6 - Effects of Family-Centered Care vs Mobile-Enhanced Family Integrated Care on Maternal Mental Health after Preterm Infant Discharge

Poster Number: 6
Publication Number: 6.337

Linda S. Franck, University of California, School of Nursing, San Francisco, CA, United States; Caryl L. Gay, University of California, San Francisco, School of Nursing, San Francisco, CA, United States; Thomas Hoffmann, UCSF, San Francisco, CA, United States; Rebecca Kriz, University of California, San Francisco, School of Medicine, Walnut Creek, CA, United States; Robin Bisgaard, UCSF Benioff Children's Hospital San Francisco, Petaluma, CA, United States; Diana M. Cormier, Community Regional Medical Center, Fresno, CA, United States; Priscilla Joe, UCSF Benioff Children's Hospital Oakland, Oakland, CA, United States; Brittany Lothe, Will’s Way Foundation, Chicago, IL, United States; Yao Sun, UCSF, San Francisco, CA, United States

Background: Improved outcomes for parents of preterm infants have been demonstrated when neonatal intensive care units (NICUs) practice Family Integrated Care (FICare) compared with Family-Centered Care (FCC); however, no studies of FICare have been conducted in the United States (US).

Objective: We aimed to compare the effects of FCC with mobile-enhanced FICare (mFICare) on mothers’ mental health after their preterm infant’s NICU discharge.

Design/Methods: In this quasi-experimental, time-lagged study, we prospectively enrolled parent/infant dyads from 3 NICUs to receive either usual FCC or mFICare. Eligible parents had an infant

Results: 178 mothers (89 FCC, 89 mFICare completed measures approximately 3 months after their infant’s discharge. Fathers were dropped from analysis due to small numbers (n=9). Approximately 29% of mothers had scores suggesting clinical levels of depression and/or PTS. A model with main effect of group showed no significant difference; however, we found a nominally significant interaction between group and parent stress when added to the model, suggesting that mFICare reduced PTS among mothers experiencing greater parental stress during the NICU stay (b=-1.04, 95% CI: -1.95, -0.127; Figure 1). A similar interaction pattern was found for maternal depression but did not reach statistical significance (b=-0.764, 95% CI: -1.53, 0.006, p=.052; Figure 2). Per-protocol analyses of the specific components of mFICare suggest that mothers’ involvement in parent classes and NICU rounds reduced depression and/or PTS in mothers with higher parent stress scores (classes*stress effect on depression: b=-0.976, 95% CI -1.76, -0.196; classes*stress effect on PTS: b=-0.963, 95% CI -1.91, -0.018; rounds*stress effect on PTS: b=-0.955, 95% CI -1.86, -0.045).Conclusion(s): mFICare had no overall effect on maternal depression or PTS approximately 3 months after preterm infant discharge but may reduce mental health symptoms for mothers who experienced higher levels of parental stress during the NICU stay. Longer follow-up studies on the effects of mFICare on maternal mental health are needed.
Figure 1.Interaction effect of parent NICU stress and mFICare intervention on post-traumatic stress after NICU discharge
Figure 2. Interaction effect of parent NICU stress and mFICare intervention on depression after NICU discharge