Parenting Stress, Parenting Self-Efficacy and Dyadic Coping in Parents of Preterm Infants in China: A Dyadic Analysis

Abstract

Aim: To examine actor and partner effects of parenting stress on self-efficacy mediated by dyadic coping among Chinese parents of preterm infants.

Design: A cross-sectional study was conducted from November 2022 to March 2024, involving 120 parental dyads of preterm infants discharged from Neonatal Intensive Care Units (NICU) in two tertiary hospitals in China. Parenting stress, self-efficacy and dyadic coping were assessed. Multiple regression and Actor-Partner Interdependence Mediation Model (APIMeM) were performed.

Results: Mothers and fathers reported similar levels of parenting stress and self-efficacy, but mothers scored significantly higher in dyadic coping. Parenting self-efficacy was associated with stress from observations of the infant's appearance/behaviour, NICU environmental stress, common coping and perceived partner support. Positive coping mediated the relationship between parenting stress and self-efficacy for mothers but not for fathers.

Conclusions: Positive coping buffered the stress-self-efficacy link only for mothers, revealing distinct gendered coping patterns. Parenting self-efficacy was directly associated with infant appearance and NICU-related stress, common coping and partner support. Couple-based NICU interventions should be tailored to gender-specific coping mechanisms. Nurses can promote family-centred, gender-sensitive support, including reducing environmental stressors, addressing appearance-related stress, encouraging common coping and fostering partner support to enhance parental self-efficacy.

Reporting method: Strengthening the Reporting of Observational Studies in Epidemiology guidelines.

Public contribution: No patient or public contribution.

Implications for the profession and patient care: Based on our findings, interventions should focus on reducing stress related to the infant's appearance and the NICU environment, promoting common coping strategies, and strengthening mutual partner support. For mothers, enhancing positive coping may be particularly beneficial, as it mediated the stress-self-efficacy relationship. For fathers, efforts to reduce avoidant coping and encourage active involvement in infant care are recommended. By addressing these specific factors, NICU teams can enhance parenting self-efficacy and foster balanced family adaptation, ultimately improving outcomes for preterm infants and their families.

Trial registration: The protocol of the study was registered at ClinicalTrials.gov (NCT05592210) on March 27, 2023.

Keywords: actor‐partner interdependence mediation model; dyadic coping; parenting self‐efficacy; parenting stress; parents of preterm infants.