Family stress and anxiety.

Family self-care

Family stress and anxiety

Self-recognition of anxiety and depression

The diagnosis of a disease has a great impact on the patient and the whole family. If this diagnosis occurs in a baby, it is normal for parents to have feelings of sadness, anxiety, or fear. Determining its intensity and duration will help you decide if it is necessary to be helped by a professional.

Being sad is a normal emotional expression in the human being in certain circumstances, while depression implies a pathology, and therefore requires professional care.

Keep in mind that, not necessarily, both members of the couple will approach the situation in the same way, since each person will develop, according to their personality, their own coping mechanisms.

Talking between the parents about everything that worries them, and being able to make explicit to the other partner what the person needs to feel better, is a way to become calmer and avoid conflicts. Accepting and respecting that each one can have a different way of coping with the situation will make the couple form a good team. This is necessary to overcome a difficult situation in the best way possible.

Information to support to reduce stress

Coping strategies are intentional mental schemes of response (cognitive, emotional, or behavioural) aimed at managing (mastering, tolerate, reduce, minimise) internal and environmental demands, conflicts between them, the pain and its repercussion on the quality of life that put to the test or exceedes the person’s resources. Some of the different coping strategies may be helpful:

  • Find spaces where you can speak openly and clearly about your thoughts and emotions.
  • Actively participate in the care of your child.
  • Collaborate closely with the professionals of the different services health, education and social assistance.
  • Request all the official support you can get.
  • Evaluate gains and losses, each in the present moment. It is important to face what is happening at every moment. Try to live in the present.
  • Promote and maintain individual and interpersonal development, spaces where you can be alone, where to disconnect, where you can take a walk, breathe and rest.
  • Increase and take care of self-esteem and self-confidence.
  • Cultivate patience.

Some of the guidelines for managing and reducing stress are:

  • Take small breaks throughout the day to “give yourself a break”: Close your eyes and breathe slowly and deeply.
  • Take care of your diet and practice physical exercise.
  • Develop your emotional intelligence. Take time to recognize your own emotions and those of your environment. If it is not possible to maintain control, it is better to take a break and, for example, take a walk until you have calmed the discomfort.
  • Encourage effective and constructive communication.
  • Try to do other pleasant activities that serve as a distraction and relief.
  • Prioritise and plan. This is to emphasise the importance of establishing a daily list of what to do and in what order.
  • Don’t forget to reward yourself for what you do well, and thank yourself for the same.
  • Discover the most recurrent negative thoughts with the aim of minimising their intensity, to counteract them with positive messages in the form of relief.
  • Not making any big decisions or big changes.
  • Keep a diary and write down whatever comes to mind, especially just before lying down to rest.

Remember the importance of resting and dedicating a space before going to sleep to activities that contribute to the relaxation of the body and mind.

Communication, empathy and family-health team trust

The hospital is uncharted territory where parents feel lonely and strangers, worried about their baby and threatened by uncertainty. In this situation, it’s essential to establish a climate of trust and good communication with the people who make up the health team.

When the relationship is not satisfactory, conflicts, therapeutic adherence problems, or errors when administering medication can arise. On the other hand, the parents have an active role in the care of their baby through close collaboration with the health professionals which contributes to the reduction of the duration of hospitalisation, safety and improvement of their baby’s quality of life.

Regarding communication, the health team is the primary source of information for parents. Professionals provide information and will try to resolve doubts, guide on the care of the baby in which it is possible for parents to collaborate at any time, and listen to their concerns.


A mother is very nervous because both parents can’t be present at the hospital all afternoon and his/her baby has been assigned to a nurse she does’t know. She is worried that as she doesn’t know the nurse, she will not care for him/her properly. The best way to express this concern to healthcare professionals is through respect, describing the behavior of the other objectively, explaining how that behavior makes the speaker feel, and explaining the changes you would like them to make. This mother addresses the nursing supervisor: “Today that we are going to be out of the hospital all afternoon, you have given us Maria as a nurse. I don’t know her, nor does she know our baby, and I won’t be able to be there to help her or inform her of what she needs. This situation makes me worried, uneasy and I will not be able to enjoy my first afternoon out of the hospital in two weeks. Next time I would like you to introduce us to the nurse who is going to be with our baby first thing in the morning, so that we can talk to her for a few minutes, so that we can rest assured that she knows her case perfectly and that she knows everything what do you need”

In addition, in order to establish a positive relationship with the health team, it is necessary that the parents/caregivers  talk to each other, and can freely address their concerns, doubts or questions with the staff which may help prevent misunderstandings or conflicts. 

Empathy is also essential in the communication process. Empathising with someone is being able to recognize and share their feelings. When there is empathy between the family and the health team, the satisfaction and the adherence to treatment increases, the communication improves and the emotional discomfort decreases, with all of which an improvement in the quality of life is achieved for the baby and his family. A good empathic relationship between health personnel and parents allows them to get to know their baby better day by day, learn what calms him down and what helps him, and to be able to put it into practice in collaboration. This collaboration can only develop if there is trust on the part of the parents in the people who are taking care of your child.

Trusting the health team supposes being able to consult all the doubts with them and understand that, since each case is unique, it is the doctors who care for a baby who best can determine their treatment in informed collaboration with parents. 

