Maternal Stress and Coping in the Neonatal Intensive Care Unit: A mixed-method study in Northern Malaysia
DOI:
https://doi.org/10.21834/e-bpj.v10iSI35.7488Keywords:
Maternal stress, Premature infants, Neonatal intesive care unit (NICU), Coping strategiesAbstract
Maternal stress in Neonatal Intensive Care Units (NICU) is a significant concern affecting both mothers and infant outcomes. This study examined stress levels and coping strategies among mothers of premature infants in northern Malaysia using a mixed-method explanatory sequential design. A total of 383 mothers were surveyed with the Parental Stressor Scale: Neonatal Intensive Care Unit (PSS: NICU) and Brief COPE, followed by interviews with 14 participants. Findings showed moderate stress (M = 2.16, SD = 0.92), highest in parental role alteration. Age and education were significantly associated with stress, and mothers relied mainly on emotional, spiritual, and social coping.
References
Apedani, D. B., Koduah, A., Druye, A. A., & Ebu, N. I. (2021). Experiences of Mothers with Preterm Babies on Support Services in the Neonatal Intensive Care Unit of a Mission Hospital in Ghana. International Journal of Africa Nursing Sciences, 15, 100366. https://doi.org/10.1016/j.ijans.2021.100366
Banjade, B. M., Pun, K. M., Khatri, S., & Pokharel, S. (2023). Stress and Coping Strategies among Parents of Infants Admitted in Neonatal Intensive Care Unit at a Tertiary Level Hospital. Medical Journal of Shree Birendra Hospital, 22(2), 44–48. https://doi.org/10.3126/mjsbh.v22i2.66360
Carver, C. S. (1997). You Want to Measure Coping, but Your Protocol is Too Long: Consider the Brief COPE. International Journal of Behavioral Medicine, 4(1), 92–100. https://doi.org/10.1207/s15327558ijbm0401_6
Clarke, V., & Braun, V. (2013). Teaching Thematic Analysis: Overcoming Challenges and Developing Strategies for Effective Learning. Psychologist, 26(2). http://eprints.uwe.ac.uk/21155/
Gomaa, Ghada Mohamed Mourad, & Galila El-Ganzoury. (2022). Stressors and Coping Strategies among Parents with Premature Infants. Egyptian Journal of Health Care, 13(4), 744–756. https://doi.org/10.21608/ejhc.2022.265088
Hendy, A., El-Sayed, S., Bakry, S., Mohammed, S. M., Mohamed, H., Abdelkawy, A., Hassani, R., Abouelela, M. A., & Sayed, S. (2024). The Stress Levels of Premature Infants' Parents and Related Factors in NICU. SAGE Open Nursing, 10. https://doi.org/10.1177/23779608241231172
Irene, A., Fatima, I., Agatha Sr, O., & Abiodun, O. (2022). Stress and Coping Strategies of Parents of Preterm Infants in Selected Tertiary Health Institutions in Ekiti State. Asian Journal of Pediatric Research, 8(2), 17–27.
Jones, L., Mariapun, J., Tan, A. X. Q., Kassim, Z., & Su, T. T. (2023). Maternal Well-Being of Malaysian Mothers after the Birth of a Preterm Infant. BMC Pregnancy and Childbirth, 23(1). https://doi.org/10.1186/s12884-023-05823-y
Lazarus, R. S., & Folkman, S. (1984). Stress, Appraisal, and Coping. Springer Publishing Company.
Lim, C. J., Jayah, K. P., & Soon, L. K. (2017). Parental Stress and Its Influencing Factors in the Neonatal Intensive Care Unit. International Journal of Public Health and Clinical Sciences, 4(2), 55–65. http://publichealthmy.org/ejournal/ojs2/index.php/ijphcs/article/view/398
Loutfy, A., Zoromba, M. A., Mohamed, M. A., El-Gazar, H. E., Andargeery, S. Y., El-Monshed, A. H., Van Belkum, C., & Ali, A. S. (2024). Family-centred care as a mediator in the relationship between parental nurse support and parental stress in neonatal intensive care units. BMC Nursing, 23(1), 572.
