Abstract
BACKGROUND: Admission of preterm infants (PTIs) to neonatal care units (NCUs) is stressful for parents, potentially affecting infant-parent attachment, parents' mental health and parenting behaviour. Identifying stressors is essential for designing interventions that reduce this burden. However, evidence on parental stress among parents of PTIs in the Nepali context is limited. We aimed to assess parental stress and its associated factors among parents of NCU-admitted PTIs. METHODS: A descriptive cross-sectional study was conducted among 305 parents of PTIs admitted to NCUs in five randomly selected public hospitals in Nepal. Data were collected through in-person interviews using a 5-point Likert scale-based Parental Stress Questionnaire (1=not stressful to 5=extremely stressful). Stress levels were categorised as mild (<3), moderate (3-4) and severe (≥4) based on median scores. Descriptive and inferential statistics, including multivariable logistic regression, were applied. RESULTS: Parents had moderate levels of stress (median score and IQR: 3.0 (2.6-3.4)). Their most common stressor was separation and altered parental role 3.3 (2.6-3.6), which was significantly higher among mothers (p<0.001). Stress level showed significant associations with parental variables (age, education, family income and antenatal clinic check-up status) and infant variables (mode of birth, birth weight and hospitalisation duration) (p<0.050). Parents whose infants were hospitalised for ≥15 days were 2.4 times more likely to experience higher stress compared with those with ≤14 days of stay (adjusted OR 2.415; 95% CI 1.420 to 4.081; p<0.001). CONCLUSIONS: NCU admission of PTIs imposes considerable stress on parents. Separation and altered parental roles are the main stressors, particularly among mothers. Longer hospitalisation significantly increases stress levels. Interventions that minimise parent-infant separation and promote parental involvement in care may help to mitigate parental stress.