Doctoral Dissertation Research: Inequity, postpartum neglect, and social support impacts on stress and mental health in parents with infants in intensive care

博士论文研究：不平等、产后忽视和社会支持对重症监护婴儿父母的压力和心理健康的影响

• 批准号: 2235954
• 负责人: Theodore Schurr
• 金额: $ 1.4万
• 依托单位: University of Pennsylvania
• 依托单位国家: 美国
• 项目类别: Standard Grant
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-03-15 至 2024-04-30
• 项目状态: 已结题
• 来源: https://www.nsf.gov/awardsearch/showAward?AWD_ID=2235954&HistoricalAwards=false
• 关键词: Doctoral; Dissertation; Research; Inequity; postpartum

Postpartum neonatal intensive care unit (NICU) parents are a widely understudied population known to be more vulnerable to adverse physical and mental health outcomes than parents of healthy infants. This Doctoral Dissertation Research project explores the biocultural pathways through which social, economic, and structural inequities are associated with stress and depression among parents with infants in an urban children’s hospital NICU. These pathways, through which the effects of biology and culture impact each other, provide key context for understanding how intersectional inequities, social support resources, and access to adequate healthcare mediate differences in wellbeing among NICU parents in the United States, who are already at high risk of poor outcomes. The results of this work are shared directly with hospital leaders, nursing staff, and social workers at the study’s hospital research site to contribute to discussions of how to reduce parental NICU-related stress and improve postpartum mental health outcomes. This project also supports undergraduate mentorship, interdisciplinary collaboration, and science engagement activities with the public. Having an infant in intensive care is linked to higher rates of postpartum depression, post-traumatic stress disorder, and pregnancy-related morbidities due to the increased stress associated with adverse birth outcomes and stressful postpartum environments. This project uses a comparative mixed-methods approach including parental surveys, ethnographic observations and interviews, and infant medical record data to provide a more comprehensive view of the lived experiences of postpartum NICU parents. It explores how embodied NICU-related stress and mental health vulnerabilities are mediated through social and economic inequities that can affect adequate access to maternal postpartum healthcare and social support resources. To assess postpartum NICU-related stress, the project employs a self-reported NICU-specific stress scale that allows investigators to understand how key stressors associated with the physical and social NICU environment contribute to parental postpartum stress. Assessing the relationship between the sociocultural and economic environment, contextual-specific stressors, and mental implications for postpartum NICU parents is critical not only for the health of the parent but also for their infants during early development and the health of future pregnancies.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.

产后新生儿重症监护病房 (NICU) 的父母是一个被广泛研究的人群，他们比健康婴儿的父母更容易受到不良身心健康结果的影响。本博士论文研究项目探讨了社会、经济和结构性不平等的生物文化途径。与城市儿童医院新生儿重症监护室婴儿父母的压力和抑郁有关。生物学和文化的影响通过这些途径相互影响，为理解交叉不平等和社会支持提供了关键背景。资源和获得足够的医疗保健的机会介导了美国新生儿重症监护病房父母的福祉差异，他们已经处于不良结果的高风险中。这项工作的结果直接与研究中的医院领导、护理人员和社会工作者分享。该项目还支持本科生指导、跨学科合作以及与公众进行婴儿重症监护相关的科学参与活动。产后抑郁症的发病率较高，创伤后应激障碍以及由于不良分娩结果和紧张的产后环境带来的压力增加而导致的妊娠相关疾病。该项目采用比较混合方法，包括父母调查、人种学观察和访谈以及婴儿病历数据。它提供了对产后新生儿重症监护病房父母的生活经历的更全面的了解，它探讨了与新生儿重症监护病房相关的压力和心理健康脆弱性如何通过社会和经济不平等来调节，这些不平等可能会影响产妇获得产后医疗保健和社会支持资源。为了评估产后 NICU 相关压力，该项目采用了自我报告的 NICU 特定压力量表，使研究人员能够了解与 NICU 物理和社会环境相关的关键压力源如何影响父母的产后压力。 评估社会文化和经济环境之间的关系。对产后 NICU 父母的特定环境压力源和精神影响不仅对父母的健康至关重要，而且对其婴儿早期发育和未来怀孕的健康也至关重要。该奖项反映了 NSF 的法定使命通过使用基金会的智力优点和更广泛的影响审查标准进行评估，并被认为值得支持。