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J Reprod Infant Psychol. 2019 Sep 10:1-14. doi: 10.1080/02646838.2019.1659940. [Epub ahead of print]

Evaluating the effect of Family Integrated Care on maternal stress and anxiety in neonatal intensive care units.

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Department of Paediatrics, Sinai Health System , Toronto , Ontario , Canada.
Family Health Care Nursing, University of California San Francisco , San Francisco , CA , USA.
Maternal-Infant Care Research Centre, Mount Sinai Hospital , Toronto , Ontario , Canada.
Department of Paediatrics, University of Toronto , Toronto , Ontario , Canada.
Department of Obstetrics and Gynaecology and Dalla Lana School of Public Health, University of Toronto , Toronto , Ontario , Canada.


Objective: To identify how Family Integrated Care (FICare) affected maternal stress and anxiety. Study Design: This secondary analysis of the FICare cluster randomised controlled trial included infants born between 1 April 2013 and 31 August 2015 at ≤33 weeks' gestation. Mothers completed the PSS:NICU and STAI questionnaires at enrolment and study day 21. Results: 1383 mothers completed the surveys at one or both time-points. The mean PSS:NICU and STAI scores at day 21 were significantly lower in the FICare mothers than controls (PSS:NICU mean [standard deviation] FICare 2.32 [0.75], control 2.48 [0.78], p = 0.0005; STAI FICare 70.8 [20.0], control 74.2 [19.6], p = 0.0004). The sights and sounds, looks and behaviour, and parental role PSS:NICU subscales and the state and trait STAI subscales were all significantly different between FIC are and controls at day 21. The magnitude of change in all stress and anxiety subscales was greater in the FICare group than controls. These differences remained significant after adjustment for confounders with the greatest change in the parental role (least-squares mean [95% confidence interval] FICare -0.65 [-0.72, 0.57], control -0.31 [-0.38, -0.24], p < 0.0001) and state anxiety subscales. Conclusion: FICare is effective at reducing NICU-related maternal stress and anxiety.


FICare; NICU; Preterm infant; anxiety; stress

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