The NICU during COVID-19 pandemic: impact on maternal pediatric medical traumatic stress (PMTS)

Objective: to assess how hospital and outpatient clinic policy changes due to COVID-19 pandemic impact on pediatric medical traumatic stress (PMTS) symptoms in mothers of newborns admitted in a NICU. Study design: observational case control study enrolling mothers of infants admitted in the NICU at birth during Covid-19 pandemic compared with mothers of infants admitted in the NICU before the COVID pandemic. Control group was selected matching 1:1 with study group for following infants’ clinical variables: gender, type of pathology, gestational age, weight at birth, day of recovery, ventilator time days, associated malformations. Italian version of the Impact of Event Scale—Revised (IES-R) was used as a measure of PMTS. Result: Mothers of study group (50) scored significantly higher than mothers of control group on three of four scales of IES-R (respectively, “IES-R Total”: F= 6.70; p= .011; IES-R subscale “Intrusion”: F= 7.45; p= .008; IES-R subscale “Avoidance”: F= 8.15; p= .005). A significantly higher number of mothers in study group scored above the IES-R total clinical cut-off compared to mothers of control group (72% vs 48%; Chi2=6.00; p=.012). Conclusion: The COVID-19 pandemic acted as a superimposed stress in mothers of newborn admitted in the neonatal intensive care unit at birth determining high levels of PMTS. Clinicians and researchers should identify and implement novel strategies to provide family-centered care during Covid-19 pandemic and beyond.

Traumatic Stress among School-Aged Pediatric Surgery Patients and Their Parents

Introduction Since hospitalization can be a traumatic event for children, many of them may suffer from a cluster of chronic psychological and emotional difficulties called Pediatric Medical Traumatic Stress (PMTS). Although PMTS causes considerable functional impairment and psychological distress and may decrease the children's compliance with post-surgical care, awareness of this condition is low and thus not enough effort is made to prevent it. The objective of this study is to assess prospectively the prevalence and characteristics of PMTS in school-age children following hospitalization in a general pediatric surgery ward and in their parents, which has not been documented before. Materials Patients and Methods We recruited parents of 88 children aged 6 to 13 years old, hospitalized in a pediatric surgery ward and which form a representative sample of the children of this age in the ward. Three to five months after discharge from the hospital, the parents completed questionnaires measuring symptoms of psychological distress. Results About 26.4% of children displayed symptoms of PMTS, and 11.6% of parents suffered from posttraumatic stress disorder following their child's hospitalization. Moreover, we found a medium high positive correlation between the parents' level of distress and that of their child. Conclusion In view of the prevalence of PMTS among school-aged children following surgical intervention, it is necessary to promote increased awareness, preventive interventions, and early identification and treatment of this condition.