Mindfulness and Relaxation-Based Interventions to Reduce Parental Stress, Anxiety and/or Depressive Symptoms in the Neonatal Intensive Care Unit: A Systematic Review
Open accessAbstract
Parents with infants in the neonatal intensive care unit (NICU) experience high levels of stress, anxiety, and depression. Mindfulness and relaxation-based interventions are effective in reducing distress in the general postpartum population. The aim of this systematic review was to evaluate whether mindfulness and/or relaxation-based interventions reduce stress, anxiety, and depression in NICU parents. A total of five studies met the inclusion criteria and were assessed for quality using the Downs & Black Checklist. The most consistent results in this review suggest that mindfulness and/or relaxation-based interventions may be effective at reducing anxiety symptoms in NICU parents, with moderate to large effect sizes, and show promise in reducing depressive symptoms. The findings show limited potential benefits on parental stress. Methodological weaknesses, heterogeneous intervention factors (including format and length), and varying participant adherence hinder the ability to make strong conclusions. Directions for future research are discussed.
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In that study, the majority reported that teaching parents and caregivers stress reduction strategies would be highly beneficial to reduce stress.
“The majority also reported that teaching par ents and caregivers stress reduction strategies would be highly beneficial to reduce stress.”
From A digital Acceptance and Commitment Therapy and education intervention targeting stress of parents and caregivers with preterm babies in the neonatal intensive care unit: A randomised controlled cluster trial protocol (2024) · cites this paper as [13]
The Results (Outcome Results; page unavailable) report stress reductions in two of four studies, and the Discussion (Implications for Clinical Psychology; page unavailable) says the interventions were acceptable to NICU parents. But the review does not report that a majority of parents or caregivers said teaching stress-reduction strategies would be highly beneficial; it describes the evidence for reducing parental stress as limited. (LLM, conf=0.82)
Experimental — accuracy not yet measuredThree systematic reviews support the efficacy of some psychosocial interventions for NICU parents, including family-centred care, cognitive behavioural therapy, and psychoeducational interventions.
“Three systematic reviews [7 -9] support the efficacy of some of these interventions, including family-centred care models that focus on increasing a parent's involve ment in their baby's medical care, psychotherapy-based interventions, particularly cognitive behavioural therapy, and psychoeducational in terventions.”
From A digital Acceptance and Commitment Therapy and education intervention targeting stress of parents and caregivers with preterm babies in the neonatal intensive care unit: A randomised controlled cluster trial protocol (2024) · cites this paper as [8]
The Introduction’s “Interventions for NICU Parents” section reports that a previous review found family-centred care associated with reduced parental distress. This paper’s own review focuses on mindfulness and relaxation; its Methods exclude programmes combining those approaches with parenting education or psychological therapy. It therefore does not establish efficacy for cognitive behavioural therapy or psychoeducational interventions. (LLM, conf=0.87)
Experimental — accuracy not yet measuredMindfulness and/or relaxation-based interventions to reduce parental distress in the NICU have shown promise, particularly for parental anxiety.
“Mindfulness and/or relaxation-based interventions to reduce parental distress in the NICU have also shown promise, partic ularly for parental anxiety [8].”
