Listening Visits for Emotionally Distressed Mothers of Hospitalized Newborns
| Status: | Not yet recruiting |
|---|---|
| Conditions: | Psychiatric |
| Therapuetic Areas: | Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 1/31/2019 |
| Start Date: | February 15, 2019 |
| End Date: | October 2021 |
| Contact: | Lisa S. Segre, PhD |
| Email: | lisa-segre@uiowa.edu |
| Phone: | 319-335-7079 |
Promoting Emotional Well-Being in Distressed NICU (Neonatal Intensive Care Unit) Mothers: A Phase 2 Evaluation of a Nurse-Delivered Approach
The proposed research has potential to dramatically improve care for emotionally distressed
mothers of newborns hospitalized on the neonatal intensive care unit (NICU). Clinical NICU
nurses are well-positioned to provide emotional support in the form of Listening Visits.
Specifically, these nurses are easily accessible to NICU mothers, are often the most trusted
professional on the healthcare team, they are knowledgeable about the newborn's medical
conditions, and, finally they are already skilled in the art of warm communication. This
intervention should not only improve depressive outcomes in emotionally distressed NICU
mothers but also indirectly impact maternal perception of nurse support which is in turn
related to depression symptoms and patient satisfaction, as well as infant length of stay by
accelerating maternal readiness for infant discharge.
mothers of newborns hospitalized on the neonatal intensive care unit (NICU). Clinical NICU
nurses are well-positioned to provide emotional support in the form of Listening Visits.
Specifically, these nurses are easily accessible to NICU mothers, are often the most trusted
professional on the healthcare team, they are knowledgeable about the newborn's medical
conditions, and, finally they are already skilled in the art of warm communication. This
intervention should not only improve depressive outcomes in emotionally distressed NICU
mothers but also indirectly impact maternal perception of nurse support which is in turn
related to depression symptoms and patient satisfaction, as well as infant length of stay by
accelerating maternal readiness for infant discharge.
Infant admission to the neonatal intensive care unit (NICU) is an extremely stressful
postpartum outcome, as evidenced by data showing significant depressive symptoms in some 63%
of new NICU mothers. Thus, as part of a Family-Centered Care philosophy, focus on the
emotional well-being of the mother (and indeed the entire family) should be widely adopted by
NICU nursing units. In current clinical practice, however, the emotional well-being of NICU
mothers is often ignored. At best, NICU mothers are screened for depression and if indicated,
referred to a mental health professional. The extremes of no treatment and full-on mental
healthcare comprise an inadequate approach for treating mothers dealing with a normative
reaction to a stressful event. In alignment with the Nurse Parent Support Model, the
investigators propose the implementation of Listening Visits as a cost-effective
nurse-delivered supportive approach, proven to relieve moderately severe depressive symptoms
in mothers of term infants. In the NICU setting, Listening Visits were first implemented in a
phase-1 feasibility trial conducted by this research team. In that first trial, Listening
Visits were delivered by a doctoral level nurse practitioner and showed promise as means to
reduce distress in NICU mothers. A Listening Visit program for emotionally distressed NICU
mothers is innovative because it is a cost-effective approach that uses resources that are
largely in place, to serve a persistent unmet need in a vulnerable postpartum population. By
having nurses provides support, the concept of emotional distress in NICU mothers is
normalized. This new application of Listening Visits also directly aligns with the NINR
emphasis on promoting coping to prevent compromising mood states. The promising results of
the feasibility trial now must be challenged with a control group comparison to definitively
attribute maternal improvements to Listening Visits. Thus the objective of the proposed
research is to conduct a Phase 2 pilot RCT to evaluate Listening Visits provided by
bachelor's-level NICU nurses as compared with the care currently provided by the NICU social
work team. The investigators will assess the relative effectiveness of Listening Visits vs.
standard care on depressive symptoms.
postpartum outcome, as evidenced by data showing significant depressive symptoms in some 63%
of new NICU mothers. Thus, as part of a Family-Centered Care philosophy, focus on the
emotional well-being of the mother (and indeed the entire family) should be widely adopted by
NICU nursing units. In current clinical practice, however, the emotional well-being of NICU
mothers is often ignored. At best, NICU mothers are screened for depression and if indicated,
referred to a mental health professional. The extremes of no treatment and full-on mental
healthcare comprise an inadequate approach for treating mothers dealing with a normative
reaction to a stressful event. In alignment with the Nurse Parent Support Model, the
investigators propose the implementation of Listening Visits as a cost-effective
nurse-delivered supportive approach, proven to relieve moderately severe depressive symptoms
in mothers of term infants. In the NICU setting, Listening Visits were first implemented in a
phase-1 feasibility trial conducted by this research team. In that first trial, Listening
Visits were delivered by a doctoral level nurse practitioner and showed promise as means to
reduce distress in NICU mothers. A Listening Visit program for emotionally distressed NICU
mothers is innovative because it is a cost-effective approach that uses resources that are
largely in place, to serve a persistent unmet need in a vulnerable postpartum population. By
having nurses provides support, the concept of emotional distress in NICU mothers is
normalized. This new application of Listening Visits also directly aligns with the NINR
emphasis on promoting coping to prevent compromising mood states. The promising results of
the feasibility trial now must be challenged with a control group comparison to definitively
attribute maternal improvements to Listening Visits. Thus the objective of the proposed
research is to conduct a Phase 2 pilot RCT to evaluate Listening Visits provided by
bachelor's-level NICU nurses as compared with the care currently provided by the NICU social
work team. The investigators will assess the relative effectiveness of Listening Visits vs.
standard care on depressive symptoms.
Inclusion Criteria:
- Ability to speak and read English
- 18 years of age or older Edinburgh Postnatal Depression Scale (EPDS) score= 12 through
19, inclusive; with a rating of 2 or less on EPDS item #10)
- Hospitalized newborn who is 32 weeks gestational age or less, or any newborn who has
an illness typically requiring at least a 4-week hospitalization
Exclusion Criteria
- No Department Human Services involvement/no incarceration
- Women is not currently receiving counseling services
RCT Randomization Women enrolled into the RCT, will be randomized to received Listening
Visits from a NICU
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