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Listening Visits for Emotionally Distressed Mothers of Hospitalized Newborns

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ClinicalTrials.gov Identifier: NCT03704948
Recruitment Status : Recruiting
First Posted : October 15, 2018
Last Update Posted : June 20, 2019
Sponsor:
Information provided by (Responsible Party):
Lisa Segre, University of Iowa

Brief Summary:
The proposed research has potential to dramatically improve care for emotionally distressed mothers of newborns hospitalized on the neonatal intensive care unit (NICU). Clinical NICU nurses are well-positioned to provide emotional support in the form of Listening Visits. Specifically, these nurses are easily accessible to NICU mothers, are often the most trusted professional on the healthcare team, they are knowledgeable about the newborn's medical conditions, and, finally they are already skilled in the art of warm communication. This intervention should not only improve depressive outcomes in emotionally distressed NICU mothers but also indirectly impact maternal perception of nurse support which is in turn related to depression symptoms and patient satisfaction, as well as infant length of stay by accelerating maternal readiness for infant discharge.

Condition or disease Intervention/treatment Phase
Nurse Delivered Counseling Emotional Distress Behavioral: Listening Visits Behavioral: Standard Care (Social Work) Not Applicable

Detailed Description:
Infant admission to the neonatal intensive care unit (NICU) is an extremely stressful postpartum outcome, as evidenced by data showing significant depressive symptoms in some 63% of new NICU mothers. Thus, as part of a Family-Centered Care philosophy, focus on the emotional well-being of the mother (and indeed the entire family) should be widely adopted by NICU nursing units. In current clinical practice, however, the emotional well-being of NICU mothers is often ignored. At best, NICU mothers are screened for depression and if indicated, referred to a mental health professional. The extremes of no treatment and full-on mental healthcare comprise an inadequate approach for treating mothers dealing with a normative reaction to a stressful event. In alignment with the Nurse Parent Support Model, the investigators propose the implementation of Listening Visits as a cost-effective nurse-delivered supportive approach, proven to relieve moderately severe depressive symptoms in mothers of term infants. In the NICU setting, Listening Visits were first implemented in a phase-1 feasibility trial conducted by this research team. In that first trial, Listening Visits were delivered by a doctoral level nurse practitioner and showed promise as means to reduce distress in NICU mothers. A Listening Visit program for emotionally distressed NICU mothers is innovative because it is a cost-effective approach that uses resources that are largely in place, to serve a persistent unmet need in a vulnerable postpartum population. By having nurses provides support, the concept of emotional distress in NICU mothers is normalized. This new application of Listening Visits also directly aligns with the NINR emphasis on promoting coping to prevent compromising mood states. The promising results of the feasibility trial now must be challenged with a control group comparison to definitively attribute maternal improvements to Listening Visits. Thus the objective of the proposed research is to conduct a Phase 2 pilot RCT to evaluate Listening Visits provided by bachelor's-level NICU nurses as compared with the care currently provided by the NICU social work team. The investigators will assess the relative effectiveness of Listening Visits vs. standard care on depressive symptoms. 50 women will be randomized into this trial. Because outcomes of infants will be obtained, the IRB has required that they be enrolled by their mothers as subjects so that data on their outcomes can be obtained. However they are not receiving the intervention.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 50 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Supportive Care
Official Title: Promoting Emotional Well-Being in Distressed NICU (Neonatal Intensive Care Unit) Mothers: A Phase 2 Evaluation of a Nurse-Delivered Approach
Actual Study Start Date : February 14, 2019
Estimated Primary Completion Date : October 2020
Estimated Study Completion Date : October 2021

Arm Intervention/treatment
Experimental: Listening Visits
Listening Visits delivered by a nurse.
Behavioral: Listening Visits
6 sessions, approximately one hour in length, delivered by a nurse who uses empathic listening and problem solving.
Other Names:
  • Person-centered counselling
  • Counselling

Active Comparator: Standard of Care (Social Work)
Standard mental health services provided by social workers.
Behavioral: Standard Care (Social Work)
Mental health services provided by social workers to emotionally distressed mothers.




Primary Outcome Measures :
  1. Mean depression symptoms score [ Time Frame: 8 weeks post enrollment ]
    • Scale: Inventory of Depression & Anxiety Symptoms-General Depression (sub) Scale (IDAS-GD).
    • The IDAS-GD assesses depression symptoms
    • The IDAS-GD is a 2-item Likert-scale instrument assesses dysphoria, suicidality, lassitude, insomnia, appetite loss and well-being, using a 5-point scale ranging from not at all to extremely, indicating how much they had experienced each symptom during the past 2 weeks.
    • Total score for IDAS-GD can range from 1-100, with higher scores indicating more depression symptoms



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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   Female
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Ability to speak and read English
  • 18 years of age or older Edinburgh Postnatal Depression Scale (EPDS) score= 12 through 19, inclusive; with a rating of 2 or less on EPDS item #10)
  • Hospitalized newborn who is 32 weeks gestational age or less, or any newborn who has an illness typically requiring at least a 4-week hospitalization

Exclusion Criteria

  • No Department Human Services involvement/no incarceration
  • Women is not currently receiving counseling services

RCT Randomization Women enrolled into the RCT, will be randomized to received Listening Visits from a NICU


Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03704948


Contacts
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Contact: Lisa S. Segre, PhD 319-335-7079 lisa-segre@uiowa.edu

Locations
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United States, Iowa
University of Iowa Stead Family Children's Hospital Recruiting
Iowa City, Iowa, United States, 52242
Contact: Lisa S. Segre, PhD    319-335-7079    lisa-segre@uiowa.edu   
Sponsors and Collaborators
Lisa Segre
Investigators
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Principal Investigator: Lisa S. Segre, PhD University of Iowa

Publications:
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Responsible Party: Lisa Segre, Principal Investigator, University of Iowa
ClinicalTrials.gov Identifier: NCT03704948     History of Changes
Other Study ID Numbers: 201805961
First Posted: October 15, 2018    Key Record Dates
Last Update Posted: June 20, 2019
Last Verified: June 2019
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Lisa Segre, University of Iowa:
Depression
Listening Visits
Nurses
Hospitalized newborns