Publication Date


Document Type


First Advisor

Musker, Kathleen

Degree Name

B.S. (Bachelor of Science)

Legacy Department

School of Nursing and Health Studies


Parents are developing increasing amounts of acute traumatic stress symptoms (ATSS) from overwhelming Neonatal Intensive Care Unit (NICU) experiences upon newborn admissions and a lack of appropriate nursing interventions (Clottey & Dillard, 2013; Bryant, Friedman, Spiegel, Ursano, & Strain, 2010). Parental stress originates from a lack of communication between healthcare team members, feelings of personal guilt and shame, and an inability to participate in complete neonatal care (Mowery, 2011). Most parents are not educated on specialty neonatal care, furthering adding to high stress levels. Witnessing invasive treatments and frightening images of their infant attached to complex machines, fluctuation of neonatal progression during treatment, and unpredictability of the future are other factors of parental stress (Hall 2014). If there is a disconnect between infant-parent attachment, child development can suffer and lead to the possibility of future psychiatric illness among NICU infants (Clottey & Dillard, 2013). Research shows that if parents do not have their psychological and physiological needs met by healthcare workers and supportive groups, ATSS can quickly develop into a long-term psychological disorder that can negatively impact the quality of life in both infants and parents (Clottey & Dillard, 2013). However cognitive behavioral therapy (CBT) and other techniques have been shown to reduce stress in parents facing traumatic situations (Cohen & Mannarino, 2008). By confronting fearful issues, reconstructing thoughts to become more positive, and proactively participating in care while taking personal responsibility to improve situations, NICU nurses should be urged to implement CBT and other stress reducing techniques in the clinical setting to assist distressed parents (Cohen & Mannarino, 2008). Daily communication, family-centered care that involves education on infant conditions, and referrals to supportive groups are the main suggestions NICU nurses can utilize strategies that involve components of CBT to improve physical and psychological well-being of new parents (Hynan, Mounts, & Vanderbuilt, 2013). Research methods included an extensive review of literature and analysis of 15 quantitative and qualitative research articles. Research grids were utilized to obtain major literature findings and to compare data. Three main themes found in this review of literature included the importance of daily, therapeutic communication, family-centered care and education, and support groups among nursing practice. In conclusion, nurses can have a tremendous influence over stressed parents in clinical settings. Research shows that if trauma-focused CBT (TF-CBT), CBT, and other stress reducing techniques are integrated into nursing interventions, this will prevent the long-term development of serious psychological disorders such as posttraumatic stress disorder (PTSD) and depression, and improve overall child development (Clottey & Dillard, 2013; Cohen & Mannarino, 2008; Hynan, Mounts, & Vanderbilt, 2013). Because there is a limited amount of CBT and TF-CBT involvement in nursing practice, further research needs to focus on the effectiveness of CBT and other stress reducing techniques in nursing interventions to show the positive impact at reducing parental ATSS in NICU parents.

Review of Literature


41 pages




Northern Illinois University

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