Maternal Anxiety and Depression Following a Premature Infants’ Discharge from the NICU: Explanatory Effects of the COPE Program

 

Bernadette Mazurek Melnyk, PhD, RN, CPNP/NPP, FAAN, FNAP, Dean and Distinguished Foundation Professor in Nursing, Hugh F. Crean, PhD, Assistant Professor of Nursing, Nancy Fischbeck Feinstein, PhD, RN, Assistant Professor of Nursing, and Eileen Fairbanks, MS, RN, COPE Study Coordinator

Bernadette Mazurek Melnyk, Arizona State University College of Nursing & Healthcare Innovation;

Contributor Information.

Corresponding Author: Dr. Bernadette M Melnyk, PhD, Arizona State University

The publisher's final edited version of this article is available at Nurs Res.

Abstract

Background

Understanding the processes through which interventions work for mothers of premature infants is necessary for the advancement of science and the translation of efficacious interventions into clinical practice settings.

Objective

To test a theoretical model examining the processes through which an educational-behavioral intervention program (COPE) influences maternal anxiety and depression 2 months following discharge of their premature infants from the neonatal intensive care unit (NICU).

Methods

A secondary analysis was conducted using data from a randomized controlled trial with 246 mothers of low birthweight (LBW) preterm infants who were randomly assigned to COPE or placebo control conditions. Measures included maternal stress in the NICU, maternal anxiety and depression, and maternal beliefs about their infants and their role. Observers blind to study group condition also rated the quality of mother-infant interaction in the NICU.

Results

Structural equation modeling suggested the model tested provided a reasonable fit to the data (χ² (64 _df) = 97.67; p = .004; RMSEA = .046; CFI = .97). Participation in COPE was both directly and indirectly, via associations with increased maternal beliefs and less maternal depression/anxiety in the NICU, related to mothers’ decreased post-hospital depression/anxiety. Participation in the COPE program also was associated with higher mother-infant interaction scores.

Conclusion

Implementation of COPE could lessen post-discharge maternal anxiety and depression, which may improve outcomes for both mothers and preterm infants.

Keywords: Premature infants, NICU, mothers

Maternal Anxiety and Depression Following a Premature Infants’ Discharge from the NICU: Explanatory Effects of the COPE Program