The Effect of Expressive Writing on Post‑traumatic Stress Disorder and Hopelessness in Mothers with Premature Neonates Hospitalized in NICU
Abstract
Background: Premature birth and hospitalization of infants in the Neonatal Intensive Care Unit (NICU) can contribute to Post‑Traumatic Stress Disorder (PTSD) in mothers who also experience high levels of hopelessness. It is essential that a proper strategy be used for managing these challenges. This study aims to determine the effect of Expressive Writing (EW) on PTSD and hopelessness in mothers with premature neonates who were hospitalized in NICU.
Materials and Methods: This clinical trial involved 65 mothers with premature neonates admitted to an NICU in Esfahan (Iran) in 2023. Samples were selected by the convenience sampling method and divided into control (n = 33) and intervention (n = 32) groups. The intervention group engaged in EW three times a week. All the participants completed the Perinatal Posttraumatic Stress Disorder Questionnaire and Beck’s Hopelessness Scale. Moreover, statistical analyses including independent t‑test, paired t‑test, Chi‑square test, and Fisher exact test were performed using SPSS 24.
Results: Following the intervention, the mean scores of PTSD and hopelessness were significantly lower in the intervention group compared with the control group ((t = 13.86, df = 63, p ˂ 0.001) and (t = 8.32, df = 63, p ˂ 0.001), respectively).
Conclusions: Expressive writing proved effective in reducing PTSD and hopelessness in mothers with premature neonates. This low‑cost and effective intervention is recommended for enhancing maternal mental health and empowering mothers for optimal care of premature infants in NICUs and after discharge.
Keywords
Full Text:
PDFReferences
Sekhavatpour Z, Reyhani T, Heidarzade M, Moosavi SM, Mazlom SR, Dastoorpoor M, et al. The effect of spiritual self‑care training on the quality of life of mothers of preterm infants: A randomized controlled trial. J Relig Health 2020;59:714‑24.
Arabzadeh M, Tirgari B, Farokhzadian J, Mohammadalizadeh S. Family environment, parental stressors, and post‑traumatic stress disorder in the parents of premature infants in the neonatal intensive care unit. J Pediatr Neonat Individual Med 2022;11:110232. doi: 10.7363/110232.
Pourmovahed Z, Yassini Ardekani SM, Roozbeh B, Ezabad AR. The effect of non‑verbal music on posttraumatic stress disorder in mothers of premature neonates. Iran J Nurs Midwifery Res 2021;26:150‑3.
Tilahun BD. Parental stress and associated factors among parents of preterm neonates admitted at neonatal intensive care unit among selected governmental hospitals Addis Ababa, Ethiopia, 2022. An institution-based cross-sectional study. Front. psychiatry. 2024;15:1377180.
Sadeghi M, Taghva A, Goudarzi N, MR. Validity and reliability of persian version of “ post‑traumatic stress disorder scale “ in war veterans. Iran J War Public Health 2016;8:243‑9.
Gangi S, Dente D, Bacchio E, Giampietro S, Terrin G, De Curtis M. Posttraumatic stress disorder in parents of premature birth neonates. Proc Soc Behav Sci 2013;82:882‑5.
Pace CC, Anderson PJ, Lee KJ, Spittle AJ, Treyvaud K. Posttraumatic stress symptoms in mothers and fathers of very preterm infants over the first 2 years. J Dev Behav Pediatr 2020;41:612‑8.
Borim Nejad L, Mehrnosh N, Seyyed Fatemi N, Haghghani H. Maternal stressor agents with premature infants in neonatal intensive care units. Crit Care Nurs 2011;4:39‑44.
Ceylan R, Aral N. An examination of the correlation between depression and hopelessness levels in mothers of disabled children. Soc Behav Pers Int J 2007;35:903‑8.
Nilsson Schönnesson L, Ross MW, Garcia‑Huidobro D, Eriksson LE, Andersson G, Williams ML, et al. Hopelessness and HIV infection: An exploratory study with a gender‑specific perspective. BMC Psychol 2022;10:46.
