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Screening for Posttraumatic Stress Disorder in Mothers of Premature Infants: An Evidence-Based Approach
Katelyn Camacho-Yau1, Lauren Vogel, Koy McEwen
1Author Affiliation: School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama.
Insights
A quality improvement initiative screened parents of preterm infants for post-traumatic stress disorder (PTSD). The screening identified significant PTSD symptoms, highlighting the need for routine assessment in neonatal intensive care units (NICUs).
Area of Science:
- Neonatal Intensive Care Unit (NICU) care
- Perinatal mental health
- Trauma-informed care
Background:
- Parents of preterm infants in the NICU experience significant trauma.
- Postpartum PTSD risks are elevated, impacting maternal-infant bonding and child development.
- Routine PTSD screening is uncommon in NICU settings despite existing guidelines.
Purpose of the Study:
- To outline a quality improvement initiative for PTSD screening in parents of preterm infants (<30 weeks gestation).
- To address the gap in routine PTSD assessment within the NICU environment.
Main Methods:
- Initiated a screening bundle including staff education on the City Birth Trauma Scale.
- Implemented planned parent PTSD assessments.
- Appointed a designated staff nurse champion for the initiative.
Main Results:
- Among 16 analyzed responses, 25% met criteria for high likelihood of PTSD.
- 75% of those with PTSD exhibited dissociative symptoms.
- High prevalence of negative cognitions/mood (68.8%) and hyperarousal (56.3%); 50% reported significant life impairment.
Conclusions:
- A screening process is a practical, parent-centered method to identify unrecognized PTSD symptoms in NICU parents.
- NICUs can foster an inclusive environment for PTSD assessment and discussion.
- Future research should focus on multi-site studies, non-response rates, and varied screening intervals.
Purpose:
The purpose of this article is to outline a quality-improvement initiative designed to improve screening for post-traumatic stress disorder (PTSD) among parents with preterm infants born less than 30 weeks of gestation into the neonatal ICU (NICU).
Background:
Parents of infants admitted to the NICU face significant trauma, leading to elevated risks of postpartum PTSD. Left undetected, PTSD can results in impaired maternal-infant bonding, parental functioning, and long-term child cognitive and emotional development. Despite available guidelines, routine assessment specifically for PTSD in the NICU environment remains uncommon.
Discussion:
A screening bundle was initiated consisting of staff education on the use of the City Birth Trauma Scale, planned parent PTSD assessments, and a designated staff nurse champion. Among 16 analyzed responses (13 mothers, 3 significant others), 25% met all diagnostic criteria for high likelihood of PTSD, with 75% of those exhibiting dissociative symptoms. Additionally, negative cognitions/mood (68.8%) and hyperarousal (56.3%) were highly prevalent, and 50% reported significant life impairment.
Implications For Research And Practice:
Implementing a screening process is a practical and parent focused method to uncover substantial, previously unrecognized PTSD symptoms among NICU parents. Clinical practice locations have an opportunity to create an inclusive environment for the assessment and discussion of PTSD and the impacts on the family and infant. Future research should explore larger multi-site studies, tracking non-response rates, and evaluating screening at multiple intervals to capture delayed-onset PTSD.
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