Family visits. Sibling participation

The admission of your baby in a NICU precipitates the interruption of family normality, it is a stressful process that affects both the patient and family. This situation requires the support of other people in the environment such as grandparents and siblings.

Grandparents can be a primordial figure within the family structure. They are usually the necessary support of the siblings and collaborators of the family dynamics in parental absence. However, the parents are the link with the rest of the family and they are the ones who have the last word on the involvement of grandparents or other relatives.

Siblings are essential during this process. They need to understand what is going on, why the parents are absent for a long time, and why your emotional situation is not the usual one.

The parents are the ones who decide on the people who should receive the information and to what extent. When informing the rest of the family, you have to consider some key aspects:

  • choose who you feel comfortable sharing information with. Remember you do not have to disclose information you are not comfortable with sharing.
  • decide with your partner how much/the extent of the information you wish to share.
  • it is okay to remind family members/relatives to respect your privacy and that you are sharing information with them in confidence.

The participation of siblings and other close people, helps humanise health care practices, provide help and alleviate the distress of parents. 

Experiencing the hospital stay as a partner

Complications during pregnancy are not just shocking for the mother. It is also tough for the partner when there have been complications during the pregnancy and/or a stay in the neonatology department follows. Possibly the mother of your child and your baby are both very ill. This can be very stressful for you as a partner. You will probably often be in hospital and at the same time have work obligations too. In addition, you will probably have to manage a lot of things at home, especially if you already have one or more children. It is important to talk to each other about everything that happens. Give each other space to digest everything and realise that maybe you each handle the stress or uncertainty differently. During this time you really need each other. Be aware that in hospital there is also professional help available to help you. Do not hesitate to ask the nurse or doctor about what is available. Please remember: asking for help means above all that you both want what is best for your child.

After the birth of your child you have certain rights about parental leave.

Psychological effects of being in hospital

Perhaps your pregnancy, delivery and/or the weeks after that was a difficult time for you. A lot has happened and it may have been very stressful for partners too. Some mothers (and/or partners) thought their child might die or that they themselves would not survive. It helps to talk about this as much as possible. If you cannot do this, for instance, if you have nightmares about the delivery or keep re-living it, talk about it with your nurse or doctor. These complaints can be like post-traumatic stress, and there are good treatments for this! 

Some women get postpartum depression. Complaints that come with this are fatigue, not feeling like doing anything, sad thoughts and crying without a reason. But sometimes also wishing that the baby is no longer there. You do not need to feel ashamed; these are reactions and thoughts that often occur after a difficult delivery or a difficult period after the birth. Every young parent can be tired or have little energy. But if this is the case (almost) every day, it is good to discuss this with the nurse/doctor.

It is hard to think what is the best way to keep going in this long, anxious time. Try to think of what has helped you before in previous difficult times. For some parents that is to get some exercise, for others to take a walk with a friend, while for others it is watching a film or show they enjoy.  Also spending the morning tidying up your house can sometimes help you feel better. Talk to each other about what your way might be and make time for it now and then. When your child comes home from hospital, you will have a tiring time ahead of you when you will need to stay on top of things.  

For partners, the hospital stay can also be experienced as an emotional period. See also the article “Experiencing the hospital stay as a partner”.

Conflict resolution

Conflict is a situation in which there is a difference of thoughts between two or more individuals, caused by the perceptions, interpretations and feelings of each. In the hospital there can be situations where failed communication leads to negative emotions as a consequence of differences in perception. Therefore, we must be able to recognize the sources and signs of conflict in order to anticipate and solve it as soon as possible.

It should not be forgotten that any change to which the members of a family are exposed causes stress.  Emotional states vary at each stage that  parents and hospitalised children pass through resulting in  changes that arise for each member of the family differently. In a situation of hospital admission, the family shows a range of needs for emotional support, guidance and information, as well as need for respect and understanding of the specific moment for which they are going through and the emotions that stem from it.

The effective relationships between family and professional should be encouraged. There are occasions in which the detection of signals by the professional can avoid the triggering of a conflict. Making the other aware that we have noticed your discomfort or dissatisfaction and investigate the causes, you can be the principle of conflict resolution. 


A mother with her baby admitted to the NICU calls for nursing control. She announces that she will be five minutes late to give her child a feeding bottle. She asks the nurse to wait for her because she wants to give it to her baby. The mother arrives at the hospital overwhelmed because she had to run so as not to be delayed any longer. When she goes to see her baby, she is informed that she has already been fed. The mother feels frustrated for having had to run so as not to be further late and angry because, despite warning, they have not waited for her. She asks the nurse why her baby has already been fed. Her nurse explains that her baby was crying from hunger and so she gave him the feeding bottle without waiting for her. The mother, hurt because she has not been taken into account and has lost the opportunity to feed her baby, complains to the nurse (“It seems very bad to me that even when I warned, no one wanted to wait for me”). The nurse, showing an empathetic and understanding attitude, shows the mother that she understands her emotional discomfort (“I understand the effort that you have made to come running. I understand the frustration of not having been able to give your baby a feeding bottle, I know it’s a very special time for parents in the NICU”), explaining that her intention was to comfort the baby (“We did it so your baby would stop crying and not be upset”). Finally, the nurse encourages the mother by indicating the rest of the tasks that she can do with her baby during that day, emphasizing other special moments in which she can take care of her baby.