1. Lindsey, Heather
  2. Chu, Julie MSN
  3. Price, Cynthia

Article Content

According to this study:


* An educational intervention can improve parents' mental health outcome and interaction with premature infants.


* The intervention can also reduce the duration of the hospital stay and costs.


The participation of parents of premature infants in an early educational-behavioral intervention program after the infants' admission to the neonatal ICU (NICU) and one week after discharge can reduce stress, depression, and anxiety; enhance interaction with the infants; and diminish the length of the hospital stay. "This program can be carried out completely by nurses," says Patricia A. Grady, PhD, RN, FAAN, director of the National Institute of Nursing Research, which funded the study. Grady adds that the program, Creating Opportunities for Parent Empowerment (COPE), "could be fairly easily implemented in other NICUs."


In a randomized, controlled trial conducted from 2001 to 2004 at two NICUs in the northeastern United States, researchers studied 260 families with premature singleton births. All parents received four intervention sessions that included audiotaped and written materials. Those participating in the COPE program (n = 147) received information about the appearance and behavioral characteristics of premature infants and the best ways to care for them, as well as instruction on behavioral activities that reinforced the information; a comparison group was given information about hospital services, discharge, and immunization.


The researchers found that mothers in the COPE program reported significantly less stress, depression, and anxiety than did those in the comparison group two months after NICU discharge. Trained, blinded nurse observers in the NICU also noted that both mothers and fathers in the COPE program group interacted more favorably with the infants than parents in the comparison group did. Furthermore, participants in the COPE program reported having greater confidence in their roles as parents and greater knowledge of the expected characteristics and behavior of infants during hospitalization.


Additionally, infants included in the COPE program were in the NICU for a mean of 3.8 fewer days than the comparison group infants, and also had a mean 3.9-day shorter total stay in the hospital. Moreover, of the infants weighing less than 1,500 g, those in the COPE group had a mean 8.31-day shorter stay in the NICU than the comparison-group infants. Overall, the shorter stay among the COPE group of infants decreased hospital costs by a mean of $5,000 per infant (four days at $1,250 per day). Grady concludes that the program could result in considerable savings for the health care system.-HL


Melnyk BM, et al. Pediatrics 2006;118(5):e1414-27.