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References 54 · Cited by 22
Research works printed but not linked: 30
- Apostolo JL Kolcaba K The effects of guided imagery on comfort, depression, anxiety, and stress of psychiatric inpatients with depressive disorders Archives of Psychiatric Nursing 2009 23 403 411 10.1016/j.apnu.2008.12.003 19926022 · DOI
- Armour M Ee C Steiner GZ Liamputtong P Randomized controlled trials Handbook of research methods in health social sciences 2018 Springer
- Cavaleri R Bhole S Arora A Liamputtong P Critical appraisal of quantitative research Handbook of research methods in health social sciences 2018 Springer
- Dabas S Joshi P Agarwal R Yadav RK Kachhawa G Impact of audio assisted relaxation technique on stress, anxiety and milk output among postpartum mothers of hospitalized neonates: A randomized controlled trial Journal of Neonatal Nursing 2019 25 200 204 10.1016/j.jnn.2019.03.004 · DOI
- Downs S Black N The feasibility of creating a checklist for the assessment of the methodological quality both of randomized and non-randomized studies of health care interventions Journal of Epidemiology Community Health 1998 52 377 384 10.1136/jech.52.6.377 9764259 PMC1756728 · DOI · Paper page
- Feher SD Berger LR Johnson JD Wilde JB Increasing breast milk production for premature infants with a relaxation/imagery audiotape Pediatrics 1989 83 57 60 10.1542/peds.83.1.57 2642620 · DOI
- Hart J Guided imagery Alternative & Complementary Therapies 2008 14 295 299 10.1089/act.2008.14604 · DOI
- Hofmann SG Sawyer AT Witt AA Oh D The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review Journal of Consulting and Clinical Psychology 2010 78 169 183 10.1037/a0018555 20350028 PMC2848393 · DOI · Paper page
- Howland CL Jallo N Connelly CD Pickler RH Feasibility of a relaxation guided imagery intervention to reduce maternal stress in the NICU Journal of Obstetric, Gynecologic & Neonatal Nursing 2017 46 532 543 10.1016/j.jogn.2017.03.004 28527300 · DOI
- Kellermeyer L Harnke B Knight S Covidence and Rayyan Journal of the Medical Library Association 2018 106 580 10.5195/jmla.2018.513 · DOI
- Kolcaba KY Fox C The effects of guided imagery on comfort of women with early-stage breast cancer undergoing radiation therapy Oncology Nursing Forum 1999 26 67 72 9921569
- Lean RE Rogers CE Paul RA Gerstein ED NICU hospitalization: Long-term implications on parenting and child behaviors Current Treatment Options in Pediatrics 2018 4 49 69 10.1007/s40746-018-0112-5 29881666 PMC5986282 · DOI · Paper page
- Liu K Chen Y Wu D Lin R Wang Z Pan L Effects of progressive muscle relaxation on anxiety and sleep quality in patients with COVID-19 Complementary Therapies in Clinical Practice 2020 10.1016/j.ctcp.2020.101132 32379667 PMC7102525 · DOI
- Lotterman JH Lorenz JM Bonanno GA You can’t take your baby home yet: A longitudinal study of psychological symptoms in mothers of infants hospitalized in the NICU Journal of Clinical Psychology in Medical Settings 2019 26 116 122 10.1007/s10880-018-9570-y 29789995 · DOI
- Luberto CM Hall DL Park ER Haramati A Cotton S A perspective on the similarities and differences between mindfulness and relaxation Global Advances in Health and Medicine 2020 10.1177/2164956120905597 32076580 PMC7003166 · DOI
- Ma X Yue ZQ Gong ZQ Zhang H Duan NY Shi YT Wei GX Li YF The effect of diaphragmatic breathing on attention, negative affect, and stress in healthy adults Frontiers in Psychology 2017 8 874 10.3389/fpsyg.2017.00874 28626434 PMC5455070 · DOI · Paper page
- Meier PP Engstrom JL Patel AL Jegier BJ Bruns NE Improving the use of human milk during and after the NICU stay Clinics in Perinatology 2010 37 217 245 10.1016/j.clp.2010.01.013 20363457 PMC2859690 · DOI
- Mohd Shukri NH Wells J Fewtrell M The effectiveness of interventions using relaxation therapy to improve breastfeeding outcomes: A systematic review Maternal & Child Nutrition 2018 14 e12563 10.1111/mcn.12563 29105966 PMC5901002 · DOI
