The NICU Through a Preemie Mom and Psychologist’s Eyes

PreemieWorld Interview with Dr. Alison Gibson of South Africa

PREEMIEWORLD: What led you to study psychology as a vocation?

I was interested in helping people with problems and specifically children when I first started studying. A prerequisite of studying Educational Psychology in South Africa at the time we had to first study teaching. So I studied a teaching degree and then continued with an honors and masters degree in Educational Psychology.

PREEMIEWORLD: You enjoy working with school-age children – what led you to do that type of work?

That was more of a calling. I am a born teacher and love teaching and imparting knowledge. I had, however, wanted to do more than just teach so I continued with Educational Psychology.

PREEMIEWORLD: And your PhD was about supporting families with a baby in the Neonatal Intensive Care Unit, yes? What led you to do this work?

I had a premature baby who spent 4 months in the NICU. I think I started to develop depression. The nurses suggested I see the hospital psychologist. I left seeing the psychologist more angry than feeling helped. She did not understand what I was going through, she did not understand what happens in a NICU. Had never even been in 1 to see it. This motivated me to look into studying what can help parents cope in the NICU – which was my PhD. My title of my thesis was “Fostering well-being in Parents of Preterm infants in a Neonatal Intensive Care Unit.”

PREEMIEWORLD: In your work supporting families, what surprised you the most about families’ struggles in the NICU? What did not surprise you?

I was surprised that the general population of parents in the NICU generally have the same emotions and fears.
In my personal experience I was surprised at the lack of support from the nursing staff to parents as they are very busy with the infant. However, doing my research I was not surprised at other hospitals where the same situation of nurses being too busy to cope with parents’ problems.

PREEMIEWORLD: Did you also find yourself supporting the professional team members as well somehow?

In my personal experience with my daughter in the NICU, we had an excellent team of nurses (the hospital was well-known as having the best NICU in the area) which helped my husband and me. When we were in the NICU, staff would ask us to talk to other parents to help them cope better.

In my research, some parents complained about the nursing staff as being insensitive and not understanding the parents’ needs. I would relay some information to the nurses and doctors of parents’ concerns.

PREEMIEWORLD: Not every NICU has a psychologist in its unit to support families. I wish that were the case. If you could do anything you wanted in NICUs across the world, what would you set up to help these families support-wise?

First, offering support and guidance to parents of high-risk pregnancies (for example during prescribed bed rest). Will need obstetricians/ gynecologists to refer.

Evaluate parents for emotional distress during birth, and admission of their infant to a NICU using a questionnaire. Re-evaluate postnatally to screen for post-natal depression and post-traumatic stress disorder. Foster relationships with psychiatrists and other referral services as needed.

Psychosocial support of parents aimed at:

  • decreasing stress, anxiety, and depressive symptoms
  • increasing self-efficacy, maternal sensitivity, and responsiveness in interactions with their infants, with the hope of improving the child’s developmental outcomes.
  • (Interventions that included psychosocial support resulted in better outcomes for mothers).
  • Educational interventions aimed at increasing parental knowledge and skill in caring for preterm infants, thus increasing parenting self-efficacy and decreasing stress.
  • Education may include (a) information about infant growth and development, (b) demonstrations of infant behavior with discussion, or (c) active involvement of the parent in interaction with the infant with feedback from a professional.
  • Educate parents of the benefits of skin-to-skin contact and initiate contact.
  • Parenting education is a key intervention component associated with decreasing anxiety, however with varying effects on stress and depression. However, parenting education alone does not reduce stress.
  • Help parents become as involved as possible in family-integrated developmental care.
  • Developmental interventions delivered by the parent may ultimately have an effect on infant development.
  • Collaboration with the Palliative care team (if one exists) and/or provide support to both families and staff during and after significant medical crises or death of a fetus or new-born.
  • Set-up a peer-to-peer counseling group and train and qualify others to support parents. This would need monitoring.
  • Set up support groups.
  • Other small matters can be an introduction book to be given to parents. A book for siblings to help them understand. Involvement of extended family to help with matters such as meal preparations, chores, and baby-sitting siblings etc.

PREEMIEWORLD: What would you like the general public to know about these families and the NICU struggle?

The general public needs to be more aware and informed of parents ‘struggles when having a preterm infant in a NICU.

Understanding the burden of preterm birth and disparities in prevalence and mortality of this condition is critical for advocacy and allocation of resources for surveillance, research, prevention, and care related to preterm birth (Walani, 2020).

PREEMIEWORLD: Is there anything else you would like to say?

Thank you for this opportunity to share my passion.

 

 

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