Maharjan, R., Mangala Shrestha, G. R., Pokhrel, N., Karna, B. K., Chaudhary, K., & Bikram Adhikari. (2022). Stress and Coping Strategies Among Parents of Neonates Admitted in Neonatal Intensive Care Unit – a Hospital-Based Study. Journal of Karnali Academy of Health Sciences, 5(3). https://doi.org/10.61814/jkahs.v5i3.646
Malaysian National Neonatal Registry. (2020). Annual report of the Malaysian National Neonatal Registry: A study of critically ill babies in neonatal intensive care units. Ministry of Health Malaysia.
Malouf, R., Harrison, S., Pilkington, V., Opondo, C., Gale, C., Stein, A., Franck, L. S., & Alderdice, F. (2024). Factors associated with posttraumatic stress and anxiety among the parents of babies admitted to neonatal care: A systematic review. BMC Pregnancy and Childbirth, 24(1), 352.
Miles, M. S., Funk, S. G., & Carlson, J. (1993). Parental Stressor Scale. Nursing Research, 42(3), 148??? 152. https://doi.org/10.1097/00006199-199305000-00005
Mukhtar, F., Iqbal, J., Aslam, Z., Ayaz, M., Sathian, B., Albarqouni, D., Rahman, S. U., Hussain, S., Sultan, A., Iqbal, J., Saba, I., Tang, M., & Mandal, A. K. (2024). Prevalence of Parental Stress Among Neonatal Mothers Admitted in Neonatal Intensive Care Unit (NICU) of Tertiary Care Hospital: A Cross-Sectional Study. Journal of Population Therapeutics and Clinical Pharmacology. https://doi.org/10.53555/jptcp.v31i2.4227
Mulani, N. D. P. H. M. A. (2022). Stress and Coping Strategies of Mothers of Preterm Infants Admitted in the Neonatal Intensive Care Unit. Journal of Pharmaceutical Negative Results, 4422–4430. https://doi.org/10.47750/pnr.2022.13.s07.554
Pathak, G., Dixit, R., Singh, N. K., Vijaywargiya, T., & Lal, N. (2022). Level of Stress and Coping Strategies Seen among Parents of Neonates Admitted in NICU. Journal of Neonatology, 36(1), 13–20. https://doi.org/10.1177/09732179211068809
Redzuan, S. A. M., Suntharalingam, P., Palaniyappan, T., Ganesan, V., Bakar, P. N. M. A., Kaur, P., Marmuji, L. Z., Ambigapathy, S., Paranthaman, V., & Chew, B. H. (2020). Prevalence and risk factors of postpartum depression, general depressive symptoms, anxiety, and stress (PODSAS) among mothers during their 4-week postnatal follow-up in five public health clinics in Perak: A study protocol for a cross-sectional study. BMJ Open, 10(6), e034458
Sosnowski, D. W., Ellison-Barnes, A., Kaufman, J., Hoyo, C., Murphy, S. K., Hernandez, R. G., Marchesoni, J., Klein, L. M., & Johnson, S. B. (2023). Financial stress as a mediator of the association between maternal childhood adversity and infant birth weight, gestational age, and NICU admission. BMC Public Health, 23(1), 606.
World Health Organization. (2023, May 10). Preterm birth – Key facts [Fact sheet]. https://www.who.int/news-room/fact-sheets/detail/preterm-birth
Yusoff, N., Low, W., & Yip, C. (2009). Reliability and Validity of the Malay Version of the Brief COPE Scale: A Study on Malaysian Women Treated with Adjuvant Chemotherapy for Breast Cancer. The Malaysian Journal of Psychiatry, 18(1). http://mjpsychiatry.org/index.php/mjp/article/viewFile/52/51
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Nurul Farhana Mat Nadzir, Rusnani Ab Latif, Wan Ismahanisa Ismail, Yoyok Bekti Prasetyo

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.