Predictors of parental stress from admission to discharge in the neonatal special care unit.

BACKGROUND: Exacerbated parental stress during a stay in the neonatal intensive care unit can negatively impact the development of the hospitalized infant, strain the dyadic relationship and put parents at risk for poor mental health. It is therefore important to identify risk factors of stress throughout the duration of a hospitalization. This longitudinal study aimed to investigate sources of stress for mothers and fathers who had a baby in the neonatal special care unit. METHODS: Parents of 57 singletons and 11 twins (68 infants) admitted to a neonatal special care unit (46% for prematurity) were recruited. Sixty-four mothers and 20 fathers were assessed at admission, and 60 mothers and 16 fathers at discharge. Participants reported their satisfaction with hospital information and completed the Perceived Stress Scale, the Brief Illness Perception Questionnaire and the Dyadic Adjustment Scale. RESULTS: Parents demonstrated similar stress trajectories, with stress on average declining over time. Higher maternal stress at admission was associated with a belief that the baby's illness would have a longer timeline, lower perceptions of treatment efficacy and lower satisfaction with the information received from medical staff. Younger age and lower levels of education predicted higher maternal stress at discharge. Fathers had higher stress at discharge when they were older, had a baby born at younger gestation and felt they had less control. At admission, information satisfaction was positively associated with parental beliefs about treatment efficacy and understanding the infant's condition. At discharge, information satisfaction was negatively associated with beliefs about illness severity and the likely time frame of the illness. CONCLUSION: The findings highlight that parents' perceptions of their baby's illness and treatment at admission and discharge have a significant association with stress. Clinical staff can use these factors to identify parents who are at risk of exhibiting a greater level of stress over the hospitalization period.

Exploring Australian pharmacists' perceptions and attitudes toward codeine up-scheduling from over-the-counter to prescription only

OBJECTIVE: Explore the perceptions, attitudes and experiences of pharmacists relating to the up-scheduling of low dose codeine containing analgesics and the impact on pharmacy practice. METHODS: A mixed design method was used consisting of an anonymous online questionnaire survey to quantitatively capture broad pre-scheduling change perceptions paired with a series of in-depth post-scheduling semi-structured interviews to provide a qualitative picture of the impact of codeine up-scheduling on pharmacy practice in Australia. RESULTS: A total of 191 pharmacists completed the quantitative survey and 10 participated in the in-depth interview. The majority of respondents supported the decision to up-schedule over-the-counter combination products containing codeine to some degree. Three main themes emerged from the data: pharmacists' perceptions of the codeine up-scheduling decision, preparing for the up-schedule and impact of the up-schedule on pharmacy practice. Pharmacists were concerned about the impact of up-scheduling on the pharmacy business, patient access to pain relief and the diminishment of their professional role. CONCLUSIONS: There were diverse perceptions, preparedness and impact on practice regarding the up-scheduling of low dose codeine products. Further research should be conducted to gauge if and how these perceptions have changed over time and to identify whether pain is being managed more effectively post codeine up-scheduling

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Exploring Australian pharmacists' perceptions and attitudes toward codeine up-scheduling from over-the-counter to prescription only.

OBJECTIVE: Explore the perceptions, attitudes and experiences of pharmacists relating to the up-scheduling of low dose codeine containing analgesics and the impact on pharmacy practice. METHODS: A mixed design method was used consisting of an anonymous online questionnaire survey to quantitatively capture broad pre-scheduling change perceptions paired with a series of in-depth post-scheduling semi-structured interviews to provide a qualitative picture of the impact of codeine up-scheduling on pharmacy practice in Australia. RESULTS: A total of 191 pharmacists completed the quantitative survey and 10 participated in the in-depth interview. The majority of respondents supported the decision to up-schedule over-the-counter combination products containing codeine to some degree. Three main themes emerged from the data: pharmacists' perceptions of the codeine up-scheduling decision, preparing for the up-schedule and impact of the up-schedule on pharmacy practice. Pharmacists were concerned about the impact of up-scheduling on the pharmacy business, patient access to pain relief and the diminishment of their professional role. CONCLUSIONS: There were diverse perceptions, preparedness and impact on practice regarding the up-scheduling of low dose codeine products. Further research should be conducted to gauge if and how these perceptions have changed over time and to identify whether pain is being managed more effectively post codeine up-scheduling.