| ObjectiveThis study aimed to investigate the current status of post-traumatic growth of parents of preterm infants in the Neonatal Intensive Care Unit(NICU),to analyze its influencing factors,and to explore the correlations between post-traumatic growth and physical development of preterm infante.In order to improve the attention of medical staff to the psychological health of preterm infants’ parents in NICU,and promote the clinical development of targeted intervention measures,making full use of favorable factors to improve the psychological state of parents of preterm infants and the prognosis of children and family health.MethodsThis study is a cross-sectional study.From February 2022 to September 2022,convenience sampling method was used to select a total of 217 cases of preterm infants from a class Ⅲ grade Ⅰ hospital in Suzhou for questionnaire survey.Social demographic Inventory,Posttraumatic Growth Inventory(PTGI)and Chinese Event Related Rumination Inventory were used.C-ERRI,Chinese Family Resilience Assessment Scale(C-FRAS),Perceived Social Support Scale,PSSS)as investigation tools.Three months after discharge,the growth and development of premature infants were evaluated by professionals using physical development measurement tools(height and weight measuring instrument and head circumference measuring tape).Epidata3.1 and SPSS26.0 were used for data entry and statistical analysis,and P<0.05 was considered as statistically significant difference.Enumeration data in social demographic were described by frequency and composition ratio.For measurement data meeting normal distribution,mean±standard deviation(x±s)was used for statistical description.For the non-normal distribution,median or interquartile spacing was used for statistical description.Two independent samples t-test analysis was used for the binary variables that followed normal distribution and had uniform variance,and univariate analysis was performed for the multivariate variables.If the normal distribution was not followed,Mann-Whitney U test was used for binary variables,and Kruskal-Wallis H test was used for multi-classification variables.Data normality test:Pearson correlation analysis was used for the relationship between post-traumatic growth and ruminative rumination,perceived social support and family resilience when normal distribution was followed;Spearman correlation analysis was used for the relationship between posttraumatic growth and rumination,perceived social support and family resilience when normal distribution was followed.Multiple linear regression method was used to analyze the factors influencing the post-traumatic growth of the parents of preterm infants with post-traumatic growth as the dependent variable and statistically significant indexes in univariate and correlation analysis as independent variables,and the mediating effect of the model was tested by deviation correction percentile Bootstrap technique in AMOS.Results1.The total score of posttraumatic growth of parents of premature infants in NICU was(61.89± 17.89),and the average item score was(3.09±0.89).The scores of each dimension from high to low were:life perception(19.50±6.07),new possibilities(12.89±3.80),self-transformation(10.33±4.54),personal power(10.23±2.96),and relationship with others(8.89±3.11).2.The total score of perceived social support of parents of premature infants in NICU was(62.24±12.15),and the average item score was(5.19±1.01).The scores of each dimension from high to low were as follows:family support(22.06±4.58),friend support(20.10±4.63)and other support(20.08±4.10).3.The total score of rumination was(20.08±11.63),and the average item score was(1.00±0.5 8).The scores of each dimension from high to low were as follows:purposive meditation(10.47±6.21),intrusive meditation(9.60±7.04).4.The total score of family resilience of parents of premature infants in NICU was(134.27±15.62),and the average item score was(3.05±0.36).The scores of each dimension from high to low were as follows:family communication and problem solving(84.74±10.10),use of social and economic resources(23.00±3.73),maintaining positive attitude(18.08±2.71),and giving meaning to adversity(8.45±1.27).5.The results of univariate analysis of parents’ posttraumatic growth in NICU preterm infants showed that there were statistically significant differences in parents’posttraumatic growth scores between preterm infants with different time of admission to NICU,whether they were only children,parents with different ages,marital status,education level,working status,and family per capita monthly income(P<0.05).6.Pearson correlation analysis showed that posttraumatic growth of parents of NICU preterm infants was positively correlated with perceived social support,rumination,family resilience and scores of each dimension(r=0.278-0.512,P<0.01).7.The results of multiple linear regression analysis of post-traumatic growth of NICU preterm infants’ parents showed that purposive meditation,family resilience,parental education level,family support,age and marital status entered the regression equation sequentially,which could explain 47.4%of the total variation(F=12.923,P<0.001).Purposive meditation,family resilience,parents’ education level and family support had positive predictive effects on posttraumatic growth(purposive meditation:β=1.203,r=8.303,P<0.01;Family resilience:β=0.296,t=4.575,P<0.01;Education level of parents:β=2.956,t=2.432,P<0.05;Family support:β=0.647,t=2.851,P<0.01);Age and marital status had a negative predictive effect(age:β=-4.116,t=-2.719,P<0.01;Marital status:β=-8.966,t=-2.032,P<0.05).8.Structural equation model showed that the modified structural equation model was well fitted with perceived social support as an exogenous latent variable,post-traumatic growth as an endogenous latent variable,family resilience and rumination as mediating variables,χ~2=168.241,χ~2/df=2.370,RMSEA=0.080,respectively.GFI=0.902,AGFI=0.855,NFI=0.920,RFI=0.898,IFI=0.952,TLI=0.938,CFI=0.952.Perceived social support 363,P<0.001),family resilience(β=0.191,P<0.001),rumination(β=0.593,P<0.001)could directly affect posttraumatic growth,and perceived social support could also affect family resilience(β=0.185,P<0.01),rumination(β=0.107,P<0.01)Two pathways indirectly affect posttraumatic growth.Conclusion1.The parents of NICU preterm infants were in the medium level of post-traumatic growth,and 64.52%were in the high level of post-traumatic growth.Among them,the single item average score of life perception was the highest,and the single item average score of relationship with others was the lowest.The time of staying in NICU,whether the only child,parents’ age,marital status,education level,working status,family per capita monthly income,perceived social support,rumination and family resilience were the influencing factors.Purposefully meditating,family resilience,education level,family support,age and marital status entered the regression equation,which together accounted for 47.4%of the total variation.Among them,marital status had the greatest influence on PTG,suggesting that medical staff should pay attention to the characteristics of post-traumatic growth and the stability of family system of parents of premature infants in NICU,and provide targeted nursing measures.Improve the psychological state of parents of preterm infants,promote the prognosis of children and family health.2.Posttraumatic growth of preterm parents is positively correlated with perceived social support,family resilience and rumination.Perceived social support,family resilience and rumination can directly predict parents’ post-traumatic growth,and perceived social support can indirectly predict parents’ post-traumatic growth through the mediating effects of two pathways:family resilience and rumination.Therefore,medical staff should strengthen psychological attention to parents of NICU premature infants,help build a good understanding of social support system,provide timely and effective counseling and doubt solving,encourage parents to mobilize family and their own favorable factors,with positive emotions and active thinking to deal with the problems during the illness of children,in order to improve the ability of self-care. |
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