Abstract 1214 Poster Session II, Sunday, 5/2 (poster 91)

The longitudinal effect on family functioning, stress, and cohesiveness during prolonged premature infant hospitalization after birth is unknown. We examined the stresses and differences in coping strategies in 13 families of premature infants < 30 weeks gestation (gest. age = 27.9±2.3 wks, range=25-31 wks; birth wt= 1070±261.7 gms, range=715-1510 gms; Apgar score at 1 min=4±2, range=1-9; Apgar score at 5 mins=7±2, range=3-9; means±std deviation). These infants were cared for in a family-centered, developmentally oriented nursery. Families completed the Parental Stressor Scale, Ways of Coping Checklist, and Perception of Infant Health at semi-monthly intervals, and a family log checklist with each contact with their infant. A SNAP (score for neonatal acute physiology) score was obtained on each infant within 24 hours(mean±std deviation=12.4±5.4). Thirteen families completed 52 questionnaires (mothers=29, fathers=23) Racial distribution of the questionnaires reflected 27 white parents, 17 black parents, and 8 hispanic parents. We performed an analysis of variance (ANOVA) and forward step-wise regression analysis on the data from the questionnaires. We found that parental stress and infant illness were independent factors and that parents in the low stress group had a previous premature infant (p<0.05). Both men and women experience stress and appear to use different coping strategies over time. Men were found to use more coping strategies in the beginning and were persistent in the use of these strategies over time. The families showed a bimodal population and we were able to compare the high stress group versus the low stress group as two separate populations. The lower stress group had a high correlation with having a previous premature infant. Parental stress levels are elevated early and remain at an elevated state throughout the hospitalization course. Parental stress and selection of coping methods were independent of infant illness. Stress and use of coping methods were related to parental characteristics, such as gender, previous experience (e.g. history of previous premature infant), and intrinsic coping abilities. The independence of parental stress and infant health coupled with the history of a previous premature infant defined a population with lower stress scores which suggests that fear of the unknown and altered expectations are key determinants of stress. Despite the provision of family oriented care, families do experience stress after the birth of an ill infant. It is important to understand that the most stressed family may not have the most critically ill infant, and specific proactive assessments of family functioning need to be implemented for families with infants requiring prolonged hospitalization in special care nurseries.