52, SE=0.91) and female parent gender (b=-3.42, SE=1.47) were associated with lower parental stress scores. Older age in years was associated with higher parental stress scores (b=0.21, SE=0.07) but lower NICU stress scores (b=-0.01, SE=0.01). Greater social support scores were associated with lower scores of general (b=-2.76, SE=0.39) and parental stress (b=-1.71, SE=0.47). Less than a college degree (b=-0.26, SE=0.11), Medicaid insurance (b=-0.43, SE=0.11) and black race (b=-0.56, SE=0.12) were associated with decreased social support scores. Level of social support modified the relationship between education and parental stress, with higher social support decreasing education-based differences in parental stress scores (p=0.049).

Conclusion: Sociodemographic risk factors may not infer stress or risk in the anticipated direction. Practice and future research should focus on identifying and supporting NICU families at high risk for stress and low support.

Trial registration number: NCT02643472.

Keywords: child health services; healthcare disparities; neonatology.