Impactos de variáveis sociodemográficas, clínicas e religiosidade na saúde mental de pais/responsáveis de crianças internados na Unidade de Terapia Intensiva Neonatal

Abstract

Introduction: The Neonatal Intensive Care Unit (NICU) provides care to newborns, whether premature or full-term, who require specialized care. Although the NICU increases the survival of babies, admission causes significant stress to parents, resulting in intense emotions and uncertainty about the health of their children. Separation and the stressful environment of the NICU, full of noise and equipment, can generate feelings of fear, sadness and guilt, impacting the bond between parents and children and the emotional development of newborns. In addition, mothers recover from the postpartum period, which is permeated by hormonal changes, in family roles and in the acquisition of new responsibilities. The high level of stress experienced by mothers in the NICU can lead to the development of depression, anxiety, symptoms of acute stress disorder and post-traumatic stress disorder. anxiety, symptoms of acute stress disorder and post-traumatic stress disorder. Religiosity, in turn, can act as a protective factor, providing emotional and spiritual support that helps parents deal with suffering and uncertainty during hospitalization. Objectives: To analyze the impact of socioeconomic variables and religiosity on the mental health of parents/guardians of children admitted to the neonatal ICU. Methodology: Non-participant observational study with a quantitative approach, carried out with parents/guardians who had children admitted to the neonatal ICU at a university hospital in the interior of Minas Gerais. Data collection instruments were used, including: Sociodemographic and clinical data collection instrument and the Duke Religiousness Inventory (P-DUREL), Parental Stress Scale: Neonatal Intensive Care Unit (PSS:NICU) and Brief Spiritual/Religious Coping Scale (CER:14). After the data collection stage, statistical analysis was performed with bivariate analyses and correlation tests. Results: 77 mothers participated in the study. Regarding stress measured by the PSS:NICU scale, the Change in the Role of Mother/Father domain presented the highest mean (N=77; SD=1.33), with the highest-scoring item being “Being separated from my baby” with the highest mean of 3.87 (SD=1.42), highlighting the difficulty faced by mothers in adjusting to the new reality. On the P-DUREL scale, Intrinsic Religiosity obtained high scores with a mean of 13.61 (SD=2.20), suggesting a high level of internalization of religiosity among the participants. On the BRIEF CRE scale, there was a predominance of positive scores with a mean of 4.03 (SD=0.77), indicating a more frequent use of positive religious coping strategies. The results indicated significant associations between variables and stress levels. Having a partner was associated with greater stress in the Change in the Role of Mother/Father dimension (p=0.012). Having a job with income was associated with greater stress in the dimensions of Baby Appearance and Behavior (p = 0.018) and in the total PSS score (p = 0.028). In addition, higher education level (complete high school) was associated with increased stress in the dimensions of Baby Appearance and Behavior (p = 0.029), Change in the Role of Mother/Father (p = 0.044) and in the total score of the PSS:NICU (p = 0.022). Skin-to-skin contact in the first hour of life was related to greater stress in the Sounds and Images dimension (p = 0.019). On the other hand, the absence of skin-to-skin contact during hospitalization was associated with increased stress in Sounds and Images (p = 0.042) and in the total score of the PSS:NICU (p = 0.049). Stressful situations during pregnancy were also associated with greater stress in the Infant Appearance and Behavior dimension (p = 0.020). The need for neonatal resuscitation was associated with greater stress in the Infant Appearance and Behavior dimensions (p = 0.019) and in the total PSS:NICU score (p = 0.05). No significant correlations were found between stress levels and the dimensions of religiosity. Conclusion: Admission to the NICU is an event that can result in several structural, financial, and mental changes with repercussions on family dynamics. This study highlighted the high stress experienced by mothers of hospitalized newborns, especially due to separation from

their children, the use of ventilatory support equipment, and the perception of pain in the babies. Although religiosity is often considered a coping resource, we did not find significant associations with stress levels in our study. Furthermore, women who have a partner, higher education level and occupation presented high stress rates, which may occur due to the need to reconcile many activities with the situation of having a hospitalized child. Mothers who experienced stressful situations during pregnancy and whose children needed to be resuscitated in the delivery room presented stress scores indicating that experiencing unexpected situations contributes to negative outcomes.