Ind. J. Sci. Res. and Tech. 2015 3(1):6-11/Chiejina et al SSN:-2321-9262 (Online) Online Available at: http://www.indjsrt.com Research Article 6 AT RISK INFANTS IN NICU: PARENTAL STRESS-RELATED FACTORS * Chiejina E. N. 1 , Ebenebe R. C. 2 , Odira C. C. 1 , Okeke J. E. 1 , Orji I. N. 1 and Osuala E. O. 1 1 Department of Nursing Science, Nnamdi Azikiwe University, Nnewi Campus, Nigeria 2 Department of Educational Foundations, Nnamdi Azikiwe University, Awka, Nigeria *Author for Correspondence ABSTRACT This study aimed at examining the stress-related factors among parents of at-risk infants in neonatal intensive care unit (NICU). 216 parents whose infants were hospitalized in the NICU of two Teaching Hospitals in the South-East zone of Nigeria formed the population of the study. Questionnaires on NICU Parental Stress were administered to the respondents. Information of the demographic characteristics of the parents and their at-risk infants were also obtained. Two research questions and one null hypothesis guided the study. Mean score, standard deviation and Spearman Rank Correlation coefficient (rho) were used to answer the research questions while Mann-Whitney U test was used to test the null hypothesis at 0.01 level of significance. Findings from the study indicate that parental stress for NICU staff behavior was significantly related to the infant birth weight, parental age correlated with the coping measures adopted by the parents to their at-risk infants in NICU, and also significant difference existed between married and single parents with regard to the stress they experience over the behaviour and appearance of their infants in NICU. Key Words: At-Risk Infant, NICU, Parents and Stress-related Factors INTRODUCTION Medically fragile infants are born into families of all races, religions, nationalities and cultural backgrounds without regard for their social environment (Syder – Greenberg and Dokkin, 2000). As technology increases, smaller and more medically fragile infants are being treated and kept alive in highly technical neonatal intensive care (NICU) environments (Miles et al., 1993). From birth, the child has an ability to respond to the environment which influences the interaction between mother and child (Wigert et al., 2006). In typical circumstances, the parent-infant bonding process that occurs during the newborn period establishes the foundation for a lifelong relationship. However, this typical process does not necessarily occur when the infant is born at risk, and spends the first several weeks or months in the NICU (Case-Smith, 1993). If this attachment is interrupted, the child’s emotional development is negatively influenced (Wigert et al., 2006). Neonatal Intensive Care Unit (NICU) environment has the potential to exacerbate stress for parents of infants admitted to the unit. NICU stressors, individually or in combination, may interfere with the parent-infant relationship and create extra difficulties for the couple and wider family (Carter et al., 2007). When parents have an infant in neonatal intensive care, they bring with them their own unique characteristics and set of circumstances. While in the NICU, parents are also influenced by the specific situational conditions of their infants. According to Miles and Carter (1983), these conditions can include the severity of their infant’s diagnosis, the infant’s appearance and level of functioning, and the duration of their infant’s stay in the unit . Environmental factors that can influence parents’ unique reaction to having an infant in the NICU might include difficulty in fulfilling their parental role, the medical equipment used for intervention, and the communication patterns and behaviours of the staff (Miles and Carter, 1983; Hunter, 2001). Miles and Carter (1983) explained that as a result of the various factors that can influence the parents, each parent develops his or her own way of cognitively appraising, or making judgments about the NICU experience. For example, some parents, may view their situation as positive since their infant is getting the care he or she needs, others may see it as negative when the infant or staff is unable to correspond to their expectations or needs, some parents may cope by using the environmental resources available to them such as the support of the NICU staff, while others may use personal resources such as family, friends or financial assets. Hence, the response to the stress of having a child in the NICU can therefore be the result of a complicated interaction of various variables that can potentially be adaptive or maladaptive. Increased information about how parents of hospitalized high-risk infants perceive NICU, and also an understanding of the needs of such parents may enable NICU Staff to identify parents at risk and plan interventions to meet those needs and promote family functioning. This is particularly important given evidence that factors such as parental well-being, family cohesion and parent-child relationships make significant contributions to infant longer-term developmental outcomes (Carlson et al., 2003; Elgar et al., 2004; Martins and Gaffan, 2000). This study was therefore intended to examine the stress- related factors among parents of at-risk infants in the NICU. Research Questions What is the relationship between the birth weight of the infant hospitalized in NICU and parental stress for NICU staff behavior and communication?