title: Forgotten parent: NICU paternal emotional response.
abstract: OBJECTIVE
  To evaluate and compare the presence of perceived paternal stress and depressive symptomatology in fathers of preterm infants over time.
  
  
  METHODS
  Fathers of NICU infants born before 30 weeks of gestation.
  
  
  METHODS
  Prospective convenience sample.
  
  
  METHODS
  Consenting fathers were given 2 self-report questionnaires: Center for Epidemiologic Studies-Depression Scale (CES-D) and Parent Stressor Scale: Infant Hospitalization (PSS:IH) on 7th (time 1), 21st (time 2), and 35th (time 3) days of life. Objective measurement of illness severity was quantified by Score for Neonatal Acute Physiology. Statistical methods included generalized linear estimating equation and mixed linear modeling.
  
  
  METHODS
  Stress and depressive symptomatology in fathers of preterm infants.
  
  
  RESULTS
  Stress scores (PSS:IH) were unchanged over time (P = .62) indicating that fathers (n = 35) remain significantly stressed. Individual subcomponents of stress (parent role alteration, infant appearance/behavior, NICU sights/sounds) also remained constant over the study period (P = .05 for each). Stress scores over time were not modified by demographic characteristics (marriage, education, insurance). Mean depressive symptomatology scores (CES-D) decreased over time (P = .04). The percentage of fathers with elevated CES-D scores (>16) decreased from a baseline 60% but did not diminish between times 2 (39%) and 3 (36%). Parent Stressor Scale: Infant Hospitalization stress scores were correlated with CES-D depressive symptomatology scores (P < .01). Socioeconomic factors influenced initial CES-D scores, but only marriage ameliorated subsequent changes in measurements. Objective measurement of infant illness (Score for Neonatal Acute Physiology) did not influence paternal CES-D or PSS:IH scores.
  
  
  CONCLUSIONS
  Fathers of premature infants in a medical NICU demonstrated elevated levels of stress that persisted across time for all domains of measured stress. Paternal self-reported stress and depressive symptomatology was independent of infant illness. One third of fathers had persistently elevated CES-D scores. If these findings are representative of general NICU population, then the emotional needs of our fathers are not being fully addressed.
authors.affiliation: Division of Neonatology, Christiana Care Health Systems, Newark, DE 19713, USA. amackley@christianacare.org
authors.forename: Amy B
authors.initials: AB
authors.lastname: Mackley
authors.forename: Robert G
authors.initials: RG
authors.lastname: Locke
authors.forename: Michael L
authors.initials: ML
authors.lastname: Spear
authors.forename: Rachel
authors.initials: R
authors.lastname: Joseph
mesh_terms: D000328:Adult; D003863:Depression / Q000453:epidemiology* / Q000523:psychology; D005220:Fathers / Q000523:psychology*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D008016:Life Change Events; D008297:Male; D011446:Prospective Studies; D011594:Psychometrics; D013315:Stress, Psychological / Q000453:epidemiology* / Q000523:psychology; D011795:Surveys and Questionnaires