Feasibility of wearable sensors in the NICU: Psychophysiological measures of parental stress

Leah I Stein Duker; Jenny Kwon; Marinthea Richter; Roberta Pineda

doi:10.1016/j.earlhumdev.2023.105814

Feasibility of wearable sensors in the NICU: Psychophysiological measures of parental stress

Early Hum Dev. 2023 Aug:183:105814. doi: 10.1016/j.earlhumdev.2023.105814. Epub 2023 Jun 30.

Authors

Leah I Stein Duker¹, Jenny Kwon², Marinthea Richter¹, Roberta Pineda³

Affiliations

¹ Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA.
² Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA; Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA.
³ Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA; Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA; Gehr Family Center for Health Systems Science and Innovation, University of Southern California, Los Angeles, CA, USA. Electronic address: bobbi.pineda@chan.usc.edu.

Abstract

Background: Parents report elevated stress during their infant's NICU hospitalization. Real-time measures may improve our understanding of parental stress in the NICU.

Aim: Examine the feasibility of wearable sensors to describe parental stress in the NICU.

Study design: In this prospective feasibility study of 12 parent-infant dyads, parents wore an Empatica E4 wristband to measure psychophysiological stress via electrodermal activity (EDA) during sensory interventions (holding, massage, reading, touch, etc) with their babies. Baseline and intervention periods were delineated during which concurrent monitoring and clinical observations of infant behavior and environmental factors were recorded. Feasibility was assessed by investigating recruitment/enrollment, retention/adherence, acceptability, sensor usability, and changes in EDA waveforms based on potential stressors. For the latter, independent samples t-tests and ANOVA were used to examine differences in EDA from baseline to intervention, and the impact of environmental and infant factors on parent stress were visually analyzed against EDA waveforms.

Results: Wearable sensor use in the NICU appeared feasible as assessed by all methods. Preliminary data analysis indicated that overall parent EDA levels during parent-infant interactions were low, and engagement in sensory intervention(s) led to a non-significant increase in parental EDA, measured by both skin conductance levels and non-specific skin conductance responses. Three main patterns of EDA emerged: a temporary increase in EDA at the beginning of the intervention followed by a decrease and plateau, a plateau in EDA from baseline to intervention, and a gradual rise in EDA throughout intervention. Specific environmental and infant factors, such as infant stress and health care providers entering the room, appeared to impact parent stress levels.

Conclusion: Although these preliminary findings provide support for use of EDA in the NICU, future studies are needed.

Keywords: Child development; Environment; Monitoring; Neonatal intensive care unit; Parental stress; Preterm infants; Risk factors; Technology.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Feasibility Studies
Humans
Infant
Infant, Newborn
Intensive Care Units, Neonatal*
Parents
Prospective Studies
Wearable Electronic Devices*

Abstract

Publication types

MeSH terms

Grants and funding