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Listening visits by NICU nurses help mothers' emotional well-being

Wednesday October 9, 2013
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In a small study, mothers who had given birth to preterm babies and who participated in a series of personal sessions with a NICU nurse had lower anxiety and depression symptoms and improved self-esteem.

“Having a prematurely born baby is like a nightmare for the mother,” Lisa Segre, PhD, assistant professor at the University of Iowa College of Nursing in Iowa City, said in a news release. “You’re expecting to have a healthy baby, and suddenly you’re left wondering whether he or she is going to live.”

Segre said the research, scheduled for publication in the Journal of Perinatology, is the first proof-of-concept study that enlisted NICU nurses in “listening visits” with mothers of preterm infants. The research shows that “listening matters,” said Segre, a psychologist. “These mothers are stressed out, and they need someone to listen to them.”

About 15 million babies are born prematurely worldwide, including 1 million who die, according to the World Health Organization. In the U.S., more than half a million babies are preterm each year, WHO reports.

The listening-visits concept comes from the United Kingdom, where post-partum mothers are screened in the home for depression. But no one had taken the idea into the NICU, much less in the form of sessions led by hospital nurses, according to the news release.

The trial at University of Iowa Children’s Hospital involved 23 mothers with preterm infants and ran from 2010 through the first half of 2012. The women received an average of five one-on-one sessions lasting about 45 minutes each with Rebecca Siewert, RNC, DNP, NNP, an associate clinical professor in the College of Nursing who has worked in NICUs for three decades and is a co-author of the paper.

The mothers chose their room, an outdoor patio or the cafeteria as the setting. The first sessions generally focused on the birth, with the women describing the emotional roller coaster of giving birth to a baby they hardly saw afterward and whose health was compromised.

“The mothers wanted to tell their birth stories,” Siewert said. “They wanted someone to understand what it felt like for their babies to be whisked away from them. They were very emotional.”

Subsequent sessions allowed the mothers to focus on themselves and their needs, which many tend to consider secondary or perhaps even trivial when compared with their newborns’ plight, Siewert noted. “But the mother needs to be healthy to be able to take that baby home and for that baby to do well.”

In the study, the mothers’ depression level dropped from an average of 14.26, considered elevated as measured by the Edinburgh Postnatal Depression Scale, before the listening visits to an average of 9, below the standard for professional help, after the sessions ended. Anxiety levels also fell, from an average of 16.57 as measured by the Beck Anxiety Inventory to an average of 9.13, according to the study. Both drops are considered statistically significant, the authors wrote.

The participants also felt better about themselves and their situation, according to the Quality of Life, Enjoyment and Satisfaction Questionnaire they filled out before and after the listening sessions. A follow-up assessment one month after the final listening visit showed further declines in depression and anxiety on average, and higher quality-of-life feelings.

The researchers said the study raises the question of whether nurses, rather than mental-health professionals, should be the first line of help for postnatal mothers. Segre acknowledges the study is preliminary, and would like to test the results in a larger randomized controlled trial.

Still, she and Siewert think nurses are well-suited for the job.

“Listening is what nurses have done their whole career,” Siewert said. “We’ve always been the ones to listen and try to problem-solve. So, I just think it was a wonderful offshoot of what nursing can do. We just need the time to do it.”

Study abstract: http://www.nature.com/jp/journal/vaop/ncurrent/full/jp201393a.html


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