Hemati G, Majidi F. Feelings of hopelessness in mothers of children with neurodevelopmental disorders. Int J Dev Disabil 2022;68:485‑94.
Qian J, Zhou X, Sun X, Wu M, Sun S, Yu X. Effects of expressive writing intervention for women’s PTSD, depression, anxiety and stress related to pregnancy: A meta‑analysis of randomized controlled trials. Psychiatry Res 2020;288:112933. doi: 10.1016/j.psychres.2020.112933.
Rabiepoor S, Vatankhah Alamdary N. The impact of expressive writing on stress and satisfaction of care in mothers of premature neonates hospitalized in NICU. Nurs Midwifery J 2019;17:656‑66.
Naeem AT, Nayeri F, Shariat M, Zarkesh MR, Abedinia N, Bakhsh ST. The incidence and risk factors associated with posttraumatic stress disorders among parents of NICU hospitalized preterm neonates. Iran J Neonatol 2019;10:76‑82.
Mollagholi N, Jahangiri MM. Comparison of Hopelessness and Post-Traumatic Stress Disorder Among Women with and without the Experience of Spousal Violence in Isfahan. REFAHJ 2021;21:171‑200.
Rabiepoor S, Vatankhah Alamdary N. The effect of expressive writing on postpartum depression and stress of mothers with a preterm infant in NICU. J Clin Psychol Med Settings 2020;27:867‑74.
Horsch A, Tolsa J‑F, Gilbert L, du Chêne LJ, Müller‑Nix C, Graz MB. Improving maternal mental health following preterm birth using an expressive writing intervention: A randomized controlled trial. Child Psychiatry Hum Dev 2016;47:780‑91.
Blasio PD, Camisasca E, Caravita SC, Ionio C, Milani L, Valtolina GG. The effects of expressive writing on postpartum depression and posttramatic stress symptoms. Psychol Rep 2015;117:856‑82.
Williams A, Hendricks‑Muñoz K, Parlier‑Ahmad A, Griffin S, Wallace R, Perrin P, et al. Posttraumatic stress in NICU mothers: Modeling the roles of childhood trauma and infant health. J Perinatol 2021;41:2009‑18.
Kadivar M, Seyedfatemi N, Akbari N, Haghani H, Fayaz M. Evaluation of the effect of narrative writing on the stress sources of the parents of preterm neonates admitted to the NICU. J Matern Fetal Neonatal Med 2017;30:1616‑20.
Vukčević Marković M, Bjekić J, Priebe S. Effectiveness of expressive writing in the reduction of psychological distress during the COVID‑19 pandemic: A randomized controlled trial. Front Psychol 2020;11:587282. doi: 10.3389/fpsyg.2020.587282.
Merz EL, Fox RS, Malcarne VL. Expressive writing interventions in cancer patients: A systematic review. Health Psychol Rev 2014;8:339‑61.
Ayers S, Bond R, Bertullies S, Wijma K. The aetiology of post-traumatic stress following childbirth: A meta-analysis and theoretical framework. Psychol Med 2016;46:1121-34.
Jouybari L, Abbariki E, Jebeli M, Mehravar F, Asadi L, Akbari N, et al. Comparison of the effect of narrative writing and art therapy on maternal stress in neonatal intensive care settings. J Matern Fetal Neonatal Med 2020;33:664‑70.
Akdogan R. A holistic approach to cope with depression and hopelessness for parents of special needs children. Int J Early Child Spec Educ 2016;8:134‑50.
Khosrobeigi M, Hafezi F, Naderi F, Ehteshamzadeh P. Effectiveness of self‑compassion training on hopelessness and resilience in parents of children with cancer. Explore 2022;18:357‑61.
Erguner‑Tekinalp B, Akkök F. The effects of a coping skills training program on the coping skills, hopelessness, and stress levels of mothers of children with autism. Int J Adv Couns 2004;26:257‑69.
Mohhamadi A, Bahri N, Talasaz F. The effect of expressive writing about thoughts and feelings of childbirth experiences on post traumatic stress disorder and postpartum depression: A systematic review. J Isfahan Med Sch 2021;38:948‑57.
Refbacks
- There are currently no refbacks.