A comparison of parent and staff perceptions of setting-specific and everyday stressors encountered by parents with very preterm infants experiencing neonatal intensive care

Background: Stress responses among parents of premature infants experiencing the neonatal intensive care unit (NICU) environment are widely reported. However, less is known about how nurses perceive parents' experiences or how stressors relating to demands on family finances and practical challenges associated with infant hospitalization contribute to parental stress levels in the NICU. Objective: 1) To compare parent and staff perceptions of the stressors facing parents experiencing neonatal intensive care; and 2) to develop a scale suitable for identifying stressors outside the NICU setting. Methods: At infant 34 weeks, parents (n = 21) of very preterm infants (≤ 32 weeks GA) and NICU nurses (n = 23) completed the Parental Stressor Scale: NICU (PSS: NICU) and a custom-made External Stressor Scale (ESS: NICU). Results: Nurses perceived parents to experience higher stress in the NICU than parents themselves (ps < 0.00001), with parents reporting low-to-moderate stress and staff rating parental stress as moderate-to-high. Parents reported slightly lower levels of stress on the ESS: NICU, with nurses again overestimating the level of parental stress (ps < 0.00001). Consideration of the extent of nurses' medical experience did not alter results. The ESS: NICU showed good internal reliability, with PCAs revealing all items to load onto a single component. Additional analyses demonstrated divergent validity, with no relation evident with stress responses on the PSS: NICU. Conclusions: Periodic reassessments of staff and parent perceptions should be encouraged along with research dedicated to a fuller understanding of the range of stressors facing parents experiencing neonatal intensive care in attempts to reduce stress levels and aid integration into the unit.