How Close Collaboration with Parents Intervention Is Associated with Anxiety and Self-Efficacy among Mothers in Estonian NICUs
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Background: Being admitted to the Neonatal Intensive Care Unit (NICU) is a large psychological stressor for mothers. Mothers of NICU infants are generally more anxious and stressed. Close Collaboration with Parents (CCP) Intervention is a structured intervention that is a care culture change intervention, which includes educating NICU staff on how to involve parents in infant care.
Aim: This study aimed to compare maternal anxiety and parenting self-efficacy between a pre-intervention and post-intervention independent cohort of mothers in Estonian NICUs and to explore the relationship between maternal anxiety and parenting self-efficacy in this population. Additionally, an exploratory regression analysis was conducted to examine factors independently associated with parenting self-efficacy.
Methods: A comparative cohort design was used, recruiting two independent groups of mothers before and after a unit-level intervention across six Estonian NICUs. Maternal state and trait anxiety were assessed by the State-Trait Anxiety Inventory (STAI), and parenting self-efficacy was assessed by the Perceived Maternal Parenting Self-Efficacy (PMP S-E) instrument.
Results: There were no statistically significant differences among the cohorts in state anxiety, trait anxiety, or parenting self-efficacy. Small effect sizes with directionally beneficial patterns were observed for anxiety. Higher state anxiety was independently associated with lower parenting self-efficacy. At both the bivariate and multivariable levels, mothers of more preterm infants had higher parenting self-efficacy scores.
Conclusions: This study found a high prevalence of maternal anxiety in Estonian NICUs. The Close Collaboration with Parents intervention was not associated with statistically significant differences in the outcome measures between cohorts, but the effect sizes were in the direction of the benefit and were small, which may mean that larger studies with more statistical power could show a beneficial impact. Results show a strong relationship between state anxiety and parenting self-efficacy, highlighting the need to consider situational anxiety when a child is hospitalised in the NICU as an opportunity to promote self-confidence in parenting and educate them.