A new stressor scale for parents experiencing neonatal intensive care: the NUPS (Neonatal Unit Parental Stress) scale

Whilst stress in parents experiencing neonatal intensive care is widely reported, relatively little is known about the sources, frequency and magnitude of the stress reactions of mothers and fathers at various stages of the experience. General scales of anxiety and/or depression reveal high levels of mood disorder; however, they fail to highlight particular issues which may inform the development of effective intervention strategies. Studies have used various theoretical models, and the instruments and methods vary considerably. The PSS:NICU is the only situation-specific scale in current use; however, there may be questions as to its comprehensiveness. This study reports on the psychometric properties of a revised and expanded stressor scale given to parents early in their stay and where applicable at a second stage, along with a concurrent assessment of general anxiety/depression (HADS) and a rating of the quality of perceived social support (FAD-GF). 748 parental responses were obtained (mothers 55%, fathers 45%) at 48-72h, and 10-14 days post birth. Exploratory and confirmatory factor analyses reduced data to three constructs, social/practical, illness/treatments, and role/relationships stress. The scale produced internally reliable results. The study produced reports of stress associated with social and practical difficulties which have not been previously measured. The scale appears to be valid and reliable and discriminates differing aspects of the experience. The stress response must be measured at differing stages of the experience to understand the changing situation.