Feasibility of wearable sensors in the NICU: Psychophysiological measures of parental stress

• Published in: Early human development Vol. 183; p. 105814
• Main Authors: Stein Duker, Leah I., Kwon, Jenny, Richter, Marinthea, Pineda, Roberta
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.08.2023
• Subjects: Child development; Environment; Feasibility Studies; Humans; Infant; Infant, Newborn; Intensive Care Units, Neonatal; Monitoring; Neonatal intensive care unit; Parental stress; Parents; Preterm infants; Prospective Studies; Risk factors; Technology; Wearable Electronic Devices; Parental stress; EDA; PMA; NICU; Risk factors; NS-SCRs; Child development; Neonatal intensive care unit; Technology; Preterm infants; Environment; SCL; EGA; Monitoring
• ISSN: 0378-3782; 1872-6232
• DOI: 10.1016/j.earlhumdev.2023.105814

Parents report elevated stress during their infant's NICU hospitalization. Real-time measures may improve our understanding of parental stress in the NICU. Examine the feasibility of wearable sensors to describe parental stress in the NICU. In this prospective feasibility study of 12 parent-infant dyads, parents wore an Empatica E4 wristband to measure psychophysiological stress via electrodermal activity (EDA) during sensory interventions (holding, massage, reading, touch, etc) with their babies. Baseline and intervention periods were delineated during which concurrent monitoring and clinical observations of infant behavior and environmental factors were recorded. Feasibility was assessed by investigating recruitment/enrollment, retention/adherence, acceptability, sensor usability, and changes in EDA waveforms based on potential stressors. For the latter, independent samples t-tests and ANOVA were used to examine differences in EDA from baseline to intervention, and the impact of environmental and infant factors on parent stress were visually analyzed against EDA waveforms. Wearable sensor use in the NICU appeared feasible as assessed by all methods. Preliminary data analysis indicated that overall parent EDA levels during parent-infant interactions were low, and engagement in sensory intervention(s) led to a non-significant increase in parental EDA, measured by both skin conductance levels and non-specific skin conductance responses. Three main patterns of EDA emerged: a temporary increase in EDA at the beginning of the intervention followed by a decrease and plateau, a plateau in EDA from baseline to intervention, and a gradual rise in EDA throughout intervention. Specific environmental and infant factors, such as infant stress and health care providers entering the room, appeared to impact parent stress levels. Although these preliminary findings provide support for use of EDA in the NICU, future studies are needed. •Wearable sensors measuring real-time parent stress in the NICU appear feasible.•Initial results suggest that parent stress responses were low when providing sensory exposures to their infants.•Environmental interruptions and distractors in the NICU impacted parent stress levels.•Future research can provide insights into real-time stress experiences of NICU parents.