title: Communicating with parents in neonatal intensive care units: The impact on parental stress.
abstract: To analyse stress in parents whose infants with very low birth weight have just concluded high-level care in a Neonatal Intensive Care Unit (NICU). More specifically, we aimed 1) to identify groups of parents in the NICU who are particularly at risk of experiencing stress, and 2) to explore the effects of clinical staffś communication on parental stress.
  
  
  
  Our multi-center-study evaluated views from 1277 parents about care for 923 infants in 66 German NICUs. Answers were linked with separately evaluated medical outcomes of the infants. Separate generalised mixed models estimated the influence of personal, medical and communication-related characteristics on specific parental stress.
  
  
  
  Parents of a younger age and those of infants with severe prognoses were more likely to experience stress. While empathetic communication as one aspect of staffś communication was shown as appropriate in reducing parental stress, an initial introduction and the quantity of information were only slightly associated with lower levels of stress.
  
  
  
  Results provide evidence for the need to involve parents empathetically from the beginning of their child's stay in the NICU.
  
  
  
  Staff in the NICU should communicate empathetically and help to reduce stress in parents particularly at risk.
authors.affiliation: Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health (ceres), University of Cologne, Cologne, Germany. Electronic address: christian.enke@uk-koeln.de.
authors.forename: Christian
authors.initials: C
authors.lastname: Enke
authors.affiliation: Department of Special Education and Rehabilitation Science, University of Cologne, Cologne, Germany.
authors.forename: Andrés
authors.initials: A
authors.lastname: Oliva Y Hausmann
authors.affiliation: Department of Business Administration and Health Care Management, University of Cologne, Cologne, Germany.
authors.forename: Felix
authors.initials: F
authors.lastname: Miedaner
authors.affiliation: Department of Neonatology, Children's Hospital University of Cologne, Cologne, Germany.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Roth
authors.affiliation: Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health (ceres), University of Cologne, Cologne, Germany.
authors.forename: Christiane
authors.initials: C
authors.lastname: Woopen
mesh_terms: D000328:Adult; D003142:Communication; D004645:Empathy; D022143:Family Nursing; D005260:Female; D005858:Germany; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal; D008297:Male; D008875:Middle Aged; D010290:Parents / Q000523:psychology*; D013315:Stress, Psychological / Q000523:psychology*
keywords: Communication; Empathy; Family-centred care (FCC); Information; Neonatal intensive care unit (NICU); Parents; Stress; Very low birth weight infant (VLBW infant)