Lambiase, Carmine Vincenzo (2025) Caring for Those Who Take Care: Fostering the Psychological Health of Parents and Nursing Staff in Neonatal Intensive Care Unit. [Tesi di dottorato]

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Abstract

Background: The Neonatal Intensive Care Unit (NICU) is a specialized ward equipped with advanced technology, aiming to improve the survival chances of critically ill and preterm infants. However, while the infant's health and survival are a central focus, the NICU environment is driven by those who care for the infants—parents and healthcare staff (mainly nursing professionals). These caregivers must possess individual and relational resources to handle demanding challenges and interact effectively. In recent decades, the Family-Centered Care Model has been widely adopted to foster relationships between parents and NICU healthcare staff, with the primary goal of enhancing infant development and well-being. Yet, there has been less attention to the psychological and physical health risks faced by parents and nursing staff, highlighting a need for more research on this topic. Objective: Based on a transactional and multidimensional approach, the aim of this thesis project is to enrich the knowledge and the tools of the Family-Centered Care practices, in order to improve the experience of both parents and nursing staff, taking into account the role of psychological, physical, financial, cultural, and work-related dimensions featuring the experience of NICU hospitalization and after discharge. Methods: A cross-sectional study design targeting parents of NICU infants and the nursing staff was employed with the aim of investigating: 1) parents' experiences (exploring and comparing psychological and physical health conditions, risks and resources by gender, and carrying out a cross-country comparison - testing specificities/differences with a comparable sample of NICU parents in Portugal); 2) nurses’ experiences (exploring and comparing psychological and physical health conditions, risks and resources - testing specificities/differences with a comparable sample of nurses in intensive care with adult patients). Validated questionnaires measuring specific sources of stress (NICU stressors; financial burden; Work-related stressors), individual and relational resources (individual and dyadic coping strategies, social support), and health outcomes (psychological and physical health conditions; quality of life) were administered to parents of NICU infants and the nursing staff. Statistical analyses were carried out using Descriptive statistics, Correlational analyses, Regression analyses, Mediation and Moderation Analyses, and Multigroup Latent Class Analysis. Results: Overall, findings from the present thesis allow the identification of specific risk and protective factors to be used to develop and implement tailored evidence-based supporting interventions, fostering parents’ and nurses’ wellbeing, and informing public health policies aimed at promoting Family-Centered Care practices within the hospital setting and beyond.

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