title: Biopsychosocial risks of parental care for high-risk neonates: implications for evidence-based parental counseling.
abstract: OBJECTIVE
  Provide an evidence base for counseling parents of high-risk neonates about the biopsychosocial impact of providing long-term care.
  
  
  METHODS
  A review of the effects of long-term care on families of high-risk neonates. Our search was limited to 1993-2010. We used the terms 'long-term care,' 'family,' 'neonate' and 'technology dependence.' Results were organized based on Engel's biopsychosocial model.
  
  
  RESULTS
  Physical-parental caregivers reported more health problems, had fewer health-promoting behaviors and lower vitality.Psychological-parental caregivers had higher rates of post-traumatic stress disorder and depressive symptoms, although some improved with time. Siblings reported greater stress and depression. Social-parental caregivers achieved fewer years of education, higher unemployment and lower incomes. Couples reported greater family strain. The effect on divorce was mixed. Siblings reported disruption in their academic and social lives.
  
  
  CONCLUSIONS
  Providing long-term care involves biopsychosocial risks. Counseling of parents should identify them and advocate strategies for prevention.
authors: Department of Pediatrics, Section of Neonatology, Baylor College of Medicine, and Texas Children's Hospital, Houston, TX, USA. fxplacen@bcm.edu
authors: F X
authors: FX
authors: Placencia
authors: L B
authors: LB
authors: McCullough
mesh_terms: D017028:Caregivers / Q000523:psychology*; D003266:Continuity of Patient Care; D003376:Counseling / Q000458:organization & administration*; D019317:Evidence-Based Medicine; D005260:Female; D006304:Health Status; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000175:diagnosis / Q000628:therapy*; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal; D008134:Long-Term Care / Q000523:psychology; D008297:Male; D008603:Mental Health; D020380:Needs Assessment; D016487:Parenting / Q000523:psychology*; D010351:Patient Discharge; D011584:Psychology; D011788:Quality of Life; D018570:Risk Assessment; D013997:Time Factors