title: The effect of Creating Opportunities for Parent Empowerment program on maternal stress, anxiety, and participation in NICU wards in Iran.
abstract: BACKGROUND
  The purpose of this study was to perform the Creating Opportunities for Parent Empowerment (COPE) program for Iranian mothers and evaluate its effectiveness on stress, anxiety, and participation of mothers who have premature infants hospitalized in neonatal intensive care units (NICUs).
  
  
  METHODS
  A randomized clinical trial was conducted with 90 mothers of premature infants hospitalized in the educational neonatal NICUs of state hospitals affiliated to Isfahan University of Medical Sciences. For measuring the variables, State-Trait Anxiety Inventory, the Parental Stressor Scale: Neonatal Intensive Care, and The Index of Parental Participation/Hospitalized Infant were used. Intervention group received two phases of COPE program. This program consisted of information and behavioral activities about the characteristics of premature infants. Sessions' interval was from 2 to 4 days. Stress and anxiety were measured three times (before each phase and 2-4 days after the second phase). Mothers' participation was evaluated 2-4 days after the second phase. The t-test, χ(2), Mann-Whitney U test, and repeated measurement test were used for data analysis.
  
  
  RESULTS
  Mothers in the intervention group reported significantly less anxiety and less stress in the NICU after performing each phase of the COPE program (P < 0.001), whereas at this time, the level of stress in the comparison group increased. Also, COPE mothers participated in their infants' care rather than the mothers in the comparison group (P < 0.001).
  
  
  CONCLUSIONS
  COPE program was effective for Iranian mothers. This study shows that irrespective of any culture, giving early and comprehensible educational-behavioral information may have positive effect on maternal psychological condition and maternal-infant interaction.
authors.affiliation: Department of Pediatric Nursing, Isfahan University of Medical Sciences, Hezarjerib St. Isfahan, Iran.
authors.forename: Soheila Jafari
authors.initials: SJ
authors.lastname: Mianaei
authors.affiliation: Department of Pediatric Nursing, Shaheed Beheshti University of Medical Sciences, Valiasr St. Tehran, Iran.
authors.forename: Fatemeh Alaee
authors.initials: FA
authors.lastname: Karahroudy
authors.affiliation: Department of Pediatric Nursing, Shaheed Beheshti University of Medical Sciences, Valiasr St. Tehran, Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Rassouli
authors.affiliation: Department of Management in Nursing, Shaheed Beheshti University of Medical Sciences, Valiasr St. Tehran, Iran.
authors.forename: Mansoureh Zagheri
authors.initials: MZ
authors.lastname: Tafreshi
keywords: Anxiety; Creating Opportunities for Parent Empowerment; Iran; participation; premature infant; stress