- Nguyen J Brymer E Nature-based guided imagery as an intervention for state anxiety Frontiers in Psychology 2018 9 1858 10.3389/fpsyg.2018.01858 30333777 PMC6176042 · DOI
- Noergaard B Ammentorp J Garne E Fenger-Gron J Kofoed PE Fathers’ stress in a Neonatal Intensive Care Unit Advances in Neonatal Care 2018 18 413 422 10.1097/ANC.0000000000000503 29746269 PMC6155352 · DOI
- Owais S Faltyn M Johnson AVD Gabel C Downey B Kates N Van Lieshout RJ The perinatal mental health of indigenous women: A systematic review and meta-analysis Canadian Journal of Psychiatry 2020 65 149 163 10.1177/0706743719877029 31601125 PMC7019461 · DOI
- Pan WL Chang CW Chen SW Gau ML Assessing the effectiveness of mindfulness-based programmes on mental health during pregnancy and early motherhood: A randomized control trial BMC Pregnancy and Childbirth 2019 19 346 10.1186/s12884-019-2503-4 31601170 PMC6785846 · DOI
- Paul G Elam B Verhulst SJ A longitudinal study of students’ perceptions of using deep breathing meditation to reduce testing stresses Teaching and Learning in Medicine 2007 19 287 292 10.1080/10401330701366754 17594225 · DOI
- Perrier MF Gurgel-Juarez N Flowers HL McCormick A Short J Mindfulness-based interventions for children and adolescents across all settings: A scoping review protocol Systematic Reviews 2020 9 286 10.1186/s13643-020-01548-7 33287887 PMC7722299 · DOI
- Phaloprakarn C Manusirivithaya S Boonyarittipong P Risk score comprising maternal and obstetric factors to identify late preterm infants at risk for neonatal intensive care unit admission Journal of Obstetric Gynaecology Research 2015 41 680 688 10.1111/jog.12610 25420697 · DOI
- Prouhet PM Gregory MR Russell CL Yaeger LH Fathers’ stress in the Neonatal Intensive Care Unit: A systematic review Advances in Neonatal Care 2018 18 105 120 10.1097/ANC.0000000000000472 29595549 · DOI
- Rajeswari S Sanjeeva RN Efficacy of progressive muscle relaxation on pregnancy outcome among anxious Indian primi mothers Iranian Journal of Nursing Midwifery Research 2019 25 23 30 10.4103/ijnmr.IJNMR_207_18 31956594 PMC6952921 · DOI
- Sabnis A Fojo S Nayak SS Lopez E Tarn DM Zeltzer L Reducing parental trauma and stress in neonatal intensive care: Systematic review and meta-analysis of hospital interventions Journal of Perinatology 2019 39 375 386 10.1038/s41372-018-0310-9 30659239 PMC7067599 · DOI · Paper page
- Shaw RJ St John N Lilo E Jo B Benitz W Stevenson DK Horwitz SM Prevention of traumatic stress in mothers of preterms: 6-month outcomes Pediatrics 2014 134 e481 e488 10.1542/peds.2014-0529 25049338 PMC4187238 · DOI
- Turner M Chur-Hansen A Winefield H Stanners M The assessment of parental stress and support in the neonatal intensive care unit using the Parent Stress Scale–Neonatal Intensive Care Unit Women Birth 2015 28 252 258 10.1016/j.wombi.2015.04.001 25956972 · DOI
- Authors
- Ginsberg, K. H., Alsweiler, J., Alyami, M., & Serlachius, A.
- Affiliations
- University of Auckland (NZ)
- Corresponding author
- Ginsberg, Kristin Harrison
- Venue
- Journal of Clinical Psychology in Medical Settings
- Published
- 2022-08-19
- Volume
- 30
- Issue
- 2
- Pages
- 387-402
- ISSN
- 1068-9583 (ISSN-L)
- 1573-3572
- PMC
- PMC9388971
- OpenAlex
- W4292332654
- Cited by
- 22
- References
- 54
- Citations by year
- 2026: 11 · 2025: 6 · 2024: 4 · 2023: 1
- FWCI
- 0.46
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Journal of Clinical Psychology in Medical Settings (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- ResearchSpace (University of Auckland) (submittedVersion, cc-by)
- Funders
- University of Auckland
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Development and Preterm Care
- Keywords
- mindfulness-based interventions, parental stress, parental anxiety, parental depression, neonatal intensive care unit, parents of preterm infants
- MeSH terms
- Anxiety, Depression, Female, Humans, Infant, Infant, Newborn, Intensive Care Units, Neonatal, Parents, Stress, Psychological, Mindfulness
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