Amor-Barbosa M1, Bagur-Calafat C1, Romero-Galisteo R2, Jiménez-González A1, Girabent-Farrés M1
1Universitat Internacional de Catalunya, Departamento de Fisioterapia, Barcelona, Spain, 2Universidad de Málaga, Facultad de Ciencias de la Salud, Departamento de Fisioterapia, Málaga, Spain
Background: Infants born preterm are at increased risk of developing cognitive and motor impairment compared with infants born at term. Preterm birth has been associated with increased parental stress in early infancy, and some reports have found this to be a risk factor for later socio-emotional and behavioral development problems. Many Early Intervention Programs (EIPs) involve parents in the treatment; however the effects on parental stress are not clear.
Purpose: The aim of this systematic review was to identify the effect of EIPs on decreasing parental stress suffered by parents of preterm children.
Methods: MEDLINE, Scopus and Web of Science databases were searched (up to April 2018) to identify randomized controlled trials that determined the effect of EIPs on parental stress. We included trials in which parents were involved in the treatment and in which the intervention was supervised by a clinician. Studies were assessed for their methodological quality using the PEDro scale for detecting risk of bias. Data were extracted and entered by two independent review authors. We synthesised the data using RevMan 5.3. We performed the meta-analysis using the Fixed-effects model and the inverse varianceve weightingmethod, and we reported statistical heterogeneity. The effect size was the Standarized Difference Mean value.
Results: 15 articles met the inclusion criteria. We could only collect data from the average and standard deviation in 11 of the 15 articles included (corresponding to 10 studies). The domains most commonly reported in the trials were the child care-related stress (Child Domain), personal discomfort (Parent Domain) and a computation of both (Total Stress). The median on the PEDro scale was 6. The results showed significant and relevant differences in favor of the EIP group. In Total Stress score at 18 months and 5 years we reported an effect size of -14,81 [-19.34, -10.27] on PSI-SF scale and -22.97 [-32.40, -13.54] on PSI scale, respectively. We also reported an effect size of -14,81 [-19.34, -10.27] on Child Domain score of PSI-SF scale and an effect size of -22.97 [-32.40, -13.54] on Parent Domain Score of PSI scale, both at 5 years. The size of the effect obtained in the Parent Child Dysfunctional Interaction Domain score at 3 months despite being significant, was considered clinically irrelevant (-0.21 [-0.02,-0.43])
Conclusion(s): EIPs that involve parents in the treatment are an effective strategy to manage their stress.
Implications: This systematic review shows that EIPs are a good way to reduce parental stress levels after preterm birth. It is well documented that heightened levels of parental stress have a negative influence on children´s socio-emotional and behavioral development. Physiotherapist interventions should be not only to treat motor disabilities but also to offer an integral treatment for the baby and his family. Therefore, the implementation of these programs could improve the global development of the baby from birth. In addition, it provides emotional support for parents of preterm infants who would have a direct impact on their well-being and reducing health care costs.
Keywords: Early Intervention Program, preterm birth, parental stress
Funding acknowledgements: The work was unfunded
Purpose: The aim of this systematic review was to identify the effect of EIPs on decreasing parental stress suffered by parents of preterm children.
Methods: MEDLINE, Scopus and Web of Science databases were searched (up to April 2018) to identify randomized controlled trials that determined the effect of EIPs on parental stress. We included trials in which parents were involved in the treatment and in which the intervention was supervised by a clinician. Studies were assessed for their methodological quality using the PEDro scale for detecting risk of bias. Data were extracted and entered by two independent review authors. We synthesised the data using RevMan 5.3. We performed the meta-analysis using the Fixed-effects model and the inverse varianceve weightingmethod, and we reported statistical heterogeneity. The effect size was the Standarized Difference Mean value.
Results: 15 articles met the inclusion criteria. We could only collect data from the average and standard deviation in 11 of the 15 articles included (corresponding to 10 studies). The domains most commonly reported in the trials were the child care-related stress (Child Domain), personal discomfort (Parent Domain) and a computation of both (Total Stress). The median on the PEDro scale was 6. The results showed significant and relevant differences in favor of the EIP group. In Total Stress score at 18 months and 5 years we reported an effect size of -14,81 [-19.34, -10.27] on PSI-SF scale and -22.97 [-32.40, -13.54] on PSI scale, respectively. We also reported an effect size of -14,81 [-19.34, -10.27] on Child Domain score of PSI-SF scale and an effect size of -22.97 [-32.40, -13.54] on Parent Domain Score of PSI scale, both at 5 years. The size of the effect obtained in the Parent Child Dysfunctional Interaction Domain score at 3 months despite being significant, was considered clinically irrelevant (-0.21 [-0.02,-0.43])
Conclusion(s): EIPs that involve parents in the treatment are an effective strategy to manage their stress.
Implications: This systematic review shows that EIPs are a good way to reduce parental stress levels after preterm birth. It is well documented that heightened levels of parental stress have a negative influence on children´s socio-emotional and behavioral development. Physiotherapist interventions should be not only to treat motor disabilities but also to offer an integral treatment for the baby and his family. Therefore, the implementation of these programs could improve the global development of the baby from birth. In addition, it provides emotional support for parents of preterm infants who would have a direct impact on their well-being and reducing health care costs.
Keywords: Early Intervention Program, preterm birth, parental stress
Funding acknowledgements: The work was unfunded
Topic: Paediatrics
Ethics approval required: No
Institution: None
Ethics committee: None
Reason not required: Ethics approval was not required because our study didn’t include research on humans or animals
All authors, affiliations and abstracts have been published as submitted.
